Here, we explain how to do a vegan keto diet (which goes a step beyond the mostly plant-based keto 2.0 diet), the potential benefits and risks, and who may want to try it. “A vegan keto diet follows the same principles [as keto] but without any animal-derived products, like meat and dairy,” says cardiologist and plant-based diet proponent Joel Kahn, M.D. The ideal macronutrient breakdown (i.e., percentage of your daily calories coming from fat, protein, and carbs) for a keto diet typically looks something like this: Some experts have expressed concern that—depending on how it’s formulated—a traditional keto diet may be too high in animal-based saturated fats and low in heart- and gut-friendly fiber. Vegan diets, on the other hand, contain no animal products and often pack plenty of fiber due to a higher intake of fiber-rich plant foods. Often, though, they’re low in fat and high in carbs, especially if they lean heavily on grains, starchy vegetables, beans, lentils, and packaged products. But if you strategically forgo these carb-rich foods in favor of healthy fats (think avocado, nuts, seeds, and certain oils), you can stay vegan and achieve nutritional ketosis “No studies demonstrate long-term outcomes of a vegan keto or low-carb plant-based diet, but people may find that their measurable health risk markers improve,” says Carrie Diulus, M.D., an orthopedic spine surgeon who personally follows a vegan keto diet to help manage her type 1 diabetes and maintain a 100-pound weight loss. Diulus sometimes recommends vegan keto (and other dietary approaches) to her patients to prep for and recover from surgery as well. “I often have patients with weight problems and diabetes, and a ketogenic diet is often beneficial,” she says. It also “has the potential to help improve their cholesterol.” While more research is needed to really establish any of these benefits, here are some possible ways a vegan keto diet may boost your health. If you have diabetes, always check with your doctor before starting a vegan keto diet so you can appropriately alter your medications—otherwise, serious side effects may occur. In fact, in a six-month study comparing the low-carb, vegan “Eco-Atkins” diet (which was not technically keto as it was quite low in carbs) to a higher-carb lacto-ovo vegetarian diet, the Eco-Atkins dieters experienced more weight loss. Additionally, there are a number of anecdotal reports of the vegan keto diet significantly suppressing appetite. Last year, plant-based cardiologist Danielle Belardo, M.D., who was initially very anti-keto, embarked on a two-week vegan keto experiment, which she detailed in this Twitter thread. Her take? Not only did she end up getting into ketosis while eating loads of veggies and plenty of fiber, but “the appetite suppression was SO intense!” she said. “Between the ketones, MUFA/PUFA, and fiber, I lost 2 lb. despite trying SO HARD to not lose any weight.” “In people wishing to reduce their LDL, a plant-based keto diet can be very high in fiber, low in saturated fat, and has polyunsaturated fats in whole food forms like those found in nuts and seeds,” says Diulus. “All of these things have been shown to help lower blood lipids.” Other experts, like Ethan Weiss, M.D., agree that vegan keto diets and mostly plant-based keto 2.0 diets may be significantly better for cardiovascular health: “As a cardiologist, I do have concerns about the tremendous increases in LDL cholesterol some people see when eating conventional ketogenic diets,” he explains. “Replacing foods high in animal-based saturated fats with foods coming from mostly plant- and fish-based sources mitigates against this and leads to improvements in cardiovascular risk markers we care about.” Sometimes the pain reduction is even enough to avoid surgery. “I had a patient who was scheduled for a complex surgery to fuse the spine from the front and the back because of severe nerve pain,” Diulus says. “The patient started the ketogenic, plant-rich, high-omega-3 diet that I put her on, and she improved so much from six weeks of the diet, we ended up canceling her surgery.” With the use of keto diets, she’s also seen patients use much less pain medication after surgery and have lower rates of surgical complications. Registered dietitian Abby Cannon, R.D., also cautions people not to jump on the vegan keto train without thinking long and hard about why they want to do it and weighing the potential risks—because there are a few significant concerns. “It’s very difficult to adhere to while also ensuring that you’re getting enough nutrients and not developing disordered eating habits,” says Cannon. “If you don’t consume soy products, it’s hard to ensure that you receive enough protein, given that you have to cut out whole grains and beans—staple protein sources in a vegan diet!” Like all vegan diets, vegan keto will also be deficient in vitamin B12 and potentially low in iron and other nutrients, so Cannon recommends a comprehensive multivitamin if you do try it. Vegan keto may also be pretty hard to sustain unless you’re particularly motivated. “It’s unlikely that anyone can stick to it long term, and any rapid weight loss experienced is likely to come right back on once you return to your normal eating habits,” says Cannon, noting that many of the healthiest, longest-living people in the world eat legumes, whole grains, fruits, and starchy vegetables—all of which are a no-go on a vegan keto diet. If there’s a medical reason for needing a ketogenic diet, the vegan keto diet might be an option, says Cannon, but it’s extremely important that when trying any restrictive diet that you do so with the support of professionals to ensure that you’re meeting your nutritional needs and doing it for the right reasons. That said, if you’re pregnant, breastfeeding, or have a history of disordered eating, you should definitely pass on this diet, she says. Additionally, your vegan keto diet may also result in side effects that are somewhat typical of all keto diets, especially ones that aren’t balanced, including a temporary but drastic upswing in cravings, moodiness, and fatigue (often called “keto flu”); too much weight loss; hair loss (especially if you’re not getting enough protein); and imbalances in electrolytes, which get flushed out when you lose water weight. To offset electrolyte imbalances, Diulus recommends increasing your sodium intake a bit and supplementing with magnesium. And, if you’re doing everything “right” and still don’t feel good, vegan keto may just not be for you—and that’s OK. In fact, Belardo switched back to her higher-carb vegan diet after her two-week vegan keto experiment because she was losing too much weight and missed some of her favorite foods, including fruits. (Here are some signs a keto diet just isn’t working for you.) If you find a vegan keto diet too restrictive and you’re willing to include some animal products, you can also experiment with a vegetarian keto diet. With guidance from Diulus, here are some vegan keto-friendly foods you can choose from, with macronutrient breakdowns based on a typical serving size. Pro tip: To check the nutritional information of any food, check out the USDA’s FoodData Central3 database. Lunch: Mixed greens salad topped with avocado, hemp seeds, lupini beans, various nonstarchy veggies, and olive oil and vinegar Snack: Celery slices with nut butter Dinner: Zucchini noodles tossed with vegan pesto (basil, walnuts, EVOO, and garlic) and sliced cherry tomatoes Lunch: Creamy broccoli soup made with full-fat coconut milk, vegetable stock, and herbs Snack: Keto chocolate mousse made with avocado, cocoa powder, and a bit of stevia (or a tiny bit of real sweetener, like maple syrup) Dinner: Spaghetti squash with caramelized onions, roasted Brussels sprouts, lupini beans, and a hefty drizzle of olive oil Lunch: Lettuce-free salad made with chopped cucumber, tomatoes, olives, edamame, and olive oil and vinegar Snack: Almonds and unsweetened coconut flakes Dinner: Broccoli and tempeh stir-fry Lunch: *Cauliflower rice made with scallions, ginger, onions, peas, chopped carrots, sesame seeds, and tofu Snack: Red bell pepper slices with guacamole or mashed avocado Dinner: Cauliflower crust pizza topped with tomato sauce or vegan pesto, mushrooms, peppers, and onions *Since you don’t need a lot of peas and carrots in cauliflower rice, it can still be considered vegan keto as long as you’re watching your intake of total carbs elsewhere. Lunch: Thinly sliced purple cabbage (or bagged “coleslaw mix”) tossed with sesame oil and unseasoned rice vinegar, topped with edamame and sunflower seeds Snack: Cucumber slices, celery, or bell peppers dunked in nut-based vegan cream cheese (like Kite Hill) Dinner: Shirataki noodles with veggies, almond butter and coconut aminos sauce, and tofu However, the restrictive nature of the diet can be triggering for those with a history of disordered eating and may also lead to nutrient deficiencies unless carefully formulated with the right foods and supplements. Overall, a lot is still up in the air, but if you choose to try a vegan keto diet, strongly consider enlisting the support of a registered dietitian.
