How to follow a healthy vegetarian keto diet

Are you a vegetarian interested in experiencing the many benefits of a keto diet? Or perhaps you’re already eating keto but have been thinking about giving up meat for ethical or other reasons. There’s good news – a vegetarian keto lifestyle is definitely doable. However, there are some potential health issues to be aware of.

Read on to learn how to follow a vegetarian keto diet in a healthy, sustainable way.

Introduction

Are there any health concerns for keto vegetarians?

Although some people avoid eating meat due to environmental or animal welfare concerns, others may choose vegetarianism because they believe it is healthier.1 Yet vegetarian diets are typically high in grains, legumes, and starchy vegetables, which may not be appropriate for those with diabetes or metabolic syndrome who want to control their condition without medications. Additionally, people may find that they often feel hungry and struggle to lose weight when they follow a low-fat, high-carb vegetarian way of eating.2

Therefore, the idea of a keto vegetarian diet may be appealing to many who want to avoid meat but still get the benefits of ketogenic living.

It’s worth noting that on a vegetarian keto diet, it’s possible to become deficient in protein, certain essential fats, and some vitamins, and minerals.3

However, your risk for nutrient deficiencies depends on what type of a vegetarian diet you follow and the types of food you eat. The more restricted your diet, the more likely you are to develop one or more deficiencies.

What are the different types of vegetarians?

These are the different vegetarian categories, in order of strictest to most liberal:

  • Vegans avoid dairy, eggs, seafood, poultry, meat, and other animal products, including honey in most cases.
  • Lacto vegetarians eat dairy but avoid eggs, seafood, poultry and meat. People in India who are vegetarians mainly follow this way of eating.
  • Lacto-ovo vegetarians eat dairy and eggs but avoid seafood, poultry and meat. This is the most common form of vegetarianism in the US, Europe, and other western countries.
  • Pescatarians eat seafood, dairy, and eggs but avoid poultry and red meat. This way of eating is considered semi-vegetarian and doesn’t pose any greater risk for nutrient deficiencies than diets that include meat.4

Which vegetarian diets work best with keto?

Keto can be incorporated into most vegetarian lifestyles. Of course, the more liberal forms of vegetarianism allow a wider range of food choices, which can make mealtimes more enjoyable.

Even a vegan keto approach is possible, albeit much more challenging. As humans, we need to consume complete protein containing all nine essential amino acids (an “essential” nutrient can’t be made by the body and must instead be obtained through diet). Animal protein provides all the essential amino acids in the amounts we need, but most plants lack one or more of them.5

By excluding all animal products, vegans typically rely on a combination of grains, legumes, and seeds to get all of the essential amino acids their bodies need. Many of these foods are too high in carbs to be included on a keto diet, which is usually restricted to 20 grams of net carbs (total carbs minus fiber) per day.

The “Eco-Atkins” is one option for those who want to avoid all animal products.6 Eco-Atkins is entirely plant based and contains fewer carbs than most vegan plans. However, it isn’t considered ketogenic because it includes grains and provides more than 60 grams of net carbs per day.

To learn more about combining carb restriction with a vegan lifestyle, see our evidence-based guide, How to eat low-carb as a vegan.


5-step action plan for eating a vegetarian keto diet

Here is our 5-step action plan for eating a well-formulated vegetarian keto diet. Click on the steps to scroll down and learn more about why we recommend it.

1. Restrict carbohydrates

In order to get into ketosis and remain there, it’s best to limit your net carb intake to 20 grams per day.7 This means you’ll need to avoid many popular vegetarian protein sources, such as quinoa, buckwheat, legumes, and pulses. These foods are simply too high in carbs to be part of a ketogenic lifestyle. Also be sure to steer clear of milk and low-fat dairy products, starchy vegetables, and fruits, other than perhaps a few berries.

2. Include a high-quality protein source at every meal

As discussed earlier, with few exceptions, only the protein in animal products contains all nine essential amino acids in the amounts needed to sustain human life. Combining keto-friendly low-carb plant protein like nuts and seeds with animal protein sources like dairy and eggs can improve the protein quality of a vegetarian diet.

At Diet Doctor, we recommend that most people aim for 1.2-1.7 grams of protein per kg of body weight. That usually comes out to at least 70 grams of protein on a keto diet per day, depending on weight, body composition, activity level, and age. Use our target protein ranges chart to find out how much you need. And for a more detailed discussion on protein requirements, see our evidence based guide, How much protein should you eat?

Our top 3 vegetarian proteins

  1. Egg: Contains high-quality, easily digestible protein; provides choline which has been associated with better brain function8; extremely versatile and economical. 14 grams of protein and 1 gram of carb per 2 large eggs
  2. Greek yogurt: Rich in protein; excellent source of calcium, potassium, and magnesium; provides probiotics that are potentially beneficial for gut health and immunity.9 15–20 grams of protein and 4–7 grams of carbs per 6 ounces (170 grams)
  3. Hemp seeds: High in protein; rich in soluble fiber; great source of magnesium, potassium and omega-3 fatty acids. 9 grams of protein and 1 gram of net carb per ounce (28 grams)

Keto vegetarian protein sources

Other great keto vegetarian protein sources

  • Cottage cheese: 20 grams of protein and 6 grams of carbs per 6 ounces (170 grams)
  • Parmesan and Romano cheese: 9–10 grams of protein and 1 gram of carb per ounce (28 grams)
  • Hard and semi-hard cheese (cheddar, gouda, provolone, Swiss, etc.): 7–8 grams of protein and 0.5–1.5 gram of carbs per ounce (28 grams)
  • Soft cheese (Brie, Camembert, feta, blue cheese, queso blanco, etc.): 4–6 grams of protein and 0–1 gram of carb per ounce (28 grams)
  • Peanut or almond butter: 7–8 grams of protein and 4 grams of net carbs per 2 tablespoons (32 grams)

Keep in mind that you’ll get small amounts of protein from vegetables as well. Most vegetables provide about 2 grams of protein per cup.

We recommend getting protein through real food rather than protein powders, bars or shakes.

What about soy?

Soy products, like tofu, can be a good source of plant-based protein. However, concerns have been raised about the health effects of soy isoflavones based on animal and test-tube studies.10 Yet the research on soy in humans is mainly positive regarding safety and disease risk.11

Although soy doesn’t seem to cause problems for people with normal thyroid function, there’s been conflicting evidence in people with subclinical hypothyroidism (also known as mild thyroid failure).12

Soy isoflavones may interfere with thyroid hormone absorption if your iodine intake isn’t sufficient.13 Therefore, it may be worth it to make sure you get enough iodine when regularly consuming soy, especially if you have hypothyroidism. The best low-carb vegetarian sources of iodine include iodized salt, seaweed, and yogurt.

At this time, some concerns remain about soy consumption in people with thyroid problems, as well as the long-term health effects of consuming ultra-processed products like soy protein powders and supplements.14

However, if you want to avoid animal products on a keto or low-carb diet, the benefits of soy seem to outweigh the risks.15

Although the potential risk to thyroid function appears very small, those who consume soy on a regular basis may want to consider having their thyroid function monitored periodically and including iodine food sources in their diet.

Soy protein options

  • Tofu (extra firm): 19 grams of protein and 2 grams of net carbs per 5 ounces (140 grams)
  • Edamame beans: 17 grams of protein and 5 grams of net carbs per 5 ounces (140 grams)
  • Tempeh: 20 grams of protein and 4 grams of net carbs per 3.5 ounces (100 grams)
  • Natto: 18 grams of protein and 9 grams of net carbs per 3.5 ounces (100 grams)

3. Have 1-3 servings of very-low-carb vegetables at least twice a day

There are plenty of keto-friendly vegetables that taste delicious, provide a nice dose of fiber and help you meet your micronutrient needs.

Keto vegetables

Our top 5 keto vegetables

  1. Spinach: rich in iron, potassium, and magnesium, with 1 gram of net carb per serving
  2. Zucchini: a good source of vitamin B6, vitamin C, and potassium, as well as a fantastic noodle substitute, with 3 grams of net carbs per serving
  3. Avocado: (technically a fruit) excellent source of potassium, magnesium, and fiber, with 2 grams of net carbs per serving
  4. Brussels sprouts: rich in vitamin C, potassium, and folate, with 5 grams of net carbs per serving
  5. Cauliflower: a great source of vitamin C and fiber and the perfect keto-friendly sub for mashed potatoes and rice, with 4 grams of net carbs per serving

For more tips on what low-carb vegetables to eat, check out our low-carb vegetable guide.

4. Use healthy oils for cooking and/or salad dressings

Healthy fats improve food’s texture and can help you stay full and satisfied for hours. In addition, they’re necessary for proper absorption of the fat-soluble vitamins A, D, E, and K.

Since fats contribute most of your calories on a keto diet, it’s important to choose the healthiest types. Vegetable and seed oils – such as sunflower, safflower, corn, and canola oil – are highly processed oils. Although the data regarding their health effects are inconclusive, as a general policy we recommend focusing on less processed foods closer to their natural source.16

Healthy fats

Instead, choose healthy keto fats and condiments, such as butter, ghee, coconut oil, olive oil, and avocado oil for meal preparation and at the table.17

5. Season your food with different herbs and spices

Spices and herbs

Cooking with herbs and spices can help increase variety on a vegetarian diet. What’s more, they’re an additional source of micronutrients and provide very few net carbs. Besides the more common ones like basil, rosemary and cinnamon, experiment with some you haven’t tried as well. You may find a few new favorites!


How to avoid nutrient deficiencies on a vegetarian keto diet

Vegetarians often rely on grains and legumes to meet their daily micronutrient needs. On a vegetarian keto diet, where these foods are restricted, make sure to consume adequate quantities of omega-3 fatty acids, iron, calcium, vitamin B12, vitamin D, zinc, potassium and magnesium.

If you follow our 5-step plan, eating good-quality vegetarian protein sources and plenty of very-low-carb vegetables, you should be able to meet your micronutrient needs. If you want to be extra sure, consuming a range of the following nutrient-dense foods on a daily basis will provide your body with the micronutrients that keto vegetarians sometimes don’t get enough of:

Nuts & seeds
  • Almonds
  • Chia seeds
  • Flax seeds
  • Hemp seeds
  • Pumpkin seeds
  • Walnuts
  • 100% dark chocolate
  • Unsweetened cocoa
Vegetables
  • Artichokes
  • Broccoli
  • Brussels sprouts
  • Kale
  • Mushrooms
  • Spinach
  • Swiss chard
Dairy
  • Plain greek yogurt
  • Cheese
Fruits
  • Avocado
  • Olives

If you follow these steps but don’t feel your best, you may benefit from paying attention to which nutrients you could be deficient in. Click on the button below to see the appendix on specific nutrients that can be an issue for keto vegetarians. But remember that if you feel good and are eating a range of nutrient-dense foods, you probably don’t need to worry about specific micronutrients. Simple does the trick!

Appendix

Delicious vegetarian keto recipes and meal plans

Here’s a sample 7-day keto vegetarian meal plan with around 20 grams of carbs per day to help you get started. Not a member yet? Try out all our 100+ low-carb meal plans and meal planner tool for free one month.

Low carb: Vegetarian #5

This week offers a delicious, colorful, and nutritious mix of vegetarian and vegan low-carb dishes. They will satisfy your appetite and make your taste buds sing. Indulge in vibrant veggies, flavorful cheeses and exciting spices.

This meal plan will keep you below 33 g net carbs per day

Full meal plan →

At Diet Doctor, you can find many delicious keto vegetarian options, from classics like Caprese salad to more unusual dishes like Keto goat cheese and mushroom frittata.

Here are a few other keto vegetarian recipes you’ll love:

Vegetarian keto breakfasts

Vegetarian keto meals

Staying keto vegetarian long term

It’s clearly possible to be both keto and vegetarian. The biggest issues may be lack of variety and meeting your nutrition needs on a regular basis without eating meat or seafood.

However, choosing foods rich in key nutrients, experimenting with different vegetable and protein combinations, and using a wide range of herbs and spices can help you create a keto vegetarian lifestyle that is healthy, sustainable, and pleasurable.

/ Franziska Spritzler, RD

Did you enjoy this guide?

We hope so. We want to take this opportunity to mention that Diet Doctor takes no money from ads, industry or product sales. Our revenues come solely from members who want to support our purpose of empowering people everywhere to dramatically improve their health.

Will you consider joining us as a member as we pursue our mission to make low carb simple?

 

Top posts and guides about keto

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  2. 14-day keto diet meal plan with recipes and shopping lists
  3. Keto recipes

Top posts by Franziska Spritzler

  • The keto flu, other keto side effects, and how to cure them
  • How to follow a healthy vegetarian keto diet
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Comments

  1. Nutrients 2010: Beliefs and attitudes toward vegetarian lifestyle across generations [observational study; weak evidence]

  2. In a study of overweight people assigned to follow either a low-carb or low-fat diet, those in the low-fat group reported feeling hungrier than those in the low-carb group:

    Obesity 2011: Change in food cravings, food preferences, and appetite during a low-carbohydrate and low-fat diet [randomized trial; moderate evidence]

  3. European Journal of Clinical Nutrition 2014: The prevalence of cobalamin deficiency among vegetarians assessed by serum vitamin B12: a review of literature [overview article; ungraded]

    Nutrition, Metabolism and Cardiovascular Diseases 2017: Position paper on vegetarian diets from the working group of the Italian Society of Human Nutrition> [overview article; ungraded]

  4. Nutrients 2014: Comparison of nutritional quality of the vegan, vegetarian, semi-vegetarian, pesco-vegetarian and omnivorous diet> [overview article; ungraded]

  5. For example, legumes and seeds are high in the amino acid lysine but very low in methionine. By contrast, grains are high in methionine but contain almost no lysine:

    Amino Acids 2018: Protein content and amino acid composition of commercially available plant-based protein isolates [laboratory study; ungraded]

  6. Archives of Internal Medicine 2009: The effect of a plant-based low-carbohydrate (“Eco-Atkins”) diet on body weight and blood lipid concentrations in hyperlipidemic subjects [randomized trial; moderate evidence]

  7. Although eating 20 or fewer grams of net carbs virtually guarantees ketosis, some people may be able to eat slightly more than this, and healthy individuals may be able to achieve and maintain ketosis while eating 50 grams of net carb daily:

    Nutrition X 2019: Effects of differing levels of carbohydrate restriction on the achievement of nutritional ketosis, mood, and symptoms of carbohydrate withdrawal in healthy adults: A randomized clinical trial [randomized trial; moderate evidence]

  8. Nutrition Review 2009: Choline: An essential nutrient for public health[overview article; ungraded]

  9. Nutrition Reviews 2018: Yogurt and other fermented foods as sources of health-promoting bacteria
    [overview article; ungraded]

  10. Isoflavones are a type of phytoestrogen (plant compounds that have a structure similar to estrogen) found in soy and other legumes. Older research in animals and on cell lines suggested that these isoflavones might potentially be harmful to health:

    Menopause 2005: Dietary soy protein and isoflavones have no significant effect on bone and a potentially negative effect on the uterus of sexually mature intact Sprague-Dawley female rats[rat study; very weak evidence]

    Biochemical Pharmacology 1997: Anti-thyroid isoflavones from soybean: isolation, characterization, and mechanisms of action[in vitro study; very weak evidence]

  11. This is true for observational studies spanning many years as well as shorter but much higher-quality clinical trials:

    Advances in Nutrition 2018: Associations between phytoestrogens, glucose homeostasis, and risk of diabetes in women: a systematic review and meta-analysis [systematic review of randomized trials; strong evidence]

    PloS One 2013: Soy, red clover, and isoflavones and breast cancer: a systematic review [systematic review of randomized trials; strong evidence]

    Gynecological Endocrinology 2013: Endometrial, breast and liver safety of soy isoflavones plus Lactobacillus sporogenes in post-menopausal women [randomized trial; moderate evidence]

    Nutrients 2018: Soy, soy foods, and their role in vegetarian diets [overview article; ungraded]

  12. Scientific Reports 2019: Systematic review and meta-analysis on the effect of soy on thyroid function [strong evidence]

    EFSA Journal 2015: Risk assessment for peri- and post-menopausal women taking food supplements containing isolated isoflavones [review of RCTs, observational and animal studies; weak evidence]

    The Journal of Clinical Endocrinology & Metabolism 2011: The effect of soy phytoestrogen supplementation on thyroid status and cardiovascular risk markers in patients with subclinical hypothyroidism: a randomized, double-blind, crossover study [moderate evidence]

    Journal of the Endocrine Society 2017: Soy protein improves cardiovascular risk in subclinical hypothyroidism: a randomized double-blinded crossover study [moderate evidence]

    Frontiers in Endocrinology 2017: The effect of phytoestrogen on thyroid in subclinical hypothyroidism: randomized, double blind, crossover study [moderate evidence]

  13. Thyroid 2006: Effects of soy protein and soybean isoflavones on thyroid function in healthy adults and hypothyroid patients: a review of the relevant literature [overview article; ungraded]

  14. Alternative Therapies in Health & Medicine 2014: Soy foods and supplementation: a review of commonly perceived health benefits and risks [overview article; ungraded]

  15. This is based on clinical experience of low-carb practitioners. [weak evidence]

  16. In addition to being highly processed, vegetable oils are extremely high in omega-6 fatty acids. This has led to an unprecedented level of omega-6 intake in the human diet. The health consequences of this shift remain unknown:


    Biomedicine & Pharmacotherapy 2006: Evolutionary aspects of diet, the omega-6/omega-3 ratio and genetic variation: nutritional implications for chronic diseases
    [overview article; ungraded]

  17. Although still controversial among medical and nutrition experts, several large systematic reviews of clinical trials have found no evidence that eating foods high in saturated fat — like butter, cream, and coconut oil — raises the risk of heart disease, early death, or other health problems:

    British Medical Journal 2016: Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73) [systematic review of randomized trials; strong evidence]

    Nutrition Journal 2017: The effect of replacing saturated fat with mostly n-6 polyunsaturated fat on coronary heart disease; a meta-analysis of randomized controlled trials [strong evidence]

    Learn more: A user guide to saturated fat