Is Vegetarian Keto Better Than Keto to Manage Weight?

The vegetarian keto diet, dubbed the “ketotarian” diet, is a low-carbohydrate plant-based diet.

It emphasizes healthy fats and moderate plant-based protein while limiting carbohydrates.

Essentially, a vegetarian keto diet aims for more pronounced health benefits than is achieved with either diet individually.

Research on the vegetarian keto diet is limited. Still, its use is encouraged for weight loss, heart health, and blood sugar management.

While this dietary pattern may benefit weight loss, it may not be sustainable for some individuals.

This article explains the vegetarian keto diet, its health benefits, safety considerations, and the challenges of adopting this eating pattern.

Is Vegetarian Keto Better for Weight Management?

Debate exists about whether a vegetarian keto eating plan is better than regular keto for weight management.

Limited research exists on vegetarian keto diets for weight management. One study reported in 2023 followed people for four years and observed less weight gain among those who ate a vegetarian keto diet than those who consumed a traditional, animal-based keto diet.

Studies comparing a low-carbohydrate ketogenic diet and a low-fat plant-based diet yield mixed results. Ketogenic and low-fat vegetarian diets influence appetite, leading to weight loss. However, how these diets affect weight loss is unclear and may depend on the percentage of calories from fat.

Additional research suggests that the lower energy density of plant-based foods contributes to weight loss. 

Other sources note an increased thermic effect of food with more plant-based items. The thermic effect of food reflects the energy required for the body to digest something. It contributes about 10% to the amount of energy the body burns in a given day (total energy expenditure).  

Ultimately, more research is needed to decipher the advantages of vegetarian keto for weight management over other eating patterns.

What Is Vegetarian Keto?

The vegetarian keto diet harnesses the health effects of unsaturated fats and lean proteins with the low-carbohydrate benefits of the ketogenic diet.

Although research is limited, studies show a positive impact of a low-carbohydrate, vegetarian diet on weight, heart health, and type 2 diabetes.

A ketogenic diet was initially designed to treat people with epilepsy, but it has since become more mainstream, with individuals trying it for weight loss and type 2 diabetes management. 

Research shows that plant-based foods like vegetable proteins, oils, nuts, and fiber support health. Specifically, these foods reduce the risk of type 2 diabetes and heart disease and contribute to weight management. 

A vegetarian keto diet emphasizes plant-based fats like oils, nuts, and avocados. It restricts carbohydrates like whole grains, fruit, legumes, and starchy vegetables. Non-starchy vegetables and low-carbohydrate proteins like soy are acceptable.

For a vegetarian keto diet, you must achieve and maintain ketosis. Ketosis is when the body burns fat instead of carbohydrates (glucose) for fuel. Fat is converted into molecules called ketones that provide energy to the body, namely the brain.  

Ketosis requires carbohydrate restriction. On a ketogenic diet (whether plant-based or regular), most calories are from fat, and some are from protein. Carbohydrates are restricted to 20 to 50 grams daily (approximately one to three pieces of bread) or 5% to 10% of total calories.

There are no long-term studies on the vegetarian keto diet. Still, it is likely challenging to sustain. 

Although transitioning to vegetarian keto may be easier for individuals already eating a plant-based diet, vegetarian keto further restricts foods by almost eliminating grains and fruit, two food groups ripe with essential vitamins and nutrients.

Other Vegetarian Keto Benefits

Research on the vegetarian keto diet focuses on its effects on weight, heart health, and insulin sensitivity, or insulin resistance (when cells do not respond well to insulin and can’t take up glucose from the blood, requiring the pancreas to produce more insulin). Its emphasis on unsaturated fat sources contributes to heart health, but it is less clear how the diet influences weight and insulin sensitivity.

Improved Insulin Sensitivity

Few studies show the benefits of a vegetarian keto diet for type 2 diabetes. A step beyond vegetarian keto, a low-carbohydrate vegan diet, improved insulin sensitivity in people with type 2 diabetes in one study. In that study, the low-carbohydrate vegan diet excluded dairy and eggs but included animal-meat replacement products and canola oil-enriched foods. 

The low-carbohydrate vegan diet reduced hemoglobin A1c (HbA1c) levels by 0.99% in people with type 2 diabetes. HbA1c is used to diagnose type 2 diabetes and reflects average blood sugar over three to four months. 

Though research on vegetarian keto diets for insulin sensitivity is limited, other research supports the use of ketogenic and vegetarian diets for diabetes management.

Heart Health

Significant research supports vegetarian or vegan diets to lower low-density lipoprotein (LDL) cholesterol (“bad cholesterol”) and slow the progression of heart disease. Elevated LDL cholesterol is a risk factor for heart disease. Swapping saturated fat from animals for unsaturated fats from oils and nuts is associated with heart-healthy benefits.

One study observed a decrease in calculated 10-year coronary heart disease risk scores with a vegetarian keto diet. Moreover, the low-carbohydrate vegetarian diet reduced LDL cholesterol by 9%. Carbohydrates constituted 26% of calories and fat 43%, mainly from vegetable oils.

When thinking about heart health, it’s important to note some plant-based saturated fat sources, such as coconut and palm oil. High saturated fat intake may increase the risk of heart conditions.

Vegetarian Keto-Friendly Foods

A vegetarian keto diet is highly nutrient-dense. Still, it is vital to ensure you meet nutrition and calorie requirements. Topping dishes with nuts and seeds boosts calorie content and provides a source of fiber. 

The following are foods to include with a vegetarian keto diet:

• Nuts: Research shows nuts support weight management, reduce fasting insulin and postprandial blood sugar, and improve cognition. They contain fiber, vitamin E, unsaturated fats, and bioactive plant compounds like antioxidants beneficial for health. Despite the benefits, nuts remain a high-calorie food and should be consumed in moderation. Studies on the health effects of nuts limit them to 50 to 100 grams daily (1 to 3.5 ounces).   
• Seeds: Seeds like flax, pumpkin, and chia provide protein, vitamins, and minerals like iron and magnesium, as well as added fiber and healthy fats.
• Plant proteins: Primary plant proteins on a vegetarian keto diet include soy and gluten in the form of seitan. Some protein also comes from vegetables, seeds, and nuts. According to one study, the cholesterol-lowering benefits of plant proteins may be due to the protein itself and not other food components such as fiber. However, additional research is necessary. Still, vegetable proteins are associated with better blood pressure and weight control, reduced lipid levels, and lower risks of heart disease.   
• Dairy: Vegetarian and ketogenic diets often allow dairy. Dairy products contain carbohydrates from the sugar lactose, so they must be factored into daily carbohydrate allotments.
• Fruit: Fruit can be part of the vegetarian keto diet as long as ketosis is maintained. Opt for fruits that are lower in sugar and higher in fiber. Berries (strawberries, raspberries, and blackberries) are suitable for the vegetarian keto diet due to their high fiber and low carbohydrate content. 
• Low-carbohydrate non-starchy vegetables: Many non-starchy vegetables contribute minimal carbohydrates and can be included in a ketogenic diet. These include leafy greens, broccoli, zucchini, cauliflower, mushrooms, asparagus, and Brussels sprouts.

Sample Meal Plan

Options for a vegetarian keto breakfast include egg-and-vegetable scrambles or chia pudding with coconut milk.

For lunch, try a kale salad with cucumbers, zucchini, and mushrooms topped with grilled tofu, sunflower seeds, and pumpkin seeds.

Dinner is roasted tempeh with grilled asparagus and broccoli. Sprinkle with hemp hearts for extra protein and fat.

Potential Challenges

Despite its health benefits, a vegetarian keto diet can be challenging. Maintaining adequate nutrition and continuing lifestyle habits like dining out requires additional thought.

Meeting Nutrient Needs

A vegetarian keto diet omits certain foods, so nutrient deficiencies are possible. Common nutrient deficiencies among vegetarians include vitamins B12 and D, calcium, and iron.

Many vegetarians get B vitamins from fortified grains rather than animal products. However, a vegetarian keto diet limits many food sources of B vitamins, such as fortified cereals and grains. People adhering to a vegetarian keto eating pattern should be mindful of B vitamin deficiencies.  

A multivitamin or supplementing vitamin B12, a B-complex, or vitamin D may be necessary to prevent nutrient deficiencies with a vegetarian keto diet. A registered dietitian can help you choose the right supplements.

Navigating Eating Away From Home

Social situations like dining out or going to friends’ houses can be challenging to navigate on a vegetarian keto diet. To make eating at other people’s houses easier, bring a vegetarian keto dish to share with others.

When dining out, look at the menu ahead of time. Scan for low-carb, vegetarian protein sources like tofu, and be mindful of sauces. Try requesting tofu with a salad or steamed, baked, or grilled vegetables.

Alternatively, adjust your meals to save your daily carbohydrate allotment for dining out. Still, focus on high-fiber starches, such as beans, lentils, quinoa, or sweet potatoes.

Is Vegetarian Keto Safe for Me?

The following health conditions warrant additional consideration with a vegetarian keto diet:

• Kidney disease: A vegetarian keto diet may be safe for individuals with mild kidney disease. Nutrients like phosphorus and potassium, common in plant-based foods, should be consumed less with late-stage kidney disease.
• Eating disorders: Eliminating multiple food groups may be too restrictive for some people, leading to an eating disorder. Individuals with a history of an eating disorder or disordered eating may need to refrain from the vegetarian keto diet until later in their recovery process.
• Pregnancy and breastfeeding: A vegetarian keto diet is discouraged during pregnancy and lactation because of increased nutrient needs and a greater risk of complications and ketoacidosis. 
• Metabolic dysfunction-associated steatotic liver disease (MASLD): MASLD results from fat build-up in the liver. A vegetarian keto diet may prevent MASLD and reduce complications through weight loss and prioritizing foods like unsaturated fats, lean proteins, and non-starchy vegetables.  
• Type 1 diabetes: High ketone levels can lead to diabetic ketoacidosis. Carbohydrate intake must be consistent and well-regulated to match insulin dosing and prevent low blood sugar.
• Type 2 diabetes: Individuals taking diabetes medications for type 2 diabetes, such as insulin or SGLT-2 inhibitors—for example, Jardiance (empagliflozin) and Farxiga (dapagliflozin)—should be mindful of hypoglycemic episodes (blood sugar levels dropping below normal) when following a vegetarian keto diet.

It is best to consult your healthcare provider before adopting a new diet like vegetarian keto.

Tips for Success

Adopting and sticking with a new eating pattern requires planning and reconfiguring your environment. Some strategies for success include meal planning and using monitoring tools like urine ketone tests, macronutrient trackers, and monitoring your blood sugar.

Urine Ketone Tests

Attaining and remaining in ketosis is crucial for a vegetarian keto diet. A urine ketone test can help you determine whether your body uses fat for energy. Ketones in urine represent a state of ketosis. 

Urine ketone tests help monitor progress toward ketosis and whether you continue relying on fat for energy. Purchase urine ketone tests at pharmacies or online. 

Monitoring Carbohydrate and Nutrient Intake

Familiarize yourself with the nutrition facts label and carbohydrate counting. Maintaining ketosis requires a low carbohydrate intake. You may be surprised how quickly carbohydrates add up without reading labels or tracking 

Calorie- or carbohydrate-counting applications help ensure you stay within macronutrient recommendations. Adjust the macronutrient distribution so that most of your calories come from fat and carbohydrates are restricted.

As you become more accustomed to vegetarian keto foods, decrease your carbohydrate intake to achieve ketosis.

Monitoring Your Blood Sugar Levels

When trying a lower-carbohydrate diet, monitoring your blood sugar can help you detect any significant changes. In addition to monitoring ketones, this can also help you detect whether you’ve reached ketosis.

Moreover, you can see how your changes in blood sugar levels correlate with how you feel in the short and long term.

You can monitor your glucose levels by using a fingerprick test (glucometer) from your local pharmacy or a continuous glucose monitor (CGM).

You can use these whether you have diabetes or not.

Meal Planning

Sticking to a specific way of eating can be challenging when you’re hungry and lack readily available foods. Stock up on vegetarian keto foods. Map a few weekly meals and keep nutrient-dense, keto-friendly foods on hand. Planning is key with the vegetarian keto diet.

Vegetarian keto-friendly snacks include the following:

Keep nuts and seeds in your backpack or purse for a convenient, shelf-stable snack for when hunger strikes. 

A registered dietitian nutritionist (RD or RDN) can assist you with the switch to vegetarian keto. They also advise on specific foods and individualized macronutrient targets.

Summary

The vegetarian keto diet incorporates elements of vegetarianism and the ketogenic diet.

It is an eating pattern that emphasizes fats—unsaturated fats, mainly oils and nuts—and limits carbohydrates, such as desserts, pastries, whole grains, and fruit. 

The vegetarian keto diet supports weight loss, heart health, and blood sugar management.

However, it can be challenging to implement and maintain.

A registered dietitian can help with transitioning to vegetarian keto and achieving ketosis.