Vegan Low Carb Diet – Beneficial or Not?

Is the vegan low-carb diet the best diet?

Could you do without bread, pasta, and potatoes? This is necessary in the (vegan) low-carb diet to some extent, in the keto vegan diet these foods are completely taboo. But are there any benefits to such a restricted diet? What does a vegan  low-carb diet look like? What is the difference between a vegan  low-carb diet and the so-called ketogenic diet? In this article, you will learn what a vegan low-carb diet is, who it is for, and what you should watch out for.

Definitions

Low-Carb Diet

The term “low carb” initially describes a diet in which the intake of carbohydrates (carbs for short) is lowered. But lower than what? What exactly does “low” mean? This is not clear and there are different interpretations. For some active people, 200 grams of carbohydrates per day may be low, but for less active, lighter people, this amount may be a lot.

Most Nutrition Societies recommend around 50 % of the daily energy intake coming from carbohydrates. Using this as a benchmark, any diet in which less than that comes from carbohydrates is a low-carb diet.

Studies investigating the effects of low-carbohydrate diets use different macronutrient distributions to differentiate between low-carbohydrate and high-carbohydrate groups. In some studies, absolute numbers (fixed grams) are used, while in other studies the percentage of energy intake is used. This makes comparisons difficult and must be taken into account when interpreting the results. Depending on the study design, amounts of 30 to 130 g are usually defined as “low carb” (Hite et al., 2011).

Ketogenic Diet

The vegan ketogenic (“keto”) diet is a strict form of the low-carb diet. The goal is to increase the body’s production of ketone bodies. Therefore, those on the vegan keto diet get most of their energy from dietary fats, the amount of carbohydrates consumed is very low, and protein intake is also limited. This is necessary to be “in ketosis”. More on this later.

Peterman’s Ketogenic Diet

In Peterman’s classic ketogenic diet, the weight percentage of fats per meal must be four times that of carbohydrates and protein combined. For example, 200 grams of soy yogurt may contain 4.6 grams of fat, 4.2 grams of carbohydrates, and 8 grams of protein. This is an unfavorable ratio because the 12.2 grams of carbohydrates and protein are 2.7 times the amount of fat. So you would have to add about 45 grams of pure fat, which you probably do not want to do.

The daily protein intake in this form of ketogenic diet is about 1 gram per kilogram of body weight, and only 10–15 grams of carbohydrates are allowed. A slice of whole wheat bread contains about 20 g of carbohydrates, and a medium-sized carrot contains about 7 g of carbohydrates! So these foods are almost impossible to include in a vegan keto diet.

Modified Atkins Diet

In the Modified Atkins Diet (MAD), adults start with 20 g of carbohydrates per day, and later may go up to 60 g – as long as it still keeps you in ketosis; protein is a maximum of 30 % of energy intake. For example, 100 grams of raw kidney beans with 50 grams of rice contains 60 grams of carbohydrates. So even with this relatively high carbohydrate intake, this is not a good food choice for the keto vegan diet.

Ketogenic Diet with MCT Fats

One way to achieve ketosis with a higher carbohydrate intake is to use products that provide medium-chain fatty acids. This is because more ketone acids are synthesized from them than from long-chain fatty acids. Most vegetable fats consist of long-chain fatty acids, only coconut fat contains a relatively high proportion (60 %) of medium-chain fatty acids, such as lauric acid (Och et al., 2017).

But how does ketosis occur and what exactly happens? Here is an interesting excursion into biochemistry.

Ketosis

Normally, your body uses glucose as its primary source of energy. This glucose normally comes from the carbohydrates in your diet. When none are available, glucose molecules stored in the form of glycogen can be used to produce energy. However, glycogen stores in the muscles and liver are limited and are depleted quickly. What happens next?

Other nutrients must be utilized. Protein can be converted to glycogen through gluconeogenesis. If only the minimum amount of protein to maintain bodily functions is consumed, dietary fat remains as a source of energy. In the vegan ketogenic diet, the body increasingly breaks down fatty acids from dietary fat – because there is enough of it. From the broken down fatty acids and ketogenic amino acids (lysine, leucine, isoleucine, phenylalanine and tryptophan), more ketone bodies are formed in the mitochondria of the liver cells:

• acetone
• acetoacetate
• ß-hydroxybutyrate

After the ß-oxidation (breakdown) of fatty acids, Acetoacetate is formed from acetyl-CoA. It is then converted to ß-hydroxybutyrate. Acetone is then formed by the elimination of CO2. However, acetone is less important for energy production because it is largely exhaled through the lungs. You may have heard that ketosis can be recognized by bad breath. Now you know why.

These ketones are then used for energy production. On a conventional diet and in a non-ketogenic metabolic state, the concentration of ketone bodies in the blood is less than 0.1 mmol/l; with an intake of about 40 g of carbohydrates, it rises sharply to a maximum of 8 mmol/l. For ketosis in the context of nutritional therapy, concentrations of 2–7 mmol/l are usually targeted.

So how can you measure ketone body concentration? In scientific practice, this can be done relatively accurately by measuring acetone in breath. However, this method is very costly and cannot be done at home. The following methods are more practical:

• urine sticks (they do not measure ß-hydroxybutyrate, and measurement errors are common, especially with higher ketone body concentrations or large amounts of alcohol)
• measurement of ß-hydroxybutyrate concentration in capillary blood (expensive, but more accurate than urine sticks)
• measurement of acetone in breath using portable sticks (no scientific evidence of accuracy).

(Och et al., 2017).

Other Aspects

Implementing the (vegan) ketogenic diet in everyday life is very difficult, and even in the clinical therapeutic setting, patient adherence is often low. This is due to the side effects of the ketogenic diet, such as weakness, hunger, constipation, abdominal pain, diarrhea, and hypoglycemia, in addition to its practicality. It is recommended to increase fat intake gradually and to regularly check electrolytes, liver and kidney values, and urine status in addition to micronutrient intake (Och et al., 2017).

Low-Carb Vegan Foods and High-Carb Vegan Foods

In the vegan low-carb diet, you– who would have thought it – have to integrate more low-carb foods into your diet. The high-carbohydrate vegan foods are rarely, if ever, on the plate. Table 1 provides an overview of vegan high-carbohydrate foods, and Table 2 provides an overview of low-carb vegan foods.

Table 1: Vegan High-Carb Foods (BLS)

Table 2: Vegan Low-Carb Foods (BLS, if not otherwise specified)

Vegan Low Carb Diet in Practice

Normally, we recommend that you base your food choices on our Vegan Food Pyramid when following a vegan diet. However, you will notice at first glance: The Vegan Food Pyramid is not suitable for the vegan low-carb diet. In addition to fruits and vegetables, grains and potatoes play a major role, while nuts and seeds, as well as fats and oils, are at the top of the pyramid and should be consumed in relatively small amounts.

The vegan low-carb diet, on the other hand, focuses on nuts and seeds and products made from them (for example nutbutters). However, with those foods you will be consuming a lot of fat, which is desirable in the keto vegan diet, but less so in the vegan low-carb diet. You need to pay special attention to your protein intake, which can be very low on a vegan low-carb diet.

This is because there are few plant foods that are both low in carbohydrates and high in protein. Especially when an increased protein intake is needed (body fat reduction, muscle building or generally during exercise, aging), it can be difficult to get enough protein as part of a vegan low-carb diet. If weight loss is the goal, and caloric intake is reduced, the intake of protein is difficult.

However, there are some foods that are high in protein and low in carbohydrates:

• tofu
• tempeh
• seitan
• lupine tofu, tempeh
• soy chunks
• protein powder

However, it is not only the amount of protein that matters, but also the amino acid composition – especially when the total protein intake is low, as is often the case with vegan low-carb diets. In the example above, you saw that the combination of beans and rice, popular in vegan diets, provides a relatively high amount of carbohydrates even in a small serving. Quinoa and amaranth are comparatively high-protein pseudo grains that can be incorporated depending on the target carbohydrate intake. One way to improve the amino acid profile of the vegan low-carbohydrate diet is to combine tofu and seitan products. Alternatively, you can get individual amino acids from isolated supplements.

What many forget: Not only fruits contain carbohydrates, so do vegetables! Since vegetables have the highest micronutrient density relative to energy density, you should get the majority of your low carb intake from vegetables. Some low-carb dieters use shredded cauliflower as a rice substitute. Grains are difficult to incorporate into the vegan low-carb diet: The few “allowed” carbohydrates should come from legumes, which are also rich in protein.

Sugar-containing drinks (soda, coffee, iced tea drinks with added sugar, fruit smoothies and juices) are not suitable. Unsweetened tea, coffee, water and drinks with artificial sweeteners contain no carbohydrates and are therefore suitable as thirst quenchers in a vegan low-carb diet.

Do you enjoy baking and do not want to give it up on a vegan low-carb diet? Then the following foods may be helpful:

• nut meals (like almond)
• coconut flour
• flaxseed meal
• lupine flour/shreds
• soy flour/chunks.

You can use those foods to replace (part of) the flour in baking or add them to meals. The fat content varies depending on the degree of processing.

A vegan low-carb day could look like this:

A Vegan Keto Diet in Practice

The most important characteristics of the vegan keto diet are a high intake of fat and a low protein intake. As you now know, this isn’t too difficult with the vegan diet. This is because the high-fat dairy products that are the focus of the ketogenic diet with products of animal origin are often high in protein as well. The following vegan fat sources, on the other hand, are low in both protein and carbohydrates:

• olives
• avocado
• vegan cream alternatives
• cheese alternatives
• meat alternatives
• coconut products (milk, flour, etc.)
• vegetable fats and oils

Tip: Dairy and meat substitutes can vary widely in their macronutrient composition due to their different ingredients, and not all are “keto-friendly”. Check the nutrition facts panel for more information.

The macronutrient ratio sought in the classic Peterman’s ketogenic diet can be achieved by adding vegetable oils to dishes. Foods that already have this ratio include macadamia nuts (5.7:1), black olives (5.0:1), or coconut and coconut meat (3.9:1) (Och et al., 2017).

Sugar-containing beverages, of course, cannot be consumed on the vegan ketogenic diet. Sugar alcohols (for example xylitol, erythritol, isomalt), which are commonly used for sweetening and popular with low-carb dieters, must also be avoided.

As you can see, the ketogenic vegan diet is a very restricted diet, and there is a lot to consider if you want to meet your needs on it. Especially at the beginning of the transition, support from experienced professionals is usually necessary. Apps can help track your macronutrient intake.

Benefits of the Vegan Low-Carb Diet

• a keto-vegan diet often leads to high satiety → easier weight loss
• on keto-vegan diets, some people can better concentrate
• reduction of carbohydrate sources such as baked goods, highly processed products → automatic lower intake of micronutrient-poor foods & lower calorie intake
• may lead to an overall healthier dietary pattern if, for example, vegetables or whole grains were previously infrequently consumed

The increased feeling of satiety is thought to be due to the ketone bodies. In studies, the release of the hormone ghrelin was reduced in the presence of ketosis. Ghrelin is the so-called “hunger hormone”, which is increased when energy intake is low and is one of the reasons why diets are so difficult and can fail. However, the exact background and mechanisms why lower caloric intake and better satiety are often observed in ketogenic diets are not clearly understood at present (Roekenes and Martin, 2021).

Disadvantages of the Vegan Low-Carb Diet

• requires close monitoring of nutrient intake, which may be perceived as burdensome
• side effects of the transition
• reduced appetite due to increased satiety and unfamiliar, possibly less palatable diet → unintended weight loss
• implementation not easy in everyday life
• overeating of fatty foods → excessive caloric intake
• adequate protein intake more difficult
• fiber intake may be low → possible side effect of constipation and other possible negative effects on (intestinal) health
• adequate micronutrient intake is more difficult
• dspecially with very high fat diets: low food volume, which can be unsatisfactory and lead to hunger
• possible decrease in (athletic) performance.

Effects of the vegan Low-Carb Diet

Weight Loss

In order to lose weight, you must maintain a negative caloric balance, meaning that you must consume fewer calories than you expend. How this is achieved is not relevant to weight loss. Of course, it makes sense to reduce the absolute amount of carbohydrates in a diet to create a calorie deficit. However, excessive restriction of carbohydrates relative to fat intake is not necessarily beneficial.

In studies, there is no long-term difference between low-carb and low-fat diets when protein intake is the same (high). Depending on individual preferences, it may be easier to maintain a caloric deficit with one diet or the other (Gardner et al., 2018; Buga et al., 2021). A meta-analysis of existing studies shows that total energy expenditure may be higher on a low-carbohydrate diet than on a low-fat diet for the same calorie and protein intake. However, the difference is very small. 60 ± 29 kcal per day have been derived from the studies (Guyenet and Hall, 2021; Ludwig et al., 2021). Judging from the results of previous studies, this seems to be of little practical relevance. Ultimately, it is important that the dietary pattern allows the caloric deficit to be maintained (Ashtary-Larky et al., 2021).

According to the current guideline of the European Association for the Study of Obesity (EASO), a well-designed, highly calorie-restricted (500–800 kcal/d) ketogenic diet may be an approach for rapid weight loss in severe obesity. However, the institution also notes that individual feasibility must be the primary consideration and that other diets provide comparable results (Muscogiuri et al., 2021).

The difficulty with a vegan low-carb diet: A high protein intake, which is even more important for weight loss, is more difficult to achieve than with a mixed-food or vegan low-fat diet. This is because most protein-rich vegan foods (for example legumes or nuts) also provide some amount of carbohydrate and/or fat.

Cardiovascular Disease and Blood Lipids

An unfavorable blood lipid profile is considered a risk marker for coronary heart disease. Intervention studies have shown variable effects of low-carbohydrate diets on blood lipid levels. Again, the amount and type of fats and carbohydrates consumed both before and after the dietary change seem to play an important role. It is likely that a high proportion of saturated fatty acids has a negative effect on the risk of various cardiovascular diseases, while a higher proportion of polyunsaturated fatty acids has a positive effect.

How the weight loss due to the diet, and baseline values and diet influenced the study results is not known. Because plant-based fat sources are likely to have a beneficial effect on cardiovascular health, a vegan low-carb diet may be superior to a diet based primarily on animal fat sources in this regard (Hite et al., 2021; Schoenegg and Iggmann, 2021; Schwingshackl et al., 2021).

An advantage of the vegan low-carb diet may be that it is generally low in saturated fat, provided there are few highly processed foods on the menu (Hite et al., 2011).

Athletic Performance

In particular endurance athletes hope that a low-carb diet will reduce the body’s reliance on limited glycogen stores and encourage it to obtain energy from fats in the first place. There are some theoretical mechanisms that support this theory, and some studies have also observed this in practice. However, the results are mixed, especially in high-intensity sessions where performance losses are also observed. It is likely that the effects depend, among other factors, on the comparison diet, the type of training, training status (Burke et al., 2004; Burke et al., 2020; Bowler and Polman, 2020).

Strength athletes may benefit from beginning training with well-filled glycogen stores to optimize performance and muscle gains. For muscle mass gain, a low-carb diet has been shown to be more disadvantageous than other diets with the same caloric and protein intake (Vargas et al., 2018; Hokken et al., 2021; Ashtary-Larky et al., 2021).

Clinical Use of the Keto Diet

A ketogenic diet is used in clinical therapy for epilepsy patients who do not respond to medication. In children with epilepsy, the nutritional management of this diet is considered safe according to the Society for Neuropediatrics S1 guideline (AWMF, 2014).

The ketogenic diet is also used for treatment of metabolic disorders such as glucose transporter deficiency (GLUT1 deficiency) and pyruvate dehydrogenase deficiency (Och et al., 2017). There are indications of beneficial effects in other diseases, but they are not part of current therapy due to insufficient studies. These include neurodegenerative diseases (for example Alzheimer’s disease) and autism (AWMF, 2014).

Some cell and animal studies show promising effects in various cancers. However, there are many types of cancer, and in some, a ketogenic diet may also promote the growth of malignant cells. In addition, the design of the ketogenic diet seems to play a role, such as the type and amount of fats and proteins fed. Existing human studies are currently insufficient to make recommendations (Elisia and Krystal, 2021).

Conclusion on the Vegan Low-Carb Diet.

Although it is often postulated as THE miracle diet for weight loss, a low-carb diet does not appear to provide any long-term benefits compared to a moderate-carb diet, as long as calories and protein intake are the same.

Those who wish to follow a vegan low-carb diet should be aware that this diet requires some effort.

The low carb vegan diet may be for you if you

• enjoy eating high-fat foods
• do not like to eat pastries, pasta, potatoes, rice, etc.
• find it easier to consume fewer calories with it when your goal is to lose weight
• like taking a closer look at your diet (for example, to ensure adequate protein and micronutrient intake)
• enjoy low-carb cooking and baking
• eat little outside your home or are comfortable not eating at social events.

Overall, the strict vegan low-carb diet is difficult to implement in everyday life, especially at social events or away from home. In addition, there are no relevant benefits that cannot be achieved with a general dietary change to a plant-based diet based on the Vegan Food Pyramid.

A vegan ketogenic diet should only be implemented for medical reasons and under the supervision of a physician and, if necessary, an experienced Vegan Nutritionist.

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Hokken, R., Laugesen, S., Aagaard, P., Suetta, C., Frandsen, U., Ørtenblad, N., and Nielsen, J. (2021). Subcellular localization- and fibre type-dependent utilization of muscle glycogen during heavy resistance exercise in elite power and Olympic weightlifters. Acta Physiol (Oxf) 231, e13561.

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• cover photo – vegan low carb: © sveta_zarzamora - stock.adobe.com

Medical Disclaimer and Other Notes

Medical Disclaimer

Like any science, medicine and related disciplines are subject to constant development. Research and clinical experience expand our knowledge, especially with regard to treatment and therapy. Insofar as a recommendation, dosage, application, etc. is mentioned in the information provided, you may trust that we have taken great care to ensure that this information corresponds to the state of knowledge at the time of completion of the work. However, no guarantee or liability can be assumed for such information. You are required to check them carefully yourself and act on your own responsibility. Furthermore, our recommendations and advice are in no way intended to replace medical advice, diagnosis or treatment in the case of an existing illness - it is not a therapy. You should therefore never use the information we provide as your sole source for making health-related decisions. In case of complaints, medical advice should be sought in any case.