Healthy keto foods
Keto is the high-fat, super-low-carb diet with staying power. As keto continues to attract followers and inspire new versions and spinoffs, it’s clear that some keto-friendly foods are healthier than others. Here are some key foods for minding your health and maintaining good nutrition while watching your weight on keto.
Avocados are the No. 1 food item for keto-friendly diets, says Lolita Carrico, a registered nutritionist and chef and founder of ketology.net, which focuses on a keto lifestyle for women over 40 but also offers plenty of tips for anyone interested in keto.
Avocados are rich in monounsaturated fat, a healthy type of fat when eaten in moderation. The fruit is also a great source of fiber and a wide array of vitamins and minerals. Eating avocados helps you feel full — which is half the battle when you’re trying to lose weight.
Salmon is a fish-based source of healthy fat. Salmon is both versatile and tough, Carrico says. It can withstand the grill without flaking out, and can be used in multiple ways. For instance, you can cube salmon for a stir-fry or make poke bowls with the high-quality fish.
Experience bread-like texture without actually eating bread. Portobello mushrooms can stand in to replace bread or buns, says Vahista Ussery, a registered dietitian nutritionist, chef and founder of To Taste, a culinary nutrition consulting and education company.
Portobello mushrooms have a somewhat beefy flavor, making them a good swap for meat. They’re also a rich source of minerals such as potassium, copper and selenium, as well as essential B vitamins. In general, mushrooms are low in net carbs while providing a good amount of protein.
Ussery herself isn’t a big keto fan overall. “The keto diet is not easy,” she says. “It requires research, dedication and sacrifice. If you follow the keto diet correctly, you will lose weight — but ask yourself if you can maintain this diet in the long run.”
She has several concerns about keto falling short as a well-balanced diet. “The keto diet restricts many foods we know to be healthy and consumed by the world’s longest-lived populations,” she says. “Whole grains, beans, fruit and starchy vegetables like sweet potatoes are all healthy and promote longevity. To me, that’s a huge red flag.”
If you’re determined to do keto, Ussery suggests opting for foods that make the diet as healthy as possible.
Grilled, pan-seared or broiled: It’s your preference when it comes to grass-fed beef. “The most important thing is to make sure you’re adding high-quality fat to keep it moist,” Carrico says. “The lovely thing about a keto lifestyle is you can cook your favorite foods the way you always have — it’s just what you eat with it.” So instead of steak and potatoes, or steak and rice, she says, sub in keto-appropriate side dishes.
Veggies belong in a healthy keto diet, but there are some caveats. Compared to fruits, “There are more choices with vegetables, but they do need to be low-carb, non-starchy ones,” Ussery says. For keto, “Skip the potatoes — including sweet potatoes — and corn, and load up on leafy greens, broccoli, asparagus, zucchini, cauliflower and more.” Radishes and tomatoes are also low-carb produce.
“Vegetables should accompany all meals to ensure people on keto are getting plant-based nutrients and phytochemicals to help fight inflammation and prevent disease,” Ussery advises.
The keto movement embraces creative takes on familiar wheat-based, carb-laden fettuccine or linguine. “Pasta substitutes include shirataki noodles, spaghetti squash and zucchini noodles,” notes Dr. Eric Westman, an associate professor at Duke University, director of the Duke Keto Medicine Clinic and author of “End Your Carb Confusion: A Simple Guide to Customize Your Carb Intake for Optimal Health.”
Using pasta adaptations like these gives you an extra plant-based health benefit. For instance, shirataki noodles, derived from Asian konjac yam, can serve as a low-carb, low-calorie, fiber-rich side dish.
Cauliflower rice, cauliflower pizza crust, cauliflower ice cream — cauliflower food hacks have almost become a keto cliché. “Cauliflower gets such a bad rap as a potato substitute, but I love making mashed cauliflower,” Carrico says. “It tastes so much better to me than mashed potatoes, now that I’ve been doing it for a while.”
You can mash, roast or even rice cauliflower in a food processor, she adds, or buy riced cauliflower at the grocery store.
Although some keto proponents recommend skin-on chicken thighs as a higher-fat poultry source, Carrico prefers to serve skinless chicken breasts. Or you could just cook the entire chicken. “Weeknight skillet roast chicken with lemon-herb pan sauce,” is a keto fan favorite, according to the recipe creators at America’s Test Kitchen.
Nuts and nut butters
Walnuts and pecans are good nut choices. “They’re the lowest-carb and have a good healthy-fat profile, as well,” Carrico explains.
Similarly, some nut butters are better than others. “I would stay away from peanut butter because peanuts are a little higher on the carb side,” she says, along with some concerns about pesticides sprayed on peanuts growing in the field. “Almond or pecan butter is great,” she adds. “I make almond butter at home — you literally just blend it into a natural nut butter.”
Some companies now make “amazing, keto-friendly nut butters that don’t have sugar,” Carrico says. “The main thing is: If you’re buying a nut butter at the store, read the label, because they usually add sugar and you have to find no-sugar-added versions.”
“Berries are the best choice, especially strawberries, raspberries and blackberries,” Ussery says. “Luckily, they are considered some of the healthiest fruits with their high amounts of phytochemicals.” Phytochemicals, which give fruits and veggies their vibrant colors, are powerful antioxidants.
Carrico suggests combining nuts and berries for a satisfying, high-antioxidant, fiber-rich keto snack.
However, for strict keto adherents, Westman says, “Unless you are young, extremely active or have a metabolism that doesn’t ‘need keto,’ there are no fruits or berries on a ‘prescription-strength’ keto diet — one that works for everyone with obesity, metabolic syndrome or diabetes.”
Kale and spinach
Healthy plant foods and the keto diet can go hand in hand. “Although a lot of people think keto is beef and butter, fiber in the form of a salad is very beneficial,” Carrico says. “So I’ll usually have a huge salad every day with kale and spinach.”
Combining these leafy greens offers a great mix of nutrients. Kale is particularly rich in calcium and vitamins C and K, while spinach is a super-source of minerals such as iron, magnesium and potassium, as well as vitamins A and E.
Butter lettuce can hold a burger like a bun or act as a sandwich wrap, making it keto-convenient. And of course, you can build a salad around it. The two main types of butter lettuce (or butterhead lettuce) are bibb and Boston lettuce, featuring tender leaves with a delicate flavor. Butter lettuce is an excellent source of dietary fiber, and it contains a variety of healthy vitamins and minerals.
Do you cringe at the idea of even smelling, much less swallowing, brussels sprouts? If so, you’re not alone. “I know, but they’re really good if you cook them right,” says Carrico, who’s a “huge fan” of the pungent, cruciferous veggie.
To encourage reluctant keto adherents to give them a try, Carrico offers a recipe for garlic-Parmesan smashed Brussels sprouts: “Even my children like them,” she swears. You’ll just need these ingredients:
— 1 pound trimmed Brussels sprouts.
— 2 tablespoons avocado oil.
— 2 teaspoons garlic powder.
— 1 teaspoon crushed red pepper.
— 1/4 cup shaved Parmesan.
Follow the simple recipe instructions on boiling the Brussels sprouts, crushing them into patties, then seasoning them with the avocado oil, garlic powder and crushed red pepper before roasting and finally sprinkling on the Parmesan cheese and briefly broiling.
If you’re on keto, skip the whole or skim milk or ‘lite’ yogurt in the dairy aisle. Instead, add lower-carb items like plain Greek yogurt and butter to your grocery cart. “As far as dairy goes, if I’m having coffee I’ll definitely have a splash of heavy whipping cream, because full fat is very important,” Carrico says, while noting that you don’t necessarily have to douse your coffee in cream.
Butter and ghee — which is simply clarified butter — are essentially carb-free. Many types of cheese work for keto, including Brie, cheddar, Swiss, provolone, mozzarella and Monterey Jack.
Yogurt and kefir
Rich in probiotics, yogurt and kefir are probably the best dairy options for keto, Ussery says. Both are types of fermented foods, a known good source for probiotics. If you’re unfamiliar with kefir, it’s a fermented milk made from kefir grains. Probiotics are the “good” bacteria in your gut. Having a normal balance of probiotics is important for gastrointestinal health.
Keep in mind that full-fat yogurt may contain some carbohydrates due to the natural lactose content of milk, Ussery adds. “For people following very strict ketogenic diets, remaining conscientious of sources like this is important.”
Popular keto-adapted foods include the chaffle — a cheese-and-egg waffle. They’re easy to make with an inexpensive mini-waffle maker, and you add a flavor boost with a dash of cinnamon or cocoa powder.
“Cheese is another healthful option,” Ussery says. “While cheese is high in saturated fat, it does contain nutritional benefit. Avoid processed cheese, and look for natural kinds like cheddar or parmesan.”
Certain plant oils — for cooking, dressings and flavoring — play a big part in keto meals and snacks. Coconut, avocado and extra-virgin olive oil are prime sources for healthy fat, Carrico says.
Many keto followers swear by MCT oil, a manufactured combination of processed palm oil and coconut oil. (MCT stands for medium-chain triglyceride, a compound made of specific fat molecules.) Carrico uses MCT in her salad dressing and coffee.
From her perspective, Ussery says, “While I hesitate to recommend coconut oil as a predominant oil for a traditional eating pattern, MCT oils actually help promote ketosis.”
Because it’s more easily absorbed than other oils, MCT may be a good choice for people who have difficulty with fat absorption, such as those with irritable bowel syndrome, among other digestive conditions.
With the keto diet, “Any non-sugar sweetener is fine, but they are counted in the total carb calculation for the day,” Westman points out.
Allulose, which is found in select plant foods such as kiwi, figs and raisins, has few carbs and essentially zero calories. Monk fruit sweetener, a powder derived from a green melon that grows in parts of Asia, is carb- and calorie-free.
For her part, Ussery is not really a sweetener enthusiast. “I’m not a fan of artificial sweeteners used for diabetics as there are still some questions with long-term safety,” she says. “If I had to recommend alternative sweeteners, I would say natural stevia extract or monk fruit, if you can find it. One of my concerns is that alternative sweeteners may alter people’s taste preference for sweet foods, leading to cravings for more. These sweeteners are so sweet, it can make natural foods — like fruit — seem less sweet and less appealing.”
Eggs are a keto staple. High in protein, eggs lend themselves to keto-friendly breakfasts such as egg-stuffed avocado, egg-and-cheese muffins and salmon omelets.
“Eggs are a keto must-have food,” Carrico says. “I buy pasture-raised eggs because they’re really high quality with all the nutrients” of regular eggs.
Following a keto diet
The ketogenic diet originated as a strict, medically supervised regimen to help reduce seizures in patients — particularly children — with epilepsy. Although evidence suggests a keto diet may help some patients with other conditions like diabetes, it must be undertaken carefully. For instance, going keto could change the way you respond to certain medications.
“There is a big difference between the keto diet as taught by internet influencers, and the keto diet as used by trained medical professionals,” Westman says.
Westman emphasizes: “If you have medical problems, and especially are taking medications for diabetes or high blood pressure, do not follow a keto diet without supervision from a health professional with experience in deprescribing medications. The medications can become too strong — on the first day of the diet change.”
For individual guidance, he says, “You might be able to find a local health professional through the Society of Metabolic Health Professionals, or the Obesity Medicine Association.”
Healthy keto foods
Going keto? Put these healthy staples on your grocery list:
— Portobello mushrooms.
— Grass-fed meats.
— Non-starchy veggies.
— Shirataki and zucchini noodles.
— Nuts/nut butters.
— Kale and spinach.
— Butter lettuce.
— Brussels sprouts.
— Yogurt, kefir and natural cheeses.
— Chaffles, or waffles made with eggs and cheese.
— Coconut, avocado, MCT and extra-virgin olive oil.
— Allulose and monk fruit sweeteners.
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Update 12/29/21: This story has been updated with new information.