Keto: How to Do It When You Have Food Restrictions


The unfortunate part about the word “diet” is that it implies restriction: The way the word is used so often today, it’s all about what you can’t have, rather than what you can.

When we talk about food — and its unbelievable power (and flavors) — I would rather focus on the green lights, rather than the red ones. 

So that’s one of the reasons why I try to make sure to highlight the keto lifestyle with all of the positives: the benefits of the food and nutrients you consume, the improvements you’ll feel in mood and energy, and the way that it has a positive effect on your overall health.

That’s not to ignore the reality — that keto does have restrictions, specifically when it comes to carbs, grains, and sugars. That’s because, as you probably know, that eating fat and protein (and restricting the other ingredients) is what helps your body be more efficient when it comes to fat burning and other processes that improve your health. 

For some of you, eating well can be a challenge when you bring in another layer of complexity. Specifically, what if you have other dietary restrictions related to your health? 

Does that mean you can’t embrace the keto lifestyle? Not at all.

When it comes to food allergies and intolerances, you can make keto work. Here’s how.

If You Have… Gluten Intolerance

What It Is: For people who have sensitivities to gluten (a protein found in grains like wheat, barley, and rye), the body senses gluten as a foreign invader (a toxin of sorts), which triggers an immune response that ultimately can cause damage to the lining of the intestines. That can manifest itself in a number of ways, such as celiac disease, gastrointestinal troubles, and problems absorbing nutrients. Some people also choose to avoid gluten for benefits like weight loss and increased energy.

Restricted Foods:

  • Most grains 
    • Wheat
    • Barley
    • Rye
    • Triticale (a cross between wheat and rye)
    • Oats (in some cases)
  • Processed foods that tend to contain gluten
    • Beer, ale, porter, stout (usually barley)
    • Breads
    • Bulgur
    • Cakes and pies
    • Candies
    • Cereals
    • Communion wafers
    • Cookies and crackers
    • Croutons
    • French fries
    • Gravies
    • Imitation meat or seafood
    • Malt, malt flavoring, and other malt products (barley)
    • Matzo
    • Pastas
    • Hot dogs and processed luncheon meats
    • Salad dressings
    • Sauces, including soy sauce
    • Seasoned rice mixes
    • Seasoned snack foods, such as potato and tortilla chips
    • Self-basting poultry
    • Soups, bouillon or soup mixes
    • Vegetables in sauce

Gluten Intolerance and Keto:

The ketogenic diet restricts all grains, so this is typically a pretty seamless transition to include keto in a gluten-free diet because they go hand-in-hand with a low-carb and high-fat approach. Now, that doesn’t mean you have to give up all the flavors you may be used to. Here’s my favorite gluten-free pizza recipe.

If You Have… Lactose Intolerance

What It Is: Those who have lactose intolerance experience GI issues such as gas, bloating, diarrhea, nausea, and cramps. That’s because they can’t fully digest the sugar in milk (called lactose). This happens when people have a deficiency in the enzyme lactase, which breaks down lactose. That means that the lactose will move to the colon, rather than in the bloodstream, leaving it undigested. There, the bacteria in your gut interact with it — and that’s what causes those GI symptoms.

Restricted Foods:

  • Buttermilk
  • Cheese spreads and cheese foods
  • Cottage and ricotta cheese
  • Cream
  • Evaporated & condensed milk
  • Hot chocolate mixes
  • Ice cream
  • Kefir cultured milk drink
  • Malted milk
  • Milk (Skim, 1%, 2%, whole)
  • Processed and natural cheeses
  • Reduced lactose milk
  • Sherbet
  • Sour cream
  • Sweet acidophilus or lactobacillus milk
  • Whey
  • Yogurt with or without live cultures

Lactose Intolerance and Keto:

You don’t need dairy to make keto work. While many keto recipes include cheese, most of mine do not, so you can have plenty of options. In addition, there are many substitutions you can make to stay keto and stay away from lactose at the same time. Some options:

  • For milk, you can sub in coconut, almond, or cashew milk (just make sure you’re choosing unsweetened). 
  • For butter, you can use ghee butter. Regular butter is 80 percent fat with only .1 grams of lactose per 3.5 grams of butter, so butter might be okay for some people who are lactose intolerant. 
  • For yogurt, try probiotic, plain, whole-fat yogurts, which contain bacteria that help break down lactase.
  • For cheese, you may find some that are based in coconut or almond milk, though they may be higher in carbs. So you will have to check the labels if you try one of these.
  • For something sweet, try my lactose-free brownie recipe. Just make sure that the dark chocolate you use is dairy free. 

If You Have… Nut Allergies

What It Is: If you’re allergic to nuts, it’s your immune system overreacting to the proteins in nuts (your body thinks it’s an invader). A peanut allergy is the second most common food allergy (technically, peanuts are legumes). Tree nuts are walnuts, almonds, hazelnuts, cashews, pistachios, and Brazil nuts (tree nuts are the fourth most common food allergy). If you have a peanut allergy, you’re more likely to have a tree nut allergy.

Restricted Foods:

  • Almond
  • Artificial nuts
  • Beechnut
  • Black walnut hull extract (flavoring)
  • Brazil nut
  • Butternut
  • Cashew
  • Chestnut
  • Chinquapin nut
  • Coconut
  • Filbert/hazelnut
  • Gianduja (a chocolate-nut mixture)
  • Ginkgo nut
  • Hickory nut
  • Litchi/lichee/lychee nut
  • Macadamia nut
  • Marzipan/almond paste
  • Nangai nut
  • Natural nut extract (e.g., almond, walnut—although artificial extracts are generally safe)
  • Nut butters (e.g., cashew butter)
  • Nut distillates/alcoholic extracts
  • Nut meal
  • Nut meat
  • Nut milk (e.g., almond milk, cashew milk)
  • Nut oils (e.g., walnut oil, almond oil)
  • Nut paste (e.g., almond paste)
  • Nut pieces
  • Pecan
  • Pesto
  • Pili nut
  • Pine nut (also referred to as Indian, pignoli, pigñolia, pignon, piñon, and pinyon nut)
  • Pistachio
  • Praline
  • Shea nut
  • Walnut
  • Walnut hull extract (flavoring)
  • Peanut or peanut products

Nut Allergies and Keto:

Nuts are non-essential to the keto diet — and several nuts, like cashews and pistachios — have too many carbs per serving to be work for those doing keto. And some nuts are coated in sugar and glazes, so you would not eat them either. While pecans, macadamias, and Brazil nuts are keto-friendly and are good sources of fat and energy, you don’t need nuts to lead a keto lifestyle. In any case, you need to read labels to make sure you avoid any nuts or nut-based ingredients that can cause an allergic reaction.


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