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Short Summary
Main recommendation: On a keto or low-carb diet, limit all vegetables by total carbohydrate content, avoiding high-starch options like potatoes, sweet potatoes, corn, and grits, and keeping non-starchy vegetables to a daily limit rather than treating them as unlimited. Dr. Eric Westman explains that even low-carb vegetables contain carbs that raise blood glucose and insulin, so portion control still matters.
Key Points
- Dr. Westman says starchy vegetables such as potatoes, sweet potatoes, corn, and grits raise blood glucose and insulin, which he links to weight gain, obesity, and diabetes.
- The "grows underground" rule of thumb is imperfect, because corn grows above ground yet is very starchy, so Westman judges vegetables by total carbs instead.
- Non-starchy vegetables commonly used in keto recipes include cauliflower, broccoli, asparagus, Brussels sprouts, cucumber, and zucchini.
- Westman uses a rule of thumb of under about five total carbs per cup of vegetable to qualify for his allowed food list.
- Dr. Westman says meat has zero carbs and can be eaten freely as long as it has no added sugar or thickeners, which he contrasts with vegetables.
- Westman says vegetables do not need to be eaten at every meal and that some people do well with one meal a day, while acknowledging the carnivore movement challenges the need for any plant foods.
Details Worth Noting
- Concrete instructions: Shop the outside perimeter of the grocery store and avoid the inner aisles where starchy foods are typically found.
- Concrete instructions: Choose non-starchy vegetables (asparagus, broccoli, Brussels sprouts, cauliflower, cucumber, zucchini) and limit the total amount eaten per day, with individual tolerance varying.
- Concrete instructions: Use low-carb substitutes such as cauliflower rice, cauliflower mash, cauliflower crust pizza, and zucchini noodles (zoodles), either bought pre-made or made with a handheld or tabletop spiralizer.
- Concrete instructions: Try cheese-and-egg "chaffles" (a cheese and egg waffle), for which recipe books now exist.
- Concrete instructions: Cooking method (steaming, grilling, pan-frying) is considered a minor factor; focus on total carb amount instead.
- Westman mentions he saw an advertisement suggesting cauliflower-based hash browns might be coming from a major U.S. food company.
- Westman's "sound modulator" concept: for people with type 2 diabetes or hypertension, the diet dial should be turned all the way up while other lifestyle factors matter less in the short term, though they are not unimportant.
- Westman mentions he is working on a special issue of Current Opinion in Endocrinology and Diabetes that will include an essay by Amber O'Hearn on the carnivore diet, and he says the carnivore diet's nutritional adequacy remains an open question needing more research.
Bottom Line
Keto-friendly vegetable choice is less about avoiding vegetables entirely and more about selecting low-starch options and tracking total carbs, since even "safe" vegetables add up on a strict low-carb plan.
