Plant-based diets are typically high in carbohydrates – but they don't have to be. Low-carb diets are typically high in animal-based foods – but they don't have to be! Healthy low-carb animal-free diets are viable... in fact, I've been eating this way for some time now.
In this brief blog, I'll touch on:
• The benefits of low-carb diets
• The problems of animal-based low-carb diets
• Tips on how to plan a healthy animal-free (or plant-predominant) low-carb diet.
The Advantages of Low-Carb Diets
In my view, low(er) carb diets are superior for diabetes management as they lower glucose variability and glucose excursions. In other words, less fluctuation as well as lower spikes in blood glucose levels. This is a considerable advantage, as it may lead to a reduction in diabetic medication. Indeed, clinical trials tend to show that carbohydrate restriction is associated with a lower requirement for glucose-lowering drugs1.
Remission of type II diabetes appears to be intimately related to sustained weight/fat loss20. Research indicates that high-carb and low-carb diets are on balance similarly effective when it comes to weight loss2,3,4. However, some individuals may find it easier to move towards their ideal weight by adhering to a low-carb approach. This may be partially explained by the fact that low-carb diets naturally lower one's consumption of ultra-processed junk foods (which are nearly always high in refined carbohydrates [as well as refined fats]). But other individuals just seem to feel more sated when eating mostly protein and fat.
Low-carb meals tend to be of higher energy density and consequently lower in volume per calorie. This may be considered an advantage for those with smaller appetites or lower stomach capacity.
Animal-Based Low-Carb Diets
Low-carb diets are typically high in animal sources of fat and protein; this is a health concern:
- Animal-based foods (especially those high in saturated fat) adversely influence surrogate markers of health (most importantly LDLC4 and ApoB5).
- Animal-based foods are associated with higher rates of morbidity and mortality6,7, 8,9, 10.
Consistent with the above:
- Lower-carb animal-based diets are associated with an increased risk of mortality11,12,13.
Thus, while animal-based low-carb diets have certain advantages (particularly in terms of diabetes management), I think there are good, evidence-based reasons to be concerned about their impact on long-term health.
To be fair, there are better and worse ways of planning an animal-based low-carb diet. Healthier forms of this diet will include less red meat and saturated fat; and more fish. However, I strongly suspect that well-planned plant-predominant low-carb diets are in all likelihood superior for health.
Plant-Based Low-Carb is Healthier
Animal-free or plant-predominant low-carb diets deliver the benefits mentioned early, ostensibly without the associated risks. Plant-heavy lower-carb diets correlate with a lower risk of all-cause mortality13, 22, 23.
This is in line with a lot of science which indicates that less red meat, more fibre14, more plants15 and lower saturated fat16 associates with a reduced risk of chronic diseases and premature death. Moreover, replacing animal-based fats and protein with plant-based equivalents improves surrogate markers of cardiovascular disease and is consistently associated with better health outcomes.
Tips on Planning an Animal-Free Low-Carb Diet
If you have a serious medical condition &/or take medication, you should consult your doctor before making any drastic changes to your diet.
1. Foods to avoid or restrict.
- Sugars/syrups (they should be restricted/avoided regardless of type of diet you are following!)
- Grains (including pseudo cereals) and grain-products
- Starchy legumes
- Starchy vegetables
- Many fresh fruits
- Dried fruits
Higher carb whole plant foods (such as starchy legumes and wholegrains) appear to be extremely healthy and are worth including in smaller amounts if feasible.
2. What to eat.
There are 4 main categories low-carb plant foods:
- Low-carb plant-based sources of protein (tofu, seitan, mycoprotein etc.).
- Non-starchy vegetables.
- Low-carb fruits
- Fats: nuts, seeds, avocados, oils.
It's important to eat (low-carb) whole plant foods abundantly, but the inclusion of some plant-based processed foods (viz. oils and refined sources of protein) will usually be required to keep net carbs low on an animal-free diet.
3. Pay attention to net carbs.
For some, just focusing on lower carb plant foods is enough to see a benefit. But others may need to be stricter and pay closer attention to net carbs‡.
The amount of net carbs can vary considerably between foods belonging to each of the four categories mentioned above. Here are some examples:
(‡Net carbs = total carbohydrate minus fibre.)
(Tofu is a firm favourite of mine and it's easy to make at home... recipe here.)
(Oils are carb-free and thus can be helpful to ensure that one consumes enough energy on a low-carb plan. Choose unsaturated vegetable oils: olive, rapeseed, sunflower etc.)
It's possible to consume below 50g of net-carbs per day on an animal-free diet. But individuals with high energy requirements (due to a high basal metabolic rate or a high energy output) are going to struggle to get below this figure without compromising diet quality (in other words, it may mean eating an excessive amounts of processed foods).
I do not endorse ketogenic (very low carbohydrate) diets, unless for medical reasons and under the supervision of a doctor. These diets are associated with side effects17,18,21, at times very serious ones (e.g., cardiac death19). Admittedly, these effects were seen mainly in people on a ketogenic diet to treat severe epilepsy. But until we have data on the long-term effects of ketogenic diets on other populations, I think caution is warranted.
4. Make sure you're hitting nutrient targets.
Nutrient tracking apps like cronometer.com can be very helpful in this respect. It can help you to check whether you are falling short on vitamins and minerals and identify low-carb plant-based food sources to correct this.
I have found that including the following foods regularly helps me to meet nutrient recommendations on an animal-free low-carb diet:
- Calcium-set tofu (protein, calcium)
- Kale (calcium, beta-carotene, vitamin K)
- Mushrooms (B5)
- Nutritional yeast (B vitamins, folate and zinc)
- Textured vegetable protein (potassium, magnesium and phosphorus).
- Hemp seeds (magnesium).
- Zucchini (potassium).
Please see Nutrients of Concern to learn about which nutrients can be hard to obtain on animal-free diets.
5. Prioritise protein.
Make plant protein the centerpiece of your meals and complement this with low-carb whole plant-based foods.
Tofu curry with cauliflower rice.
Yogurt bowl with berries and protein powder
Crackers with tofu cheese
The recipe for low-carb seed crackers can be found here.
Mycoprotein fillets with sauce and baked veggies
Pesto with edamame pasta
Tofu Bolognese (pair with "zoodles" or edamame spaghetti)
Animal-free "mayo" can make salads+protein more interesting
Chocolate mousse is my go-to dessert
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1. Snorgaard, O., Poulsen, G.M., Andersen, H.K. and Astrup, A., 2017. Systematic review and meta-analysis of dietary carbohydrate restriction in patients with type 2 diabetes. BMJ Open Diabetes Research and Care, 5(1), p.e000354.
2. Johnston, B.C., Kanters, S., Bandayrel, K., Wu, P., Naji, F., Siemieniuk, R.A., Ball, G.D., Busse, J.W., Thorlund, K., Guyatt, G. and Jansen, J.P., 2014. Comparison of weight loss among named diet programs in overweight and obese adults: a meta-analysis. Jama, 312(9), pp.923-933.
3. Ge, L., Sadeghirad, B., Ball, G.D., da Costa, B.R., Hitchcock, C.L., Svendrovski, A., Kiflen, R., Quadri, K., Kwon, H.Y., Karamouzian, M. and Adams-Webber, T., 2020. Comparison of dietary macronutrient patterns of 14 popular named dietary programmes for weight and cardiovascular risk factor reduction in adults: systematic review and network meta-analysis of randomised trials. bmj, 369.
4. Chawla, S., Tessarolo Silva, F., Amaral Medeiros, S., Mekary, R.A. and Radenkovic, D., 2020. The Effect of Low-Fat and Low-Carbohydrate Diets on Weight Loss and Lipid Levels: A Systematic Review and Meta-Analysis. Nutrients, 12(12), p.3774.
5. Guasch-Ferré, M., Satija, A., Blondin, S.A., Janiszewski, M., Emlen, E., O'Connor, L.E., Campbell, W.W., Hu, F.B., Willett, W.C. and Stampfer, M.J., 2019. Meta-analysis of randomized controlled trials of red meat consumption in comparison with various comparison diets on cardiovascular risk factors. Circulation, 139(15), pp.1828-1845.
6. Budhathoki, S., Sawada, N., Iwasaki, M., Yamaji, T., Goto, A., Kotemori, A., Ishihara, J., Takachi, R., Charvat, H., Mizoue, T. and Iso, H., 2019. Association of animal and plant protein intake with all-cause and cause-specific mortality in a Japanese cohort. JAMA internal medicine, 179(11), pp.1509-1518.
7. Kaluza, J., Wolk, A. and Larsson, S.C., 2012. Red meat consumption and risk of stroke: a meta-analysis of prospective studies. Stroke, 43(10), pp.2556-2560.
8. Yang, C., Pan, L., Sun, C., Xi, Y., Wang, L. and Li, D., 2016. Red meat consumption and the risk of stroke: a dose–response meta-analysis of prospective cohort studies. Journal of Stroke and Cerebrovascular Diseases, 25(5), pp.1177-1186.
9. Abete, I., Romaguera, D., Vieira, A.R., de Munain, A.L. and Norat, T., 2014. Association between total, processed, red and white meat consumption and all-cause, CVD and IHD mortality: a meta-analysis of cohort studies. British Journal of Nutrition, 112(5), pp.762-775.
10. Al-Shaar, L., Satija, A., Wang, D.D., Rimm, E.B., Smith-Warner, S.A., Stampfer, M.J., Hu, F.B. and Willett, W.C., 2020. Red meat intake and risk of coronary heart disease among US men: Prospective cohort study. bmj, 371.
11. Fung, T.T., van Dam, R.M., Hankinson, S.E., Stampfer, M., Willett, W.C. and Hu, F.B., 2010. Low-carbohydrate diets and all-cause and cause-specific mortality: two cohort studies. Annals of internal medicine, 153(5), pp.289-298.
12. Li, S., Flint, A., Pai, J.K., Forman, J.P., Hu, F.B., Willett, W.C., Rexrode, K.M., Mukamal, K.J. and Rimm, E.B., 2014. Low carbohydrate diet from plant or animal sources and mortality among myocardial infarction survivors. Journal of the American Heart Association, 3(5), p.e001169.
13. Seidelmann, S.B., Claggett, B., Cheng, S., Henglin, M., Shah, A., Steffen, L.M., Folsom, A.R., Rimm, E.B., Willett, W.C. and Solomon, S.D., 2018. Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis. The Lancet Public Health, 3(9), pp.e419-e428.
14. Kim, Y. and Je, Y., 2016. Dietary fibre intake and mortality from cardiovascular disease and all cancers: a meta-analysis of prospective cohort studies. Archives of cardiovascular diseases, 109(1), pp.39-54.
15. Kim, H., Caulfield, L.E., Garcia?Larsen, V., Steffen, L.M., Coresh, J. and Rebholz, C.M., 2019. Plant?Based diets are associated with a lower risk of incident cardiovascular disease, cardiovascular disease mortality, and All?Cause mortality in a general population of Middle?Aged adults. Journal of the American Heart Association, 8(16), p.e012865.
16. Kim, Y., Je, Y. and Giovannucci, E.L., 2021. Association between dietary fat intake and mortality from all-causes, cardiovascular disease, and cancer: A systematic review and meta-analysis of prospective cohort studies. Clinical Nutrition, 40(3), pp.1060-1070.
17. Sourbron, J., Klinkenberg, S., van Kuijk, S.M., Lagae, L., Lambrechts, D., Braakman, H.M. and Majoie, M., 2020. Ketogenic diet for the treatment of pediatric epilepsy: review and meta-analysis. Child's Nervous System, 36(6), pp.1099-1109.
18. Liu, H., Yang, Y.I., Wang, Y., Tang, H., Zhang, F., Zhang, Y. and Zhao, Y., 2018. Ketogenic diet for treatment of intractable epilepsy in adults: a meta?analysis of observational studies. Epilepsia Open, 3(1), pp.9-17.
19. Bank, I.M., Shemie, S.D., Rosenblatt, B., Bernard, C. and Mackie, A.S., 2008. Sudden cardiac death in association with the ketogenic diet. Pediatric neurology, 39(6), pp.429-431.
20. Lean, M.E., Leslie, W.S., Barnes, A.C., Brosnahan, N., Thom, G., McCombie, L., Peters, C., Zhyzhneuskaya, S., Al-Mrabeh, A., Hollingsworth, K.G. and Rodrigues, A.M., 2019. Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial. The lancet Diabetes & endocrinology, 7(5), pp.344-355.
21. Martin-McGill, K.J., Bresnahan, R., Levy, R.G. and Cooper, P.N., 2020. Ketogenic diets for drug?resistant epilepsy. Cochrane Database of Systematic Reviews, (6).
22. Wan, Z., Shan, Z., Geng, T., Lu, Q., Li, L., Yin, J., Liu, L., Pan, A. and Liu, G., 2022. Associations of Moderate Low-Carbohydrate Diets with Mortality among Patients with Type 2 Diabetes: A Prospective Cohort Study. The Journal of Clinical Endocrinology & Metabolism.
23. Zhao, Y., Li, Y., Wang, W., Song, Z., Zhuang, Z., Li, D., Qi, L. and Huang, T., 2023. Low-carbohydrate diets, low-fat diets, and mortality in middle-aged and older people: A prospective cohort study. Journal of Internal Medicine.