How to Do Keto with Dietary Restrictions

Eliminating foods from dietAlmost everyone has at least one dietary restriction. Maybe your religion or cultural traditions prohibit specific foods or food pairings. Maybe your physiological response to certain foods—an allergy or intolerance—prevent you from eating them. Or perhaps your immediate goals preclude a food’s inclusion in your diet.

Like every other diet, keto is already circumscribed by basic principles, which can make further limitations difficult to accommodate. But the benefits of going keto, at least for part of the time, are well-established and worth the effort. You want to do it. How can you go keto while honoring your own dietary bounds?

It depends on the restriction.


This is a tough one. Dairy is one of the most reliably healthy sources of fat available, repeatedly showing strong and consistent links to good cardiovascular and overall health. Many keto adherents rely heavily upon it. We cook our eggs and veggies in butter. We treat ourselves with Greek yogurt. We take our stevia with coffee and cream. Dairy is just a great way to get calcium, healthy fat, and probiotics. What to do without it?

Make sure you know what part of dairy you can’t handle.

If you can’t handle lactose, you can probably do hard cheeses (like pecorino romano), well-fermented yogurt or kefir (the lacto bacteria consume the majority of the lactose), butter, cream, ghee, and pretty much everything but fluid milk or softer, runnier cheeses. Those dairy foods are pretty much fat and/or protein with very little lactose. The most severely sensitive may have to cut out everything but ghee.

If you can’t handle dairy proteins, cheese and yogurt/kefir are out. Depending on the severity, cream and butter may be out too. Again, ghee is still pretty safe in this situation. Casein intolerance is far more prevalent than whey intolerance, so even if you can’t eat yogurt, cottage cheese, cheese, and other high-casein foods, you may be able to do ricotta or whey protein.

How to Replace Cream?

Nut milks are a decent replacement, but they often come loaded with additives, sweeteners, and are almost always low-fat. A good way around this is to find a nut milk without sweeteners or additives and whisk in some powdered coconut oil or MCT oil powder. In times where I’ve run out of cream for my coffee, a couple scoops of MCT powder whisked into whatever nut milk I have lying around is a great approximation. Sometimes I even prefer that. Straight up coconut milk or cream also work well.

How to Replace the Calcium In Dairy?

Canned sardines. Leafy greens, shmeafy greens. The best way to get calcium without dairy is through dietary bone, and canned bone-in sardines are a great way to do it. (Still eat leafy greens, just don’t rely on them for calcium.)

How To Replace the Probiotics?

Eat fermented veggies like sauerkraut, kimchi, real pickles. Take a quality probiotic like Primal Probiotics. And as I mentioned before, you may actually be able to tolerate fermented dairy.

How To Replace the Fats?

Dairy fats are beneficial and convenient, especially if grass-fed, but they aren’t essential. You can get plenty of saturated fat from meat, red palm oil, and coconut oil. You can get conjugated linoleic acid from grass-fed ruminant meat, like lamb or beef. Butyric acid, found in butter, is also produced (in vaster amounts) in our colons when gut bacteria metabolize prebiotic fiber.

Nuts are a handy snack to have around. They’re nutrient-dense, even the ones high in linoleic acid aren’t as bad as eating soybean oil, since nuts come with phytonutrients and micronutrients that protect the fragile fats from oxidation. They’re often rich in sometimes-hard-to-obtain minerals, like selenium in Brazil nuts, manganese in hazelnuts, or magnesium in almonds. And a little known fact is that almonds and pistachios are incredibly rich sources of prebiotic fiber that’s great at increasing butyrate production and improving gut health; that can be hard to find while remaining low-carb.

If you’re allergic to Brazil nuts and walnuts but almonds and cashews are fine, this section doesn’t really apply; just eat the nuts you can safely eat and avoid the ones you can’t.

How To Replace the Rest…

How to replace the selenium? Eat wild salmon and other wild-caught seafood, pastured eggs, canned sardines. If you’re really adventurous, start eating beef kidney.

How to replace the manganese? Eat shellfish, especially mussels. Another option is pumpkin seeds.

How to replace the magnesium? Eat spinach.

How to replace the prebiotic fiber? Get yourself some resistant starch, which also stimulates butyrate production. Good keto sources include green bananas (the resistant starch has yet to convert to digestible glucose, so don’t worry about the carbs) and raw potato starch. Many other low-carb plants offer prebiotic fiber as well, like garlic, leeks, and Jerusalem artichokes.

How to replace the easy snack? Jerky, hardboiled eggs, cold chicken legs, smoked salmon, and coconut butter are all good options.

Stop snacking. Snacking should be an elective activity. That’s the goal of going keto—the ability to thrive on our own body fat in between meals. We shouldn’t be so ravenous throughout the day that we keep a satchel full of snacks on our persons.


Eggs are great for most people. They contain all the nutrients you need to build an organism, like cholesterol. They’re quick and easy to cook. They go with almost everything. They’re rich in important micronutrients that keto dieters really need to process fat, like choline. The nutrients they do contain, like vitamin D, tend to be more bioavailable than other sources. And they have a great ratio of protein to fat.

But they’re also a common allergen. Many people with the allergy have expressed difficulties making keto work.

First, make sure you’re allergic to or intolerant of the entire egg. Many people are only sensitive to the egg white. If that applies to you, it may be possible to safely enjoy egg yolks (which is where most of the nutrition is anyway). To be even safer, you can puncture the yolk sac, squeeze out the innards, and discard the sac.

How To Replace the Easy Breakfasts?

Eat some combination of bacon, smoked salmon, olives, cheese, Greek yogurt. Try a Turkish breakfast, with olives, cheese, cucumbers, and tomatoes. Eat non-traditional breakfast items, like burger patties with avocado, steak and greens, lamb chops with mushrooms sautéed in the lamb fat.

How To Replace the Choline?

Get acquainted with liver. Liver paté is a delicious, high-fat way to eat the stuff.

How To Replace the Cholesterol?

You don’t necessarily have to replace it. Your liver is probably quite adept at manufacturing it. However, folks engaged in strength training can probably use the extra cholesterol to produce sex hormones like testosterone. Shrimp, liver, and shellfish are solid sources of cholesterol.

How To Replace the Bioavailable Vitamin D?

Take supplements and (of course) sunlight. Eat cod liver oil, sardines, salmon roe, or wild salmon.


Coconut isn’t that common an allergy in the general population, but coconut’s prominence in paleo/Primal/keto circles tends to expose those that are allergic or sensitive rather quickly.

But you don’t actually need to eat coconuts or coconut fat on a ketogenic diet. You don’t need to replace coconuts with anything special. They aren’t particularly high in any specific nutrients you can’t get elsewhere. Sure, the medium chain triglycerides are ketogenic fats, meaning they promote the production of ketone bodies, and that can be helpful. You know what else is ketogenic? Going keto, getting fat-adapted, consuming your own body fat.

There is one major downside: Thai curries will be difficult to make without coconuts. That’s why you turn to Indian cream or yogurt-based curries instead.


You’re not really worrying about this, are you?

That’s it for today, folks. I hope those of you with food restrictions feel empowered and enabled to do keto—because you should. It’s completely doable.

And for the vegetarians out there, I’ve got a post dedicated to you and keto in the works, so stay tuned.

I’m looking for your thoughts today. What health conditions and healing protocols are you looking for more information on? A particular autoimmune disorder? A particular food allergy? The road back from damage of a specific disease or condition? Whether you’re asking for yourself or a friend, I’d love to hear your interests. Thanks for stopping by today, everyone.

Also, if you have any other questions on the restrictions I talked about today (or others), feel free to leave a comment below!

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending more than three decades educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates flavorful and delicious kitchen staples crafted with premium ingredients like avocado oil. With over 70 condiments, sauces, oils, and dressings in their lineup, Primal Kitchen makes it easy to prep mouthwatering meals that fit into your lifestyle.

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