"Keto 2.0" Has Arrived & It Makes The Diet Way More Accessible

“The keto diet has been around for a very long time, originally used in the treatment of epilepsy and even before that as a diet to keep Type 1 diabetics alive before insulin,” explains says Carrie Diulus, M.D., an Ohio-based orthopedic spine surgeon. “It has come much more into the forefront in recent years though with the mounting data on potential benefits, including weight management and improvement of blood sugar control1—with even Type 2 diabetes remission in some studies2."

The diet, in which the body flips its metabolic switch from using glucose to using fats and ketones for fuel, is high in fat, moderate in protein, and low in carbs. The studied positive outcomes are far-reaching—beyond the blood sugar benefits mentioned by Diulus, followers of the diet have experienced weight loss3, better brain health4, improved metabolic health4, and sustained energy."

The traditional keto diet, though, is heavy on animal fats and proteins, which concerned many cardiologists, and was difficult to follow when confronted with the realities and inconveniences of modern life. Still, the results of the suddenly ubiquitous keto diet were striking. 

The new version of keto comes from three places—the need to make the ketogenic diet flexible enough to do in a long term, sustainable way, doctors’ interests in refining the diet to make it as healthy as possible, and a bevy of new products and consumer packaged goods that make keto accessible to an ever-expanding group of people. "There is clearly not just one way to do keto," says Ethan Weiss, M.D., a San Francisco–based cardiologist. "Many people assume that to do it, you have to eat nothing but bacon, butter, steak, and other foods high in animal-based saturated fats, but my favorites are olive oil, nuts, avocado, and fatty fish such as salmon."

According to Weiss, replacing those foods high in animal-based saturated fats with foods coming from mostly plant and fish-based sources preserves the integrity of the keto diet (ie, you can still achieve ketosis), but leads to improvements in cardiovascular risk markers. In fact, keto 2.0 can make the diet even more accessible and effective. “It can be easier to get into and maintain ketosis when prioritizing foods rich in unsaturated fats,” says Weiss. “It affords all the benefits of conventional keto, but fixes the biggest concerns.” 

Weiss thinks that keto 2.0 will address the problems of the first version of the diet, to allow even more people to reap the many benefits. "As a cardiologist, I do have concerns about the tremendous increases in LDL cholesterol some people see when eating conventional ketogenic diets," Weiss explains. "Replacing foods high in animal-based saturated fats with foods coming from mostly plant- and fish-based sources mitigates against this and leads to improvements in cardiovascular risk markers we care about."  

Keto 2.0 also addresses one of the biggest criticisms about the traditional keto diet—the lack of fiber. “When the keto diet is based on real food and plant strong it can be very high in fiber because of low net carbs (total carbs minus fiber) and still ketogenic,” says Diulus. 

The plant-based version also has specific benefits for women. In her book The Hormone Fix, published earlier this year, Anna Cabeca, D.O., recommends a modified version of the keto diet that she calls "keto-green" as a way for women to take control over out-of-whack hormones. "Keto-green is a combined approach of getting our body into ketosis through intermittent fasting and low-carb, healthy fats and protein, and the amazing benefits of low-carb plants, greens that add an alkalizing effect on our body," she explains. "It's essential for women, especially as we get older. It improves brain health, weight loss or maintenance, menopause symptoms, and energy through mastery of hormone balance."

Mindsets around the diet have shifted as well, as consumers start seeing it as delicious rather than deprivation-based. "I have followed a plant-based ketogenic diet for several years and enjoy deliciously rich foods including olives, avocado, nuts, seeds, olive oil, tons of nonstarchy vegetables, tofu, lupini beans, and even some low-sugar berries," says Diulus, who made waves when she shared her plant-based approach to keto at mbg’s forward-thinking revitalize in 2017. "There are bread recipes and even chocolate cake with chocolate frosting that are fully plant-based keto. Some have criticized the ketogenic diet for being low in fiber, but in reality when it is based on real food and plant strong, it can be very high in fiber because of low net carbs (total carbs minus fiber) and still ketogenic."

New tools and products are also making those delicious options available to everyone. “I’m most excited about the tremendous increase in the availability of health low-carb and high fat foods,” says Weiss. “Even in the past year alone there has been a huge expansion and we expect that trend to continue.” He personally is the co-founder of Keyto, a product that helps painlessly measure ketosis and provides customized diet plans, where there plans for 2020 directly reflect this new iteration of keto. “We’re developing heart healthy versions of some of the foods that are showing up in the market with optimal balance of fats and often entirely from plant-based sources,” he says. “It will help enable a healthier and more sustainable version of keto for more and more people.

A number of companies have stepped in to make crave-worthy keto food readily available. Base Culture makes a keto sandwich bread with a rich, nutty taste, while Lily's chocolate utilizes stevia to make dark chocolate that's entirely sugar-free. Lilly's Hummus even cracked the traditional chickpea spread, making a keto version that utilizes cauliflower with tahini as its base. Keto coffee brand Know Brainer has even made marshmallows keto-friendly, so you can indulge in plenty of decadent sweet treats on the diet.