Sticking to a very-low-carb, moderate-protein, and high-fat diet like keto when you’re out at a restaurant can pose some unique challenges beyond resisting your favorite plate of fries. First, the portions are skewed — and not in your favor. “Protein portions tend to be too large, and vegetable portions too small, leading to an unbalanced meal,” says Alicia Romano, RD, clinical registered dietitian at the Frances Stern Nutrition Center at Tufts Medical Center in Boston.
Then there are the hidden ingredients that find their way in. “Added sauces or gravies can sneak in sources of carbohydrates from added sugars or flours that you were not intending to eat,” she says.
The reasons you’re on the ketogenic diet — weight loss or perhaps a doctor-advised diet for a medical problem such as type 2 diabetes — also matters when choosing the best order for you. “The ketogenic diet can lead to successful weight loss; however, it’s typically not necessary for most people,” says Jillian Kubala, RD, of Jillian Kubala Nutrition in Westhampton, New York. Although she says she finds the keto diet extremely restrictive (and therefore doesn’t recommend it), “the reality is that most people who are (on) keto are simply following a low-carb, high-protein diet,” Kubala says.
But that’s not necessarily a bad thing. This is what’s referred to as a “modified Atkins diet,” a less restrictive form of keto that counts carbohydrates but doesn’t restrict proteins, according to the Epilepsy Foundation. (Scientists originally developed a medical ketogenic diet as a treatment for children with epilepsy.) “If you’re following a ketogenic diet that falls in line with the modified Atkins diet approach, there’s much more flexibility with food choices, thus making eating out more reasonable,” says Romano.
Understanding Macronutrient Ratios in Meals
There are several types of the keto diet and they all depend on strict macronutrient (carbs, fat, protein) calculations. Generally speaking, the medical keto diet used to treat epilepsy prescribes 4 grams (g) of fat for every 1 g of carbohydrate and protein, which means you’re getting 90 percent of your calories from fat, 6 percent from protein, and 4 percent from carbs, according to the Charlie Foundation for Ketogenic Therapies. A modified Atkins diet has no protein restriction, and ends up being comprised of about 65 percent fat, 29 to 32 percent protein, and 3 to 6 percent carbohydrates. When it comes to keto for weight loss, you might eat 70 to 80 percent of calories from fat, 10 to 20 percent from protein, and 5 to 10 percent from carbohydrates, according to the Harvard T.H. Chan School of Public Health.
Calculating Net Carbs and Ketones
Many people on keto use net carbs when measuring their carb intake. According to Atkins, you can calculate net carbs by taking total carbohydrates minus grams of fiber and sugar alcohols. The idea behind that, the company says, is that net carbs are what affect your blood sugar level and can compromise weight loss, so they, rather than total carbs, are worth counting. But you should know that neither the federal government nor the American Diabetes Association (ADA) recognizes this term, nor is calculating them an exact science, registered dietitians agree. The ADA says that net carbs are difficult to determine from the nutrition label (for instance, sugar alcohols are not required to be listed), making it an imprecise number.
Also know that if you’re on a classic keto diet, you may need to connect with a registered dietitian to come up with a personalized plan for hitting more specific macronutrient targets, says Romano. Some people on this version of keto might measure ketones, which are a substance your body produces when it burns fat instead of carbs for fuel, according to the University of California in San Francisco.
General Tips for Dining Out on a Keto Diet
That all may sound daunting, but the good news is that because keto is becoming more mainstream, restaurants understand when customers need to modify their meals. In fact, some chains have even come out with menu options specifically catered to keto dieters. But you still may need to do some legwork. “Like all healthy-eating patterns, a well-rounded ketogenic diet should mainly consist of whole, nutritious foods,” says Kubala. Consuming plenty of nonstarchy veggies should also be a staple rule, Kubala adds, and eating some fruits here and there is also a smart move despite this diet’s very low-carb nature.
You may need to finesse some of the meals to fit your desired macronutrient ratios as well. Romano recommends starting with a base of a simply prepared protein (such as poultry, fish, or meat grilled and without sauce, for instance) combined with a nonstarchy vegetable (like zucchini, broccoli, or leafy greens such as kale or collard greens). Then add healthy fats (ask for extra-virgin olive oil and vinegar, sliced avocado, olives, slivered nuts or seeds, and cheese) to “optimize fat intake while maintaining low carbohydrate intake,” she says.
In general, smart picks include a bunless burger over a bed of greens with lemon and olive oil or avocado; steak tips; grilled fish; or a bunless sandwich all served with — you guessed it — salad or a side of broccoli or vegetable-based “rice,” like from cauliflower, Romano says. “You can find this order, or a version of it, at many restaurants,” she explains.
And remember: Healthy restaurant eating while on keto is possible. “A well-planned ketogenic diet has the potential to still be nutritious if you crowd the diet with healthful fats and protein choices, including when eating out,” says Romano.
30 Top Restaurants for People on Keto
Follow those rules when ordering out from or dining in at the following restaurants that offer keto-friendly dishes:
The simplest choices are the best here. Steak plus a green veggie is one perfect keto combo.
On their Guiltless Grill menu, choose the smaller, 6-ounce (oz) portion (versus the 10-oz serving) to keep protein in check. This is a great opportunity to add a source of digestion-friendly fiber with the broccoli (4 g of fiber). Avocado adds healthy fats.
Nutrition per Serving: 400 calories, 18g fat, 10g net carbs, 42g protein