By Dr. Ryan Kneessi, ND — licensed naturopathic doctor in Maryland · Move Forward Natural Health, Odenton, MD (in-office and telehealth visits) · Last reviewed: October 9, 2026
Quick answer: On keto, spend your limited carbs on fiber-rich, nutrient-dense foods: leafy greens, non-starchy vegetables, small amounts of berries, nuts and seeds, fermented vegetables and coconut. Avoid added sugars, syrups, juices, sweets, refined grains and higher-sugar fruits like bananas and grapes.
Carbs to include
- Leafy greens: spinach, kale, lettuce, arugula, chard
- Low-carb vegetables: broccoli, cauliflower, zucchini, peppers, asparagus
- Berries: raspberries, blackberries and strawberries in small portions
- Nuts and seeds: almonds, walnuts, chia and flax
- Fermented vegetables: sauerkraut and kimchi
- Coconut: unsweetened coconut and coconut and almond flours for baking
- Avocado
Carbs to avoid
- Sugar in all forms, high fructose corn syrup, honey, maple syrup and agave
- Soft drinks and fruit juice
- Candy, pastries and refined-flour baked goods
- Sugary breakfast cereals
- Jams and jellies with added sugar
- Higher-sugar fruits such as bananas, grapes and pineapple
- Grains, potatoes and most legumes
Simple vs. complex carbs
Simple sugars spike blood sugar quickly. Complex, fiber-rich carbs from vegetables are digested slowly. See understanding macronutrients and net carbs.
Healthy aging lens
Fiber feeds beneficial gut bacteria, which make short-chain fatty acids that support the gut lining and metabolic health.
When to see a naturopathic doctor
- You have diabetes or take insulin, sulfonylureas or SGLT2 inhibitors (risk of low blood sugar or ketoacidosis)
- You take blood pressure medication or diuretics
- You have kidney, liver, gallbladder or pancreas disease, or high cholesterol
- You are pregnant, breastfeeding, or have a history of disordered eating
- You want a keto plan tailored to your labs and goals
See a medical provider promptly for nausea and vomiting, abdominal pain, confusion, fruity-smelling breath with rapid breathing, or very high blood sugar or ketone readings, which can signal ketoacidosis.
Want a keto plan that’s safe for your health?
A free 15-minute consultation with Dr. Kneessi. No cost, no obligation. In-office in Odenton, MD or by telehealth.
Frequently asked questions
What carbs can I eat on keto?
Leafy greens, non-starchy vegetables, berries, nuts and seeds.
Can I eat fruit on keto?
Small portions of berries fit best.
Are fermented vegetables keto?
Yes, unsweetened sauerkraut and kimchi are low in carbs.
Which carbs should I avoid?
Added sugars, juices, grains, starchy vegetables and higher-sugar fruits.
Sources
This article is for educational purposes only and is not medical advice. It does not replace an individual evaluation. Talk with your healthcare provider before starting supplements or changing medications, especially if you are pregnant, nursing, or managing a health condition.
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