Keto-Friendly Substitutes for Bread, Pasta, Sugar and More

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

Bread and bakery

Try almond or coconut flour bread, lettuce wraps, or cauliflower-based wraps and buns.

Pasta and rice

Swap in zucchini noodles, shirataki noodles or cauliflower rice.

Sweets and desserts

Enjoy dark chocolate with a high cocoa content, fat bombs made with coconut oil and nut butter, berries with whipped cream, or chia seed pudding. Keto cheesecake, cookies or mousse made with almond flour and a keto sweetener are options too.

Condiments and sauces

Choose full-fat mayonnaise without added sugar, plain mustard, and homemade olive oil dressings. Use coconut aminos instead of soy sauce, and enjoy pesto and chimichurri or sugar-free BBQ sauce.

Breakfast cereal

Try homemade granola from nuts, seeds and coconut, chia pudding, or “noatmeal” from flax, chia and hemp seeds.

Milk and dairy

Choose unsweetened almond, coconut, cashew, macadamia, hemp or flax milk, heavy cream, and full-fat Greek yogurt, cheese and sour cream.

Flour

Good flours include almond flour, coconut flour, ground flaxseed and psyllium husk, as well as sunflower, hazelnut, walnut or pecan flour.

Sweeteners

Sweetener options include stevia, monk fruit, erythritol and allulose. Xylitol is another, though it is toxic to dogs and can cause digestive upset, and sugar alcohols can cause bloating and diarrhea in some people.

Chips, potatoes and fries

Try cheese crisps, flax or almond crackers, nori, or zucchini or radish chips. Cauliflower, turnip or rutabaga mash and zucchini, eggplant or jicama fries can replace potatoes, and pork rinds or roasted seaweed can stand in for popcorn.

Pizza

Try a cauliflower, almond flour, coconut flour or “fathead” crust, or use portobello caps, zucchini boats or eggplant rounds.

Drinks

Drink water and sparkling water, unsweetened tea and black coffee, bone broth, and sugar-free electrolyte drinks.

Healthy aging lens

Swaps help, but whole foods should still be the base of your plate. See keto carb foods and keto snacks.

When to see a naturopathic doctor

It may be time to see a naturopathic doctor if you have diabetes or take insulin, sulfonylureas or SGLT2 inhibitors (risk of low blood sugar or ketoacidosis), or if you take blood pressure medication or diuretics. The same is true if you have kidney, liver, gallbladder or pancreas disease, or high cholesterol, if you are pregnant, breastfeeding, or have a history of disordered eating, or if 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.

Practitioner-grade options in my Fullscript catalog: if you and your clinician decide a supplement makes sense, my supplement guide by health goal links to the practitioner-grade products I trust.

Frequently asked questions

Sources

• Ashwell M. Stevia, Nature’s Zero-Calorie Sustainable Sweetener: A New Player in the Fight Against Obesity. Nutr Today 2015. PMID: 27471327. https://pmc.ncbi.nlm.nih.gov/articles/PMC4890837/
• Piscitelli CM, Dunayer EK, Aumann M. Xylitol toxicity in dogs. Compend Contin Educ Vet 2010. PMID: 20473849. https://pubmed.ncbi.nlm.nih.gov/20473849/
• Lenhart A, Chey WD. A Systematic Review of the Effects of Polyols on Gastrointestinal Health and Irritable Bowel Syndrome. Adv Nutr 2017. PMID: 28710145. https://pmc.ncbi.nlm.nih.gov/articles/PMC5508768/
• MedlinePlus: Carbohydrates
• MedlinePlus: Food Labeling

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.