I first opened Dr. Will Cole’s book Ketotarian while on the train, wilted from a busy day of meetings in Manhattan. It was close to two o’clock; I was tired and thirsty. While flipping through its glossy pages – dedicated to articulating Cole’s philosophy for health and wellness – it dawned on me that the only thing I had consumed that day a vegan poppy seed loaf. Oh, and a big cup of coffee and some water.

Not exactly the type of fuel that Dr. Cole, a leading functional medicine expert, IFMCP, and D.C. would recommend.

Yes, the loaf was vegan. But as a former vegan himself, Dr. Cole makes the convincing argument that many vegetarian and vegan diets tend to be high in inflammation-increasing carbohydrates and sugars, low in healthy fats and deficient in recommended protein. This isn’t to diminish the value of plant-based eating; rather, through his extensive and well-informed research, Dr. Cole came to understand that many traditional plant-led diets contained notable shortcomings. His solution? Pair plant-based eating with several guiding principles gleaned from the ketogenic diet, a low-carb and high-fat diet that forces the body to burn fats for energy instead of carbohydrates.

The elegant marriage of the two diets is the bedrock of Dr. Cole’s philosophy; he advocates for eating ample healthy fats – including both fish and meat – alongside ample proportions of vegetables and modest servings of approved fruits. His Ketotarian “lifestyle” – a careful semantic choice, as opposed to “diet” – is purported to enhance energy, improve mental clarity and promote sustainable weight loss.

Ahead, I interview Dr. Cole on his recommendations, including how the concept of “food freedom” ties into his overarching wellness philosophy. Read on.

Can you explain how the Ketotarian lifestyle reconciles the shortcomings of both the traditional ketogenic and vegetarian/vegan diets?

Traditional ketogenic diets rely heavily on fatty meat and dairy, which doesn't take into consideration the many people who would rather be more plant-based or have sensitivities to these foods that can further perpetuate inflammation in the body and ongoing health problems. On the other side, conventional plant-based diets can also be high in inflammatory foods such as grains.

I designed Ketotarian to be the marriage of the best of both ketogenic and plant-based diets. By removing the problematic foods in both ways of eating, we are able to take the benefits of ketosis through the high-fat, moderate protein, and low-carb way of eating in a ketogenic diet and combine it with the nutrient-dense benefits of whole-food plant foods, to achieve the best of both worlds.

While I think cultural attitudes have shifted significantly in the last couple of years, fat still frightens people because of its caloric content. Can you explain the benefits of healthy fat, and why it is such a foundational element of the Ketotarian lifestyle?

Just looking at it from a biological and evolutionary perspective, we started our lives relying on fat in the form of breast milk for energy and development. Fat is also a more sustainable and long-lasting fuel source for our bodies. Sugar, on the other hand, acts more like kindling to a fire for our bodies. While it does give us a quick boost of energy, but it wears off just as quickly —leaving us in a constant state of “hanger,” with a slew of metabolic and other health problems. Fat on the other hand is like a log to a fire: slow burning and long lasting.

The goal of a ketogenic diet is to reach a state of ketosis where fat is your body's primary source of fuel instead of sugar. Since the benefits of ketosis are widespread, Ketotarian just takes that principle and gives it a plant-based twist, so we are getting our healthy fats from whole-food, plant sources rather than meat and dairy, like in a traditional keto diet.

Inflammation appears to be a pervasive and problematic issue for the general population. How is the Ketotarian lifestyle designed to address inflammation?

Inflammation is not inherently bad. In fact, it is an essential part of our immune system. For example, when you get a cut or are exposed to a virus, inflammation is there to help you heal. However, inflammation becomes a problem when it is perpetuated. Chronic inflammation can be triggered by many things such as poor diet and gut permeability and has been linked to everything from autoimmune conditions anxiety, depression, diabetes, fatigue, cancer, and even heart disease.

Sadly, many people today are somewhere on what I call the autoimmune-inflammation spectrum. Studies have shown that being in a state of ketosis can help down-regulate inflammatory pathways in the body and enhance pro-antioxidant pathways. And by focusing on clean, whole-foods you are also eliminating foods that most often perpetuate inflammation.

No legumes! Surprised by that. Why?

Legumes aren't entirely bad. For a lot of people, they can have legumes in moderation and be ok. It's just that most conventional plant-based diets rely heavily on legumes as a protein source which can be problematic for some people in large amounts due to their lectin and phytate content.

Phytates are considered antinutrients that bind to minerals in your body and make them unusable; not something you want when you are eating other nutrient-dense foods in an attempt to bring healing to the body. Lectins are also harder for your body to digest, which can contribute to digestive distress and inflammation.

Again, while some people can handle these in moderation, on Ketotarian we want to rely more so on other plant-based protein sources to avoid these potential pitfalls. There are legume exceptions in the book: pod-like legumes like peas and green beans as well as organic non-GMO fermented soy like tempeh and natto.

I am interested in the connection of intermittent fasting and the Ketotarian lifestyle. Can you elaborate?

One of the goals with a Ketotarian lifestyle is to transition from a sugar-burner to a fat-burner. Intermittent fasting has been shown to not only boost ketosis fat-burning, it can also decrease inflammation and increase autophagy – your body's process of clearing out old and damaged cells.

I like how you attempt to differentiate “diet” vs. “lifestyle.” Can you explain why and how Ketotarian falls in the latter camp?

A diet is something many people feel bound to and with that can come a lot of shame and anxiety. Ultimately, there should be a grace and lightness to wellness. The whole idea of Ketotarian is that I want to encourage people to love their body enough to nourish it with good food medicines. Instead of a dieting consciousness, Ketotarian wants you to focus on feeling fantastic and understanding what makes your body thrive and what doesn't. It's about experiencing food freedom.