Constipation on the Keto Diet: Why It Happens and What To Do!

Ah, nothing like talking about bowel habits to start your day!  But for many newcomers to the keto diet, constipation can be a real struggle – so it’s something important to talk about.

While this site focuses a lot on keto cooking, it’s also helpful to touch on some aspects of the keto diet and low carb lifestyle, because we know those topics are important to you too.

Today, I’ve brought in Christine Carroll, MPH, RD (also known as my wife) to talk about constipation on the keto diet.  Learn why it happens and what you can do about it!

There are several different contributing factors to constipation on the keto diet.  Depending on which of these is affecting you, there are simple strategies for each that you can try putting into place:

Lack of fiber

Fiber is involved in keeping the digestive system healthy and bulking up stool.  The problem?  Almost everyone in the United States falls short on meeting their fiber needs.  In fact, 95% of Americans don’t meet the recommended fiber intakes, which range from 21 grams to 38 grams per day for adults based on age (source).

This lack of fiber intake is happening for people eating a standard diet, despite that they have access to abundant fruits, vegetables, whole grains, and beans – all great sources of fiber.  But as you can imagine, it becomes much more challenging on a keto diet when many of these sources are restricted.

That said, it is still completely possible to meet your fiber needs on a keto diet, and doing so will help reduce the risk of constipation.

One of the biggest mistakes people may make when transitioning to a keto diet is focusing only on the high-fat foods like cheese, oils, fatty meats, etc.  Non-starchy vegetables are an essential part of a healthy diet, keto or otherwise.  These veggies pack in a lot of fiber without excessive digestible carbohydrates.

If you find yourself constipated, try increasing fiber intake by working some of these low carb, high fiber choices into your meal plan:

  • Cacao nibs – 3 tbsp = 8 g fiber (3 g net carbs)
  • Collard greens – 1 cup cooked = 7.5 g fiber (3 g net carbs)
  • Avocado – half of one = 6.75 g fiber (2 g net carbs)
  • Artichoke hearts – 1/2 cup = 4.8 g fiber (4.8 g net carbs)
  • Chia seeds – 1 tbsp = 4 g fiber (1 g net carbs)
  • Ground Flax – 2.5 tbsp = 4 g fiber (1 g net carbs)
  • Raspberries – 1/2 cup = 4 g fiber (3.4 g net carbs)
  • Blackberries – 1/2 cup = 3.8 g fiber (3 g net carbs)
  • Asparagus – 1 cup cooked = 3.5 g fiber (4 g net carbs)
  • Mustard greens – 1 cup cooked = 3 g fiber (3.5 g net carbs)
  • Almonds – 1 ounce (23 almonds) = 3 g fiber (2.75 g net carbs)
  • Cauliflower – 1 cup cooked = 3 g fiber (2 g net carbs)
  • Unsweetened Shredded Coconut – 3 tbsp = 3 g fiber (1 g net carbs)
  • Pecans – 1 ounce (19 halves) = 2.7 g fiber (1 g net carbs)
  • Kale – 2 cups raw = 2 g fiber (2 g net carbs)
  • Roasted pumpkin seeds – 1/4 cup = 2 g fiber (2.4 g net carbs)
  • Mixed greens (salad) – 2 cups raw = 1.5 g fiber (0.8 g net carbs)

Quick tip: Increase fiber intake gradually and also increase your fluid intake at the same time.  This will help your body adjust, rather than going from a few grams to 30 grams a day immediately.

a man in jeans holding a roll of toilet paper in a bathroom

Dehydration

Falling short on your daily hydration needs is another factor that can increase the risk of constipation (source).  This is easy to fix though – simply work to meet your needs each day!

While there’s no one hard and fast amount of fluid that’s “right” for everyone, the Institute of Medicine sets an Adequate Intake level that should be suitable for most people.  For men, total fluid intake should be around 3.7 liters per day, and for women, 2.7 liters per day (source). 

However, about 20% of fluid comes from foods we eat.  As such, it’s estimated men need around 3 liters per day of fluid they drink, and women need around 2.2 liters per day of fluid they drink.

If you’re dealing with constipation, try tracking your fluid intake over a few days and see if you’re meeting your needs.  If not, you can try to drink more water to do so.  Seltzer water, water infused with cucumber or herbs, and unsweetened tea are also good options on a keto diet to help you meet hydration needs.

Quick Diet Changes

When you switch from the standard American diet to a keto diet, your body is forced to quickly adapt to this new way of eating.  If you were used to eating many high carb foods, and now you’re only eating many high-fat and protein-rich foods, your digestive system might need a little time to catch up.

Similarly, focusing on too many processed keto foods can affect your digestive system.

You can alleviate some of these issues by switching to a keto diet more gradually (though obviously many people prefer not to do that).  For some people, following a low carb lifestyle rather than strict keto may be the answer.

It is of course possible for people to follow a keto diet and restore good digestive health, though.  Follow the tips above about fiber and hydration, and focus on mostly whole foods on your keto diet.  Avoid too many processed keto foods.

Other Tips

  • Anecdotally, some people find warm drinks like coffee or tea help move things along.  While there’s no peer-reviewed research to support this, I know many people that would attest to this being true!  If anything, it helps meet your hydration needs for the day (yes, coffee and tea can count towards your fluid needs in limited amounts – but you can also choose decaf if you’d prefer not to have the effects of caffeine).
  • Ask your doctor about a magnesium supplement.  Certain types of magnesium supplements, like magnesium oxide, act as a natural aid to relieve occasional constipation.
  • Give yourself time to use the bathroom.  If you’ve been dealing with constipation and you’re trying to quickly use the bathroom before running out the door to work – the stress of that situation can make using the bathroom worse.  Instead, try to allow yourself a few minutes after breakfast and after dinner each day to peacefully poop. 😉  You don’t want to sit on the toilet forever, but giving yourself a few minutes of non-stressful time in there (especially after eating, which can help push things along) may help get things going again.
  • Be sure to exercise.  Physical activity can help keep things moving in the digestive system.  Going for a walk after meals is an easy way to try to support regular bowel habits.
  • When in doubt, talk to your doctor.  They may have recommendations for over the counter medications or supplements, or (depending on the severity of your digestive issues) may recommend a different diet for your body.

Hopefully these tips are helpful as you continue on your keto diet!  Following them should help support your digestive health, keeping you comfortable as you continue to enjoy your low-carb lifestyle.



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