Keto vs. Mediterranean Diet

“Keto vs Mediterranean Diet: Which Diet is Best for You?” was written by Registered Dietitians Solana Nicole Faerman. Reviewed/edited by Su-Nui Escobar, DCN, RDN, FAND.

Keto vs Mediterranean diet: While the ketogenic diet promotes the consumption of cheese and meat; the Mediterranean diet pushes for fruits, vegetables, and whole grains.

 Can two completely different diets both be healthy and right for you?

In this blog post, we will dive deeper to learn the pros and cons of each and see which popular diet fits your lifestyle best. 

Keep in mind healthy eating should always be a priority and restrictive dieting may lead to long-term consequences.

What is the Mediterranean Diet?

Mediterranean Diet

The Mediterranean diet is a pattern of eating based on the traditional cuisine of the countries bordering the Mediterranean Sea (Spain, Southern France, Albania, Greece, Turkey, and Morocco). 

As a result, the diet is typically high in fruits, whole grains, vegetables, beans, nuts and seeds, and olive oil. Small quantities of lean meats and wine are accepted, while processed foods are highly discouraged.

On another note, the diet also focuses on enjoying meals around the table with friends and family.

Benefits of the Mediterranean diet include improvement in heart, cognitive, and gut health. We will go into further detail on these health benefits below. Studies also suggest that the Mediterranean diet may help with anxiety and depression.

Nutrition experts consider the Mediterranean eating style safe and easy to follow long term, making it one of the best diets. 

Rules for Mediterranean Diet

What Foods Can You Eat?

  • Focuses on whole foods
  • Vegetables
  • Fresh Fruits
  • Whole grains
  • Healthy fats
  • Fish
  • Poultry
  • Beans 
  • Eggs
  • Moderate Dairy 
  • Limited intake of red meat

What Foods Do You Need to Avoid?

  • Processed foods
  • Large amounts of sugar
  • Sweetened beverages such as sodas and energy drinks

Sample Meal Plan

Mediterranean Diet

Breakfast: 

  • Small caffè latte, eggs, cheese, olives, fresh tomatoes, cucumbers, and bread
  • Shakshuka with coffee

Lunch: 

  • Tomato, cucumbers, greens, and feta cheese salad
  • Grilled Octopus and vegetables, hummus as appetizer

Dinner: 

  • Greek-style baked fish served with potatoes
  • Lentil salad with cucumber 

What Is the Keto Diet?

The keto diet became popular for fat loss and its potential impact on blood sugar for diabetes.

In comparison to other low-carb diets, the keto diet is higher in fat and moderate in protein intake. Ideally, focusing on unsaturated fats as the main source of fat intake and controlling animal protein to a moderate amount.

Compared to a regular diet, the keto diet requires dramatically decreasing carbohydrate intake and substituting it with fat; this low carbohydrate state forces your body to enter a metabolic state of ketosis. 

Ketosis is a state where your body burns fat instead of carbohydrates for energy, and in the process, it creates ketones, which it can use for fuel.

Who Is the Keto Diet Recommended For?

The ketogenic diet may help patients with diseases such as epilepsy, while it may also be beneficial for those overweight or trying to simply lose weight.

In addition, the keto diet may improve neurological conditions like Alzheimer’s (1) and Parkinson’s disease (2).

You must keep in mind that this is a very low carbohydrate diet, therefore if you are taking blood glucose medication you must speak to your health care provider to modify the diet.

What Foods Can You Eat in the Keto Diet?

MeatBeef, chicken, turkey, veal, buffalo meat, etc.
Cured meatsBacon, sausage, ham, etc.
Fish and seafoodSalmon, tuna, trout, mackerel, shrimp, scallops, octopus, calamari, etc.
EggsEggs, egg products and foods made with eggs.
CheeseUnprocessed cheese like cheddar, cream, glue, and mozzarella
FatButter, cream, ghee
OilsCoconut oil, olive oil, grape-seed oil, avocado oil.
AvocadosAll types.
NutsAlmonds, Brazil nuts, walnuts, flaxseeds, pumpkin seeds, and others
SeedsChia, sesame, and others
VegetablesAll low carb: green leafy vegetables, tomatoes, onions, peppers, etc.
CondimentsSalt, pepper, herbs, and spices.

What Foods Do You Need to Limit in the Ketogenic Diet?

The most important aspect is to meet the macronutrient goals. In order to reach ketosis, you will need to limit sugar and carbohydrates. 

Sugary FoodsCookies, ice cream, cake, candy, jam, jelly, and other preserves with added sugar, canned fruit packed in sugar, pastries, donuts, milkshakes, and some ready-to-eat cereals.
Sugary beveragesSoda, energy drinks, fruit juice, etc.
GrainsBread, rice, pasta, cereal, and all types of grains.
FruitsAll, except small portions of berries.
Beans and LegumesBlack beans, kidney beans, lentils, peas, chickpeas, and all beans and legumes.
Root vegetablesPotatoes, malanga, sweet potatoes, carrots, and others.
Condiments with added sugarBarbecue sauce, ketchup, honey mustard, teriyaki sauce, etc.
AlcoholBeer, wine, mixed drinks

Sample Meal Plan

Breakfast: 

  • Bacon with Eggs 
  • Eggs omelet with avocado and cheese

Lunch: 

Dinner: 

Alcohol Consumption

Moscow mule
Two Moscow mule with plenty of ice and mint. A plate of limes is in the background.

Alcohol Consumption is permitted on the keto diet but in pure forms of alcohol like gin, tequila, rum, whiskey, and vodka. These are low-carb and therefore approved.

These beverages may be consumed alone or with low-carb mixers to enhance the flavor. Keto-approved mixers include seltzer, sugar-free tonic water, diet soda, and crystal light drink mix. 

Non-keto-friendly beverages include those made with sugar or other carbs; for example  margarita, bloody mary, sangria, piña colada, vodka with orange juice, rum and coke, Smirnoff Ice, and regular beer.

Keto vs Mediterranean Diet: Which one is Easier to Follow?

Considering the level of restrictions on the keto diet, the Mediterranean diet is easier to follow. This is a major point to the success of the Mediterranean diet, allowing people to sustain the lifestyle approach long term.

Keto vs Mediterranean Diet: Weight Loss

The keto diet can result in faster weight loss short term because it is more restrictive than the Mediterranean diet. Furthermore, the keto diet can result in a spontaneous decrease in appetite.

However, since the Mediterranean diet focuses on lifestyle changes it is easier to sustain and maintain the results long-term.

Keto vs Mediterranean Diet: Heart Health

The Mediterranean diet has been vastly researched in regards to cardiovascular disease and a clear connection has been established between heart health and this eating style.

The PREDIMED Study involved ~7,500 individuals with a high risk of heart disease as they followed a Mediterranean diet for 5 years. The Primary Prevention of Cardiovascular Disease supplemented the Mediterranean diet with Nuts or Extra Virgin Olive Oil. The study concluded that a Mediterranean diet with either nuts or olive oil may reduce the combined risk of stroke, heart attack, and death from heart disease (3).

A report published in the Journal of the American College of Cardiology concludes that ketone bodies can help protect the heart in people with cardiovascular disease (4)

Therefore, both diets have been shown to potentially have beneficial effects. However, more research has been proven in regards to the Mediterranean diet.

Keto vs Mediterranean Diet: Blood Sugar Levels

The ketogenic diet may be beneficial for type 2 diabetics to help them maintain glucose levels within a normal range. Since the diet lowers the carbohydrate intake immensely this may help the patient reduce the need for insulin. Research from 2018 has found that ketogenic diets can be helpful in controlling the level of HbA1c – the glucose traveling in the blood during a 3 months period (5).

Studies about the effectiveness of a Mediterranean eating style have shown beneficial effects on diabetes mellitus and glucose metabolism in general. 

For example, in a large study among 380 university graduates, a traditional Mediterranean eating pattern was associated with an 83% reduction of developing type 2 diabetes (6).

Keto vs Mediterranean Diet: Cognitive Health

Research in the last year suggests that the Mediterranean diet can protect brain health. It has been shown that the diet can slow down cognitive decline that results in dementia.

However, the combination of the Mediterranean diet with the DASH diet has gained more respect in terms of protecting the brain against rapid cognitive decline (7).

Multiple studies have shown promising results of the ketogenic diet in neurological disorders such as epilepsy, dementia, ALS, and metabolic disorders (8).

Keto vs Mediterranean Diet: Required Effort

The Ketogenic diet requires increased effort when compared to the Mediterranean diet because it drops the carbohydrate intake so low it is almost making you eliminate a macronutrient from your diet. Meanwhile, The Mediterranean diet focuses on eating less processed foods and more fruits, vegetables, and whole grains.

Keto vs Mediterranean Diet: Costs

Considering the Mediterranean diet permits foods such as beans and lentils it causes its followers to spend less on groceries. Whereas, the Keto diet focuses more on grass-fed animal proteins which are usually more expensive.

Keto vs Mediterranean Diet: Health Risks

Most health professionals experts agree that the Mediterranean diet is a safe and effective eating style because it includes all food groups, making nutrition deficiencies less likely to occur. 

The keto diet could be less safe because of the low intake of carbohydrates. This decreased intake could lead to vitamin and mineral deficiencies, potentially leading to a wide variety of diseases. 

Keto vs Mediterranean Diet: The Bottom Line

To conclude, both diets have the potential to help you lose weight if you are in a calorie deficit. The traditional Mediterranean diet and Keto diet may both reduce the risk of disease and improve overall health.

Give yourself enough time to test out the diets and evaluate which is best for you. The Mediterranean and keto diets will help you cut out processed foods from your diet. However, there are differences between the diets, so keep those in mind when deciding. There is no one best overall diet, evaluate how you see the best results in long-term weight loss and overall good health. Always keep in mind that rapid weight loss is not the goal, regardless of the eating plan.

If you want to review other diets, visit our other blog posts to compare different ones, such as the paleo vs Mediterranean dietpaleo vs keto, vegan vs keto, and food freedom.  

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