Keto vs Mediterranean Diet: Which Wins?

Mediterranean diet

Keto vs Mediterranean Diet: Which Wins?

Many people find the keto diet easy to follow because it allows you to eat cheese, bacon, cream, and a lot of the foods that are typically forbidden when dieting. Plus it helps suppress your appetite, making it much easier to lose weight.

For some, that’s dieting heaven! But others find it difficult because it only allows a tiny portion of carbohydrates daily.

In contrast, the Mediterranean diet is one of inclusion. Everything is allowed, but it favors healthy foods like lean meats, vegetables, fruits, and whole grains.

So, which one wins?

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).

It’s typically high in fish and seafood, fruit, whole grains, vegetables, beans, nuts, seeds, and olive oil. Small quantities of lean meats and wine are also included, but the ingredients are all fresh, so processed foods are highly discouraged.

This eating style also focuses on enjoying meals with friends and family around the dinner table.

The Mediterranean diet’s benefits include improved heart, cognitive, and gut health. Studies also suggest that this program may even help with anxiety and depression.

Nutritionists and doctors consider the Mediterranean one of the best eating styles you could choose.

The best part about this diet plan is that it’s sustainable in the long term. People tend to be able to stick with it because it’s easy to follow.

What is the Keto Diet?

keto vs Mediterranean diet- keto meal

The keto diet became popular for fat loss and its potential positive impact on blood sugar. In comparison to other low-carb plans, the keto style is much higher in fat and lower in protein.

It requires dramatically lowering your carbohydrate intake and substituting it with fat. This low-carbohydrate state forces your body to enter a metabolic state of ketosis.

Ketosis describes the condition in which your body burns fat for energy instead of carbohydrates and, in the process, it creates ketones, which it uses for fuel.

The most important aspect for success is to meet the macronutrient goals. To reach ketosis, you will need to limit sugar and carbohydrates strictly.  

What Can You Eat?

Food GroupMediterranean DietKeto Diet
MeatChicken, turkey, small amounts of red meatAll types allowed: chicken, turkey, veal, buffalo meat, and others
Cured meatsAllowed in small amountsBacon, sausage, ham, etc.
Fish and seafoodSalmon, tuna, trout, mackerel, shrimp, scallops, octopus, calamari, etc.Salmon, tuna, trout, mackerel, shrimp, scallops, octopus, calamari, etc.
Dairy productsCheese, yogurt, milkUnprocessed cheese like cheddar, cream cheese, cottage cheese, and mozzarella.
Plain yogurt.
Cream and half and half
Unsweetened plant based
Whole GrainsOats, brown rice, rye, barley, corn, buckwheat, whole wheat bread and pastaNot allowed
LegumesBlack beans, kidney beans, lentils, peas, chickpeas, and all beans and legumesNot allowed
Fat and oilsOlive oil, olives, avocados, and avocado oilButter, cream, ghee, coconut, olive, grape seed, avocado, avocados, etc.
NutsAlmonds, Brazil nuts, walnuts, and all types. Almond and peanut butter.Almonds, Brazil nuts, walnuts, and all types. Almond and peanut butter.
SeedsChia, flaxseeds and pumpkin seeds, sesame, and othersChia, flaxseeds and pumpkin seeds, sesame, and others
VegetablesButter, cream, ghee, coconut, olive, grape seed, avocado, avocados, etc.All low carb: green leafy vegetables, tomatoes, onions, peppers, etc.
Starchy vegetablesPotatoes, sweet potatoes, and othersNot allowed
CondimentsSalt, pepper, herbs, and spices.Salt, pepper, herbs, and spices.
AlcoholRed wine in moderationModerate amounts of gin, tequila, rum, whiskey, or vodka.

What Foods You Need to Avoid?

Food GroupMediterranean DietKeto Diet
Sugary FoodsDiscouragedCookies, 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 beveragesDiscouragedSoda, energy drinks, fruit juice, etc.
Processed foodsDiscouragedAllowed only if do not contain sugar or carbohydrates
GrainsAllowedBread, rice, pasta, cereal, and all types of grains
FruitsAllowedAll, except small portions of berries.
Beans and LegumesAllowedBlack beans, kidney beans, lentils, peas, chickpeas, and all beans and legumes
Root vegetablesAllowedPotatoes, malanga, sweet potatoes, carrots, and others
Condiments with added sugarNot a traditional part of the dietBarbecue sauce, ketchup, honey mustard, teriyaki sauce, etc
AlcoholAllowed in moderationBeer, wine, mixed drinks

Sample Meal Plan

Mediterranean DietKeto Diet
BreakfastSmall caffè latte, eggs, cheese, olives, fresh tomatoes, cucumbers, and bread
Shakshuka with coffee
Avocado toast with egg
Bacon with Eggs 
Eggs omelet with avocado and cheese
Lunch Tomato, cucumbers, greens, and feta cheese salad
Grilled octopus and vegetables, hummus as an appetizer
Greek-style baked fish served with potatoes
Grilled Salmon with broccoli
Taco stuffed avocados
DinnerItalian baked chicken
Greek baked cod with lemon and garlic
Chicken lettuce wraps 
Keto Asian cabbage Stir-fry

Alcohol in the Keto Diet

Moderate amounts of alcohol are permitted on the keto diet but in pure forms of alcohol like gin, tequila, rum, whiskey, or vodka. These are low-carb, so they are permitted.

These drinks 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, margaritas, bloody Mary, sangria, piña colada, vodka with orange juice, rum and Coke, Smirnoff Ice, and regular beer.

Alcohol in the Mediterranean Diet

Moderate wine drinking is allowed. Moderation is defined as a glass of wine per day for women and two a day for men.

Keto vs Mediterranean Diet

Which One is Easier to Follow?

Considering the level of restriction when you follow keto, the Mediterranean style of eating is easier to follow. This is a major point contributing to its success, enabling people to sustain the lifestyle long-term.

Weight Loss

Following a keto program can result in faster weight loss in the short-term because it’s more restrictive than the Mediterranean diet. As an extra benefit, following a keto plan can result in a spontaneous decrease in appetite.

On the other hand, since the Mediterranean approach focuses on lifestyle changes, it’s easier to sustain and maintain the results over time.

Heart Health

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

A very large study concluded that it reduces the risk of stroke, heart attack, and death from heart disease. The results were so overwhelming that the study stopped ahead of its scheduled end because they considered it unethical to have the control group not eating this way.

The keto diet also has positive studies showing it improves heart health. 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.

However, there are not yet enough studies to be able to make the claim that the keto diet is good for the heart.

The Mediterranean diet wins this round. You will find many more doctors and dietitians prescribing this type of eating to their patients.

Blood Sugar Levels

The ketogenic diet may be beneficial for type 2 diabetics to help them maintain glucose levels within a normal range.

Since it significantly lowers carbohydrate intake, it would be expected to reduce the individual’s need for insulin. Research has found that eating this way can be helpful in controlling the level of HbA1c—the glucose traveling in the blood during a three-month period.

But it could be risky for people taking medication to control blood sugar. The combination of this diet and medication can lower blood glucose to dangerous levels. Therefore, it’s essential to talk to your doctor to adjust your medication before starting on keto.

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 in the development of type 2 diabetes. Keep in mind that the Mediterranean diet is not a carbohydrate-controlled plan. So, if you’re diabetic, you will still need to control the amount of carbohydrates you eat.

Brain Health

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

It’s interesting to note, though, that the combination of the Mediterranean and DASH diets (Mediterranean-DASH intervention for neurodegenerative delay) has gained more respect in terms of protecting the brain against rapid cognitive decline. Multiple studies have shown promising results with the ketogenic plan on neurological disorders like epilepsy, dementia, ALS, and metabolic disorders.

Required Effort

The ketogenic style of eating requires increased effort when compared to the Mediterranean because it drops the carbohydrate intake so low that it almost eliminates the macronutrient altogether.


Because the Mediterranean diet permits foods such as beans and lentils, it can result in its followers spending less on groceries. Keto can be more expensive—especially if you buy the many ready-made keto products available. These products tend to be processed and less healthy than fresh foods.

Health Risks

Most health 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. Both the traditional Mediterranean and keto diets may reduce the risk of disease and improve overall health.

Give yourself enough time to test out different eating plans and evaluate which is best for you. Both eating plans will cut processed foods from your diet if you choose well. There are big differences between the plans, so keep those in mind when deciding.

In fact, there’s no one best overall diet because individuals’ preferences will also have a big impact on what works for them. It’s best to evaluate results on long-term weight loss and overall good health. Always keep in mind that rapid weight loss is not a healthy goal, regardless of the eating plan.

“Keto vs Mediterranean Diet” was written by Registered Dietitian Solana Nicole Faerman, and reviewed and edited by Su-Nui Escobar, DCN, RDN, FAND.

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