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 allows only a tiny portion of carbohydrates each day. 

In contrast, the Mediterranean diet is one of inclusion. Everything is allowed, but it heavily 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 therefore 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 style of eating also focuses on enjoying meals around the table with friends and family.

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 Foods Can You Eat?

  • Whole foods
  • Vegetables
  • Fresh fruit
  • Whole grains
  • Healthy fats
  • Fish
  • Poultry
  • Beans 
  • Eggs
  • Moderate dairy 
  • Limited red meat
  • Red wine

What Foods do You Need to Avoid?

  • Processed foods
  • Large amounts of sugar
  • Sweetened beverages, like sodas and energy drinks

Sample Meal Plan


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


  • Tomato, cucumbers, greens, and feta cheese salad
  • Grilled octopus and vegetables, hummus as an appetizer
  • Greek-style baked fish served with potatoes


What Is the Keto Diet?

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 that you dramatically lower your carbohydrate intake and substitute it with fat. This low-carbohydrate state forces your body to enter a metabolic state of ketosis. 

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

What Foods Can You Eat on 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 on the Ketogenic Diet?

The most important aspect for success is to meet the macronutrient goals. In order to reach ketosis, you will need to strictly 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


  • Bacon with Eggs 
  • Eggs omelet with avocado and cheese



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.

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 approach long-term.

Weight Loss

Following a keto program can result in faster weight loss 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.

However, 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’s likely 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 3-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 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 (MIND) has gained more respect in terms of protecting the brain against rapid cognitive decline.
Multiple studies have shown promising results of the ketogenic plan in neurological disorders such as 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 a macronutrient altogether. 


Because the Mediterranean diet permits foods such as beans and lentils, it can result in its followers spending less on groceries. On the other hand, keto can be more expensive—especially if you buy the many ready-made keto products available. 

Health Risks

Most health professional 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 the keto diet 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 the Mediterranean and keto diet will cut processed foods from your diet. There are big differences between the plans, so keep those in mind when deciding.

In fact, there is 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 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.

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

“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.

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