Keto vs Paleo Diet: Which Diet is Best for You?

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

Keto vs Paleo: which one is best for you? With the wide variety of diets in the market today it is difficult to know which one to choose. Keto and Paleo are two of the most popular for weight loss and overall health. The question is, which one is best for you?

Both diets have followers with successful stories. Let’s dive into the similarities and differences between the two diets so that you can select which suits your goals and lifestyle best long term; or if you need to look for a different eating style.

What Is the Keto Diet?

Paleo & Keto

The term “ketogenic diet” was created by Russel Wilder in 1921 when he used the diet to treat children with epilepsy (1). Later, the diet became popular for fat loss and its potential impact on blood sugar for diabetes.

The ketogenic diet  (or keto diet, for short) is distinctive from other low-carb diets because of its high-fat content and moderate protein intake.

A keto diet consists mostly of fats (70-80%), proteins (10-20%), and carbohydrate foods (5-10%) (2).

Compared to a regular diet, the distribution of macronutrients is significantly in favor of fat. 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 called 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 (2).

Who Is the Keto Diet Recommended For?

A ketogenic diet may be great for overweight people and looking to lose weight too, but it can also help with diseases such as epilepsy and heart disease.

In addition, the keto diet may improve neurological conditions like Alzheimer’s (3) and Parkinson’s disease  (4).

Keep in mind that the diet is very low in carbohydrates, thus if you are taking blood glucose medications, you must speak to your health care provider to adjust your medications or modify the diet. 

This diet is not recommended for athletes who need to increase muscle mass or exercise for extended periods of time.

What Foods Can You Eat in the Keto Diet?

  • Seafood and Fish
  • Non-starchy vegetables such as asparagus, broccoli, and leafy greens
  • Cheese
  • Meat and Poultry
  • Eggs
  • Oils (such as coconut oil), butter, and cream
  • Nuts and seeds
  • Berries

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

The most important aspect is to meet the macronutrient goals. Sugar and carbohydrate consumption should be limited in order to reach ketosis.

The keto flu sometimes accompanies this transition of macronutrient adjustment. This definition describes some unpleasant side effects experienced when initiating the diet due to the lack of carbohydrates. Symptoms may include nausea, vomiting, and headaches.

Foods to Avoid or Limit

  • Sugary foods
  • Starchy foods
  • All carbohydrates are significantly limited

Keto Diet Sample Meal Plan

  • Breakfast: vegetable omelet served with avocado slices
  • Lunch: Grilled Salmon with salad 
  • Dinner:  Chicken lettuce wraps 
  • Snack: veggie sticks and almond butter

Alcohol in Keto

Even on a keto diet, there are plenty of low-carb alcoholic beverages to enjoy in moderation.

Pure forms of alcohol like gin, tequila, rum, whiskey and vodka are free of carbs and therefore allowed in the diet.

Those beverages can be consumed alone or combined with low-carb mixers for added flavor. 

Keto-friendly mixers include seltzer, sugar-free tonic water, diet soda, and crystal light drink mix. Moderation is still key when consuming alcohol in its pure form or with keto-friendly mixers to avoid adverse health effects.

Alcoholic beverages to avoid include margarita, bloody mary, sangria, piña colada, and regular beer.

It is important to remember to consume a lot of water when drinking alcoholic beverages to avoid dehydration.

What Is the Paleo Diet?

Paleo diet
Foods typically found in the paleo diet

The paleo diet sometimes referred to as “the caveman diet”, focuses on eating foods that humans ate during the Paleolithic era. Therefore, eliminating modern-day processed foods to improve health or achieve weight loss. 

Dieters must remove grains, beans, and legumes from their diet. Their plate is high in meat and fish, mimicking the diet of the hunter-gatherer era. 

Paleo followers usually focus on more than just a diet. It is usually seen as a way to improve lifestyle practices, saving the environment and overall well-being.

There are high standards for the quality of foods you select on the paleo diet. Protein should be grass-fed and ingredients should preferably be organic.

Rules for Eating Paleo Diet

  • Real, unprocessed foods are preferred. After all, our ancestors did not have the convenience of modern foods.
  • The Paleo diet is higher in protein, fat and lower in carbohydrates. Vegetables are also a large component of the diet. 
  • Eat low sugar foods, including sugars found in high glycemic fruits.
  • Emphasis place on eating grass-fed, organic, and pasture-raised meats. Organic produce is also preferred.
  • Avoid whole grains and legumes to reduce inflammation in the body.

What Foods Can You Eat in the Paleo Diet?

  • Lean protein such as chicken, turkey, pork, beef, veal, bison, and eggs.
  • Healthy fats like olive oil, avocado oil, coconut oil, grass-fed butter, and ghee.
  • Fish, best those rich in omega 3 fatty acids, such as salmon and trout.
  • Seafood
  • Nuts such as almonds, cashews, hazelnuts, pecans, macadamia nuts, and walnuts.
  • Seeds such as sunflower seeds, sesame seeds, chia seeds, flax seeds, and pumpkin seeds.
  • All non-starchy vegetables such as asparagus, artichoke hearts, carrots, spinach, celery, broccoli, zucchini, cabbage, peppers, eggplant, onion, squash, yam, and sweet potatoes.
  • Fruits lower in sugar such as apples, berries, watermelon, and cantaloupe.

What Foods Do You Need to Avoid in the Paleo Diet?

  • Whole grains, including wheat, oats, and barley.
  • Bread, English muffins, crackers.
  • Pasta
  • Legumes, including beans, lentils, garbanzo, peanut butter, soybeans,
  • Dairy products including milk, cheese, dairy spreads, cream cheese, pudding, ice cream, and yogurt.
  • Sugar
  • Starchy vegetables such as potatoes, yucca, and malanga.
  • Processed foods
  • Fruit juices and sugary beverages.
  • Processed meats such as hot dogs, sausages, and low-quality meats.

Paleo Diet Sample Meal Plan

  • Breakfast: Avocado with turkey and eggs
  • Lunch: Grilled Chicken with spinach and olive oil
  • Dinner: Turkey with asparagus
  • Snack: strawberries with nuts and tea

Paleo Diet and Alcohol


In short, alcohol was not consumed by our ancestors and it is processed as a toxin, but flexibility is common with most diets to make a sustainable change. Therefore, some diet followers approve of an occasional glass of wine or cup of tequila.

Just like with the ketogenic diet, to achieve your weight loss and health goals moderation is key.

Keto vs Paleo: Similarities

  • The paleo and keto diet promote the consumption of whole foods that are nutritious and exclude modern-day processed foods. Whole foods are those that have undergone minimal amounts of processing by the time you consume them.
  • Both diets exclude the consumption of grains and legumes while emphasizing the importance of protein and healthy fats. In addition, both paleo and keto discourage the excessive use of processed fats and trans fats.
  • On the Keto diet, the removal of grains and legumes ensures the body stays in the state of ketosis because they are higher carbohydrate foods.
  • In addition, keto and paleo strongly encourage the elimination of added sugars. The paleo dieters accept honey and maple syrup, but the keto dieters do not because of the high carbohydrate content found in these sweeteners.
  • Both diets have become popular because they promote weight loss.

Keto vs Paleo: Differences

The keto diet has a big emphasis on specific macronutrient requirements in order to allow the body to burn fat as the main fuel source instead of carbohydrates. About 5% of your calories or less is coming from carbohydrates on the keto diet, this is considered a very low carbohydrate diet.

Meanwhile, the paleo diet does not have specific macronutrient requirements. Instead, it focuses on eating as your ancestors did back in the day; by eliminating grains, legumes, and sugar, the diet tends to be a low carbohydrate diet. However, low glycemic carbohydrates such as sweet potato and certain fruits are permitted.

The intentions of the diets are drastically different because the goal of the keto diet is the state of ketosis. Meanwhile, the purpose of the paleo diet is to improve food quality intake and digestion.

A great example of the difference in eliminating food groups is the avoidance of legumes and grains.  Paleo dieters eliminate grains and legumes because they were not part of the paleolithic age. Keto dieters eliminate legumes and grains because of their high carbohydrate content.

If Keto dieters consume grains and legumes they risk throwing their body out of ketosis. Meanwhile, the paleo diet is usually low carb only because of its limited sources of carbohydrates permitted.

In terms of sugars, the keto diet permits artificial sweeteners. Meanwhile, the paleo diet allows maple, coconut sugar, and honey.

Health Benefits

Keto vs Paleo Diet: Which One Is Easier to Follow?

Both diets have its pros and cons, it is up to you to decide which will fit best with your lifestyle. 

Take into consideration the main differences. The paleo diet is very specific and the keto diet is macronutrient focused. Generally, the keto diet is less flexible because only about 10% of your daily food intake can come from carbohydrates. This means that you have also limited healthy foods, such as fruits and vegetables. 

Keto vs Paleo: Which One is Best for Weight Loss

Both diets have been shown to be beneficial for weight loss. 

While the paleo diet does not guarantee weight loss, often results in weight loss. A review of studies found significant weight loss in people following this diet (5). In post-menopausal women, a recent study showed that the paleo diet resulted in a 10.6% weight loss at 12 months (6).

For the ketogenic diet, studies  show that this diet can produce rapid weight loss and can reduce food cravings as it is very high in fat (7). 

It is important to consider that both diets are low carbohydrate diets, which have numerous studies showing positive results in terms of weight loss (8). 

Keto vs Paleo Diet Blood Sugar Levels

Type 2 Diabetics may follow the ketogenic diet to maintain glucose levels within a normal range. Since the diet lowers the carbohydrate intake drastically 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 (9).

It is believed that the paleolithic diet is effective in blood sugar control due to the decrease in carbohydrate intake.  While many studies suggest this is true, there is not enough evidence to determine that the paleo diet is effective in lowering blood glucose.

It is important to remember that the paleo diet is a low carbohydrate diet and the ketogenic is a very low carbohydrate diet. Thus, if you are on blood glucose-lowering medications, it is essential that you consult your physician to adjust your medications. 

Keto vs Paleo Diet Mental and Cognitive Health

Various studies have shown promising results of the ketogenic diet in neurological disorders such as epilepsy, dementia, ALS, and metabolic disorders (2).

It has been suggested that a paleolithic diet could potentially be beneficial for cognitive health (10). However, there have not been many scientific studies corroborating the theory.

One of the studies available revealed that post-menopausal women following the paleo diet had a significant improvement in episodic memory performance, which was associated with increased hippocampal activity, smaller waist circumference, and reduced fatty acids (11). 

Keto vs Paleo Costs

The keto and paleo diet both rely heavily on the meat counter and produce section making both eating plans expensive.

Keto vs Paleo: What Are the Risks of Following These Diets?

For perimenopausal and menopausal women, it is important to consider that low carbohydrate diets can cause increased production of cortisol -the stress hormone- making it more difficult to lose weight (12); specifically the weight around the abdominal area. Other hormones could also be affected by following low carbohydrate diets (13).

Furthermore,  the ketogenic diet is a very restrictive diet, resulting in vitamins and mineral deficiencies.  Supplementation might be necessary in order to prevent these deficiencies.

The increased consuming of saturated fat and protein above recommended levels may also increase the risk for kidney  and heart disease.

While the paleo diet is less restrictive, it can still result in nutritional deficiencies.

Keto vs Paleo: The Bottom Line

Both diets have the potential to help you lose weight and reduce the risk of disease.

It is important to keep in mind that what works for one person might not be beneficial for another. 

Allow yourself to test out which diet is best for you with patience because results take time. The paleo and keto diet will help you cut out grains and processed foods from your diet. However, there are differences between the diets, so keep those in mind when deciding.

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