As nutrition science has evolved, many diets have come and gone but keto and the Mediterranean diet are two of the few that have stood the test of time. The diets seem very different on the surface but at their core, they share several qualities. Read this article to learn more about the two diets and find out which one best suits you.
The Mediterranean diet, as the name suggests, was inspired by the people that live in the region around the Mediterranean Sea. The Mediterranean region includes countries such as Italy, Greece, Spain, and Southern France.
The diet became popular around the world in the 1960s when researchers found that the people in this area had very low rates of chronic diseases and some of the highest life expectancies in the world.
The macronutrient distribution on the Mediterranean diet is flexible but on average it is 50% carbohydrate, 15% protein, and 30-40% fats (*).
Foods to Eat on the Mediterranean Diet
The Mediterranean diet encourages a high consumption of foods like:
- Plant oils, mostly olive oil
- Beans and legumes, such as beans, peas, and lentils
- Nuts and seeds
- An abundance of fruits and vegetables
- Moderate amounts of dairy, especially yogurt and cheese
- Seafood as the main source of non-vegetarian protein — at least twice a week
- Unrefined whole grains, including brown rice, quinoa, and whole-grain bread
- Moderate amounts of wine, especially red wine
- Herbs and spices
The Mediterranean diet favors poultry and fish over red meat as a source of protein. It recommends no more than 2 servings of red meat per week. It also encourages incorporating plant based protein from foods like legumes and nuts.
This style of eating isn’t just about the diet. It’s more of a lifestyle that includes other aspects besides food, such as exercising regularly and having meals with others. The idea is that these holistic elements work together to achieve many of the benefits of the Mediterranean diet.
Foods to Avoid or Limit on the Mediterranean Diet
Foods to avoid or limit on the Mediterranean diet include:
- Red meat such as beef
- Refined grains
- Refined sugars
- Processed foods
- Animal products in general
Benefits of the Mediterranean Diet
The Mediterranean diet is one of the best diets for weight management (*). By limiting high-calorie low nutrient foods and encouraging filling nutrient dense foods, the diet can help you reach and maintain a healthy weight. The Mediterranean diet is also very likely to give sustainable results since it isn’t restrictive.
Risk of Chronic Diseases
The Mediterranean diet reduces the risk of developing chronic diseases like cardiovascular disease, type 2 diabetes, kidney disease, lung disease, cancer, Alzheimer’s, and Parkinson’s disease (*). A JAMA (Journal of the American Medical Association) study followed 25,317 women for 20 years and found a reduced risk of diabetes and other chronic disease in the participants on a Mediterranean diet (*).
This effect is achieved through several aspects of the diet like high fiber intake, which supports gut health and regular consumption of antioxidants like omega-3 fatty acids which prevent cell damage (* , *).
The ketogenic diet is a low-carb, high-fat, and moderate protein diet. It was first developed in the early 20th century as a treatment for epilepsy.
Over time, the keto diet was found to have other benefits besides epilepsy treatment. Today, it is popular for many of these benefits, but mostly for its ability to facilitate weight loss. The diet has a unique macronutrient distribution of 70-80% fat, 10-20% protein, and 5-10% carbohydrates (*).
The process of burning fat produces chemical compounds known as ketone bodies. It is from these compounds that the diet gets its name. When the ketone bodies in your body reach a certain level, you enter a state known as ketosis.
Foods to Eat on the Keto Diet
The Keto diet recommends the consumption of foods like:
- Fats and oils including olive oil, avocado oil, and coconut oil
- Nuts and seeds like peanuts, walnuts, pumpkin seeds, and chia seeds
- Full-fat dairy products like butter, ghee, cream, and cheese
- Animal protein like beef, organ meats, fatty fish, and poultry
- Low-carb fruits like lemons and avocados
- Low-carb vegetables like asparagus, tomatoes, celery, lettuce, and spinach
Foods to Avoid on the Keto Diet
The foods to avoid on a keto diet include:
- Starchy vegetables like potatoes
- Grains and grain products like rice, bread, pasta, and quinoa
- High sugar fruits like bananas, dates, mangoes, raisins, and pears
- Legumes like beans and lentils
- Ultra-processed foods
- Sweets like hard candy and sugar-sweetened chocolate
- Sugar-sweetened and alcoholic beverages
Benefits of the Keto diet
The keto diet has been proven to be an effective method of promoting healthy weight loss. It has been shown to promote weight loss while preserving muscle mass in the long term (*).
Reduced Risk of Chronic Disease
Similar to the Mediterranean diet, keto can also aid the management and prevention of diet-related chronic diseases, particularly type 2 diabetes, heart disease, and neurodegenerative diseases like Alzheimer’s disease and dementia (* , *).
In addition to these conditions, the ketogenic diet is one of the most effective treatments for epilepsy, especially in children (*).
The Mediterranean and keto diets differ in four main aspects which include macro tracking, macronutrient intake, food components, and health risks.
1. Macro tracking
The keto diet requires macro tracking while the Mediterranean diet doesn’t.
Macro tracking refers to following up on the number/grams of macronutrients (carbohydrates, proteins, and fat) that you consume to ensure that you’re consuming them in the right ratios.
The keto diet is strict on macro composition to maximize your chances of achieving and maintaining ketosis.
The Mediterranean diet, on the other hand, has no restrictions and doesn’t require macro tracking. It’s more concerned with the quality of food you include in your diet than the specific nutrients in the food.
2. Carbohydrate Intake
The keto diet is a very low carb while the Mediterranean diet includes and even encourages certain types of carbs.
As mentioned above, carbohydrate intake on the ketogenic diet is very low. Most people on the ketogenic diet don’t consume more than 50 grams of carbohydrates in a day. For context, one cup of whole strawberries (about 8 large strawberries) has about 8.2 grams of carbohydrates, about 16% of your daily carb limit.
Unlike the ketogenic diet, the Mediterranean diet doesn’t shy away from carbohydrate foods. In fact, many of the recommended food groups are loaded with carbohydrates. These include whole grains, legumes, and fruits.
This shouldn’t be a reason to stay away from the Mediterranean diet. The diet only encourages consumption of high quality carbs that come from whole foods. Like the keto diet, it discourages the regular consumption of refined carbohydrates and sugars.
3. Food sources
The Mediterranean diet is mainly plant-based while the keto diet allows for animal protein.
Most of the foods recommended on the Mediterranean diet are plant-based, for example fruits, vegetables, whole grains, legumes, olive oil, spices, and herbs. The diet recommends moderate consumption of animal foods like eggs, seafood, meat, poultry, fish, and dairy.
Considering the best sources of fats in the diet are animal foods, it is only natural that a ketogenic diet encourages a high intake of animal foods. Very few plant foods contain substantial amounts of fats and oils. Among common foods, avocado, nuts, and seeds are the best sources of fat and even they don’t measure up to animal foods like pork or cheese.
4. Fat intake
The Mediterranean diet recommends consumption of unsaturated fat and moderate consumption of saturated fat while keto recommends high consumption of all high quality fat.
The main type of fat encouraged on a Mediterranean diet are unsaturated fats like oleic acid from olive oil (*). Other sources of fat on the diet include nuts, seeds, and fish, all of which are rich in unsaturated fat. The diet also recommends that you minimize your intake of foods that contain saturated fats like dairy and fatty meat.
The keto diet, on the other hand, recommends the consumption of a high-fat diet including saturated fat. Most of the high-fat foods recommended contain saturated fat, for example, beef, whole dairy foods, and dairy products like cream, butter, ghee, and cheese. However, it also encourages consumption of sources of healthy unsaturated fat like olive oil, avocado, nuts, and seeds.
5. Health risks
Since the Mediterranean diet is less restrictive, it is considered one of the best diets for most people including children, the elderly, and even patients with diet-related diseases.
On the other hand, the keto diet, due to its restrictive nature, isn’t suitable for everyone. Certain groups of people are encouraged to only follow a ketogenic diet under the strict supervision of a qualified trained medical doctor. Such groups include pregnant women, breastfeeding women, and those with eating disorders.
Despite their differences, the Mediterranean diet and keto diet have some similarities between them.
1. Fat consumption
Both the Mediterranean and ketogenic diets allow liberal consumption of high-quality fat.
Despite the difference in the amounts and types of fats consumed, the keto and Mediterranean diets both recommend the consumption of fat-containing foods like olive oil, avocado, nuts, and seeds.
2. Health benefits
Both the Mediterranean and ketogenic diets have several health benefits. The diets are both effective in managing diet-related conditions, particularly diabetes and cardiovascular disease.
3. Weight loss
Both the Mediterranean diet and keto can promote weight loss.
By discouraging unhealthy foods and replacing them with nutrient dense foods, both these diets are able to encourage healthy sustainable weight loss. Research has shown that both diets are effective means of encouraging weight loss in overweight individuals (* , *).
The Mediterranean and ketogenic diets are both quite flexible.
Both diets allow you to make adjustments to accommodate your individual needs, for example, a lactose intolerant person can follow a dairy-free keto diet and a pescatarian can follow a meat free Mediterranean diet.
5. Food groups
The Mediterranean and ketogenic diets have some overlap in the recommended food groups.
Both diets recommend an average protein intake of around 20-25% of calories. The two diets also have some commonalities in the foods recommended like fish and seafood, eggs, nuts and seeds, and minimal or no consumption of processed foods.
If you still have questions regarding the Mediterranean or ketogenic diets, keep reading as we answer some of them.
Can you get into ketosis in the Mediterranean Diet?
No, you can’t get into ketosis on a traditional Mediterranean diet.
Ketosis occurs due to a low carbohydrate intake that causes your body to break down fats energy. The Mediterranean diet recommends a macro distribution that includes 50% carbohydrates. It would be very difficult to get into ketosis with such a high carbohydrate intake, assuming you are eating a healthy balanced diet.
A few individuals have attempted to modify the Mediterranean diet to make it more keto-friendly. The combination of the two diets forms the “keto Mediterranean diet.” You could possibly get into ketosis on this diet. However, this isn’t a true Mediterranean diet since whole grains, fruits, and legumes should be eliminated.
Is the Mediterranean diet considered low-carb?
No, the Mediterranean diet isn’t considered low-carb. This is because it encourages consumption of high-carb foods like whole grains such as bread and pasta, fruits such as apples and bananas, and legumes such as beans and peas.
Which diet is better for weight loss: keto or Mediterranean diet?
The best diet for weight loss varies from person to person. Always remember that the best diet for you is the one you can sustain for a long period of time. In general, the keto diet results in faster weight loss than the Mediterranean diet. However, the Mediterranean diet is said to give more sustainable and long-term effects since it is less restrictive.
The keto and Mediterranean diets are different but they share many fundamental principles. The key difference between the diets is their macro distributions. The ketogenic diet is a high fat low carb diet while the Mediterranean diet follows a more flexible macro distribution.
The diets are similar in their emphasis on whole foods over processed foods and their encouragement of high fat foods.
The best diet for you depends on your individual goals, activity level, age, health, genetics, and many other factors.
If you aren’t sure, you can try to discover which one is best for you. A study found that alternating between the keto and the Mediterranean diets may help in successful long-term weight loss (*).
Remember to always consult your doctor before making any changes to your diet.
Kirkpatrick C et al. Review of current evidence and clinical recommendations on the effects of low-carbohydrate and very-low-carbohydrate (including ketogenic) diets for the management of body weight and other cardiometabolic risk factors: A scientific statement from the National Lipid Association Nutrition and Lifestyle Task Force. 2019 September to October