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The Mediterranean Keto Diet: Food List, Sample Meal Plan, and Recipes


The Mediterranean keto diet combines aspects of the ketogenic diet and Mediterranean diet to provide you with health benefits, such as weight loss, better blood sugar and cholesterol levels, and brain health.

Keto Mediterranean emphasizes clean eating. It includes fish, olive oil, low-carb veggies, and moderate amounts of red wine. Because it’s very low-carb, you should avoid whole grains, most fruits, honey (and other traditional sweeteners), and starchy vegetables.

This article takes a closer look at the keto diet and Mediterranean separately — and how you can combine them to experience the best of both worlds.

What is the Mediterranean Diet?

The Mediterranean diet or “med diet” is a primarily plant-based diet that includes a wide variety of green vegetables, legumes, fruits, whole grains, and olive oil (a staple of this diet). As for dietary protein, sources include fish and poultry. It requires dairy and red meat to be consumed only in limited amounts (* , *).

This diet was coined in the 1960s when Ancel Keys, an American scientist, noted that people living in the Mediterranean region — Italy, France, Spain, and Greece — had lower rates of heart disease and mortality rates probably because of what they ate (*).

The Mediterranean diet is much healthier than a Standard American Diet (SAD). That’s because it forbids processed foods and refined sugar, which contribute to obesity, cardiovascular disease, diabetes, non-alcoholic fatty liver disease (NAFLD), and some cancers (*).

What is Keto Diet?

The Ketogenic diet or “keto diet” is a high-fat, moderate-protein, and very low-carb eating plan that’s best known for fat loss. Restricting carbohydrates — which are abundant in grains, most fruits, starchy vegetables, baked goods, and highly processed foods — induces nutritional ketosis.

Here’s how it works:

When you restrict carbohydrates to 50 grams or lower, you deplete your glycogen stores and enter the fat-burning state of ketosis. During this metabolic state, your liver produces ketones, which now become your fuel source (instead of glucose).    There’s no shortage of research on the keto diet. Studies have shown that it helps not just with weight loss, but also with diabetes reversal, reducing inflammation, seizure reduction, cognitive health, and more (* , *, *, *).

Healthy low-carb and high-fat keto diet staples include meat, poultry, seafood, eggs, full-fat dairy, nuts, seeds, salad greens, cruciferous veggies, avocados, and berries.

To reach and maintain ketosis, you should avoid all grains, high-sugar fruits (such as apples, mangoes, bananas, pineapples, and other tropical fruits), and starchy vegetables (such as potatoes, corn, carrots, turnips, and beets).

You can refer to this complete keto diet food guide for more options and what to avoid.

Combining the Mediterranean and the Keto Diet

Doing the keto and Mediterranean diet together means you only eat Mediterranean diet-friendly foods that are low in carbs. For example, while whole grains, sweet fruits, and starches (potato, corn, and beets) are normally allowed on a traditional Mediterranean plan, these are to be avoided on a keto Mediterranean diet.

Keep in mind to avoid foods that are neither keto-friendly and Mediterranean diet-friendly, such as heavily processed foods. These include sugary desserts and anything made with vegetable oils (canola oil, sunflower oil, cottonseed oil, sunflower oil, peanut oil, and safflower oil).

Benefits of the Mediterranean Keto Diet

Aside from having plenty of food options on a keto Mediterranean plan, this diet has been shown to support better health in many ways. Their advantages are backed by studies on the diet itself and separate topics like carb reduction, avoiding processed foods, and healthy fat consumption.

1. Promotes weight loss

The Mediterranean keto diet can lead to a significant reduction in body weight safely.

In a 2008 study, researchers placed overweight subjects on a “Spanish Ketogenic Mediterranean Diet” (SKMD) where they consumed virgin olive oil, green vegetables, and different types of fish as their main protein source (*).

Although they weren’t asked to limit their calories, they kept their daily carbs to only 30 grams max per day. The participants avoided trans fats such as margarine and processed meats with added sugar (*).

The results were surprising. Within a matter of 12 weeks, they went from 108.62 kg to 94.48 kg (*). This led the researchers to conclude that their “Spanish Ketogenic Mediterranean Diet” intervention can be an effective treatment for obesity (*).

They believed that the significant weight loss may have happened due to the combination of a higher protein intake (since keto allows for more protein than a Standard American Diet) and healthy fats like MUFAs and PUFAs (*).

2. Manages blood sugar levels

People with diabetes and those who are trying to keep their blood glucose under control can benefit from the keto diet (*). The same thing goes for a Mediterranean version of keto since it retains the low-carb aspect of the diet, which is essential for blood sugar management.

The 2008 study on a “Spanish Ketogenic Mediterranean Diet” also found that in addition to significant weight loss, the participants experienced improvements in their fasting blood glucose levels. Results showed glucose reductions from 109.81 mg/dl to 93.33 mg/dl (*).

Olive oil, an important fat source in the Mediterranean keto diet, contains high amounts of monounsaturated fatty acids (MUFAs), which improve blood glucose control and lower inflammation (* , *).

Another way that Mediterranean keto improves your blood sugar numbers is through weight loss. In other words, losing weight can control or lower your risk of diabetes (*).

3. Emphasizes eating clean

It’s worth noting that a keto Mediterranean diet emphasizes clean eating. All your calories should come from high-quality whole foods like fish, seafood, low-carb vegetables, and olive oil.

Choosing real foods over highly processed foods helps you avoid sugar and additives (such as carrageenan and carboxymethylcellulose) that cause inflammation, weight gain, obesity, hypertension, Type 2 Diabetes, cancer, and a higher risk of all-cause mortality (*).

Eating cleaner may sometimes be challenging, but you can get started through simple actions — for example, reading food labels and avoiding those with added sugars, and replacing refined carbs (such as bread and pasta) with salad greens.

4. Improves cholesterol levels

Optimizing your cholesterol numbers becomes easier with a keto Mediterranean meal plan.

One reason is the presence of monounsaturated fats in olive oil, nuts, and avocados, which may raise high-density lipoprotein (HDL) known as good cholesterol (*).The very low-carb nature of this diet also reduces triglyceride levels (*). This combination of high HDL and low triglycerides lowers your risk of heart disease.

Note: Some people who follow a standard keto diet may experience increases in their low-density lipoprotein (LDL) cholesterol, which is the case with lean mass hyper-responders. Lean mass hyper-responders refer to lean and athletic individuals who go on carb-restricted diets and see increases in their LDL, along with increases in HDL and decreases in triglycerides. Carb-restricted diets particularly increase the size of LDL particles, which aren’t a marker for cardiovascular disease risk (* , *).

5. Helps with cognition and brain health

Studies show that both the keto and Mediterranean diets improve brain function. When done together, they provide an array of brain benefits — thanks to the antioxidant effect of ketones, micronutrients in unprocessed foods, and healthy fats.

18 longitudinal studies found that adhering to a Mediterranean diet was linked to better global cognition and verbal ability (*). As for the keto diet, several human studies have shown that keto can be an effective non-pharmacologic intervention for various stages of dementia — on top of the fact that keto has been successful in treating epilepsy (*).

While its mechanism isn’t clearly understood yet, keto may help stabilize mood in individuals with anxiety, depression, and autism spectrum disorders (* , *).

Mediterranean Keto Diet Food List

Here’s a Mediterranean keto food list with everything you need to maintain ketosis:

  • Proteins: all kinds of fish, seafood, poultry, eggs, and red meat in moderation
  • Fats: olive oil, avocado oil, coconut oil, MCT oil, and dairy in moderation
  • Non-starchy veggies: salad greens, broccoli, cauliflower, tomatoes, zucchini
  • Low-carb fruits: avocado, strawberries, blueberries, lemons, cantaloupe
  • Herbs and spices: black pepper, chili powder, paprika, garlic
  • Nuts and seeds: almonds, walnuts, hazelnuts, pistachios
  • Sweeteners: stevia, monk fruit, and other keto-friendly sweeteners

Sample Mediterranean Keto Meal Plan

Check out our meal plan below so you can start experiencing the benefits of a keto Mediterranean lifestyle. Feel free to tweak any of these meals to suit your preference:

Day 1

  • Breakfast: scrambled eggs, cherry tomatoes, and black coffee
  • Lunch: fresh salmon lettuce wraps
  • Dinner: chicken, cheese, and broccoli casserole

Day 2

  • Breakfast: avocados stuffed with tuna
  • Lunch: grilled chicken salad with cucumbers and tomatoes
  • Dinner: baked tilapia with asparagus as a side dish

Day 3

  • Breakfast: salmon patties made with salmon, almond flour, mayo, and herbs
  • Lunch: bell peppers stuffed with ground beef
  • Dinner: lamb chops with butter, garlic, and rosemary

Day 4

  • Breakfast: pork meatballs with blueberries on the side
  • Lunch: garlic butter shrimp and zucchini noodles
  • Dinner: fried calamari (squid coated with almond flour)

Day 5

  • Breakfast: almond flour pancakes
  • Lunch: brussels sprouts salad with almonds and parmesan cheese
  • Dinner: crab salad made with crab meat, salad greens, feta cheese, and tomatoes

More Mediterranean Keto Recipes

Discover some of Perfect Keto’s keto Mediterranean recipes below:

The Bottom Line

If you’re already on a keto diet and curious about experimenting with the Mediterranean way of eating — go ahead and combine both diets. Research studies show that it improves your overall health through weight loss, blood sugar control, better brain function, and more.

As a rule of thumb, your primary source of protein should be fish and seafood. Eat red meat (beef, pork, lamb, venison) and dairy in moderation. Get your carbohydrates from non-starchy plants while being careful not to exceed your daily net carb limit of 50 grams.

Need help figuring out your carbs, fat, and protein macros on a keto Mediterranean approach? Use our keto calculator. Next, follow the five-day sample meal plan and try our recipes above to stay in ketosis.

27 References

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Cleveland Clinic. Can You Have Dairy on the Mediterranean Diet?. 2020 December 8

Rees K et al. ‘Mediterranean’ dietary pattern for the primary prevention of cardiovascular disease. 2013 August 12

Rippe J et al. Relationship between Added Sugars Consumption and Chronic Disease Risk Factors: Current Understanding. 2016 November 4

Brehm B et al. A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women. 2003 April 1

Hallberg S et al. Reversing Type 2 Diabetes: A Narrative Review of the Evidence. 2019 April 1

Kozioł M et al. Ketogenic Diet and Epilepsy. 2019 October 18

Ota M et al. Effect of a ketogenic meal on cognitive function in elderly adults: potential for cognitive enhancement. 2016 August 27

Guisado J et al. Spanish Ketogenic Mediterranean diet: a healthy cardiovascular diet for weight loss. 2008 October 26

Guisado J et al. Spanish Ketogenic Mediterranean diet: a healthy cardiovascular diet for weight loss. 2008 October 26

Guisado J et al. Spanish Ketogenic Mediterranean diet: a healthy cardiovascular diet for weight loss. 2008 October 26

Guisado J et al. Spanish Ketogenic Mediterranean diet: a healthy cardiovascular diet for weight loss. 2008 October 26

Guisado J et al. Spanish Ketogenic Mediterranean diet: a healthy cardiovascular diet for weight loss. 2008 October 26

Alarim R et al. Effects of the Ketogenic Diet on Glycemic Control in Diabetic Patients: Meta-Analysis of Clinical Trials. 2020 October 5

Guisado J et al. Spanish Ketogenic Mediterranean diet: a healthy cardiovascular diet for weight loss. 2008 October 26

Brehm B et al. One-Year Comparison of a High–Monounsaturated Fat Diet With a High-Carbohydrate Diet in Type 2 Diabetes. 2009 February 1

Cheah M et al. Dietary Manipulations for Nonalcoholic Fatty Liver Disease (NAFLD). 2019

Johns Hopkins Medicine. Endoscopic Weight Loss Program.

Matos R et al. Review: The Consumption of Ultra-Processed Foods and Non-communicable Diseases in Latin America. 2021 March 24

Etherton P et al. High–monounsaturated fatty acid diets lower both plasma cholesterol and triacylglycerol concentrations. 1999 December 1

Dong T et al. The effects of low-carbohydrate diets on cardiovascular risk factors: A meta-analysis. 2020 January 14

Norwitz N et al. Case Report: Hypercholesterolemia “Lean Mass Hyper-Responder” Phenotype Presents in the Context of a Low Saturated Fat Carbohydrate-Restricted Diet. 2022 April 14

Kelly M. Heart and Neurologic Disease. 2021

Petersson S et al. Mediterranean Diet, Cognitive Function, and Dementia: A Systematic Review of the Evidence. 2016 September 7

Davis J et al. Ketogenic Diet for the Treatment and Prevention of Dementia: A Review. 2020 January 30

Operto F et al. The Ketogenic Diet for the Treatment of Mood Disorders in Comorbidity With Epilepsy in Children and Adolescents. 2020 November 24

Li Q et al. A Ketogenic Diet and the Treatment of Autism Spectrum Disorder. 2021 May 11


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