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Paleo vs. Keto: Which Diet is Healthier?

Disclaimer

When choosing between paleo vs. keto, it’s important to remember that there is no one-size-fits-all diet. You may have learned that the keto diet is effective for controlling blood sugar management while paleo allows for more flexibility in carbs — but at the end of the day, the best diet is the one that you can stick to and supports your health.

To help you decide, this guide discusses these two diets in detail. Learn their similarities and differences, pros and cons, and more.

Paleo vs. Keto

The difference between keto and paleo is that keto focuses on very few carbs and high fat, whereas paleo puts emphasis on whole foods consumed by Paleolithic hunter-gatherers. Both eating patterns value animal protein and fats while eliminating grains and legumes. Another thing to note is that these diets are being embraced as a way of life by many.

What is the Paleo Diet?

The paleolithic diet or “paleo” diet for short, is a diet that tries to mimic the eating habits of our prehistoric ancestors. Thus, it’s also called the caveman diet or stone-age diet.

Foods you can eat include lean meats, fish, eggs, fruits (except for high-sugar fruits like bananas), and vegetables (except for potatoes and corn, which are high on the glycemic index).

Paleo has become more popular over the years, especially among younger people and those who struggle with cardiometabolic problems, such as diabetes and heart disease. It is also believed that hunter-gatherers had slender physiques and didn’t have chronic ailments (*).

As for macronutrients, the paleo diet doesn’t focus on counting carbs, protein, and fat. Essentially, you’ll only need to eat lots of unprocessed foods.

For those who are interested, macronutrient composition may vary depending on who you ask — e.g. 35% fats, 35% carbs, and 30% protein or 35% fats, 25% carbs, and 40% protein. Note that while it eliminates many high-carb sources like grains, refined sugar, and processed foods, the diet itself isn’t very low-carb (unlike keto).

What is the Keto Diet?

The ketogenic diet or “keto” diet for short, is a very low-carb, moderate-protein, and high-fat eating pattern. With that said, the keto diet emphasizes following a specific macronutrient ratio for the goal of reaching a metabolic state of ketosis.

During ketosis, your body burns its own stored fat for fuel and does not have to rely on carbs (as is the case for most people following a standard high-carb diet).

You will need to follow these macro percentages on keto (*):

  • 55% to 60% fat
  • 30% to 35% protein
  • 5% to 10% carbohydrates, usually 20 to 50 grams per day

Foods allowed on keto include meats (both lean and fatty cuts), leafy greens, eggs, berries, avocados, nuts, and seeds. Processed foods are allowed as long as they’re very low-carb and do not use vegetable oils (e.g. soybean oil, canola oil, and sunflower oil).

Keto may have been used to treat epilepsy back in the 1920s by mimicking fasting, but nowadays millions of people follow it each year for different reasons. Weight loss is a popular one. Others include improving insulin sensitivity, reversing type 2 diabetes, and boosting cognitive function.

What’s also interesting about the keto diet is that it can be suited to different lifestyles and preferences. For example, physically active individuals may choose a cyclical keto diet or targeted keto diet, whereas those who love animal-based foods and their benefits can follow a keto carnivore approach.

Similarities Between the Paleo Diet and the Keto Diet

You might be surprised that keto and paleo have a lot of similarities in terms of forbidden foods, and the emphasis on protein and healthy fats.

As mentioned previously, the paleo diet avoids grains and so does keto. The reason is that compared to other whole foods, such as meat, eggs, poultry, and seafood, grains are less nutrient-dense. Grains (such as wheat, corn, rye, quinoa, and barley) have high levels of lectins — an anti-nutrient that promotes inflammation and may cause health problems (*). Keto dieters steer clear of grains also because they contain high amounts of carbohydrates, which kick you out of ketosis.

To promote optimal health, the paleo and keto diets emphasize whole-food proteins and healthy fats. Some paleo dieters look for lean protein sources, such as top sirloin steak and skinless chicken breast, while others value fattier cuts like pork belly and chicken thighs.

Healthy fats are highly encouraged, such as omega-3 fatty acids, monounsaturated fats, and saturated fats, on both diets. Foods containing these fats include eggs, red meat, chicken, salmon, avocado, olives, and pumpkin seeds.

New research suggests that saturated fat has little effect on heart disease, contrary to popular belief (*, *). There’s no need to stress about avoiding or going overboard with saturated fat, as long as you get these fats from whole, unprocessed foods.

If you’re trying to avoid added sugars, the good news is that you can choose between keto or paleo. Added sugars are found in many processed items, such as pastries and fruit drinks, and offer no nutritional value. Examples of added sugars include cane sugar, glucose, dextrose, and maltose (*). See this guide for a complete list of sugar names.

One minor exception, though, is that paleo allows honey — but only in small amounts.

The Main Differences Between Paleo and Keto

Some notable differences between these diets are their macronutrient ratios, the presence of whole-food carbohydrates and avoidance of dairy products (for paleo), and their health uses. We’ll discuss each in more detail below.

Macronutrient ratios

The majority of keto calories come from fat, whereas paleo keeps fat at a moderate amount — around 35%. Another important highlight is that keto is extremely low in carbs (only up to 50 grams a day) while paleo has a higher carb limit compared to keto — although it’s generally lower than the standard recommendation for Americans, which is 45% to 65% of total daily calories (*).

For a clearer comparison, here are the macros for paleo vs keto diets:

Paleo Keto Note
Carbs 25-35% 5% to 10% carbohydrates.

Also, note that some people eat close to zero carbs.

Fat 35% 55% to 60%, but can also go as high as 70-80%
Protein  30-40% 30% to 35%

It’s worth pointing out that despite the given macro percentages for a paleo diet, tracking macros is not necessary. However, some people would consider doing it to reach specific goals like building muscle and managing a weight loss plateau, which would likely involve adjusting carbs.

Foods

While the paleo diet restricts high-glycemic carbs — these are carbs that break down quickly, raising your blood sugar levels fast — it still permits a lot of whole-food carbs. Examples of these paleo-friendly carbs include apples, citrus fruits, and kiwis, grapes.

The keto diet is different in that it restricts all high-carb foods. Sweet fruits, in general, are not allowed on keto. The only fruits that are keto-approved, because they have very few carbs per serving, include avocados, berries, coconut meat, watermelon, and cantaloupe. You should also be careful with veggies on keto — stick to leafy greens, cruciferous veggies, and small amounts of herbs and spices.

Foods Paleo Keto
Fruits: apples, citrus, kiwis, grapes Allowed Not Allowed
Dairy: Milk, cheese, yogurt, sour cream Not Allowed Allowed

Potential Health Benefits

While both paleo and keto diets work for weight loss, the paleo helps you lose weight through whole, unprocessed foods which are nutrient-dense and lower in calories than processed options. Meanwhile, keto promotes weight loss by increasing ketone bodies through carbohydrate restriction. Ketosis, a fat-burning mode, also helps suppress your appetite (*).

People who are trying to control their blood glucose levels to prevent or manage diabetes may also benefit from keto or paleo.

However, between the two diets, keep in mind that keto is more restrictive with carbs, which can cause blood glucose to fall substantially (*). For this reason, those with diabetes should consult with their healthcare provider regarding adjusting their glucose-lowering medications when on a keto diet.

Potential Drawbacks

Keto and paleo diets are both restrictive; however, keto focuses on carb restriction (an emphasis on macros) whereas paleo focuses on the avoidance of processed foods (an emphasis on food quality). Avoiding certain foods works for many people trying to prevent or overcome health problems. Conversely, it may trigger overeating for some.

Which is Healthier: Keto or Paleo?

When it comes to supporting health, both keto and paleo are good options as long as you properly implement them. Whether you choose keto or paleo, spend some time researching its basic rules (e.g. foods allowed and forbidden) as well as the common obstacles beginners face and how to overcome them.

Consider these additional factors when choosing between keto and paleo for your health:

  • Enjoyability: A healthy diet should also be one that you enjoy. When you like the diet, you’re more likely to stick with it long-term. Consider whether you’re willing to give up certain foods, such as grains, sugar, and other high-glycemic items. More importantly, find delicious replacements for these foods that are off-limits.
  • Your budget: Does your chosen diet allow you to meet your nutritional needs economically? The good news is that you can do paleo or keto on a budget by buying foods in bulk, selecting cheaper cuts of meat, and cooking most of your meals at home.
  • Diets you’ve tried in the past: Recall the diets you’ve done previously and whether they’ve worked or not. If a diet didn’t work, explore the possible reasons — for instance, it caused you to feel overwhelmed and burned out, have a poor relationship with food, and experience hunger more often.
  • Health condition: Do you struggle to keep your blood sugar, blood pressure, etc. within a normal range? Do you have certain allergies and food intolerances? Consider these things before deciding between keto and paleo.
  • Studies to support the diet: There’s plenty of research showing how keto and paleo can improve your health. When finding studies published online, keep in mind that randomized controlled trials (RCTs) reduce bias, making them a more reliable resource (*).
Paleo vs Keto

Frequently Asked Questions

Below are more questions and answers on paleo vs keto:

Does paleo put you in ketosis?

Unlike the keto diet, the paleo diet is not designed to put your body in ketosis. This is because paleo allows for more carbs (except grains and foods with a high glycemic load) as long as they come from whole food sources.

Which diet is better for weight loss: paleo or keto?

From a macronutrient standpoint, the keto diet may be more advantageous for weight loss because it limits carbs to less than 50 grams per day. Among the three types of macros — carbs, protein, and fats — carbs have the greatest effect on your blood sugar and insulin. When insulin levels rise, you’re more likely to store body fat.

Which diet is sustainable in the long run: paleo or keto?

It depends on which diet resonates most with you and can help you reach your personal goals. You will discover this along the way as you experience the diet.

Is it possible to combine paleo and keto?

You may be able to merge both diets to get the best of both worlds. An example is incorporating some paleo diet principles into the keto diet, such as going dairy-free on keto and removing all processed sources.

The Bottom Line

Both diet plans can be great for you — although it’s important to consider factors like the long-term benefits associated with a diet, enjoyability, budget, and potential drawbacks.

At the end of the day, keep in mind that nutrition is a personal thing. For instance, if focusing on cutting carbs makes more sense for you than focusing on excluding dairy and processed foods, then the keto diet would be a better option.

You can also benefit from speaking with a healthcare professional, such as a doctor or registered dietician, who’s knowledgeable and has previously worked with clients on keto or paleo.

9 References

Annapoorna S et al. The Paleolithic Diet. 2023 January 25

Wajeed M et al. Ketogenic Diet. 2022 June 11

Loren C et al. Modulation of immune function by dietary lectins in rheumatoid arthritis. 2007 March 9

Marinka S et al. Dietary Fatty Acids, Macronutrient Substitutions, Food Sources and Incidence of Coronary Heart Disease: Findings From the EPIC-CVD Case-Cohort Study Across Nine European Countries. 2021 December 7

Zahra G et al. The association between dietary fats and the incidence risk of cardiovascular outcomes: Tehran Lipid and Glucose Study. 2021 October 30

Harvard Health Publishing. How to spot — and avoid — added sugar. 2014 October 16

Mayo Clinic Staff. Nutrition and healthy eating. 2022 March 22

Gibson A et al. Do ketogenic diets really suppress appetite? A systematic review and meta-analysis. 2015 January

Eduardo H et al. Randomised controlled trials—the gold standard for effectiveness research. 2018 Dec 1

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