I hear people asking all the time, “What is the difference between the Mediterranean Diet vs Keto Diet?

Honestly, I don’t think that it’s very useful for someone looking for a healthier diet to get too caught up in the science. When this happens, often people begin to obsess over this molecule or that molecule, while losing sight of the bigger picture: your overall health and well-being. 

I’ve written against this type of reductive reasoning before. It serves us well to study these factors under perfect laboratory conditions, but does little to produce results in the real world. Our bodies are just too complex to comply with this sort of false logic. 

In other words, leave the science to the scientists. They’re good at analyzing minutiae. But in our daily lives, we should instead follow the example from the generations of healthy populations in the Mediterranean. Life is to be lived, after all, not analyzed. 

Still, there might be something useful to be learned from making this comparison. So let’s dive into it anyway, and perhaps in the process we can dispel the lure of hyper-managing every molecule in our diets in favor of a simpler way to approach nutrition and wellness. 

On The Podcast: Mediterranean Diet vs. Fad Diets

What Is the Difference Between Mediterranean Diet and Keto Diet?

As we all know, the Mediterranean Diet and the Keto Diet are two popular regimes that have gained a lot of attention in recent years due to their “potential” health benefits, both physical as well as for mental health. While there are a few similarities, there are also a number of significant differences in their approach to nutrition.

Similarities Between Mediterranean Diet and Keto Diet

Both diets emphasize the importance of whole foods: The Mediterranean Diet and the Keto Diet both recommend eating whole, unprocessed foods like vegetables, fruits, nuts, and seeds.

Both diets encourage the limiting or even elimination of sugar and processed foods, which are high in calories, unhealthy fats, and refined sugars.

Both the Mediterranean Diet and the Keto Diet require a long-term commitment to achieve lasting results. The Keto Diet promises quick results, particularly in regards to weight loss, but then requires a long-term commitment to maintain a healthy weight.

Differences Between Mediterranean Diet and Keto Diet

Macronutrient composition: The Mediterranean Diet is a low-to-moderate fat diet, while the Keto Diet is a high-fat, very low-carb diet.

Carbohydrate intake: The Mediterranean Diet is higher in carbohydrates than the Keto Diet, which severely restricts carb intake to less than 50 grams per day.

Protein intake: The Mediterranean Diet promotes a moderate protein intake, while the Keto Diet promotes a higher protein intake.

Sustainability: The Mediterranean Diet is generally considered to be a more sustainable diet in the long term, as it allows for a wider variety of foods and is easier to maintain for most people, while the strict limitations of the Keto Diet may make it more challenging to sustain over time.

Healthy Mediterranean Diet ingredients

Mediterranean Diet vs Keto for Weight Loss

When it comes to weight loss, both the Mediterranean Diet and the Keto Diet have been shown to be effective in helping people shed pounds. However, the approach to weight loss is different between the two diets, and each has its own unique advantages and limitations. 

Here are some key points to consider when comparing the Mediterranean Diet and the Keto Diet for weight loss:

Mediterranean Diet:

The Mediterranean Diet is not specifically designed for weight loss, but it can still be an effective way to shed pounds, especially when combined with a calorie deficit, such as during periods of fasting. Here are some ways that the Mediterranean Diet can promote weight loss:

  1. Emphasis on whole, nutrient-dense foods: The Mediterranean Diet emphasizes whole, nutrient-dense foods like vegetables, fruits, whole grains, legumes, and healthy fats. These foods tend to be lower in calories and higher in fiber, which can help promote feelings of fullness and reduce overall calorie intake.
  2. Moderate calorie intake: The Mediterranean Diet does not require calorie counting, but it does emphasize portion control and moderation. This can help individuals maintain a calorie deficit and promote weight loss over time.
  3. Elimination of processed foods: The Mediterranean Diet discourages the consumption of processed foods, which are often high in calories, unhealthy fats, and added sugars. By reducing the intake of these foods, individuals can reduce their overall calorie intake and promote weight loss.

Keto Diet:

The Keto Diet has gained popularity as a weight loss diet because it promotes rapid weight loss in the short term. Here are some ways that the Keto Diet can promote weight loss:

  1. Promotes ketosis: The Keto Diet promotes a state of ketosis, where the body burns fat for fuel instead of carbohydrates. This can lead to rapid weight loss in the short term, as the body burns through its fat stores.
  2. Suppresses appetite: The high fat and protein content of the Keto Diet can help promote feelings of fullness and reduce appetite. This can help individuals maintain a calorie deficit and promote weight loss.
  3. Reduces insulin levels: The Keto Diet can reduce insulin levels, which can help prevent fat storage and promote weight loss.

Limitations:

  1. Sustainability: Both the Mediterranean Diet and the Keto Diet require a long-term commitment to achieve lasting results. However, the strict limitations of the Keto Diet may make it more challenging to sustain over time.
  2. Health risks: The Keto Diet can increase the risk of certain health conditions, such as kidney stones, nutrient deficiencies, and high cholesterol levels.
  3. Social limitations: The strict limitations of the Keto Diet can make it challenging to dine out or enjoy meals with friends and family, which can make it difficult to sustain in the long term.

Both the Mediterranean Diet and the Keto Diet can be effective for weight loss, but the approach to weight loss is different between the two diets. The Mediterranean Diet is a more sustainable and balanced approach to weight loss, while the Keto Diet can promote rapid weight loss in the short term, but may be more challenging to sustain over time. Ultimately, the best diet for weight loss depends on an individual’s personal health goals, preferences, and lifestyle.

Mediterranean Diet for diabetics

Mediterranean Diet vs Keto for Diabetes

Type 2 diabetes is a chronic condition that affects how the body processes glucose. Diet plays an important role in managing blood sugar levels and preventing complications of diabetes.

Both the Mediterranean Diet and the Keto Diet have been studied for their potential benefits in managing type 2 diabetes. Here are some key points to consider when comparing the Mediterranean Diet and the Keto Diet for managing type 2 diabetes:

Mediterranean Diet:

The Mediterranean Diet has been shown to have numerous health benefits, including reducing the risk of type 2 diabetes and managing blood sugar levels in individuals with diabetes. Here are some ways that the Mediterranean Diet can benefit individuals with type 2 diabetes:

  1. Emphasis on whole, nutrient-dense foods: The Mediterranean Diet emphasizes whole, nutrient-dense foods like vegetables, fruits, whole grains, legumes, and healthy fats. These foods are generally low in glycemic index (GI), meaning they cause a slower and more gradual increase in blood sugar levels. This can help individuals with diabetes manage their blood sugar levels.
  2. Rich in fiber: The Mediterranean Diet is rich in fiber, which can help slow down the absorption of glucose and promote feelings of fullness. This can help individuals with diabetes manage their blood sugar levels and control their appetite.
  3. Reduces inflammation: The Mediterranean Diet has anti-inflammatory properties, which can help reduce the risk of complications associated with type 2 diabetes, such as cardiovascular disease.

Keto Diet:

The Keto Diet has been studied for its potential benefits in managing type 2 diabetes, particularly in promoting weight loss and improving blood sugar control. Here are some ways that the Keto Diet can benefit individuals with type 2 diabetes:

  1. Promotes weight loss: The Keto Diet can promote rapid weight loss, which can help improve blood sugar control and reduce the risk of complications associated with type 2 diabetes.
  2. Reduces insulin resistance: The Keto Diet can reduce insulin resistance, which can help improve blood sugar control in individuals with type 2 diabetes.
  3. Reduces inflammation: The Keto Diet has anti-inflammatory properties, which can help reduce the risk of complications associated with type 2 diabetes, such as cardiovascular disease.

Limitations:

  1. Sustainability: Both the Mediterranean Diet and the Keto Diet require a long-term commitment to achieve lasting results. But as mentioned previously, the strict limitations of the Keto Diet may make it more challenging to sustain over time.
  2. Nutrient deficiencies: The Keto Diet can lead to nutrient deficiencies, particularly in vitamins and minerals that are found in fruits, vegetables, and whole grains.
  3. High fat intake: The Keto Diet is a high-fat diet, which can increase the risk of cardiovascular disease and other health complications in some individuals.

In sum, the Mediterranean Diet is a more balanced and sustainable approach to managing blood sugar levels, even if the Keto Diet may be more effective for rapid weight loss and improving blood sugar control in the short term. 

*However, it’s important to consult with a healthcare professional before starting any new diet, especially if you have a chronic condition like type 2 diabetes.

Mediterranean Diet vs Keto for Heart Health

Genetics and high cholesterol are two of the biggest risk factors for cardiovascular disease. While we can’t do much about our genetics (yet), diet plays an important role in managing cholesterol levels and promoting heart health. 

Mediterranean Diet for heart health

Here are a few key points to consider when comparing the Mediterranean Diet and the Keto Diet for managing high cholesterol and promoting heart health:

Mediterranean Diet:

The Mediterranean Diet is well-known for its potential benefits for heart health. Here are some ways that the Mediterranean Diet can benefit individuals with high cholesterol and promote overall heart health:

  1. Emphasis on healthy fats: The Mediterranean Diet emphasizes healthy fats like extra-virgin olive oil, nuts, and fish, which can help reduce bad cholesterol (LDL) levels and promote good cholesterol (HDL) levels.
  2. Rich in antioxidants: The Mediterranean Diet is rich in antioxidants, which can help reduce inflammation and oxidative stress, both of which are risk factors for cardiovascular disease.
  3. Low in processed foods: The Mediterranean Diet is low in processed foods and refined carbohydrates, which can contribute to high cholesterol and poor heart health.

Keto Diet:

The Keto Diet has been studied for its potential benefits in managing cholesterol levels and promoting heart health. Here are some ways that the Keto Diet can benefit individuals with high cholesterol and promote overall heart health:

  1. Promotes weight loss: The Keto Diet can promote rapid weight loss, which can help improve cholesterol levels and reduce the risk of complications associated with cardiovascular disease.
  2. Reduces triglycerides: The Keto Diet can reduce triglyceride levels, which are a type of fat in the blood that can contribute to cardiovascular disease.
  3. Increases HDL: The Keto Diet can increase “good” cholesterol (HDL) levels, which can help reduce the risk of cardiovascular disease.

Both the Mediterranean Diet and the Keto Diet have potential benefits for managing high cholesterol and promoting overall heart health. The Mediterranean Diet may be a more balanced and sustainable approach to managing cholesterol levels and promoting heart health, while the Keto Diet may be more effective for rapid weight loss and reducing triglyceride levels in the short term. 

Mediterranean Diet vs Keto for Fatty Liver

Fatty liver disease is a condition that occurs when there is an excessive accumulation of fat in the liver cells. It is commonly associated with obesity and insulin resistance, and if left untreated, can lead to liver damage and cirrhosis. 

There are some key points to consider when comparing the Mediterranean Diet and the Keto Diet for managing fatty liver.

The Mediterranean Diet has been shown to reduce liver fat in individuals with non-alcoholic fatty liver disease (NAFLD), a type of fatty liver disease that is not caused by alcohol consumption.

Meanwhile, both diets seem to improve insulin sensitivity, which can help reduce the accumulation of fat in the liver. Furthermore, as mentioned, both diets also promote weight loss, which can also help reduce the amount of fat in the liver.

Mediterranean Diet vs Keto for Fertility

The Mediterranean Diet and the Keto Diet have both been studied for their potential effects on fertility.

 Here are some ways that the Mediterranean Diet can benefit fertility:

  1. Improved insulin sensitivity can help regulate ovulation and improve fertility.
  2. The Mediterranean Diet is rich in essential nutrients such as folate, iron, and antioxidants, which can support reproductive health and reduce the risk of birth defects.
  3. The Mediterranean Diet is rich in anti-inflammatory foods, such as fruits, vegetables, and nuts, which can help reduce inflammation in the reproductive system and improve fertility.

On the other hand, the Keto Diet has some limitations when it comes to promoting fertility:

  1. Nutrient deficiencies: The Keto Diet can lead to nutrient deficiencies, particularly in vitamins and minerals that are found in fruits, vegetables, and whole grains, which can negatively impact fertility.
  2. Limited research: There is limited research on the effects of the Keto Diet on fertility, and more research is needed to fully understand its potential benefits and risks.
  3. Unsustainable: The strict limitations of the Keto Diet may make it challenging to sustain over time, which can impact fertility in the long term.

Conclusion:

The Mediterranean Diet provides essential nutrients and antioxidants that can support reproductive health. However, while the Keto Diet may help regulate insulin levels and reduce inflammation, it may also lead to nutrient deficiencies. 

*It is important to consult with a healthcare professional before starting any new diet, especially if you are trying to conceive or have a history of fertility issues.

Fasting on the Mediterranean Diet

Another notable difference is that the Mediterranean Diet includes occasional periods of fasting, while the Keto Diet does not. Fasting has long been part of Mediterranean cultures, whether for religious reasons or the simple lack of food during certain times of the year. 

In any case, we now know that fasting can significantly contribute to healthy aging and reduced risks of degenerative diseases such as cardiovascular disease, cancer, and dementia. 

Pure fasting can be challenging, especially when you’re surrounded by the abundance of food choices in our modern societies. One thing that has worked for me personally is the Fasting Mimicking Diet, developed by Dr. Valer Longo at the University of Southern California (by way of Italy). It allows you to “fast” while eating. However the protocol created by Dr. Longo still produces the desired state of ketosis, which can lead to weight loss.

So from a metabolic perspective, this is precisely where The Mediterranean Diet and The Keto Diet converge. Both can produce this state of ketosis. 

However, fasting also creates a phenomenon called auto-phagy, which is a method of cellular repair that has been shown to produce anti-aging effects in humans. 

Is The Keto Diet the Same as The Paleo Diet?

The Keto Diet is often compared to the Paleo Diet, and they certainly have a lot in common. The Paleo diet is based on the premise of eating like our ancestors did during the Paleolithic era, emphasizing whole, nutrient-dense foods such as meats, fish, vegetables, fruits, nuts, and seeds. In other words, what we imagine that a “hunter-gatherer” group might have eaten.

Paleo Diet vs Keto Diet

This seems tempting to embrace, pointing to our evolutionary biology. But the truth is that we have evolved a good bit since our Paleolithic ancestors walked the Earth a few millions years ago. The Paleo Diet works under the false assumption that we have the same metabolism and gut health as our ancestors, which of course we do not.

The Paleo Diet is known for being very restrictive and can put you at risk for deficiencies in calcium and vitamin D, which are crucial for bone health. Consuming high amounts of meat on this diet can also result in increased levels of saturated fat and protein, leading to a higher risk of heart disease, kidney disease, and certain cancers.

Additionally, because the Paleo Diet cuts out several food groups, it can be hard to sustain long-term. Constantly operating under the mentality of “avoiding” certain foods can be tiresome, leading to frustration, and ultimately, defeat. It can also be expensive to maintain.

Furthermore, the exclusion of grains and dairy can be particularly challenging for vegetarians, especially since it excludes beans. 

Mediterranean Diet vs Low Carb Diet

The Keto Diet and The Paleo Diet are both low-carb regimes. However, some people who don’t necessarily subscribe to the full set of rules for these trendy diets, still try to limit their carbohydrate intake for perceived health benefits. 

It’s important to note that individuals following this nebulous “plan” often don’t distinguish between good carbs and bad carbs, which would be a big mistake. 

Low-carb diets typically to less than 20-50 grams per day, and encourage higher intakes of protein and fat. The types of foods allowed on a low-carb diet may vary, but typically include meat, poultry, fish, eggs, nuts, seeds, non-starchy vegetables, and some dairy products.

On the positive side, a low-carb diet “can” be effective for short-term weight loss, likely due to their ability to reduce appetite and increase fat burning. It can also improve blood sugar control and insulin sensitivity, making them a potential option for managing type 2 diabetes. And it can certainly reduce risk factors for heart disease, such as blood pressure, triglycerides, and HDL cholesterol levels.

However low-carb diets are not without potential drawbacks. Low-carb diets may be low in fiber, vitamins, and minerals that are abundant in fruits and whole grains, which may increase the risk of nutrient deficiencies. The strict limitations of low-carb diets may be challenging to sustain over the long term, leading to weight regain or other negative health effects.

But some people still want the “quick fix” of rapid weight loss associated with the (very) low-carb Keto Diet, along with the sustainability of The Mediterranean Diet. What, if anything, can be done in this case?

One possible compromise…

Mediterranean Diet and Keto Diet Combined

This would not be the recommended path, but for some, it might be the best solution. The best solution is the one that you’re able to maintain. 

So what would Keto and Mediterranean diet combined look like? Fortunately they have a few things in common, mostly notably the elimination of processed foods. 

Beyond that, one path might be to start on a Keto Diet for the first six to eight weeks, striving for the promise of quick weight loss, and then slowly transitioning to a more sustainable Mediterranean model for long-term weight maintenance and overall health.

Mediterranean Diet vs Keto Diet – Conclusion

Overall, both the Mediterranean Diet and the Keto Diet have their advantages and disadvantages, and the best choice depends on an individual’s personal health goals and lifestyle preferences. 

For quick weight loss, one might opt for the Keto Diet. But for an overall, long-term, sustainable lifestyle, the Mediterranean Diet wins every time. 

*It’s always important to consult a healthcare professional before starting any new diet.

Rick Zullo


Former doctor, current science teacher, and life-long food lover, Rick's passion for Mediterranean cuisine was ignited while living as an expat in Rome, Italy. 


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