The Mediterranean diet was initially described in the 1960s by physiologist Ancel Keys, who based it on the historic eating patterns of nations such as Italy, Spain, and Greece (1).
Meanwhile, even though the ketogenic (keto) diet was created in 1921 as a therapy for epilepsy, it has only recently achieved popularity among the general public (2).
While both diets are popular among those trying to reduce weight, improve heart health, and increase energy levels, many better questions.
This article will evaluate the primary advantages and disadvantages of the Mediterranean versus the keto diet to help you decide which is best.
Basics of the Mediterranean and keto diets
Both the Mediterranean diet and the ketogenic diet limit and restrict several items.
Mediterranean diet
While no foods are legally forbidden on a Mediterranean diet, some should be avoided.
Red meat, such as beef, hog, and lamb, is only eaten on rare occasions while following the Mediterranean diet. Instead, alternative protein sources such as chicken, fish, and lentils are more commonly ingested (3).
Processed foods and sweets, such as refined grains, processed meat products, convenience meals, and foods high in added sugar, are also restricted (3).
Sugar-sweetened beverages, such as soda, sweet tea, and sports drinks, are also often avoided.
Keto diet
The keto diet is substantially more stringent than the Mediterranean diet.
The ketogenic diet entails increasing your fat consumption while rigorously restricting your carb intake to enter ketosis, a metabolic state in which your body burns fat for fuel rather than sugar (2).
Though there are no particular standards for which meals to restrict or avoid, many items are unlikely to fit within your daily carbohydrate allowance, typically ranging from 20 to 50 grams per day (2).
As a result, many high carb items, including healthful ones like fruits, starchy vegetables, grains, and legumes, are generally eliminated from a conventional keto diet.
Sugary foods, such as candy, baked goods, sugary beverages, and desserts, are also prohibited.
Instead, the ketogenic diet emphasizes low-carb, high-fat meals such as animal proteins, dairy products, non-starchy vegetables, and oils or butter.
Benefits of Mediterranean and keto diets
Mediterranean and ketogenic diets have been linked to several health advantages.
May support heart health
The Mediterranean diet is best known for its potential to promote cardiovascular health.
For example, adherence to a Mediterranean diet was related to a decreased risk of heart disease and stroke in one central evaluation of 41 research (4).
According to research, the Mediterranean diet can help lower blood pressure and prevent plaque development in the arteries, which can contribute to heart disease (5, 6).
The research on the keto diet and heart health has shown conflicting results. According to some research, the keto diet may lower total and low density lipoprotein (LDL or “bad”) cholesterol levels (7).
However, keep in mind that this may vary depending on a variety of factors, and other studies have found that the ketogenic diet may raise LDL cholesterol levels, which can contribute to the buildup of plaque in the arteries and block blood flow to your heart (8, 9, 10).
The extent of the keto diet’s effects on heart health may also depend on the foods you eat, as many high fat ingredients commonly found in the diet, such as processed meats, have been linked to an increased risk of heart disease (11, 12).
Furthermore, various people’s bodies react differently to dietary cholesterol, which may influence heart health (13).
May support blood sugar management
The Mediterranean diet promotes a range of nutrient-dense, high fiber foods, which may stabilize blood sugar (14).
According to research, the Mediterranean diet helps enhance blood sugar control and may be linked to a decreased risk of acquiring type 2 diabetes (15, 16).
The keto diet has also been demonstrated to help persons with type 2 diabetes regulate their blood sugar (17).
According to little research on 30 persons with diabetes, 26% could quit taking all diabetic medicines after following a deficient calorie keto diet for 12 months (18).
Both diets may also assist with insulin sensitivity. According to one research, a Mediterranean diet and a low carb diet were equally efficient at reducing insulin resistance, affecting the body’s capacity to control blood sugar levels (19, 20).
However, the study’s low carb diet had roughly 30% carbohydrates, substantially more carbs than a regular keto diet. As a result, it’s unknown how much, if any, advantage the keto diet may provide in improving insulin sensitivity.
It may support healthy brain function
According to some studies, the Mediterranean diet may assist in sustaining brain function as you age.
One study, for example, discovered that higher adherence to the Mediterranean diet was related to lower indicators of cognitive decline and dementia in older persons (21).
Another study found that the Mediterranean diet may be associated with enhanced brain function and memory and reduced depressive symptoms in older persons (22).
The ketogenic diet has also been investigated for its potential to improve brain function.
Indeed, the ketone bodies created as an alternative energy source on the keto diet may have neuroprotective qualities. They are being examined for their capacity to protect against illnesses such as Alzheimer’s disease (23).
Furthermore, the ketogenic diet is frequently used to treat epilepsy.
According to one analysis, several forms of the keto diet have been used to prevent seizures since the 1920s. They are regarded as an effective therapy for persons with epilepsy that does not respond to drugs (24).
Downsides of the Mediterranean and keto diets
Though the Mediterranean and keto diets have significant health benefits, each has a few drawbacks.
Mediterranean diet
Unlike many other diet regimens, the Mediterranean diet has no stringent rules or requirements.
While some may favor this eating pattern’s flexibility, others may prefer planned diets with more precise directions.
The Mediterranean diet also supports moderate red wine drinking with meals.
Although red wine has been linked to various health advantages, certain people, particularly those pregnant or with a history of alcohol use disorder, may need to reduce their alcohol intake (25, 26).
Furthermore, because the Mediterranean diet emphasizes whole and minimally processed foods, it can be more expensive and time-consuming than other diets, which may be a significant factor for some.
Keto diet
The keto diet is far more restricted than the Mediterranean diet and may be more challenging to adhere to since it demands you to watch your carb consumption closely.
Tracking can be difficult and time-consuming, but some studies show that it may establish an unhealthy connection with food and produce emotions of guilt, shame, anxiety, or inadequacy after eating (27, 28).
The keto diet can also create some adverse effects while your body changes, known as the “keto flu.”
Headache, nausea, exhaustion, dizziness, and brain fog are some of the most often reported adverse symptoms of the ketogenic diet (29).
Though there have been few long-term studies on the ketogenic diet’s safety or adverse effects, some evidence shows that it may raise your risk of fatty liver disease, constipation, and kidney stones (2).
Furthermore, careful preparation is required to ensure that dietary requirements are satisfied on the ketogenic diet since it has been associated with an increased risk of vitamin and mineral shortages (30).
Restrictive weight loss programs like the keto diet may harm mental health and body image.
They may even lead to eating disorders, such as obsessing over food, neglecting hunger and satiety (fullness), and developing an obsessive preoccupation with healthy eating (31).
Which is better for weight loss?
Though there has been no direct comparison of the effectiveness of the Mediterranean and ketogenic diets, both can aid in weight reduction (2, 32).
According to one study, the Mediterranean diet can lose up to 22 pounds (10 kg) after one year and is just as successful as low carb and diabetes-friendly diets (33).
A short research of 32 obese persons revealed that those who followed a low carb, low calorie diet lost 58% more body weight after 4 weeks than those who followed a low calorie Mediterranean diet (19).
However, remember that both groups reported comparable decreases in belly fat and overall fat mass. Furthermore, the low carb diet provided around 30% of daily calories from carbohydrates, more significant than a regular keto diet (19).
Even though studies indicate that the keto diet can produce quick, short-term outcomes, weight reduction often plateaus after approximately five months and is seldom sustained long-term (2, 34).
Furthermore, the ketogenic diet is more challenging to follow, and evidence of its long-term safety and efficacy is weak (35).
However, evidence suggests that diets moderate or low in carbohydrates but higher in carbs than keto are easier to stick to and result in comparable weight reduction (36).
In contrast, research demonstrates that increased adherence to the Mediterranean diet may help avoid long-term gains in body weight or belly fat (37).
Interestingly, one study evaluating the benefits of low fat, low carb, and Mediterranean diets discovered that the Mediterranean diet was linked with the highest adherence and the longest-lasting weight reduction of all three diets after six years (38).
As a result, the Mediterranean diet is likely a superior alternative to the keto diet for promoting long-term, sustained weight reduction since it is simpler to follow, more flexible, and connected to a lengthy number of health advantages (39).
Combine well-rounded and nutritious food with a healthy lifestyle and frequent physical activity to achieve the most outstanding results.
This can not only help with consistent weight reduction that is easier to sustain in the long run, but it can also help with many other aspects of health while building a healthy connection with food and your body.
The bottom line
Two prominent eating patterns researched for their possible advantages are the ketogenic (keto) and Mediterranean diets.
Both, in particular, may benefit heart health, blood sugar control, and cognitive function. However, other studies have revealed that the keto diet may raise LDL cholesterol levels, making it less helpful in maintaining heart health.
While both diets can help you lose weight, the Mediterranean diet is considered a safer, more sustainable alternative in the long run. Weight reduction on the keto diet is expected to peak within a few months and is seldom sustained.
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