The Mediterranean diet, rooted in the traditional eating habits of nations such as Italy, Spain, and Greece, was initially characterized by physiologist Ancel Keys in the 1960s.
In contrast, people first introduced the ketogenic (keto) diet in 1921 as a therapeutic approach for epilepsy, and it has only recently gained popularity among the wider public. Individuals frequently adopt both dietary plans to lose weight, enhance cardiovascular health, and increase energy levels.
This article aims to evaluate the primary advantages and disadvantages of the Mediterranean and keto diets to assist in determining which may be more suitable for your needs.
Basics of the Mediterranean vs keto diets
The Mediterranean diet and ketogenic diet both feature specific food limitations, albeit in different contexts.
Mediterranean diet
The Mediterranean diet suggests that certain foods should be limited, but it does not enforce a complete prohibition on any specific items.
For example, people usually consume red meats like beef, pork, and lamb only on special occasions, while they prioritize other protein sources such as poultry, seafood, and legumes.
Additionally, the diet advocates for a reduction in processed foods and sweets, which includes refined grains, processed meats, convenience meals, and foods high in added sugars. People usually avoid beverages that contain added sugars, including sodas, sweet teas, and sports drinks.
Keto diet
1. In contrast to the Mediterranean diet, the ketogenic diet is significantly more restrictive. The ketogenic approach emphasizes a higher intake of fats while imposing strict limitations on carbohydrate consumption to achieve a state of ketosis, wherein the body utilizes fat as its primary energy source instead of sugar.
Although there are no explicit rules regarding which foods to limit or avoid, many items are unlikely to fit within the daily carbohydrate allowance, typically ranging from 20 to 50 grams.
Consequently, a standard ketogenic diet often excludes numerous high-carbohydrate foods, including many that are nutritious, such as fruits, starchy vegetables, grains, and legumes.
Additionally, we omit foods high in sugar, such as candy, baked goods, sugary beverages, and desserts. The ketogenic diet instead emphasizes low-carbohydrate, high-fat foods, including animal proteins, dairy products, non-starchy vegetables, and various oils or butter.
Benefits of Mediterranean vs. keto diets
Numerous health benefits have been associated with both the Mediterranean diet and the ketogenic diet.
Support heart health
Experts widely recognize the Mediterranean diet for its positive impact on cardiovascular health. A comprehensive review encompassing 41 studies indicated that following a Mediterranean diet is associated with a reduced risk of heart disease and stroke. Additionally, research suggests that this dietary pattern may aid in lowering blood pressure and preventing plaque accumulation in the arteries, both of which are significant contributors to heart disease.
In contrast, studies examining the connection between the ketogenic diet and heart health have produced varied findings. Some research indicates that the ketogenic diet may lower total cholesterol and low-density lipoprotein (LDL or “bad”) cholesterol levels. Nevertheless, you should consider that multiple factors can influence these outcomes. Other studies have reported that the ketogenic diet might actually elevate LDL cholesterol levels, which could potentially lead to plaque formation in the arteries and obstruct blood flow to the heart.
Many high-fat items commonly included in the ketogenic diet, such as processed meats, can increase the risk of heart disease, and the impact of the diet on heart health may depend on the specific foods consumed. Furthermore, individual responses to dietary cholesterol can vary, which may also influence cardiovascular health.
Support healthy brain function
Research indicates that the Mediterranean diet may contribute positively to brain health in older individuals.
For example, one study revealed that a higher adherence to the Mediterranean diet correlated with reduced indicators of cognitive decline and dementia among older adults.
Additionally, another study suggested that this diet could be associated with enhanced brain function and memory, along with a decrease in depressive symptoms in the elderly population.
Researchers have also investigated the potential benefits of the ketogenic diet on brain health.
Scientists are currently investigating the neuroprotective qualities of ketone bodies, which are generated as an alternative energy source during the ketogenic diet, for their potential to safeguard against conditions such as Alzheimer’s disease.
Additionally, many practitioners frequently use the ketogenic diet as a therapeutic approach for epilepsy.
A review highlighted that experts have utilized various forms of the ketogenic diet to prevent seizures since the 1920s, recognizing it as an effective treatment for individuals with epilepsy who do not respond to conventional medications.
Support blood sugar management
The Mediterranean diet promotes the consumption of a diverse array of nutrient-rich, high-fiber foods, which may assist in stabilizing blood sugar levels.
Research shows that following the Mediterranean diet improves blood sugar regulation and may lower the risk of developing type 2 diabetes.
Similarly, the ketogenic diet has demonstrated effectiveness in managing blood sugar levels among individuals with type 2 diabetes.
A small-scale study involving 30 diabetic participants revealed that 26% of those who adhered to a very low-calorie ketogenic diet for a duration of 12 months were able to discontinue all diabetes medications.
Both dietary approaches may also contribute to improved insulin sensitivity. Notably, one study found that both the Mediterranean diet and a low-carbohydrate diet were comparably effective in decreasing insulin resistance, a condition that hinders the body’s capacity to control blood sugar levels.
However, it is important to note that the low-carbohydrate diet in the study comprised approximately 30% carbohydrates, which is significantly higher than the carbohydrate content typically found in a ketogenic diet. Consequently, the extent of the ketogenic diet’s benefits, if any, regarding insulin sensitivity remains uncertain.
Downsides of the Mediterranean and keto diets
Both the Mediterranean diet and the ketogenic diet may yield several health benefits; however, it is crucial to take into account some potential limitations inherent to each diet.
Mediterranean diet
In contrast to numerous other dietary regimens, the Mediterranean diet is characterized by its lack of stringent rules or regulations. While this flexibility may appeal to some individuals, others might find greater satisfaction in more structured diets that offer comprehensive guidance.
Additionally, the Mediterranean diet advocates for the moderate consumption of red wine during meals. Although there are several health benefits associated with red wine, certain individuals, such as those who are pregnant or have a history of alcohol use disorder, may need to restrict their alcohol consumption.
Furthermore, as the Mediterranean diet emphasizes whole and minimally processed foods, it may prove to be more costly and time-consuming to adhere to compared to other dietary plans, which could be a significant factor for some individuals.
Keto diet
The keto diet presents a greater level of restriction than the Mediterranean diet, which may complicate adherence due to the necessity of closely monitoring carbohydrate intake. This process can be both stressful and time-consuming, and research indicates that food tracking may contribute to an unhealthy relationship with food, leading to feelings of guilt, shame, anxiety, or inadequacy after meals.
Additionally, individuals may experience various initial side effects as their bodies adapt, commonly referred to as the “keto flu.” Frequently reported symptoms include headaches, nausea, fatigue, dizziness, and cognitive fog. While research on the long-term safety and side effects of the ketogenic diet is limited, some findings suggest a potential increase in the risk of fatty liver disease, constipation, and kidney stones.
Moreover, careful dietary planning is essential to meet nutritional requirements on the ketogenic diet, as it may be associated with a heightened risk of vitamin and mineral deficiencies. Restrictive weight loss diets, such as the ketogenic diet, may also adversely affect mental health and body image.
In reality, they might also lead to the development of disordered eating habits, which can manifest as an intense focus on food, a disregard for hunger and satiety cues, and an unhealthy obsession with maintaining a healthy diet.
Which is better for weight loss?
While there is no existing research that directly compares the Mediterranean diet to the ketogenic diet, both diets have been associated with weight loss benefits.
One study demonstrated that participants on the Mediterranean diet could achieve weight loss of up to 22 pounds (10 kg) over the course of a year, showing effectiveness similar to that of low-carbohydrate and diabetes-friendly diets.
In contrast, a smaller study involving 32 individuals with obesity found that those on a low-carbohydrate, low-calorie diet lost 58% more weight after four weeks compared to those following a low-calorie Mediterranean diet. It is noteworthy that both groups experienced comparable reductions in visceral fat and total fat mass.
Additionally, the low-carbohydrate diet included around 30% of daily calories from carbohydrates, which is higher than what a conventional ketogenic diet typically allows.
Although the ketogenic diet may lead to quick short-term results, evidence shows that most people reach their peak weight loss after about five months and often don’t maintain it in the long term.
Moreover, the ketogenic diet can be more difficult to adhere to, and there is a lack of comprehensive research on its long-term safety and effectiveness.
Evidence suggests that diets characterized by moderate or low carbohydrate intake, while still exceeding the carbohydrate levels of the ketogenic diet, are generally easier to maintain and can lead to similar weight loss outcomes.
On the other hand, research has shown that a strong commitment to the Mediterranean diet may help mitigate increases in body weight and abdominal fat over time.
A comparative study of low-fat, low-carb, and Mediterranean diets found that the Mediterranean diet was associated with the highest adherence rates and the most prolonged weight loss after six years.
Therefore, given its greater ease of adherence, flexibility, and numerous health benefits, the Mediterranean diet is likely a more effective option than the ketogenic diet for promoting long-term, sustainable weight loss.
For optimal results, it is advisable to integrate a well-balanced and nutritious diet with a healthy lifestyle and consistent physical activity.
This combination not only supports gradual weight loss that is easier to sustain but also contributes to various health improvements while fostering a positive relationship with food and one’s body.
The bottom line
The ketogenic (keto) diet and the Mediterranean diet are two prominent dietary frameworks that have garnered attention for their possible health advantages. Specifically, both diets may aid in enhancing heart health, managing blood sugar levels, and improving brain function.
However, some research suggests that the keto diet might raise LDL cholesterol levels, potentially diminishing its effectiveness in supporting cardiovascular health.
Moreover, while both diets can lead to weight loss, the Mediterranean diet is typically easier to adhere to and is likely a safer, more sustainable option over an extended period. People often experience peak weight loss within a few months on the keto diet, but they frequently do not maintain it in the long run.
