Mediterranean diet vs keto go head-to-head, although they approach diet and wellness from two very different directions
One of the changes in diet for many people as a result of COVID lockdown orders is that they are not eating out as often. With restaurants limited to either take-out or delivery, more people are instead preparing their meals at home. Both the keto and the Mediterranean diets have gained a great deal of popularity over the past few years and can easily be followed with ingredients found in most supermarkets. Although there are some similarities, in terms of foods that can be eaten, there are also key differences in terms of goals, potential risks, and long-term benefits. Who wins in the Mediterranean diet vs. keto match-up?
The defining feature of the keto diet is that it is extremely low in carbs and high in fat.1 In fact, carbs should be less than 10% of the total daily intake.
When the body no longer has carbs or glucose as a fuel source, it will instead turn to fat, which the liver turns into ketones. These ketones then become the body’s new fuel source, replacing the sugars found in carbs. Because the body needs to replace so many carbs, fats are increased to make up as much as 90% of a 2,000 calorie per day diet.1 A sample, keto-friendly diet might include:
- Rib eye steak, pork roast and bacon, instead of lean meats
- Dark chocolate and nut butters
- Leafy greens, instead of starchy vegetables such as sweet potatoes
- Oil- or mayonnaise-based salad dressings
A 2013 meta-analysis of smaller studies appear to show that the keto diet has success over the short term, compared to just a standard low-fat diet.2 A 2018 study found that patients still retained modest weight loss for periods of up to a year, but there was also a high drop-out rate of as many as one-third of all patients.3
While some promote the keto diet as a lifestyle, many point it out as unhealthy over the long term due to its high fat requirements.
The Mediterranean diet is not as strict or regimented as the keto diet. Instead, it is loosely based around the standard diet found among countries surrounding the Mediterranean.
Some examples of food that could be found in a Mediterranean diet include:
- Fresh fruit and vegetables
- Whole grains, beans, lentils, and nuts
- Herbs, spices, and healthy fats such as olive oil
- Seafood twice a week
- Moderate amounts of dairy, including eggs and poultry
It should not be surprising that the Mediterranean diet has long-term health benefits for most people who follow it. A 2018 study followed the health status of almost 26,000 healthy American women. The researchers found that the risk of cardiac disease was reduced by approximately 25% for those women who followed the Mediterranean diet.4
Mediterranean diet vs Keto — which diet is better?
The answer to this question really comes down to each individual patient’s health, lifestyle, and goals.
Because the keto diet puts stress on both the kidneys and liver, it may not be the best option for your patients who are prone to kidney stones or liver problems. On the other hand, it may be an excellent way for them to “jump start” their weight loss plan, before transitioning to a long-term change in eating habits, such as the Mediterranean diet.
On the other hand, the Mediterranean diet will not produce rapid weight loss, so it is likely to be more successful with your patients who are committed over the long term to a wellness lifestyle.
- Masood W, Uppaluri KR. Ketogenic diet. [Updated 2020 March 29]. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing.
- Bueno NB, de Melo IS, de Oliveira SL, da Rocha Ataide T. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: A meta-analysis of randomised controlled trials. British Journal of Nutrition. 2013;110(7):1178-1187.
- Ting R, Dugré N, Allan GM, Lindblad AJ. Ketogenic diet for weight loss. Canadian Family Physician. 2018;64(12):906.
- Ahmad S, Moorthy MV, Demler OV, et al. Assessment of risk factors and biomarkers associated with risk of cardiovascular disease among women consuming a Mediterranean diet. JAMA Network Open. 2018;1(8):e185708.