Is the Mediterranean Diet Better than Keto? | Weight Loss Clinic

• Dr. David Nazarian
• 0 Comment
• Plant-Based Diet

Is the Mediterranean Diet Better than Keto?

When choosing a diet that supports health and wellness, two popular options are often at the forefront of the conversation: the Mediterranean and the ketogenic (Keto) diet. Each diet has unique principles and benefits, but how do they compare regarding long-term health outcomes? This blog will explore the key elements of both diets and dive into which one might be better for you.

What is the Mediterranean Diet?

The Mediterranean diet is based on the traditional eating habits of people in countries bordering the Mediterranean Sea. It emphasizes a high intake of plant-based foods, healthy fats, whole grains, and legumes, and a moderate consumption of fish and poultry. Red meat is consumed sparingly, and dairy products are generally moderately enjoyed.

This diet is rich in heart-healthy fats, particularly olive oil, and encourages the consumption of various fruits, vegetables, and nuts. The Mediterranean diet also includes a moderate amount of wine, usually consumed with meals.

Health Benefits of the Mediterranean Diet

The Mediterranean diet is known for its numerous health benefits. A comprehensive review of 41 studies found that adhering to a Mediterranean diet was associated with a significantly lower risk of heart disease and stroke, underscoring its effectiveness in promoting cardiovascular health [1]. Additionally, studies have shown that the diet can help lower blood pressure levels and protect against plaque buildup in the arteries, further enhancing heart health.

Incorporating the Mediterranean diet into your lifestyle can help reduce inflammation, improve blood sugar control, and promote overall well-being. It is often praised for its potential to improve longevity and reduce the risk of chronic diseases such as diabetes and cancer.

What is the Keto Diet?

The ketogenic (Keto) diet is a high-fat, low-carb diet that aims to put the body into a state called ketosis. In ketosis, the body burns fat for fuel instead of carbohydrates, which can lead to significant weight loss. The Keto diet typically involves drastically reducing carbohydrate intake to between 20–50 grams per day, while increasing the consumption of fats and moderate amounts of protein [2].

Unlike the Mediterranean diet, which is plant-based and emphasizes whole foods, the Keto diet primarily focuses on high-fat animal products, such as meat, butter, and cheese, as well as low-carb vegetables like leafy greens. The Keto diet trains the body to rely on fat for energy rather than sugar.

Health Benefits of the Keto Diet

The Keto diet has been shown to offer several health benefits, particularly in weight loss and managing blood sugar levels. It has been found effective for individuals with type 2 diabetes in improving insulin sensitivity and reducing blood sugar levels. Moreover, some studies suggest the diet may have potential benefits for neurological conditions such as epilepsy, though more research is needed in this area.

While the Keto diet may be effective for short-term weight loss, its long-term effects are still debated. Some studies suggest that it may not be as sustainable as other dietary patterns due to its restrictive nature and focus on high-fat foods.

Keto vs. Mediterranean Diet: Which is Better for Health?

Now, let’s compare the Mediterranean and Keto diets based on their health impacts. Both diets can be beneficial in various ways, but they each have distinct approaches and outcomes.

Macronutrient Breakdown

The Mediterranean diet is a balanced eating plan. The majority of calories come from healthy fats (primarily olive oil), followed by carbohydrates (whole grains, fruits, and vegetables) and a moderate amount of protein (fish and poultry). The distribution is roughly 40% carbohydrates, 40% fats, and 20% protein.

In contrast, the Keto diet is extremely low in carbs, often consisting of 70–75% fat, 20–25% protein, and only 5–10% carbs. This sharp reduction in carbohydrates is what triggers ketosis, where the body burns fat for fuel.

Health Impacts on Heart Disease, Weight Loss, and Diabetes

Research suggests that the Mediterranean diet is particularly beneficial for heart health. Studies have shown that it lowers the risk of heart disease and stroke. Additionally, it can help lower blood pressure and prevent plaque buildup in the arteries, which are significant factors in cardiovascular disease.

On the other hand, the Keto diet can also benefit heart health, but the high intake of saturated fats may increase cholesterol levels in some individuals, which could pose a risk for heart disease over time. The Mediterranean diet, with its emphasis on healthy fats like olive oil, is generally seen as more heart-healthy.

When it comes to weight loss, a study published in the International Journal of Environmental Research and Public Health compared the Mediterranean diet with a very low-calorie ketogenic diet (VLCKD) for weight loss. While both diets were effective, the Mediterranean diet showed more notable improvements in waist circumference and fat-free mass, indicating its potential for promoting healthier body composition [3].

For managing diabetes, the Keto diet has shown significant promise in improving insulin sensitivity and reducing blood sugar levels. However, the Mediterranean diet also plays a crucial role in stabilizing blood sugar, making it a good option for individuals with or at risk of diabetes.

Effectiveness for Long-Term Health

The Mediterranean diet is considered more sustainable when it comes to long-term health. It emphasizes balanced eating, making it easier to adhere to in the long run. In contrast, the Keto diet is more restrictive, and many individuals find it difficult to maintain, mainly due to the limitation on carbs.

3 Cons of the Mediterranean Diet

While the Mediterranean diet offers many health benefits, it has challenges.

1. Limited focus on processed foods: While the Mediterranean diet emphasizes whole foods, it doesn’t provide specific guidelines on occasionally consuming processed foods. Some individuals may find it challenging to avoid processed options consistently.
2. Possible high-calorie intake with olive oil: Although olive oil is considered a healthy fat, it’s also calorie-dense. Consuming large amounts can contribute to a high calorie intake, which might not be ideal for weight loss goals.
3. Difficulty in sticking to the diet for some individuals: While the Mediterranean diet is more flexible than the Keto diet, some individuals may still struggle with the cultural shift required to incorporate more plant-based foods and reduce red meat consumption.

Is the Mediterranean Diet Really the Healthiest?

Scientific evidence strongly supports the Mediterranean diet. Numerous studies have found that this eating pattern is linked to reduced risks of heart disease, stroke, and other chronic conditions. Many health experts consider it one of the healthiest diets in the world, primarily because of its emphasis on whole foods, healthy fats, and plant-based nutrients.

The Mediterranean diet has also been associated with longevity and improved quality of life, making it a great choice for long-term health.

Is the Keto Diet Better Than the Mediterranean Diet for Fatty Liver?

Both the Mediterranean and Keto diets can impact liver health, but they do so in different ways. The Mediterranean diet is known for its positive effects on liver health, with studies showing that it can help reduce liver fat and inflammation, making it a good choice for individuals dealing with fatty liver disease.

On the other hand, some research suggests that the Keto diet may also help with fatty liver, particularly in the short term, as it encourages weight loss and may reduce liver fat. However, the long-term impact of the Keto diet on liver health is still unclear, and more research is needed.

The Mediterranean Diet for Weight Loss: Is it Effective?

The Mediterranean diet can be effective for weight loss, especially when combined with a balanced lifestyle. Unlike the restrictive nature of the Keto diet, the Mediterranean diet promotes long-term weight management by encouraging healthy eating patterns, including plenty of fruits, vegetables, and healthy fats.

In comparison, the Keto diet may initially lead to rapid weight loss, but some individuals may find it difficult to maintain the strict carb restrictions over time.

Health Risks and Side Effects of the Keto Diet

While the Keto diet may lead to rapid weight loss, it has potential health risks. Common side effects include nutrient deficiencies, the so-called “Keto flu,” and digestive issues. Additionally, the high intake of saturated fats may negatively affect heart health in some individuals.

In comparison, the Mediterranean diet is generally considered safer, with fewer health risks due to its balanced and sustainable approach.

The Mediterranean Diet for Cardiovascular Health

The Mediterranean diet is particularly renowned for its benefits to heart health. Scientific evidence shows that it helps lower cholesterol levels, reduce blood pressure, and prevent heart disease, thanks to its focus on healthy fats like olive oil and omega-3-rich foods like fish [4] [5].

In contrast, while the Keto diet may improve some heart disease markers, it can also increase LDL cholesterol (the “bad” cholesterol) in some people, making it a less heart-healthy option in the long run.

Which Diet is Easier to Stick to Long-Term?

When it comes to sustainability, the Mediterranean diet is easier to maintain in the long term. Its flexibility allows for a wide variety of foods and meals, which makes it easier to integrate into daily life. On the other hand, the Keto diet is highly restrictive, making it difficult for some individuals to stick with over time.

Conclusion: Mediterranean Diet vs. Keto—Which is Better for You?

Ultimately, both diets have their merits, but the best choice for you depends on your personal health goals. The Mediterranean diet may be the better option if you’re looking for a heart-healthy, sustainable eating plan that emphasizes whole foods. It’s particularly effective for reducing the risk of heart disease, managing blood sugar levels, and promoting longevity.

However, suppose your goal is rapid weight loss or managing a specific condition like epilepsy. In that case, the Keto diet may be worth considering, though it may come with more challenges and potential long-term health risks.

If you’re unsure which diet is best for your health goals, schedule a consultation at our Weight Loss Clinic to receive personalized guidance and support in choosing the right diet for you.

References:

1. Becerra-Tomás N, Blanco Mejía S, Viguiliouk E, Khan T, Kendall CWC, Kahleova H, Rahelić D, Sievenpiper JL, Salas-Salvadó J. Mediterranean diet, cardiovascular disease and mortality in diabetes: A systematic review and meta-analysis of prospective cohort studies and randomized clinical trials. Crit Rev Food Sci Nutr. 2020;60(7):1207-1227. doi: 10.1080/10408398.2019.1565281. Epub 2019 Jan 24. PMID: 30676058.

2. Masood W, Annamaraju P, Khan Suheb MZ, et al. Ketogenic Diet. [Updated 2023 Jun 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499830/

3. Di Rosa, C., Lattanzi, G., Spiezia, C., Imperia, E., Piccirilli, S., Beato, I., Gaspa, G., Micheli, V., De Joannon, F., Vallecorsa, N., Ciccozzi, M., Defeudis, G., Manfrini, S., & Khazrai, Y. M. (2021). Mediterranean Diet versus Very Low-Calorie Ketogenic Diet: Effects of Reaching 5% Body Weight Loss on Body Composition in Subjects with Overweight and with Obesity—A Cohort Study. International Journal of Environmental Research and Public Health, 19(20), 13040. https://doi.org/10.3390/ijerph192013040

4. De Pergola G, D’Alessandro A. Influence of Mediterranean Diet on Blood Pressure. Nutrients. 2018 Nov 7;10(11):1700. doi: 10.3390/nu10111700. PMID: 30405063; PMCID: PMC6266047.

5. Jimenez-Torres J, Alcalá-Diaz JF, Torres-Peña JD, Gutierrez-Mariscal FM, Leon-Acuña A, Gómez-Luna P, Fernández-Gandara C, Quintana-Navarro GM, Fernandez-Garcia JC, Perez-Martinez P, Ordovas JM, Delgado-Lista J, Yubero-Serrano EM, Lopez-Miranda J. Mediterranean Diet Reduces Atherosclerosis Progression in Coronary Heart Disease: An Analysis of the CORDIOPREV Randomized Controlled Trial. Stroke. 2021 Nov;52(11):3440-3449. doi: 10.1161/STROKEAHA.120.033214. Epub 2021 Aug 10. Erratum in: Stroke. 2021 Nov;52(11):e754. doi: 10.1161/STR.0000000000000393. PMID: 34372670.