Mediterranean Diet vs. Keto Diet

By Janet Bond Brill, PhD, RDN, FAND, LDN

Consumers are bombarded with dietary advice. How do we choose a diet that fulfills our individual needs?

It depends on your goals and tastes and the fact that there is no one diet that is best for everyone. Two of the most popular diets—the Mediterranean diet and the Ketogenic (AKA “Keto”) diet—appeal to people with different tastes and health objectives. Let’s do a quick recap of the basics of both diets and see how they stack up against one another, nutrition-wise.

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The Mediterranean Diet

For the last 4 years, the Mediterranean diet has been named the No.1 “Best Overall Diet” by US News and World Report. While it has been around for centuries, the Mediterranean diet has grown increasingly popular in health circles.

In a nutshell (yes nuts are a component of the Mediterranean diet), the Mediterranean diet plan consists of primarily whole (less processed) foods, with plant foods comprising the base of this diet. The Mediterranean diet meal plan is low in saturated fats and animal protein, and high in antioxidants and fiber. The regimen focuses on enjoying delicious food and drink with loved ones and living an active lifestyle. The Mediterranean diet features lots of fresh fruits, vegetables, grains, nuts and seeds, legumes, seafood, and the hallmark, liberal use of extra virgin olive oil. Followers are encouraged to drink a little red wine, socially, with dinner. Moderation is key, especially when it comes to dairy, eggs, and poultry. Red meat and sweets (refined sugar) are limited. Approximately 50%–60% of daily calories in the Mediterranean diet come from carbohydrates (whole grains, vegetables, and starches). About 25%–35% of calories come from fat (with a heavy emphasis on natural unsaturated fats—the heart-healthy “good fats” found in plants and fish), and the remainder from lean protein (mostly plant protein with some fish).



Here are a few of the proven health benefits of long-term adherence to the Mediterranean diet:

  • Eating a Mediterranean diet can promote significant weight loss and help treat obesity.
  • Eating a Mediterranean diet can reduce risk of heart disease.
  • Eating a Mediterranean diet can lower risk of stroke in women.
  • Eating a Mediterranean diet can reduce risk of Alzheimer’s disease.
  • Eating a Mediterranean diet can help prevent and manage Type 2 diabetes.
  • Eating a Mediterranean diet can help prevent certain types of cancers, specifically breast cancer and colorectal cancer.
  • Eating a Mediterranean diet has also been shown to cut the reduce the risk of non-alcoholic fatty liver disease (NAFLD) in half.

Indeed, the popularity of the Mediterranean diet lies in the ability to stick to a delicious and health-promoting lifestyle.

The Keto Diet

In contrast, the keto diet is an ultra low-carb diet. Unlike the Mediterranean diet, the keto diet is extremely strict and difficult to maintain. The plan consists of 5-10% carbohydrates, 15-30% protein and 60-75% fat, By minimizing your carbohydrate intake, the keto diet drastically cuts your daily calorie intake. The low carb intake flips a switch on your metabolism, prompting your body to burn fat for energy (called ketosis), which uses calories at a faster rate.

Protein plays a large role in the keto diet, but it doesn't typically discriminate between lean protein foods and protein sources high in saturated fat such as beef, pork, and bacon (animal protein). Some healthy unsaturated fats are allowed on the keto diet — like nuts, seeds, and avocados. But, artery-clogging saturated fats from oils (palm, coconut), lard, butter, and cocoa butter are encouraged in high amounts. Certain fruits (usually berries) are allowed, in small portions. Vegetables are restricted to only leafy greens, cauliflower, broccoli, Brussels sprouts, asparagus, bell peppers, onions, garlic, mushrooms, cucumber, celery, and summer squashes.

Here are a few of the proven health benefits of short-term adherence to the KETO DIET:

  • Eating a Keto diet can reduce the frequency of epileptic seizures in children.
  • Eating a Keto diet can lead to significant and fast weight loss.

Here are a few of the potential health RISKS of adherence to the KETO DIET:

  • Eating a Keto diet can increase "bad" LDL cholesterol, which is linked to heart disease.
  • Eating a Keto diet can lead to nutrient deficiencies in micronutrients such as selenium, magnesium, and phosphorus.
  • Eating a keto diet can result in liver problems. With so much fat to metabolize, the diet could make any existing liver conditions worse.
  • Eating a keto diet can result in kidney problems. The kidneys help metabolize protein; hence the keto diet may overload them. Animal protein is especially hard on the kidneys.
  • Eating a keto diet can result in constipation. The keto diet is low in high-fiber foods like grains and legumes.
  • Eating a keto diet can result in irritability and confusion. The brain needs sugar from healthy carbohydrates to function correctly.
  • Eating a keto diet, high in red meat, is associated with higher risk of type 2 diabetes, cardiovascular disease, certain types of cancers including those of the colon and rectum, and premature death.

Clearly, when comparing the keto diet and Mediterranean diet, the Mediterranean diet is by far the wiser choice for better long-term health and longevity.

Are you looking to start a Mediterranean diet plan or Mediterranean diet meal plan?

If so, you should highly consider ModifyHealth. ModifyHealth is a Mediterranean diet meal delivery service that provides fresh, home-delivered meals and optional dietitian coaching and support. Their Mediterranean meal delivery makes getting started very easy and also helps people stay on track. They make Mediterranean diet food delivery easy - you can simply heat and eat in 2 minutes or less. To learn more, visit www.modifyhealth.com  


Dr. Janet is a nationally recognized expert in the field of health, wellness and cardiovascular disease prevention and is frequently sought after by the media as a trusted source of nutrition and fitness information. Janet holds master's degrees in both nutrition and exercise physiology and a doctorate in exercise physiology.

She is a registered dietitian and certified by:
  • American College of Sports Medicine
  • National Strength and Conditioning Association
  • Wellcoaches, Inc.
  • Academy of Nutrition and Dietetics, Certified Specialist in Sports Dietetics