Mediterranean Diet vs. Keto Diet

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

Consumers are constantly 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.  

The main thing that these two diets have in common is weight loss, but they achieve this in two very different ways. Let’s do a quick recap of the basics of both diets and see how they stack up against one another, nutrition-wise. 

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 and known as the best overall healthy diet. Plus it supports healthy weight loss! 

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 Mediterranean foods and drinks with loved ones and living an active lifestyle.  

The Mediterranean diet features lots of fresh fruits, vegetables (bell pepper), whole grains, nuts and seeds, legumes, fresh herbs, seafood, and 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 (Feta Cheese), eggs, and poultry. Red meat and sweets (refined sugar) are also limited.  

Approximately 50%–60% of daily calories in the Mediterranean diet come from carbohydrates (whole grains, vegetables, fresh herbs, 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 fatty fish), and the remainder from lean protein (mostly plant protein with some fish). 

Mediterranean foods can definitely help somebody lose weight, but the main goal of the Mediterranean diet is to fight against chronic conditions and to promote an overall healthy lifestyle. It also wouldn't be called a "low fat" diet, but it does focus only on eating healthy fat. 

The Mediterranean Sea 

Many of the foods consumed in the Mediterranean Diet recipes are consumed on a daily basis by people who live in countries that touch the Mediterranean Sea (hence the name of the diet). Many of the most famous Mediterranean Diet recipes comes from Greece and Italy. 

Healthy Fats

The Mediterranean Diet focuses on healthy fats (like Olive Oil), Whole Grains, Fresh Foods (Leafy Greens), Fresh Herbs, plant based foods, and Lean Proteins (Fish). Healthy fats is a very important aspect of the diet because they are very important for heart health, healthy skin and hair etc. Olive Oil and Fatty Fish are typically the go-to when consuming healthy fats in Mediterranean recipes. Mediterranean Recipes completely avoid processed foods and added sugars. 

Olive Oil 

Olive oil is the main healthy fat that is consumed in most Mediterranean recipes. Extra Virgin Olive oil is important because its a great source for healthy fats, which helps to lower cholesterol. It also has antioxidants that can help reduce the risk of cancer and heart disease. People who live in the Mediterranean are known for cooking almost every meal with Olive oil and even use olive oil to dip their bread in. 

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 (Ketogenic Diet) 

In contrast, the ketogenic 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, dairy (Feta Cheese), and bacon.  

Some healthy unsaturated fats are allowed on the keto diet — like nuts, seeds, and avocados. But, artery-clogging saturated fat 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. 

The main goal of the Keto diet is to lose weight which isn't always the most important goal when it comes to overall health. 

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. 


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. The liberal use of unhealthy saturated fats in the Keto Diet are not good for your heart health. 

History of the Mediterranean Diet 

Believe it or not, the Mediterranean Diet originated in the 1950s as a research project conducted by Ancel Keys, an American scientist. The study focused on cardiovascular disease and how different populations of people ate around the world to prevent heart attacks.  

The first phase of this diet was called the "Seven Countries Study" which involved studying seven countries around the world: Greece, Italy, Serbia, Croatia, South Africa, Finland, and the United States. 

The conclusion of the "Seven Countries Study" was that the Mediterranean Diet was very effective at reducing cardiovascular disease. These findings influenced many doctors to prescribe this diet for heart patients, resulting in a massive decline in cardiac related deaths. 

The "Seven Countries Study" also found that people living within these nations consumed large amounts of olive oil, legumes (beans), fruits and vegetables, whole grains, nuts, and lean protein which is all included in most Mediterranean recipes. The study helped formulate what the Mediterranean Diet is made up of today.  

Mediterranean Diet Recipes 

There are thousands of amazing Mediterranean Diet recipes, but we wanted to include some of our favorites for you to enjoy if you have the extra time for cooking: 

  • Grilled Shrimp Skewers with Quinoa and Roasted Red Peppers 
  • Chicken Cacciatore 
  • Roasted Pistachio Salmon with White Beans and Kale 

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. Whether your goal is weight loss or a complete lifestyle change, 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. They also focus on providing the best and most delicious Mediterranean recipes when creating their dishes. To learn more, visit www.modifyhealth.com   

Written by Janet Bond Brill, PhD, RDN, FAND, LDN