Although they’re both popular, the Mediterranean diet and keto diet are incredibly different — and the Mediterranean diet was just voted the best of the year while keto was voted one of the worst.
The ketogenic diet involves eating high-fat foods with moderate amounts of proteins and a low amount of carbohydrates. This diet tricks the body into burning fats and ketones over carbohydrates.
The Mediterranean diet focuses on plant-based foods, fresh fruits and vegetables, and eating lean proteins. This diet shifts the emphasis away from processed foods and is considered more of a way of eating than a traditional diet.
Here are some of the key differences between the trendy diets:
Keto is a true diet, but the Mediterranean diet is actually an eating pattern
By definition, a diet includes the kinds of food that a person eats — or doesn’t eat — on a very regular basis. A diet limits your food options and may be used for weight loss, medical purposes, or personal reasons.
This is one of the main ways where the keto diet and the Mediterranean diet differ.
“The keto diet is based on more rigid rules about what you can and can’t eat and it uses grams as a measurement tool,” Rachael Hartley, a registered and licensed dietitian, told Insider.
“While people can use the Mediterranean diet pattern and turn it into a diet, research-wise it is based on a dietary pattern of eating and has much less like riding rules about what you can and can’t eat like the keto diet. The Mediterranean diet pattern is a pretty big-picture model,” she added.
Keto is a lot more restrictive than the Mediterranean diet
Unlike the Mediterranean diet, the keto diet focuses on restrictions by naming a number of foods you should not consume.
“Really no foods are off-limits on the Mediterranean diet plan. With keto, that are very specific foods that you aren’t allowed to eat or don’t have room to eat because your carb grams are so limited. The Mediterranean diet allows you to work in any food that you like,” Hartley explained.
“The Mediterranean [diet] is focused on inclusion and emphasizes olive oil and other healthy fats, whole grains, legumes, leafy greens,” said Hartley. “The keto diet follows a very high-fat, moderate protein, very low-carbohydrate way of eating.”
She continued, “Unlike the keto diet, there are not rigid rules attached to the Mediterranean diet pattern. That’s why we call it a dietary pattern and not a diet.”
Both diets encourage foods with fat, but not the same types of fats
Those embarking on the keto diet may find themselves eating foods such as cheese, bacon, and butter. These foods, which are high in fat, are encouraged on the keto diet.
And although the Mediterranean diet also encourages followers to eat foods containing fat, the two recommendations are not the same.
“From a nutritional standpoint, the keto diet is much higher in fat, although, both diets emphasize fat,” said Hartley. “The Mediterranean diet plan used to be called high fat. But, compared to keto, it’s definitely nowhere close. Most diets emphasize fat, but the keto diet is significantly higher in fat where fats make up the vast components of energy that you’re getting from the diet.”
The Mediterranean diet plan encourages followers to consume healthy fats like avocados and olive oil.
Hartley added, “The keto diet also emphasizes fats to the point that it can be challenging to get adequate amounts of other macronutrients.”
The Mediterranean diet calls for nutrient-rich food groups, but keto does not
The two styles of eating are built on a foundation of different food groups.
“Another nutritional difference between the Mediterranean diet pattern and the keto diet is that the Mediterranean emphasizes whole grains, legumes, and other fiber-rich carbohydrate foods,” said Harley. “The keto diet does not emphasize these nutrient-rich food groups.”
The keto diet requires you to track your food, but the Mediterranean diet does not
The Mediterranean diet takes less planning than the keto diet.
Followers of the Mediterranean diet plan do not need to count calories or carbs, but participants of the keto diet need to keep a close eye on what they are eating in an effort to be be in ketosis.
“With the keto diet, there’s a lot of numbers and counting involved. In order to supposedly maintain ketosis, you have to count grams of carbs, grams of protein, grams of fat, and be a human calculator when it comes to food,” said Hartley. “With the Mediterranean diet pattern, the emphasis is really on foods rather than on numbers.”
The sustainability rate for each diet is very different
Lisa De Fazio, a registered dietitian nutritionist, told Insider that she sees patients who have followed the keto diet and now have high cholesterol as a result.
“You cannot eat large amounts of meat, cheese, and fat without consequences. You can’t eat this way until you die,” said De Fazio. “When you stop keto eating and eat carbs you gain the weight back and more because you have screwed up your body’s metabolism.”
Hartley agreed, and said, “I don’t think it’s super viable for most people to adhere to the keto diet long-term.”
The keto diet may have more health risks than the Mediterranean eating plan
The ketogenic diet can cause high cholesterol, low blood pressure, and hypoglycemia from not eating carbohydrates.
“There are significantly more health risks associated with keto than the Mediterranean. It is possible for someone to take any nutritional advice too far — including with the Mediterranean diet pattern — but with the ketogenic diet, there is much more risk for health concerns,” said Hartley. “Also constipation from not getting enough fiber, because those fiber-rich carbs are restricted.”
Aside from what foods are and aren’t included, Hartley told Insider that the setup of the ketogenic diet may be triggering for someone at risk of developing an eating disorder.
“I think many people who are at risk of eating disorders and attempt a diet pattern that’s very rigid and numbers-focused can be very triggering for them,” said Hartley. “Even for people who don’t have an eating disorder, adhering to a rigid diet can often trigger eating disorder behaviors.”
Both diets moderate your sugar intake but in a different way
The Mediterranean diet does not necessarily restrict your sugar consumption, but rather it emphasizes other fresh foods, per Hartley. This isn’t really the case when it comes to the keto diet, though, she said.
“The principle is more crowding out the sugar. The Mediterranean diet pattern highlights lots of other fresh foods like fruits, and veggies. So, there is a lower intake in sugar but there aren’t rules like ‘you can’t have this or that’ on the Mediterranean diet,” said Hartley.
Hartley continued, “With the keto diet, I’d imagine a very small amount of sweets that would chip into your total daily allowance pretty quickly. I can’t imagine you could realistically work in something that has actual sugar in it.”