- The Mediterranean diet is not an actual "diet," but the keto diet is, according to Rachael Hartley, a registered and licensed dietitian.
- The keto diet involves counting and numbers, but the Mediterranean diet is more of a general guideline for eating.
- Both diets include fats, but the types of fats are not the same.
It seems like everyone is talking about the ketogenic diet these days. On the other hand, the Mediterranean diet was just voted the best of the year. But, how do you know which one is right for you? It's important to understand how each diet works — and what sets them apart.
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.
Read more: 10 things you should know before starting the Mediterranean diet
Rachael Hartley, a registered and licensed dietitian, explained some of the key differences between the trendy diets.
Keto is a true diet, while 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," Hartley told INSIDER. "While certainly 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."
One diet restricts what you can eat, the other does not
The keto diet focuses in on restrictions such as foods you can't consume, unlike the Mediterranean dietary pattern, according to Hartley.
"The Mediterranean 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. 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."
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. While 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; 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 that have a ton of evidence supporting the health benefits of eating them," said Harley. "The keto diet does not emphasize these nutrient-rich food groups."
The keto diet requires you to track your food, while 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 successful.
"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 Keto diet can help treat people who suffer from epilepsy
According to Hartley, the keto diet was originally created to help epilepsy patients. According to the Epilepsy Foundation, studies show that the ketogenic diet can help ease seizures for certain children in instances when prescribed medications don't work. In fact, the organization reports that more than half of children who follow the diet saw their seizures reduced by at least 50%. These benefits have not been linked to the Mediterranean diet.
"There is evidence that the keto diet can help certain people who have seizures and are not responding to other treatments. This is a real benefit for this certain population. The often have life-threatening seizures and following this rigid diet is not fun for them, but it is saving their life and very important. While the Mediterranean diet has many health benefits, this is not one of them," said Hartley.
Read more: 6 unexpected benefits of the Mediterranean diet
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, "There's research that shows the adherence rate for the keto diet is around 45%. I think that's actually significantly higher than what it is in the real world because this was a population that did have severe epilepsy. I imagine the adherence rate if you're just attempting the keto diet for general health or weight loss, that the attempt would be quite lower, especially when you start to think about long-term. 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 diet plan
Hartley said that the ketogenic diet can cause high cholesterol, low blood pressure, and hypoglycemia from not eating carbohydrates.
Read more: These biggest pros and cons of the keto diet, according to a nutritionist
"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 tells 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. "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."
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