Has The Mediterranean Diet Gone Keto-Crazy?

Both the Mediterranean diet and the Keto diet offer effective ways for you to lose weight without counting calories. But what happens if you combine both together?

Diet (Illustrative Photo).  (photo credit: ILLUSTRATIVE; INGIMAGE/ASAP)
Diet (Illustrative Photo).
Both the Mediterranean diet and the Keto diet offer effective ways for you to lose weight without counting calories. But what happens if you combine both together?
A growing diet trend combines both and is called Keto Mediterranean Diet (KMD). Studies for KMD have shown that by adding virgin olive oil as the principal source of fat, people were able to lose……..And the best part, it includes moderate red wine intake!
For all you keto professionals, you're probably asking how is this possible? Lets rip these diets apart and see what's behind the most popular diets today. 

What is the Mediterranean Diet?

The Mediterrean diet became hugely popular after 1958 when a scientist named Ancel Keys published his research in his paper called the Seven Countries Study. By studying the inhabitants of Greece, Italy, Spain, South Africa, Japan, and Finland, Keys and his colleagues were able to weigh the effect of their dietary habits on their health. They specifically analyzed the correlation of how diet relates to coronary heart disease. The countries which had the lowest incidences of coronary heart disease were Greece and Italy. This lead to the creation of what is known as the Mediterranean diet, which is based on the eating patterns post-World War 2 in this region.
The basis of this diet is whole, clean foods as well as foods which are easily available to people living in Greece and Italy. The emphasis on whole, clean foods may be because after the war, this area was not yet under the influence of fast foods. Additionally, olive oil is available in abundance due to the agriculture in these countries and therefore is a staple of this way of eating. 

What is the Mediterranean Diet Food List?

Unlike strict diet regimens, the Mediterranean diet is centered on basic principles and guidelines which can be adjusted according to each individual’s lifestyle.
  • Place a strong emphasis on the following foods: Vegetables, fruits, seeds, nuts, legumes, herbs, spices,  potatoes, whole grains, breads, fish, seafood and olive oil. 
  • Eat the following foods in moderation: Cheese, eggs, poultry, yogurt and red wine (optional).
  • Eat the following only rarely: Red meat.
  • Avoid the following foods:  Added sugar, refined grains, processed foods, trans fats and refined oils.

Mediterranean Diet Pros and Cons


  • May reduce risk of coronary heart disease.
  • May improve cholesterol levels.
  • May protect against oxidative stress.
  • Contains anti-inflammatory properties.
  • Does not limit any major food group.


  • May be more expensive than other diets - Depending on your food preferences within this diet, you may find that your supermarket bill rises dramatically.
  • Not targeted for weight loss - This may be better as a maintenance diet once you hit your goal weight. 
  • Limits milk - If you are calcium deficient, this may not be the best diet for you. 
  • Not specific enough - Can be challenging for people to follow. It may be difficult to put a cap on portions, such as how much red wine or fat to consume.

Bottom Line

Any nutritionist will tell you that eliminating overly processed and packaged food is a wise idea. Choosing to mimic a diet based on a specific region from a specific time period can also make sense for some people. Having documented research comparing and contrasting diets from various locations around the globe is an ambitious and noteworthy project which provides many insights into our current eating patterns.
The question is if changing a diet without changing an overall lifestyle can still be as effective. Will this way of eating promote the same health benefits to those not living alongside the Mediterranean, working the same hours or having the same sleep cycles? A big part of the Mediterranean diet (which you can see at the bottom of the food pyramid) is the daily physical activity. Additionally, eating meals together, taking a siesta midday and having a close social network are all considered part of the Mediterranean diet lifestyle. The question is if you can manage to replicate all of this and if you need to in order to reap all the benefits.
One more thing to consider is if you are the type of person who can stick to loose diet guidelines. If you’re looking to lightly tweak your current diet, this may be enough for you. If you are looking to lose a significant amount of weight, perhaps in the beginning, a stricter diet may be what you need. This is something each individual must figure out for themselves. 

What Is The Keto Diet?

The Ketogenic diet was developed in 1920 as a therapeutic approach to childhood epilepsy. Although the exact mechanism is still not fully understood by scientists, going on the Keto diet helped regulate seizure activity. This was a life saver for children who didn’t respond to medication.
Over the years, many studies have been done examining the Keto diet’s effect on various health benefits such as weight loss, blood sugar, cognitive function, etc.
Dr. Gianfranco Cappello, an associate professor of surgery at the Sapienza University in Rome, Italy, studied the Keto diet on 19,000 participants in 2012. This study showed  how participants experienced rapid and considerable weight loss which they were able to keep off for at least a year.  

How Does The Keto Diet Work?

The Ketogenic diet aims to lower the glucose and glycogen stores in the body in order to force the body into ketosis.
When your body needs energy, it turns to glucose. But when there are low levels of glucose in the bloodstream, your body is able to adapt via ketogenesis, i.e. creating ketones. Ketones are synthesized by breaking down fat molecules and can be utilized by your body as fuel. When enough ketones are produced, your body is in ketosis, which is the metabolic state where fat is being burned for energy.
Not all parts of your body can use ketones in the same way, but for an example, ketones are known for providing energy to the brain in a very efficient manner.
If more ketones are produced than are needed, they are broken down into carbon dioxide and acetone. The acetone evaporates from the breath which is the reason people test for sweet smelling breath when they are in ketosis. Another, more accurate, way of testing if someone is in ketosis is to get a blood test done to see the ketone levels found in the bloodstream or use  urine strips. 

What is The Ketogenic Diet Food List?

Foods to enjoy include: Low-carb vegetables, seafood, cheese, avocados, eggs, coconut oil, olive oil, meat, poultry, plain greek yogurt, cottage cheese, butter, cream, nuts and seeds.
Foods to enjoy in moderation: Low-carb fruits such as berries, low-carb alcohol such as vodka or gin.
Foods to avoid include: Sugars, highly processed foods, beer, bread, pasta, and high-carb veggies.
The key is eating the right amounts of each macronutrient, which includes fat, protein and carbohydrates. Because the amount of carbs consumed is very low, most people choose to eat as many low-carb vegetables as they can instead of one high-carb vegetable. This way, you can eat a lot without going over your carb allotment. 
There are a few different kinds of Keto diets, however the basic version is the Standard Keto Diet (SKD).You can view the others below and choose what would suit your lifestyle best.

The Standard Ketogenic Diet macronutrients are divided as follows:

  • 75% Fat
  • 20% Protein
  • 5% Carbohydrates
  • Other types of the Ketogenic diet include the following:
  • Targeted Ketogenic Diet (TDK) - Eating carbs around the times of a workout.
  • Cyclical Ketogenic Diet (CKD) - Cycling off the SKD every 5 days or so.
  • High-protein Ketogenic Diet - Increasing the amount of protein intake to 35%.

Ketogenic Diet Pros and Cons


  • Promotes weight loss
  • Therapeutic treatment for pediatric epilepsy
  • May help with PCOS
  • Regulates blood sugar levels


  • Keto-flu - Before your body is fat-adapted, you may experience flu-like symptoms such as headaches, nausea, brain fog, stomach distress, diarrhea, dizziness, etc. Many people rely on a nutritional supplement to alleviate these symptoms.
  • Adherence may be difficult in the beginning - People used to a high-carb and high sugar diet may have a challenging time in the beginning of the keto diet. Taking a supplement will ease these symptoms as well.
  • Not suitable for those with type 1 diabetes - If someone does not produce insulin in their bodies, which is what occurs in type 1 diabetes, they can be at risk for a dangerous condition called ketoacidosis. Because their bodies cannot regulate their own blood sugar levels, they must inject themselves with insulin and carefully monitor their diet to ensure a safe glucose to ketone ratio.

The Mediterranean Diet vs Keto Diet: What Are The Similarities?

Both have no added sugar

Both the Mediterranean diet and the Ketogenic diet are centered around the idea of cutting back on sugar. Overconsumption of sugar is being studied as the main culprit behind many diseases from type 2 diabetes to fatty liver disease. It may even cause premature skin aging!
In addition to the health benefits, reducing sugar intake will decrease the amount of calories you consume. People find that the more they cut back on sugar, the more they lose their sweet tooth. After an extended period of time on a low-sugar diet, many people even report that sugary treats no longer satisfy them as they once did.

Both may result in weight loss

As mentioned above, the Keto diet has been extensively studied and proven to help people lose a significant amount of weight.
The Mediterranean diet was not specifically designed for weight loss, although it definitely provides a weight loss advantage over low-fat diets.
Results will depend on where you are on your weight-loss journey. The Ketogenic diet can have dramatic results which is motivating at the beginning of a diet. Whereas the Mediterranean diet may have slower results.

Both are tried and tested 

There is a plethora of information - both anecdotal as well as scientific studies - which examine both diets in depth. Both of these eating plans are rooted in science and are not fad diets casually developed by famous Instagram celebrities without any real hard data to back them up!

Both have health benefits

The Ketogenic diet has been researched and shown to reduce LDL (bad) cholesterol,  increase HDL cholesterol, and lower triglycerides. Studies have been done which show how it can regulate blood sugar levels. It’s also been studied to boost brain power and enhance workouts.
The Mediterranean diet has similar results and since the Seven Seas study was published, many further studies have been done on the reduced risk of chronic heart disease, improved cholesterol levels, protection against oxidative stress and anti-inflammatory properties of this way of eating

Both promote clean eating

Both the Ketogenic diet and the Mediterranean diet shun highly processed foods and promote eating clean foods. Because of this, you can expect to spend more time on food prep and less money on packaged items.

The Mediterranean Diet vs Keto Diet: What Are The Differences?

Carb Consumption

While both diets eschew refined sugar, they are quite different when it comes to carb intake. The Mediterranean diet allows a large amount of carbohydrates. These include pasta, whole grains and fruit. On the other hand, the Keto diet limits the amount of carbs, therefore only certain fruits and vegetables are encouraged. Grains, pastas and bread are highly discouraged as they would eat up the entire carb allotment.

Fat Consumption

Some people still have a notion that eating fat is harmful to their health. Both diets reflect more recent scientific studies showing that fat is essential for our health and can actually benefit weight loss. Additionally, the low-fat diet fad has been proven to not be as effective as it was once thought to be especially when it comes to sustaining weight loss.
The difference is in the amount of fat allowed as the Mediterranean diet has less fat included than the Keto diet does.

Types of Allowed Fat

Whereas the Mediterranean diet stresses the importance of monounsaturated fats, the Keto diet includes saturated and unsaturated fats. Neither of them allow artificial trans fats, which are found in hydrogenated oils. It is always best to read labels in order to avoid these unhealthy fats, no matter which diet you are on.


Probably the largest difference is that the purpose of the Keto diet is to plunge someone into ketosis and change their metabolism from using carbs as fuel to burning fat instead. The Mediterranean diet does not do this because of its high level of permitted carbohydrates.

Is The Keto Mediterranean Diet The Answer?

Why choose a favorite when you can have both? Instead of making the tough Keto vs Mediterranean diet decision, many people have instead decided to combine the most appealing parts of the two diets to create a new option called the Keto Mediterranean Diet (KMD). Macronutrients are divided as follows:
  • 7-10% carbs 
  • 55-65% fat 
  • 22-30% protein 
  • 5-10% alcohol

What is The Keto Mediterranean Diet Food List?

  • Fats - olive oil, coconut oil and avocados
  • Proteins - fish, cheese, eggs and lean meats
  • Vegetables - non-starchy varieties
  • Red wine - moderate amount
  • No sugars, starches, grains allowed
Carbs are limited, the way they are with the Keto diet and red wine is allowed, like in the Mediterranean diet. For people who want keto results and still enjoy going out at night for a drink, this seems like a good compromise!

Keto Mediterranean Diet Pros and Cons


  • Benefits of the Keto diet while still enjoying a glass of red wine 
  • More flexibility in food choices 
  • Healthy option  for diabetes sufferers 
  • Lower risk of experiencing keto-flu symptoms 


  • Constant checking to make sure you are still in ketosis 
  • No strong boundaries which could weaken the results you experience 

Change Your Lifestyle, Change Your Life

It’s now clearer than ever before that our lifestyles need an overhaul. Eating fast food and processed foods are convenient but are proving to be the culprit behind many harmful conditions from inflammation to high blood sugar. No matter which healthy lifestyle you embrace, choosing one with real health benefits can change your life in unimaginable ways. Don’t just cut calories for your waistline, do it for your overall health and wellbeing.