Mediterranean Keto Diet? We need to talk.
If you’ve come across any of my content before you’ll probably know that I advocate quite strongly for nutrition practices that are not centered around the restriction, or avoidance of foods.
What I practice (and preach) is balance, and flexibility alongside diet optimisation - this is in part due to my own lived experience, but mostly because of the science. In lieu of a true allergy or intolerance, avoiding whole food groups has the potential to do more harm than good, both from a psychological and physiological standpoint. Not to mention that food restriction often makes reaching and maintaining health goals harder in the long run.
So it should be no surprise that “low-carb and keto’’ are usually on my hit list of fad diets, especially because the low-carb voices happen to be some of the loudest, and seem to taint even the most well-meaning of health protocols.
Enter the ‘Mediterranean Keto diet”
The very title of this particular fad diet is an oxymoron. You simply cannot follow a Mediterranean way of eating and maintain ketosis at the same time because carbs or more to the point, the foods that contain them, are indispensable to the Mediterranean Diet.
A typical Mediterranean-style diet consists of 45-65% of energy intake from carbohydrates foods, including fruit, vegetables, legumes, dairy, nuts, seeds, and grains. Yes, that’s right, those carbs that are so highly demonised make up some of the most objectively nutritious foods. In fact, one of the overriding reasons the Mediterranean diet is known to be one of the healthiest in the world, is because of the abundance of whole, plant foods, and their beneficial effects on our health.
But, shying away from these healthful foods and their vital nutrients is only half the story…
Breaking down the numbers
Macronutrient distribution describes the relative proportions of macronutrients (our main energy sources) in the diet. This means that if you have a diet low in carbs, you must replace them with more protein and/or fat to make up your energy needs each day - thus changing the distribution of macronutrients in your overall diet.
The keto diet advocates for a mere 5% of daily energy intake to come from carbs, leaving the remaining 95% to come from fat and protein. This means that the macronutrient distribution of the keto diet is quite far removed from typical health guidelines and the Mediterranean diet, which generally recommend that macronutrient distributions fall between these ranges:
Carbohydrates: 45-65%
Protein: 15–25%
Fat: 20–35%
This is a problem because we know that large imbalances in the relative proportions of macronutrients can increase the risk of developing chronic diseases, and can also negatively affect mineral and vitamin intake, potentially leading to nutritional deficiencies (1).
In the case of keto, this distribution practically translates to a greater reliance on animal proteins. Unlike their plant-protein counterparts, animal products like meat, contain little to no carbs… They do however contain higher levels of saturated fats. A keto diet will also typically have a very low fibre intake due to limiting carb-rich plant foods. Both of these characteristics are almost the complete opposite of the Mediterranean diet recommendations… hence the oxymoron, and why you simply cannot practice Keto and the Mediterranean diet at the same time.
The sustainability piece
If you made it past the sciencey talk, there’s another concept that is important to touch on, and that is of sustainability. Aside from the nutritional composition of the Mediterranean diet, another key benefit of this way of eating is the value that’s placed on balance and flexibility. We know that when a diet allows for life balance, enjoyment, and flexibility rather than rigidity and restriction, there is a much higher likelihood that those habits (and results) are maintained long-term. This is simply because the more enjoyable a way of eating is, the easier it is to integrate into everyday life and to stick to long-term.
In terms of keto, if we look at weight-loss as an outcome alone, many individuals find initial success with rapid results, but said weight-loss generally peaks at a few short months, and is not sustained long-term (2,3). It is also common for individuals to see a rapid regaining of weight, sometimes even more than what they started out with. This is because the keto diet is incredibly hard to stick to for any significant amount of time (4).
Conversely, following a Mediterranean-style diet has been shown to provide long-term weight-loss results - that’s several years, not just a few short months (5,6). This is largely due to the fact that it is easier to follow, is more enjoyable, and comes with an exhaustive list of health benefits - simply put, you feel good when you eat this way!
I want to highlight here, that weight loss is by no means the best and only judge of a diet’s adequacy or efficacy for overall health, but serves as a good demonstration in this case.
One last thing
I recognise that the word “diet” has been thrown around a lot in the article and that comes with certain connotations, but I want to be abundantly clear - despite the name, the Mediterranean diet is not really “a diet” in how we’ve come to know that term…at least not in the sense that it gives a set of rules and restrictions to follow for a set amount of time, as most fad diets do. Instead, we can view it as a holistic lifestyle and pattern of eating that gives us a set of skills and habits to rely on, for life. Unlike keto, the Mediterranean way is about adding into your life rather than taking away and, for that reason, the two can never really work synergistically.
If the Mediterranean way of eating resonates with you and you’re looking to improve your health, then The Med Reset online course will be a great fit for you. The Med Reset is your step-by-step guide to restoring your vitality and reaching your healthy weight with the Mediterranean diet. This course is for you if you want to feel good in your own skin and develop lifelong healthy habits without restriction.
Learn more about the course!
References:
1. National Health and Medical Research Council. (2014, March 17). Chronic disease [Macronutrient balance]. https://www.nrv.gov.au/chronic-disease/macronutrient-balance
2. Masood, W., Annamaraju, P., & Uppaluri, K. R. (2022). Ketogenic Diet. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK499830/
3. Ting, R., Dugré, N., Allan, G. M., & Lindblad, A. J. (2018). Ketogenic diet for weight loss. Canadian Family Physician, 64(12), 906.
4. Schutz, Y., Montani, J.-P., & Dulloo, A. G. (2021). Low-carbohydrate ketogenic diets in body weight control: A recurrent plaguing issue of fad diets? Obesity Reviews: An Official Journal of the International Association for the Study of Obesity, 22 Suppl 2, e13195.
5. Agnoli, C., Sieri, S., Ricceri, F., Giraudo, M. T., Masala, G., Assedi, M., Panico, S., Mattiello, A., Tumino, R., Giurdanella, M. C., & Krogh, V. (2018). Adherence to a Mediterranean diet and long-term changes in weight and waist circumference in the EPIC-Italy cohort. Nutrition & Diabetes, 8(1), 22.
6. Yokose, C., McCormick, N., Rai, S. K., Lu, N., Curhan, G., Schwarzfuchs, D., Shai, I., & Choi, H. K. (2020). Effects of Low-Fat, Mediterranean, or Low-Carbohydrate Weight Loss Diets on Serum Urate and Cardiometabolic Risk Factors: A Secondary Analysis of the Dietary Intervention Randomized Controlled Trial (DIRECT). Diabetes Care, 43(11), 2812–2820.