Paleo vs. keto: Which diet is right for you?

• The key difference between paleo and keto is the end goal of each diet.
• Both eating styles are challenging to sustain, but can lead to weight loss and other potential health benefits. 
• To make a choice between paleo vs. keto, it’s all about which works best for you and your lifestyle. 

If you’ve been looking to change up your eating style, it’s very likely you’ve heard of the paleo and keto diets somewhere along the way. 

Maybe you’ve seen endless labels for keto-friendly foods at your local grocery store. Or you have a coworker who’s been successful with weight loss on paleo. So you may be wondering which one would work best for you.

At Noom, we don’t define foods as “good” or “bad.” Nor do we typically focus on restricting or eliminating entire food groups from what you eat. However, many people have good reasons for following paleo or keto, and we want to support them.

To help make the paleo vs. keto decision a bit easier, we talked with Noom coaches and nutritionists Emily Rivelli, MS, NDTR, NBC-HWC, and Ashley Bannister, MS, RDN. These experts shared their expertise on paleo and keto to help guide your choice. 

Note: Consult with your health care provider before making dietary changes.

What is the difference between paleo and keto?

The key difference between paleo and keto comes down to the goal of each diet, Bannister explains. 

Paleo is about eating how we think our Paleolithic hunter-gatherer ancestors did—think whole, unprocessed foods, like meats and vegetables. By contrast, keto focuses on reaching ketosis, a state where your body uses fat as an energy source instead of carbs.

Bannister says keto is also a high-fat diet with moderate protein and low carbohydrates, while paleo is high in protein and allows carbohydrates from whole foods.

There are some similarities, however. Both diets eliminate grains (refined and whole), legumes, and added sugars. 

Origins and philosophy

The paleo and keto lifestyles are not new, but they’ve become popular diets today.

Bannister and Rivelli explain how each diet plan came to be—and the philosophies they’re based on.

The paleo diet

Paleo—also known as the Stone Age diet or “caveman” diet—dates back to the 1970s. Bannister says that public interest in the diet grew in 2002 after the publication of Loren Cordain’s book, The Paleo Diet: Lose Weight and Get Healthy by Eating the Foods You Were Designed to Eat.

With paleo, the idea is to rid your body of a processed diet and eat like the early humans of the Paleolithic era did to improve your overall health. 

The keto diet

The ketogenic diet emerged in the 19th century as a way to treat diabetes. And in the 1920s, keto also started being used as a treatment method for pediatric epilepsy—which research still supports today, says Rivelli.

Keto’s main goal is to get your body into a metabolic state of ketosis by significantly cutting down on carbohydrate intake. During periods of minimal carb consumption, the body burns fat for energy—increasing the presence of blood ketones that jumpstart ketosis. 

According to Rivelli, ketosis will usually take place three to five days after decreasing daily carb intake to 50 grams or less. The exact time will depend on the person, though.

Food differences between paleo and keto

One of the biggest food differences between paleo and keto is how macronutrients are treated. Rivelli notes that keto has strict guidelines around macronutrients—55% to 60% fat, 30% to 35% protein, and 5% to 10% carbs in your diet.

By contrast, there aren’t exact numerical rules for macros for paleo. Paleo eaters aren’t typically tracking their carbs—they’re focusing on the types of food they’re eating.

Bannister explains that there are different variations of paleo, but the diet is typically high in protein and fiber—and low in sodium, sugar, and processed foods. There is also an emphasis on low-glycemic fruits and vegetables, which can help stabilize blood sugar. 

Check out the food chart below to see which foods you can and can’t eat with paleo and keto. 

	Keto	Paleo
Vegetables	Yes, with an emphasis on low-carb vegetables.	Yes, with an emphasis on raw or minimally processed, low-glycemic vegetables.
Fruits	Typically no, but low-carb fruits (like some berries) are allowed.	Yes, with an emphasis on raw or minimally processed, low-glycemic fruits.
Meat	Yes	Yes, with an emphasis on grass-fed, organic, free-range, and lean meat options.
Seafood	Yes	Yes, with an emphasis on wild-caught options.
Dairy	No cow’s milk, but low-carb dairy products like cheese, butter, cream cheese, cottage cheese, sour cream, and heavy cream are allowed.	No. However, there are a few paleo eaters who say that milk from grass-fed cows is allowed.
Eggs	Yes	Yes, with an emphasis on grass-fed, organic, and free-range animals.
Legumes	For the most part, no. Soybeans and green beans are allowed, though.	No
Grains	No	No
Nuts and seeds	Yes	Yes
Healthy fats and oils	Yes, keto-friendly options like olive oil and ghee. (No vegetable oil.)	Yes, to paleo-friendly options like extra virgin olive oil and avocado oil. (No vegetable oil.)
Sugary/processed foods	No	No

If you want to explore more foods for these diets in depth, we have comprehensive food lists for paleo and keto for you. 

Are keto and paleo low carb?

Keto is a low-carb diet by definition—by contrast, eating fewer carbs isn’t the goal of the paleo diet. 

In practice, though, paleo excludes grains and legumes that are higher in carbs, Bannister says. The result is that paleo eaters often eat fewer carbohydrates than a standard diet.

Which diet is healthier—paleo or keto?

Both the paleo and keto diets can have potential health benefits. And there’s evidence that both may help with certain medical conditions.

Research suggests that keto may aid in the treatment of diseases like epilepsy, type 2 diabetes, and PCOS, and can lower respiratory and heart disease risk. Studies also indicate the keto diet may improve insulin sensitivity—and, therefore, insulin resistance. 

Research shows that the paleo diet could also help with chronic diseases like diabetes, metabolic syndrome, and cardiovascular disease. Paleo has also been used as a treatment for inflammation. 

But the answer to whether paleo vs. keto is actually healthier really comes down to the types of food you’re eating. 

“The paleo diet has a bit more of a balanced approach by allowing for fruits, veggies, and some sugars,” Bannister says. “The strong emphasis on fats in the keto diet can be a bit concerning, especially for cardiovascular health long term.”  

Is paleo or keto harder?

Paleo and keto are both incredibly challenging because it’s tough to follow their restrictions in the long term. 

With keto, you’re dealing with a very low-carb diet—which is difficult because carbs are found in so many things (even fruit!). 

“If you’re someone who needs some carbohydrates to function (like fresh fruit or starchy vegetables), then keto may be more challenging for you,” Bannister says. 

Paleo, on the other hand, is harder logistically. 

You can easily count carbs for keto, but you can’t always tell if a modern meal fits a paleo eating lifestyle. Because of these unclear criteria, you’re more likely to find labeled keto-friendly foods at the grocery store than paleo (especially because it’s more commercially widespread). 

“With paleo, you have to consider the ingredients list more often to ensure that the ingredients are paleo-friendly, whereas, with keto, you can check for carb content on the label and be good to go,” Bannister explains.

The two diets are also really tough emotionally. You’ll likely have to give up your favorite comfort foods you turn to when times get tough. And you might be the person at dinner who can’t eat pasta, bread, or desserts. 

Paleo vs. keto for weight loss

When it comes to paleo vs. keto for weight loss, Bannister says that one isn’t necessarily better than the other.

Research indicates that paleo and keto can both lead to weight loss. A quick online search will also show many success stories from people who’ve lost weight using these diets.

Bannister recommends choosing the eating style you’re most likely to stick with. 

“What’s most important is that you pick an eating style that feels good for you and is sustainable long term,” Bannister says. “The key to long-term weight loss is sustainable changes that last.” 

That said, weight loss is not guaranteed with either paleo or keto. You have to take into account what you’re eating, too. 

For any weight loss to take place, you need to be in a calorie deficit. In other words, your body has to be burning more calories than it takes in. 

Calorie deficits are easier to achieve with a balanced diet. And the key to balance is keeping calorie density—the number of calories in a serving—in mind when making food choices. 

The key is filling up on foods with low caloric density and eating foods with high caloric density in moderation. 

The paleo and keto diets allow plenty of foods with a low caloric density—like low-carb or low-glycemic vegetables and fruits—that will keep you fuller longer on fewer calories. But they also allow foods with a higher caloric density (think red meat) that have more calories for smaller portions. 

For more guidance on using each diet for weight loss, we have guides for paleo and keto to help. 

How to choose between the paleo and keto diets

Your final decision on paleo vs. keto should ultimately be based on your wellness goals and which diet you’d be able to sustain for the long haul.

The keto diet is probably better if you’re looking to get your blood sugar levels under control or eat fewer carbs. Meanwhile, the paleo diet is a good option if you want to rid your diet of processed foods. 

On the other hand, keto probably isn’t a good option for people who really like to snack on fruit. And paleo likely isn’t for those who don’t have the time to read through endless ingredient labels. 

“If you’re someone who really enjoys carbohydrates and can’t see yourself cutting out grains or legumes, then it’s likely that neither of these diets will fit with your lifestyle,” Bannister adds. “It really depends on what feels and works best for you.”

That might be the most important message: You may find that neither paleo or keto is right for you. And that’s okay. Want to explore options? Read more about the philosophy behind Noom, or sign up today.