The Mediterranean diet vs. keto: Which eating style is best for you?

• The keto diet is all about cutting out carbs, while the Mediterranean diet is a balanced way of eating.
• The Mediterranean diet is easier to sustain because it’s less restrictive than keto—but both can lead to weight loss and other health benefits.
• Your choice depends on your goals, and which eating style you’re likely to stick with.

If you’re wondering whether the Mediterranean diet or keto diet is right for you, you’re not alone.

Both eating styles have become popular in recent years. While there are pros and cons to each, your choice will depend on your individual needs and goals.

We chatted with Noom coaches Emily Rivelli, MS, NDTR, NBC-HWC, and Ashley Bannister, MS, RDN, to get their takes on keto versus the Mediterranean diet. They broke down the key differences between the two, and how to decide which is right for you.

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

What is the difference between keto and the Mediterranean diet?

Keto is a restrictive diet that limits carbohydrates and focuses on high-fat foods. 

The goal of keto is to enter a state of ketosis, which is when your body starts burning fat for energy instead of carbohydrates.

The Mediterranean diet, on the other hand, isn’t a strict diet. 

Instead, it’s a way of eating that’s based on the traditional eating habits of people who live in the Mediterranean region, in countries like Italy, Greece, France, and Spain. 

It emphasizes eating more whole foods—like vegetables, fruits, and whole grains—and limiting added sugars and processed foods, Rivelli says.

But that’s just a high-level look at how the diets differ—there’s much more to it.

Food guidelines

Since the keto diet requires that you significantly cut down on carbs and increase your fat intake, it’s important to track what you eat to make sure you’re staying within the limits.

In general, it’s recommended that people following a keto diet aim for the following calorie breakdown:

• 70% to 80% fat.
• 10% to 20% protein.
• 5% to 10% carbs.

For example, in a 2,000-calorie diet, you’d only be allowed 25 grams to 50 grams of carbs per day.

However, when following the Mediterranean diet, there are no strict rules about what you can and can’t eat.

Instead, the focus is on consuming mostly nutrient-dense, whole foods—like fruits and vegetables, whole grains, beans and legumes, and healthy fats. 

But you can still enjoy a glass of red wine or your favorite sweets on occasion.

Take a look at the chart below to see what you can and can’t eat on the keto and Mediterranean diets.

	Keto diet	Mediterranean diet
Vegetables	Yes, with an emphasis on low-carb, non-starchy vegetables.	Yes.
Fruits	Typically no, but low-carb fruits (like some berries) are allowed.	Yes.
Meat	Yes.	Limit red meats (like beef, pork, lamb, and venison) in small portions, and eat poultry in moderate amounts.
Seafood	Yes.	Yes.
Dairy	No cow’s milk, but low-carb dairy products like cheese, butter, cream cheese, cottage cheese, sour cream, and heavy cream are allowed.	Yes (in moderation).
Eggs	Yes.	Yes (in moderation).
Beans and legumes	For the most part, no. Soybeans and green beans are allowed.	Yes.
Grains	No.	Yes—primarily whole grains.
Nuts and seeds	Yes.	Yes.
Healthy fats and oils	Yes, keto-friendly options like olive oil and ghee. (No vegetable oil).	Yes—primarily extra virgin olive oil.
Sugary/processed foods	No.	Limit sweets and heavily processed foods to small portions.

For more in-depth food guidance, we’ve created comprehensive food lists for both the Mediterranean diet and keto diet for you to explore.

Reflection exercise

You’re reaching for a snack while following keto or the Mediterranean diet. Which of the following should you choose?

A. Pretzels.
B. Sunflower seeds.
C. Graham crackers.
D. Potato chips.

Answer: The answer is B—sunflower seeds. Seeds are whole foods that are a good source of protein and healthy fats (and low in carbs), and they are allowed on both diets. 

The pros of each diet

Both the Mediterranean diet and keto have unique pros that make them appealing diet options.

The Mediterranean diet is well-researched with studies indicating that it can help with cardiovascular health, chronic disease prevention, and brain function. Research also suggests that the Mediterranean diet may prolong life expectancy.

Additionally, Bannister notes that the Mediterranean diet is very sustainable—as it’s a balanced way of eating that’s not overly restrictive. 

No major food groups are cut out, and most foods can be enjoyed in moderation and/or with slight variations. That’s something that we love at Noom.

“Noom’s philosophy is all about finding balance and creating a sustainable approach to weight loss,” Bannister says.

Meanwhile, keto studies show that the diet is potentially promising for treating conditions like epilepsy, type 2 diabetes, and PCOS and improving respiratory and cardiovascular disease risk factors. 

The ketogenic diet has also been linked to improved insulin sensitivity (in other words, lowered insulin resistance).

The keto diet’s guidelines are also clearly outlined, making it easier to know what to eat and what to avoid. Because of keto’s commercial popularity, you’re likely to find plenty of keto-friendly food products at the grocery store.

The cons of each diet

There are cons to take into consideration for any diet—and keto and the Mediterranean diet aren’t exempt. 

For starters, keto comes with health side effects and long-term diet sustainability challenges, while food on the Mediterranean diet may not always be accessible or affordable.

The keto diet has been linked to side effects like the keto flu and digestive issues (due to a lack of fiber and increased fat intake), Rivelli says. Studies also link the keto diet to an increased chance of developing kidney stones.

Rivelli also points out that keto has very limited research on its long-term impacts and efficacy.

But the most prominent con is how difficult the diet is to sustain because it’s so restrictive. At Noom, we believe in making sustainable changes that will support your wellness goals long term.

“The keto diet is very restrictive in nature which can make compliance and sustainability in the short and long term very challenging,” Rivelli explains.

As far as the Mediterranean diet is concerned, the cons boil down to accessibility and affordability. 

With a diet so heavy on fresh fruits, vegetables, fish, and seafood, it can be difficult to stick with, depending on your location and seasons, which can limit access to these foods. These natural ingredients are often more expensive than more convenient processed foods.

While sweets and processed foods aren’t entirely off-limits on the Mediterranean diet, they are limited. If you have a sweet tooth, it might be a bit of an adjustment to cut back on these types of foods if they’ve been a big part of your diet.

Is keto or the Mediterranean diet better?

It depends. There’s no one-size-fits-all diet when it comes to achieving your wellness goals. 

Some thrive on keto, while others don’t. The same is true with the Mediterranean diet. The “better” diet is the one you’re more likely to stick with and that treats your body better.

That said, at Noom, we’re focused on eating in a sustainable way that promotes lasting change. That’s hard to do with restrictive diets like keto. In that regard, the Mediterranean diet is a more balanced way of eating.

“The Mediterranean diet is less restrictive in its approach and embraces a wide variety of nutrient-dense foods,” Rivelli says.

Let’s dive a little deeper.

Which one is healthier?

Due to its numerous well-researched health benefits and focus on a broad range of natural, healthy foods, Rivelli says that the Mediterranean diet is healthier.

“The Mediterranean diet has been positively linked with many promising, research-backed benefits on overall health,” Rivelli says.

While keto has been shown to have health benefits as well, the research is still in a more exploratory phase.

“Keto is still being explored by the scientific community regarding weight management, disease management, and overall long-term effects on individuals,” she says.

Rivelli recommends being careful and working with professionals like your medical provider, registered dietitian, and nutritionist when following the keto diet.

“With a slim repertoire of data—especially peer-reviewed—people who choose to partake in this eating style should move with caution and with a well-informed care team of credentialed, reputable professionals,” she says.

Which diet is harder to stick with?

In general, keto is harder to stick with for most because of how restrictive it is—as it’s a very low-carbohydrate diet.

“Limiting carbohydrate intake is hard,” Rivelli says. “And carbs aren’t just limited to bread or potatoes—they’re also in fruits, vegetables, whole grains, dairy products, and legumes.”

All it takes is one carb-heavy day to knock you out of ketosis.

“You can quickly fall out of ketosis—which is the whole point of keto weight-loss efforts—thus ending or even negating many of the effects you were aiming for,” Rivelli explains.

With the Mediterranean diet, you’re focusing on nutrient-dense food groups while limiting others with less nutritional value, like sweets and red meats. There’s less of a dramatic difference in your day-to-day eating, as you’re not eliminating entire food groups from your diet.

“Because of this, there isn’t as dramatic of an effect if you have an ‘off’ day while trying to maintain a Mediterranean diet compared to what you may experience while on keto,” Rivelli says.

Overall, Rivelli explains that change is tough, and which diet is “harder” may depend on a person’s lifestyle and personal tastes.

Mediterranean diet vs. keto for weight loss

In general, weight loss on the Mediterranean diet is more attainable and manageable long term because of its flexibility, Rivelli explains.

“Maintaining weight loss with this way of eating could feel more sustainable since it is more relaxed in its approach,” she says.

Research supports this.

“There is much more robust and comprehensive research out there on the Mediterranean diet and its long-term effects on weight loss,” Rivelli says.

One systematic review of the Mediterranean diet found that the average long-term weight loss among participants was approximately 9 pounds to 22 pounds in one year. Additional research suggests that the diet can help you maintain weight loss long term, too.

Meanwhile, weight loss research on the keto diet indicates that people could lose up to 10 pounds in two weeks or sooner than that. But some of this initial keto weight loss may be from water weight. 

“The rapid weight loss is very hard to sustain and often due to a diuretic effect—also known as a loss of water weight—not true weight loss,” Rivelli says.

It’s important to note that neither diet guarantees weight loss. Healthy eating in each diet determines results.

“Regardless of the dietary approach, if someone is trying to lose weight, they also will need to be in a caloric deficit while changing their eating pattern,” Rivelli adds.

A calorie deficit means you’re burning through more calories than you’re eating. But don’t go overboard and get too restrictive to achieve a daily calorie deficit.

“For a significant and lasting decrease in body weight, an individual will need to be in a caloric deficit that is healthy and sustainable for that individual,” Rivelli says.

It’s easier (and best) to achieve this deficit when you base your food choices on caloric density (the number of calories in food servings).

Keto vs. the Mediterranean diet: How to choose

Your final decision when it comes to choosing between keto and the Mediterranean diet comes down to your body and goals, Rivelli says.

Before you choose, ask yourself:

• Which one do you think you could stick to more easily?
• Which foods appeal to you more?
• Which one feels like it would take less effort for you to maintain?
• Which diet is better for your health needs and goals?

Once you answer these questions, you’ll be able to determine which eating style is right for you and aligns with what you want out of your wellness journey.

When you make that choice, we’re here to support you. Learn how Noom works with keto and with the Mediterranean diet. Sign up for Noom today!