“The downside of the keto diet is that to get and stay in ketosis—the state where your body burns fat rather than glucose as its predominant fuel source—you’ll need to keep your carbohydrate intake between about 20 and 50 grams a day1,” says board-certified internist and mbg Collective member Vincent M. Pedre, M.D. (For reference, a small apple has 20 grams of carbohydrates2.) Because carbohydrates are so restricted on a keto diet, this usually means eliminating most high-carb foods, but that doesn’t mean your plate should be stacked with meat and cheese. “Ask somebody what keto is, and the foods that pop up would be bacon and butter and steak and lard. Most of us don’t appreciate that you can do keto without that,” Ethan Weiss, M.D., preventive cardiologist and co-founder of Key Eats previously told mbg. While you do eliminate many high-carb options like beans, fruits, legumes, starchy vegetables, grains, and low-fat dairy products, you’re free to consume a wide variety of low-carb foods like meat, poultry, seafood, eggs, cheese, avocados, nuts, oils, butter, and some full-fat dairy. In a 2021 study, researchers compared the outcome of following a keto diet versus a Mediterranean diet for 12 weeks in 33 people. While both plans resulted in a similar rate of adherence, the participants on the keto diet experienced better glucose control and a more significant decrease in triglycerides and LDL levels. They also lost more weight, on average. In another 2021 study published in Nutrients, researchers set out to compare a Mediterranean diet with a low-carbohydrate diet5. They divided 36 participants into two groups—one group followed a traditional Mediterranean diet, while the other followed a low-carb (but not quite keto) nutrition plan with the same amount of calories. While both groups experienced health benefits, like improved insulin sensitivity, the low-carbohydrate group lost about 60% more weight, on average. Years ago, researchers also looked at an unlimited-calorie Mediterranean keto diet, specifically, and found that it can promote weight loss, normalize blood pressure, and reduce total cholesterol, LDL cholesterol, and triglycerides in individuals with obesity. It can also raise HDL, or “good,” cholesterol. A 2011 study showed similar results6, although it’s worth noting that participants in this study also took plant-based herbal extracts daily (like mint, guarana, and ginseng, to name a few) to increase their overall phytonutrient intake and leverage functional botanical bioactives. While there are potential benefits to both the Mediterranean diet and the keto diet7, there is very limited research on the combined effects of this diet, with all the studies mentioned previously lasting for only short periods of time with a small number of people. Aside from the physical health benefits, the Mediterranean keto diet is also a bit more flexible than a traditional keto diet. Because there’s no focus on strict macro counting, many people find it easier to adhere to long term than a traditional keto diet. It’s also more adaptable to other diet preferences, like vegetarian or vegan plans. But like any new diet plan, there may be an adjustment period when you’re first starting out. If you’re coming from a really high-carbohydrate diet, you may experience some signs of carbohydrate withdrawal8. The most common signs of carbohydrate withdrawal are headaches, impacts on digestion regularity, bad breath, muscle cramps, muscle weakness, and lightheadedness. These issues usually resolve on their own within two weeks of starting a low-carb diet, during which time you may notice an ease in bloating and fewer sugar cravings. However, if these unpleasant side effects persist, reach out to a health professional for support. And quality matters too. “Always opt for organic produce whenever possible,” says Pedre. “With animal foods, choose grass-fed beef, wild-caught cold-water seafood, and organic free-range poultry and eggs [whenever possible].” Here’s a breakdown of what you can expect to eat on a Mediterranean keto diet: When following a Mediterranean keto diet, you should eat plenty of fatty fish, like salmon, and other healthy fats like olive oil and avocado. Low-carb vegetables and nuts and seeds are the other foundational foods, with the occasional lean meats and cheese. She has written twelve books and has had more than 2,000 articles published across various websites. Lindsay currently works full time as a freelance health writer. She truly believes that you can transform your life through food, proper mindset and shared experiences. That’s why it’s her goal to educate others, while also being open and vulnerable to create real connections with her clients and readers.
