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This Take On The Mediterranean Diet May Be Even Better For You

Two tried-and-true diets come together.

  • Posted on 18th May, 2022 14:00 PM
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Both the Mediterranean and keto diets have a long list of potential health benefits. But if you’ve checked them both out and neither feels quite right, there’s a possible solution: the Mediterranean keto diet. This nutrition plan combines the best of both worlds, focusing on heart-healthy, fresh foods with a lower overall carbohydrate intake. 

What is the Mediterranean keto diet?

Before getting into the specifics of the Mediterranean keto diet, it’s helpful to dive into the basics of each of the individual plans.

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Mediterranean diet

A Mediterranean diet consists of foods that are commonly eaten by people who live near the Mediterranean Sea in countries like Italy, France, and Greece. The diet emphasizes whole grains, beans, nuts, legumes, fruits, veggies, and olive oil, leaving room for fish and seafood a couple times a week. Eggs, cheese, and yogurt are recommended in moderation, and red meat and sweets are limited. While there isn't a specific emphasis on macros—meaning you have to count how many grams of fat, protein, and/or carbohydrates you’re eating—the eating style diet typically consists of 50% carbohydrates (including grains and veggies), about 15% proteins, and 35% fats (more on Mediterranean diet macros here.)

Keto diet

The keto diet is a high-fat, low-carb plan. Unlike the Mediterranean diet, the success of the keto diet relies heavily on macro counting. Typically, carbs are limited to about 5 to 10% of calories, while 75% of calories should come from fat. Protein makes up the rest of the plan, at 10 to 20% of calories.  

“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 day,” says board-certified internist and mbg collective member Vincent M. Pedre, M.D. (For reference, a small apple has 20 grams of carbohydrates.)

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. 

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Mediterranean keto diet

The Mediterranean keto diet combines the best of both nutrition plans, maximizing the benefits and offering a middle ground for those who aren’t totally sold on either. It looks very similar to the traditional Mediterranean diet, but without the high-carb foods like legumes, fruits, beans, and whole grains.

What to expect

There’s no shortage of studies backing the Mediterranean diet—it offers many potential health benefits, like improved blood sugar control, better cardiovascular outcomes (like lower blood pressure and cholesterol), and can help maintain healthy inflammatory response. But adding the keto angle may take things up a notch. 

In a 2021 study, researchers compared the outcome of following a keto diet versus a Mediterranean diet for 12 weeks. 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 diet. 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.

Researchers have 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. It can also raise HDL, or “good,” cholesterol.

A 2011 study showed similar results, although it’s worth noting that participants in this study also took plant-based herbal extracts to up their overall nutrient intake.

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 symptoms of carbohydrate withdrawal.

The most common signs of carbohydrate withdrawal are headaches, impacts on digestion regularity, bad breath, muscle cramps, muscle weakness, and lightheadedness. These symptoms usually resolve on their own within two weeks of starting a low-carb diet, during which time you may notice an ease in bloating symptoms and fewer sugar cravings.

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Med-Keto ingredient staples 

Olive oil and fatty fish are the foundations of a Mediterranean keto diet. These foods provide a hefty dose of monounsaturated fats and omega-3 fatty acids, which promote heart and brain health and deliver anti-inflammatory properties.*

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Weiss explains that there’s a hierarchy of both fats and animal-based proteins. He recommends getting fats mostly from olive oil, avocado, and nuts, and eating plenty of fatty fish. "If you're a person who does eat animals, fish is the best," he says, adding that he tries to eat salmon five to seven times a week. And if that doesn't seem practical for you (let's face it: that's a lot of fish!) supplementing with a high quality omega-3 supplement, like mbg's omega-3 potency+ can be a more convenient and enjoyable way to increase your omega-3 levels.*

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:

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Seafood

  • Salmon
  • Mackerel
  • Sardines
  • Tuna
  • Mussels

Vegetables and Fruits 

  • Leafy greens (kale, spinach, Swiss chard, Collard greens, arugula, Romaine lettuce)
  • Broccoli
  • Brussels sprouts
  • Mushrooms
  • Tomatoes
  • Cucumbers
  • Eggplant
  • Zucchini
  • Berries
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Oils and healthy fats

Nuts & Seeds 

  • Almonds
  • Walnuts
  • Pistachios
  • Pine nuts
  • Sesame seeds

Dairy

  • Cheese (occasionally)

Meats & Poultry

  • Chicken
  • Duck 
  • Turkey
  • Eggs
  • Red meat (occasionally)

You can also drink red wine on occasion—the participants in the 2008 study in Nutrition Journal drank about 7 to 13.5 ounces per day.

The takeaway.

The Mediterranean keto diet is a low-carb plan that emphasizes eating fresh, whole foods that are high in monounsaturated fats and omega-3 fatty acids. Like the traditional Mediterranean diet, this keto version helps normalize blood sugar levels and promotes heart health by lowering blood pressure, LDL cholesterol, and triglycerides—but it may be more effective at all of the above. Based on research, the Mediterranean keto diet may also lead to a higher degree of weight loss. 

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.

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