Keto vs. Mediterranean Diets: Which is Best for Weight Loss and Lowering Blood Pressure?

In a recent study published in May in the journal Nutrients, both the ketogenic (keto) and Mediterranean diets were found effective in aiding weight loss and reducing blood pressure in overweight and obese individuals with elevated blood pressure. With approximately 40% of U.S. adults experiencing obesity and nearly half having high blood pressure, these diets could serve as accessible interventions for many seeking improved health outcomes.

Two Diets Put to the Test

The study assessed 26 participants who were either overweight or obese and had slightly elevated blood pressure. Participants were divided into two groups—15 followed the keto diet, and 11 adopted the Mediterranean diet. The diets were designed with specific macronutrient levels: the keto diet emphasized high protein and fat with low carbohydrates, while the Mediterranean diet focused on high carbohydrates and potassium with low sodium. Both groups followed a calorie-restricted regimen, consuming about 1,300 calories per day.

After three months, participants from both groups experienced reductions in weight, blood pressure, waist circumference, BMI, and fat mass. Notably, those on the keto diet experienced a more significant drop in nighttime blood pressure, which is an indicator of improved heart health. However, the study was limited by its short duration and small sample size, and participants weren't randomly assigned to diets.

Understanding the Keto and Mediterranean Diets

Although both diets achieved similar results, they function differently. The keto diet is high in fat and protein, low in carbohydrates, prompting the body to enter ketosis—a state where it burns fat for energy rather than carbs. Conversely, the Mediterranean diet is rich in carbohydrates, especially whole grains, fruits, and vegetables, and lower in animal protein and fat. It emulates traditional eating habits from regions around the Mediterranean Sea, promoting longevity and various health benefits.

The keto diet can lead to weight loss by significantly reducing carbohydrate intake, while the Mediterranean diet encourages weight loss through the reduction of saturated fats and increased consumption of nutrient-dense foods. The weight loss in both groups likely contributed to improved blood pressure levels, emphasizing the direct correlation between weight loss and blood pressure reduction.

Which Diet is Better?

Experts generally recommend the Mediterranean diet over the keto diet for sustainable health management. Despite keto's effectiveness in rapid weight loss and blood sugar control, its restrictive nature makes it hard to maintain long-term. The keto diet's elimination of carbohydrates can lead to reduced fiber intake, which is vital for weight management, heart health, and gut health. Keto also carries several potential downsides, such as increased cholesterol levels, digestive issues, and cognitive effects.

Meanwhile, the Mediterranean diet is less restrictive, allowing the inclusion of a wide range of foods while focusing on health-promoting options. It's been linked with numerous benefits, such as reduced inflammation, improved heart health, decreased diabetes risk, cancer prevention, and enhanced brain function. Though it can encourage weight loss, the Mediterranean diet is more of a holistic eating approach that promotes overall well-being.

Choosing the Right Diet for You

While the keto diet may be suitable for specific groups like those preparing for bariatric surgery or managing epilepsy, the Mediterranean diet is universally applicable. It can be adapted to fit different cultural preferences, such as substituting specific foods. When selecting a diet, consider your long-term goals, personal preferences, and the sustainability of the eating plan. Consulting with a dietitian can provide personalized guidance aligned with your health objectives.

Ultimately, a healthy diet should be maintainable over the long term. Working with nutrition experts can help develop a diet plan that supports your unique needs and lifestyle, ensuring lasting benefits for your health.