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The Mediterranean Diet: Benefits and Relationship to Keto

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  Published on January 5th, 2021
  Reading time: 3 minutes
  Last modified April 14th, 2023
Ingredients for the mediterranean diet

The Mediterranean diet is one of the most popular diets believed to be healthier than the standard American or Western diet. What are the benefits of this diet, and what exactly does it involve? How does the Mediterranean diet tie in with the ketogenic diet?

What is the Mediterranean Diet?

The Mediterranean diet stems from the belief that people around the Mediterranean traditionally followed a diet rich in vegetables, fruits, and plant-based foods, whole grains, nuts, seeds, and legumes. The diet is also rich in fish and olive oil with moderate amounts of poultry, dairy, eggs, and red wine. Red meat only plays a small part.

Globally, this diet has gained popularity, and many advocates believe it’s a healthier diet choice that might also help lower the risk of heart disease.

Let’s discuss some of the science behind the Mediterranean lifestyle and how it ties in with keto [1].

What are the Benefits of the Mediterranean Diet?

Several randomized, controlled trials have examined the possible health benefits of the this diet. Most of the people involved in these studies had health problems, such as metabolic syndrome, diabetes, or a high risk of heart disease.

Most studies assessed common health markers, such as heart disease risk factors, markers of diabetes, and body weight. Some larger studies also looked at heart attacks and fatalities.

For example, one large study called the PREDIMED study involved 7,447 people with a high risk of heart disease. The participants followed one of three diets for almost five years:

  • Low-fat diet control group
  • Mediterranean with added extra virgin olive oil (Med + oil)
  • Mediterranean with added nuts (Med + nuts)

None of the diets increased physical activity or reduced calories.

Many researchers used the data from PREDIMED to investigate the diet’s effect on different risk factors and endpoints. The results from PREDIMED showed the risk of combined stroke, heart attack, and death from heart disease was lower by 28% in Med + nuts, and 31% in the Med + oil [2].

Researchers analyzed data from 1,224 individuals in the PREDIMED study after one year following a Mediterranean diet. They assessed whether the diet reversed metabolic syndrome and found the prevalence of metabolic syndrome decreased by 13.7% in the Med + nuts group and 6.7% in the Med + olive oil, showing statistical significance only for the Med + nuts group [3].

Scientists also looked at 372 people in the PREDIMED study with a high risk of heart disease after following a diet for three months. They found a reduction in levels of oxidized LDL, (often called the bad cholesterol) in both Mediterranean diet groups [4].

Researchers also assessed the risk of developing type 2 diabetes. They looked at 418 people without diabetes in the PREDIMED study for four years and concluded the Mediterranean diet seemed to reduce the risk of developing type 2 diabetes by 52% [1].

How Does the Mediterranean Diet Tie in with Keto?

Mediterranean foods and keto have crossovers and similarities. Just like keto, the Mediterranean diet also calls for lots of healthy fats like olive oil, nuts and seeds, and fatty fish. Most Mediterranean diets allow for grains without limiting quantities, which isn’t suitable for a ketogenic diet that typically involves a carb count of below 50 grams daily.

If you’re following the Mediterranean lifestyle and you also plan to go keto, you’ll need to watch your intake of starchy veggies and tubers, grains, and other carbs. The Mediterranean diet isn’t necessarily low-carb, but you can make it low-carb with a few alterations and by watching your carb intake.

In conclusion, the Mediterranean diet might be a healthier dietary choice when it comes to heart disease, type 2 diabetes, and other risk factors. It’s a much better option than the standard low-fat diet or a traditional Westernized diet with sugar-filled junk foods and refined and processed foods.

Steph Green is a writer, researcher, and singer/songwriter with a passion for all things wellness. In 2016, after four years of struggling with her own health problems and painful autoimmune disease, Steph developed a life-changing and extensive knowledge of keto, nutrition, and natural medicine. She continues on her healing journey and enjoys helping others along the way.



Mayo Clinic. The Mediterranean Diet: A Heart Healthy Eating Plan. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801


Estruch, R., Ros, E., Salas-Salvado, J., Covas, M-I., Aros, F., Gomez-Gracia, E., Ruiz-Gutierrez, V., Fiol, M., Lapetra, J., Lamuela-Raventos, R. M., & Serra-Majem, L. (2013). Primary prevention of cardiovascular disease with a Mediterranean diet UPDATE: RETRACTED ARTICLE. New England Journal of Medicine, 368, 1279-1290. DOI: 10.1056/NEJMoa1200303


Salas-Salvado, J., Fernandez-Ballart, J., Ros, E., Martinez-Gonzalez, M-A., Fito, M., Estruch, R., Corella, D., Fiol, M., Gomez-Gracia, E., Aros, F., Flores, G., Lapetra, J., Lamuela-Raventos, R., Ruiz-Gutierrez, V., Bullo, M., Basora, J., Covas, M-I., & Covas, M-I. (2008). Effect of a Mediterranean diet supplemented with nuts on metabolic syndrome statues: One-year results of the PREDIMED randomized trial. Archives of Internal Medicine, 168(22), 2449-2458. DOI:10.1001/archinte.168.22.2449


Fito, M., Guxens, M., Corella, D., Saez, G., Estruch, R., De La Torre, R., Frances, F., Cabezas. C., Lopez-Sabater, M. C., Marrugat, J., Garcia-Arellano, A., Aros, F., Ruiz-Gutierrez, V., Ros, E., Salas-Salvado, J., Fiol, M., Sola, R., & Covas, M-I. (2007). Effect of a traditional Mediterranean on lipoprotein Oxidation: A randomized controlled trial. Archives of Internal Medicine, 167(11), 1195-1203. DOI:10.1001/archinte.167.11.1195


Salas-Salvado, J., Bullo, M., Babio, N., Martinez-Gonzalez, M., Ibarrola-Jurado, N., Basora, J., Estruch, R., Covas, M. I., Corella, D., Aros, F., Ruiz-Gutierrez, V., & Ros, E. (2011). Reduction in the incidence of type 2 diabetes with the Mediterranean diet: Results of the PREDIMED-Reus nutrition intervention randomized trial. Diabetes Care, 34(1), 14-19. DOI: 10.2337/dc10-1288

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