They both lead to weight loss. But do they heal? Which one protects your heart? And which can you actually stick with?
The ketogenic diet has become a trend: lots of fat, almost no carbs, and promises of rapid fat burning. But is this restrictive model sustainable? The Mediterranean diet, known for its plant-based foundation and olive oil, also promotes weight loss — but is it effective enough in comparison? Which one offers better metabolic benefits? And ultimately, which of these diets is truly viable for most people?
A recent randomized clinical trial compared these two approaches in overweight individuals, revealing surprising insights not only about how much weight is lost, but what living on each diet actually feels like.
Keto Works — But at a Cost
In the study, participants followed one of the two diets for 12 weeks. Those on the keto diet lost weight more quickly during the first 4 to 8 weeks. The dramatic calorie reduction due to cutting out almost all carbs (less than 10% of total intake) triggered significant drops in weight and body fat.
However, researchers noted frequent side effects: constipation, fatigue, irritability, insomnia, and poor adherence after the third month. In addition, lipid profiles (cholesterol and triglycerides) worsened in some participants, especially those who increased intake of meats and full-fat dairy products.
Mediterranean: Less Drastic, More Sustainable
Meanwhile, the Mediterranean diet — rich in fruits, vegetables, olive oil, fish, whole grains, and nuts — led to slower but steadier weight loss over time.
The study also showed that participants on the Mediterranean diet experienced broader improvements in cardiovascular health, including reduced triglycerides, blood pressure, and fasting glucose, along with a general increase in well-being and diet adherence.
By the end of the study, most people in the Mediterranean group were still comfortably following the diet, while many in the keto group had abandoned or significantly modified their original plan.
What the Study Really Reveals
The trial highlighted a crucial point: both diets can lead to weight loss, but long-term success depends on adherence and side effects.
The ketogenic diet might be a short-term strategy for rapid loss, but it’s not sustainable for everyone. Meanwhile, the Mediterranean diet, though less intense, proved to be effective in a gentler way — with broader and more sustainable metabolic benefits, especially for those with cardiovascular risk factors or metabolic syndrome.
What if the Answer Isn’t Just on the Scale?
At the end of the 12 weeks, the question “which diet leads to more weight loss?” may not be the most important one. Instead, the study encourages deeper reflection: which diet can you stick to without sacrificing your physical and mental health? Which fits your culture, lifestyle, and pleasure in eating?
Scientific References:
- Gardner et al. (2023) — “Ketogenic versus Mediterranean Diet for Weight Loss and Cardiometabolic Health in Overweight Adults: A Randomized Trial”, American Journal of Clinical Nutrition.
https://pubmed.ncbi.nlm.nih.gov/36726895/ - Estruch et al. (2018) — “Primary Prevention of Cardiovascular Disease with a Mediterranean Diet”, New England Journal of Medicine.
https://www.nejm.org/doi/full/10.1056/NEJMoa1800389 - Saslow et al. (2017) — “Twelve-month outcomes of a randomized trial of a moderate-carbohydrate vs very low-carbohydrate diet in overweight adults”, Nutrition & Diabetes.
https://pubmed.ncbi.nlm.nih.gov/28327506/
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