A recent study published in Nutrients highlights that both the ketogenic and Mediterranean diets can help overweight and obese individuals lower their weight and blood pressure. With nearly 40% of American adults living with obesity and about half affected by high blood pressure, these findings could offer valuable dietary options for many at risk of heart disease and other chronic illnesses.
The study involved 26 participants who were overweight or obese and had elevated blood pressure or hypertension. They were divided into two groups: 15 followed a ketogenic diet, which is high in protein and fat but low in carbohydrates, while 11 followed a Mediterranean diet, which is higher in carbohydrates and potassium but low in sodium. Both groups consumed about 1,300 calories daily.
After three months, both groups experienced weight loss and reductions in blood pressure, waist circumference, BMI, and fat mass. One notable difference was that those on the ketogenic diet showed a larger drop in nighttime blood pressure, a sign that could suggest improved heart health. However, the study had limitations, including a small sample size, short duration, and lack of random assignment, as participants chose their diets based on personal preferences.
Despite these differences, the two diets are quite distinct. The ketogenic diet encourages the body to enter ketosis, burning fat for energy by restricting carbohydrates. Meanwhile, the Mediterranean diet emphasizes whole grains, fruits, vegetables, and moderate protein and fat intake, reflecting traditional eating patterns from Mediterranean regions, often associated with longevity.
Experts note that weight loss on the ketogenic diet happens mainly because it cuts out a major macronutrient—carbohydrates. In contrast, the Mediterranean diet promotes weight loss by reducing saturated fats and increasing nutrient-rich foods. For the study participants, weight loss was likely the key factor behind improved blood pressure, though the quality of nutrients and whole foods may also contribute.
Health professionals generally recommend the Mediterranean diet over keto for most people. While keto can lead to rapid weight loss and better blood sugar control, its strict restrictions make it hard to maintain long term. It also eliminates many fiber-rich foods important for heart health, gut function, and weight management. Keto can cause side effects like higher cholesterol, digestive issues, cognitive problems, and symptoms known as “keto flu,” such as fatigue and headaches.
The Mediterranean diet allows for all foods but prioritizes those known to support health. It has been shown to reduce inflammation, support heart health, lower diabetes risk, prevent some cancers, and improve brain function. Although it is not specifically designed for weight loss, many find it naturally leads to shedding pounds due to its balanced and satisfying approach.
Choosing the right diet depends on individual needs and goals. The ketogenic diet may benefit certain groups, such as those preparing for bariatric surgery or individuals with epilepsy, and there is emerging evidence it may help people with type 2 diabetes. However, the Mediterranean diet is more adaptable and suitable for most people, with easy modifications to fit different cultural food preferences.
Experts suggest considering long-term goals, realistic expectations, and personal preferences when selecting a diet. Consulting a registered dietitian can help tailor a plan that supports weight loss, blood pressure control, and overall health. Ultimately, the best diet is one that can be followed consistently over time to sustain lasting benefits.
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