Which Is Better for Weight Loss?

The ketogenic (keto) and Mediterranean diets can help overweight or obese people lose weight and lower their blood pressure. The diet that’s best for you may depend on your personal preferences and how well you stick to it.

In a 2025 study, researchers followed 26 participants divided into two groups: 15 people followed a keto diet and 11 adopted the Mediterranean diet.

Both diets involved calorie restriction, with all participants consuming around 1,300 calories per day.

After three months on the diet, participants in both groups saw a drop in their weight and blood pressure. People also saw a reduction in waist circumference, body mass index (BMI), and fat mass.

The only significant difference between the diets was their effect on nighttime temperature drops, or the natural drop in blood pressure while you sleep. Keto diet participants experienced greater drops in nighttime blood pressure, which may indicate better overall heart health.

The main limitations of the study were its short duration and small sample size. It was also not randomized, meaning participants were not assigned to a diet by chance. Instead, they were placed into each plan based on their nutritional profile and personal preferences.

Although the two diets produced similar results in the study, they are actually very different.

• Keto : This diet is generally high in fat and protein and low in carbohydrates. It aims to cause weight loss by inducing ketosis, when the body burns fat for fuel instead of carbohydrates.
• Mediterranean diet: This diet is high in carbohydrates, especially whole grains, fruits and vegetables, and low in protein and animal fats. It is based on traditional eating habits from the Blue Zones around the Mediterranean Sea and is believed to help people live longer.

Despite their differences, both diets can help you lose weight.

Cutting out carbs helps with weight loss on the keto diet. “You’re going to lose weight because you’re cutting out a major macronutrient,” says Sue-Ellen Anderson-Haynes, MS, RDN, spokesperson for the Academy of Nutrition and Dietetics and founder of 360Girls&Women. Health.

Cutting out saturated fat helps with weight loss on the Mediterranean diet. “Not only are you cutting out saturated fats, but you’re also including more nutrient-dense foods,” Anderson-Haynes said.

Although both diets can help manage weight and blood pressure, experts generally recommend the Mediterranean diet over the keto diet.

Keto can lead to rapid weight loss and help control blood sugar, but its restrictions make it difficult to maintain long-term, said Laura Acosta, DCN, RDN, LDN, an educational associate professor in the department of food sciences and human nutrition at the University of Florida. Health.

Experts were also concerned about cutting out carbs, primarily due to the loss of fiber, a specific type essential for weight management, heart health, gut microbiome, and more.

“I would consider the keto diet unhealthy because you’re cutting out these fibrous foods,” Anderson-Haynes said. “They remove the types of fiber in your diet that you need to stay healthy.”

The keto diet also has several other disadvantages:

• Higher cholesterol levels: This can worsen heart health over time.
• Digestive problems: Symptoms may include constipation, diarrhea and bloating.
• Cognitive decline: Symptoms may include brain fog and memory problems.
• Keto Flu: During the first few weeks of the diet, you may experience side effects such as vomiting, headaches, fatigue, and insomnia.
• Keto breathing: This is a distinct, unpleasant odor in the mouth that comes from chemicals produced during ketosis.

The Mediterranean diet also has risks, such as lower iron levels and increased red wine consumption, but experts say it is not as extreme or restrictive as keto.

“No food is forbidden, which is the only characteristic of [the Mediterranean diet] which I really appreciate,” said Lisa Moskovitz, RD, CDN, CEO of NY Nutrition Group and author of “The Core 3 Healthy Eating Plan.” Health. “Any food can work, but we highlight and prioritize the foods we know are healthiest.”

The Mediterranean diet has a number of well-studied benefits, including:

• Reduce inflammation
• Support heart health
• Reduce the risk of diabetes
• Prevent certain cancers
• Improve brain health

Although the Mediterranean diet may promote weight loss, Acosta said it’s not really a weight loss diet. “It’s just a helpful way to eat,” she said. “And I think sometimes weight loss follows naturally because it’s a type of eating that will be really filling.”

“Both diets can help, but I would say the strength and sustainability of the Mediterranean diet is stronger,” Acosta added.

The keto diet may be the right choice for some specific groups, Anderson-Haynes said, including:

But the Mediterranean diet can work for everyone, experts agree.

It may not fit the foods in everyone’s culture, Anderson-Haynes noted, but simple adjustments can usually make it work. For example, Anderson-Haynes recommends red snapper instead of salmon for customers in the African diaspora.

When developing a diet plan, Moskovitz recommends considering several questions:

• What are your long-term goals?
• What is realistic for you?
• What looks good to you?
• What can you continue to follow throughout your life?

Consulting a dietitian can also help you find a diet that’s right for you and your goals, whether it’s losing weight, lowering blood pressure, or something else.

“A healthy diet is something you can stick to for the long term,” Anderson-Haynes said. “Working with an expert will get you there.” »