A recent study shows that both the ketogenic (keto) and Mediterranean diets can help overweight and obese adults lose weight and reduce blood pressure. The research involved 26 participants with elevated blood pressure and was published in Nutrients in May.
Participants were split into two groups: 15 followed the keto diet, which is high in protein and fat but low in carbohydrates, while 11 followed the Mediterranean diet, which is high in carbohydrates and potassium but low in sodium. Both groups ate about 1,300 calories daily.
After three months, both groups saw significant drops in weight, blood pressure, waist size, body mass index (BMI), and fat mass. The keto group experienced a larger decrease in nighttime blood pressure, which may signal better heart health.
The study had some limits, including its short length, small size, and the fact that participants chose their diet based on preference, not random assignment.
Despite their differences, both diets led to weight loss. The keto diet encourages the body to burn fat by cutting carbs, while the Mediterranean diet emphasizes nutrient-rich foods like whole grains, fruits, and vegetables, and limits saturated fats.
Experts say weight loss likely caused the blood pressure improvements. Sue-Ellen Anderson-Haynes, a registered dietitian, noted that cutting calories was key, but food quality also plays a role.
Most experts recommend the Mediterranean diet over keto for long-term use. Laura Acosta, a nutrition professor, explained that keto can be hard to maintain because it restricts carbs and fiber, which are important for heart and gut health.
Keto can also cause side effects such as digestive issues, increased cholesterol, brain fog, and “keto flu” symptoms like headache and fatigue. The Mediterranean diet is more flexible, allowing all foods but focusing on those that promote health.
The Mediterranean diet is linked to reduced inflammation, better heart health, lower risk of diabetes and some cancers, and improved brain function. Although it’s not designed for weight loss, it often leads to natural weight reduction due to its satiating nature.
Keto may be suitable for some groups, such as people preparing for bariatric surgery or those with epilepsy. Early evidence also suggests benefits for people with type 2 diabetes.
For most people, the Mediterranean diet is a safer, more sustainable choice. It can be adapted to fit different cultural foods with simple changes.
Experts suggest choosing a diet based on your goals, preferences, and what you can maintain long term. Consulting a dietitian can help you find a plan tailored to your needs.
“A healthy diet is one you can stick to for life,” Anderson-Haynes said. “Working with a professional can help you get there.”
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