Mediterranean Ketogenic Diet: All You Need to Know

Mediterranean Ketogenic Diet: All You Need to Know

The Mediterranean Ketogenic Diet seeks to bring together the benefits of these two eating styles. Do you know what the benefits are?

What is the Mediterranean diet and what are its benefits?

If we ask 100 people on the street about what is the healthiest diet out there, more than half are likely to opt for the Mediterranean diet. Why?

This reputation, more or less justified, has been given to it after several decades of studying this dietary model as the “gold standard” of health.

The Mediterranean diet has its strengths and weaknesses.

Firstly, we are not sure what “Mediterranean diet” means. In various parts of the Mediterranean area, the diet has varied (sometimes very much so).

Types mediterranean diet

In other words, there is not “one” Mediterranean diet, there are many.

On the other hand, the diet includes as “Mediterranean eating patterns” the low-moderate intake of fermented alcoholic beverages, which leaves ample room for the “healthiest diet in the world”.

The two most renowned proponents of the Mediterranean diet are the epidemiologist Leland G. Allbaugh and the even better known American physiologist Ancel Keys (author of the seven-country study).

The characteristics and benefits of the Mediterranean diet are

  • Prevention of cardiovascular disease.
  • Prevention of metabolic pathologies (obesity, type 2 diabetes, metabolic syndrome).
  • Improved cognitive performance.
  • Lower incidence of various neoplasms (colorectal, prostate, stomach, among others).
  • Anti-inflammatory diet.
  • Rich in polyphenols and antioxidants.
  • Very active, frugal lifestyle and based on a vegetarian diet.
This point is essential, as the “creators” of MD spoke of a “Mediterranean lifestyle” that included many more elements than the diet itself.

Foods which are included

The Mediterranean lifestyle includes, as we said, not only food, but also a Mediterranean “way of life”: family life, frugality, respect for circadian rhythms, plenty of physical activity, cooking and adequate rest.

Beyond that, the foods included belong mostly to the plant kingdom.

Plant based diet

It should be a plant-based diet; and I say ‘should’ because in practice this is rarely the case.

The main food groups of a Mediterranean diet are:

  • Vegetables and fruits in every meal.
  • Legumes.
  • Whole grains.
  • Dried fruits, seeds and olives.
  • Fish (of particular interest is blue fish).
  • White meat and eggs.
  • In smaller amounts: red meats.

Mediterranean Keto

What is the Mediterranean ketogenic diet?

What if we took the benefits of the Mediterranean diet and the ketogenic diet and established synergies between them? Is it possible to do this?

Benefits mediterranean diet

For despite the initial shock it may cause to many, it is not a crazy idea, although it would be useful in some specific contexts.

As we know, the ketogenic diet is a very carbohydrate-restricted diet (less than 50 grams per day), which generates the so-called nutritional ketosis, an elevation of ketone bodies in the blood (mainly beta-hydroxybutyrate). This model of diet is used mainly, but not exclusively, in weight loss, with good results. Click click here to learn more.

How it works

Transforming a Mediterranean diet into a low-carb diet does not require much juggling.

We will mainly restrict four classic food groups of the Mediterranean diet: cereals, legumes, higher carbohydrate fruits and wine.

Foods keto mediterranean diet

In this way we already have a low or very low carbohydrate diet based on typically “Mediterranean” products.

The idea behind this ruse is to obtain the benefits of the Mediterranean diet and at the same time take advantage of nutritional ketosis in those (mainly clinical) contexts where it is useful (mainly metabolic pathology).

Benefits of this diet with Spanish products

A well thought-out Mediterranean ketogenic or low-carbohydrate diet should bring us many ( but not all) of the benefits of the original Mediterranean diet:

  • Very rich in monounsaturated fatty acids (MUFA), as the main fat will remain extra virgin olive oil.
  • A clearly anti-inflammatory omega-3 and 6 profile.
  • Very rich in antioxidants and polyphenols. The latter are bioactive compounds present in foods of plant origin that reduce the risk of many diseases.
  • Includes raw food and some good processed food and excludes ultra-processed products altogether.
  • Increases production of butyrate (not to be confused with beta-hydroxybutyrate).

Recipes mediterranean ketogenic diet

Butyrate is a molecule which, like BHB, is also ketogenic.

As a signalling molecule, both increase BDNF levels, promote neuronal health, inhibit the so-called histone deacetylases that modify gene expression (epigenetic changes), inhibit the NFkB factor and activate regulatory T-lymphocytes to decrease inflammation and induce the FGF21 factor that increases beta-oxidation.

What can you eat on the Mediterranean keto diet?

We might think that this is a very restrictive diet in terms of food variety, but it is a well planned diet that can move away from monotony.

You can include:

  • Sources of proteins: eggs, sardine, mackerel, bonito, tuna, seafood, white meat, beef, pork.
  • Fats: olives, EVOO, avocado, butter.
  • Fruits: red fruits, citrus fruits in small quantities.
  • Vegetables: spinach, broccoli, artichoke, courgette and in general most of the vegetables that grow above ground.
  • Seeds: chia, linseed, sesame.
  • Nuts: walnuts, almonds, pistachos, macadamia nuts.
  • Mushrooms.
  • Dressings: pesto, aioli, vinaigrette, EVOO, chimichurri.
  • Fatty cheeses.

What are the results?

There is no specific literature on the keto-mediterranean diet except for some studies such as (Paoli et al., 2013).

The expected results are those achieved with the classic ketogenic diet.

Healthy diet

Diet with an “abundance” of vegetables.

We remind the reader that nutritional ketosis together with an adequate caloric deficit are tools to produce a weight loss that can oscillate between 5 and 10% of the initial weight at 12 weeks (see additional literature).

Is it a long-term diet?

The ketogenic diet should not be considered as a long term lifestyle except in very specific contexts (such as refractory epilepsy and some other situations).

That said, you can go on a ketogenic Mediterranean diet for an initial period lasting several weeks and then switch to a low carb diet.

Even later use a moderate carbohydrate diet as a long-term maintenance diet.

Why opt for a Mediterranean ketogenic diet?

The most frequent attacks on the ketogenic diet are:

  • Its high protein content: the well-planned keto diet rarely exceeds 1.2 g of protein/kg body weight;
  • Its low fibre content: with a Mediterranean keto this should not be a problem; and,
  • Its high content in saturated fats: when the main source of fat is the OVE, the avocado or the seeds, this simply does not happen.

Mediterranean Keto Salad

Mediterranean Keto Salad

We recommend you try this delicious Mediterranean Keto Salad.

Recipe Tips: Mediterranean Keto Salad

  • Preparation time: 8 minutes
  • Cooking time: 1 minute
  • Portion size: 1 Bowl
  • Number of servings: 1
  • Cooking style: American


  • Chopped cucumber
  • Cherry tomatoes
  • Yellow pepper, chopped
  • Half a spring onion
  • Black olives
  • 1 cup cooked and shredded cauliflower
  • 100g sliced Feta cheese
  • Olive oil
  • Salt
  • Garlic and Spice Sauce from FoodSeries
Nutritional Information per serving
of which saturates:19,9g
of which sugars:10g

How to make: Mediterranean Keto Salad

  1. In a bowl we mix all the ingredients.
  2. Dress with a pinch of salt, olive oil and the garlic and spice sauce to taste.

Discover a keto Mediterranean menu

Try these keto-mediterranean recipes:


  1. Estruch, R., Ros, E., Salas-Salvadó, J., Covas, M.-I., Corella, D., Arós, F., Gómez-Gracia, E., Ruiz-Gutiérrez, V., Fiol, M., Lapetra, J., Lamuela-Raventos, R. M., Serra-Majem, L., Pintó, X., Basora, J., Muñoz, M. A., Sorlí, J. V, Martínez, J. A., Martínez-González, M. A., & PREDIMED Study Investigators. (2013). Primary prevention of cardiovascular disease with a Mediterranean diet. The New England Journal of Medicine, 368(14), 1279–1290.
  2. Moreno, B., Bellido, D., Sajoux, I., Goday, A., Saavedra, D., Crujeiras, A. B., & Casanueva, F. F. (2014). Comparison of a very low-calorie-ketogenic diet with a standard low-calorie diet in the treatment of obesity. Endocrine.
  3. Paoli, A., Bianco, A., Grimaldi, K. A., Lodi, A., & Bosco, G. (2013). Long term successful weight loss with a combination biphasic ketogenic Mediterranean diet and mediterranean diet maintenance protocol. Nutrients.
  4. Westman, E. C., Tondt, J., Maguire, E., & Yancy, W. S. (2018). Implementing a low-carbohydrate, ketogenic diet to manage type 2 diabetes mellitus. In Expert Review of Endocrinology and Metabolism.

Related Entries

  • All you need to know Vegan Ketogenic Diet in this link.
  • Can you gain muscle mass with the Ketogenic Diet? Our response is in this post.
Review of the Mediterranean Diet

What it is - 100%

Benefits - 100%

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About Carlos Sánchez
Carlos Sánchez
Carlos Sánchez has a degree in Human Nutrition and Dietetics, and therefore all his actions are rigorously backed by science.
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