The Mediterranean Keto Diet: A Comprehensive Guide to Flavor and Health

The Mediterranean ketogenic diet is a healthy option for a variety of people who want to improve their food choices or lower their risk of potential diseases.
The Mediterranean ketogenic diet is a healthy option for a variety of people who want to improve their food choices or lower their risk of potential diseases.

First, let us introduce you to the Mediterranean diet. The Mediterranean diet combines lean proteins, fresh fruits and vegetables, whole grains, and healthy fats. This way of eating may reduce the risk of heart disease, lower blood pressure, support healthy body weight or weight loss, improve blood glucose control, lower cholesterol, and help you live longer.

The Mediterranean diet emphasizes nutrient-dense foods while still being flexible and customizable. It focuses less on specific caloric intake or formulas for health goals and more on improving overall health and making better lifestyle choices. 

Keto is a high-fat, low-carb diet. The keto Mediterranean diet combines lean proteins, healthy fats, and fresh vegetables. While you would not have to completely eliminate whole grains from the diet, you would have to monitor the amounts consumed.

In this article, we will discuss how to properly follow the Mediterranean keto diet. 

What Is the Mediterranean Diet? 

The traditional Mediterranean diet mimics the diet of people living in countries bordering the Mediterranean Sea, such as Italy, Greece, and Spain. However, it is quite the opposite of a typical Western diet. It focuses on fresh, whole foods and ingredients, lean protein, and healthy fats such as oils and nuts while limiting refined grains and highly processed foods.

Research has shown that the Mediterranean diet is one of the healthiest diets followed in the world.   Woman on mediterranean keto diet making a meal.

Studies have shown that the Mediterranean eating style can reduce the risk of chronic diseases such as cardiovascular disease and type 2 diabetes. It can also reduce inflammation, lower blood pressure, decrease blood sugar, lower LDL cholesterol, and improve brain function. With all these known health benefits, following the Mediterranean eating style is a no-brainer.

In addition to being the most overall healthy diet to follow, the Mediterranean diet is easy to follow and includes an abundance of delicious foods. Foods included are: 

  • Fruits and vegetables – greens, tomatoes, peppers, eggplant, onions, cucumber, berries
  • Whole grains – brown rice, quinoa, whole wheat pasta, whole grain braid
  • Legumes – lentils, beans, chickpeas
  • Nuts and seeds – walnuts, cashews, sunflower seeds
  • Healthy fats – avocado, olive oil, olives
  • Fish – salmon, white fish, tuna
  • Seafood – shrimp, mussels, lobster
  • Poultry – chicken and turkey
  • Dairy and eggs – yogurt, cheese, milk
  • Herbs and spices – garlic, basil, cilantro, parsley, mint

With such an extensive list of included foods comes an abundance of recipes and combinations to satisfy even the pickiest of eaters. Meals include grilled seafood and green vegetables, hearty and fibrous salads, and whole grain dishes with fresh and herbaceous sauces and dressings.

Small lifestyle changes or food choices may be all you need to transition into a typical Mediterranean diet. Start by incorporating more fruits and vegetables, add healthy fats such as avocado and olive oil, and swap fatty protein for lean protein sources such as seafood. 

Mediterranean diets tend to have very few restrictions, making them easy to follow. It does limit eating processed foods, including sugary sweets and snacks, red meat, and saturated fats. However, by making a few changes, you can incorporate the Mediterranean diet into other lifestyles, including the keto lifestyle.

As you read on, you’ll learn the difference between keto and Mediterranean diet, including the types of fats typically consumed and how to seamlessly integrate the two.

What Is the Ketogenic Diet? 

The ketogenic diet, or “keto” for short, is a high-fat, moderate-protein, low-carbohydrate diet designed to put your body into ketosis. Ketosis is the metabolic state in which the body uses up glucose and uses ketones for energy. 

Low-carb diets can lower blood sugar levels, reduce insulin, and switch the body’s fuel source to fat.

People with epilepsy use the standard keto diet to control seizures. However, it has become popular as a diet to reduce body fat and lower the risk of chronic disease.

keto quiz

As mentioned, the standard keto consists of high-fat, moderate-protein, and low-carbohydrate intake. Therefore, macronutrient ratios are very different from traditional Westernized low-fat diets.

The keto diet typically yields 70–75% of calories from fat, 20–25% from protein, and 5–10% from carbohydrates. This ratio is significantly higher in fat than typically consumed by an individual each day.

However, it is crucial to recognize that these macronutrient ratios can and will differ for each person following the standard keto diet. Therefore, it is best to consult a healthcare professional before beginning any new weight loss diet. 

Healthy keto foods are:

  • Grass-fed red meat
  • Fatty fish/seafood
  • Eggs
  • Avocado
  • Cheese
  • Berries 
  • Non-starchy (low-carb) vegetables, including cruciferous vegetables
  • Nuts and seeds
  • Full-fat dairy/high-fat dairy
  • Olive oil

Foods to avoid while on the keto diet:

  • Highly processed foods
  • Whole grains
  • Refined oils, including coconut oil
  • Sugar-sweetened beverages
  • Saturated fat sources
  • High-carb foods

While the types of foods in the keto diet may seem more restrictive than others, they can be adaptable and easy to follow. In addition to following a high-fat, moderate-protein, low-carbohydrate diet, monitoring ketones is important when following the keto diet. 

What Is the Mediterranean Ketogenic Diet?

Now that we know and understand the keto and Mediterranean diets separately, let us combine them into the ketogenic Mediterranean diet and discuss its implications. This diet is exactly what it sounds like, a combination of the Mediterranean diet and the keto diet.

The ketogenic Mediterranean diet incorporates the traditional Mediterranean diet of fruits, vegetables, and high-quality fats and the high-fat, low-carb macronutrients of the traditional keto diet. This is one of the healthiest keto variations. Other keto types include keto carnivore, pescatarian keto, or dirty keto, among others. 

One significant difference between the two diets is that the Mediterranean diet emphasizes unsaturated fats. In contrast, the keto diet includes both saturated and unsaturated fats. However, finding a balance between the two can lead to weight loss and health benefits, including reducing the risk of chronic disease and lowering blood pressure and cholesterol levels.

Key characteristics of the Mediterranean keto diet

There are key characteristics to focus on while following the ketogenic Mediterranean diet, including:

  • Choosing high-quality sources of fat, including saturated fats and unsaturated fats (e.g., olive oil, avocado oil, avocado, nuts).
  • Including fibrous and seasonal fruits and vegetables to increase dietary fiber intake (e.g., strawberries, blueberries, kale, spinach). 
  • Combining high-fat and lean protein sources in various meals. While the Mediterranean diet prevents red meat, the keto diet encourages fatty protein sources like beef and pork. Luckily, there are alternative protein sources that don’t include red meat. Some examples include salmon, chicken, and eggs.

A Mediterranean keto diet sample menu might include a vegetable omelet for breakfast, grilled chicken and roasted vegetable salad for lunch, and fish tacos with guacamole for dinner.

Restrictions to the Mediterranean ketogenic diet 

Although the keto Mediterranean diet is a flexible alternative to a traditional diet, it does restrict certain foods. Some of these restrictions include:

  1. Limited processed foods and sugars. Processed snacks and foods, such as packaged snacks, should be limited or eliminated. 
  2. Limited saturated fat consumption. Natural unsaturated fats are acceptable, but foods such as butter, coconut oil, cheese, and fatty cuts of meat should be eaten in moderation. Because the Mediterranean keto diet focuses on healthy fat consumption, it is important to learn the differences between saturated and unsaturated fat.
  3. Limiting the number of total carbohydrates consumed in a day. Choosing nutrient-dense sources of carbohydrates, such as fibrous fruits and vegetables, is essential. 

Health implications of the Mediterranean ketogenic diet

If you are considering following the Mediterranean keto diet, there are benefits and drawbacks to be aware of. Benefits may include:

  1. Weight loss. Being in a calorie deficit while following the Mediterranean diet on keto may lead to a decrease in body fat and weight loss.
  2. Improved blood sugar levels and blood sugar control. A high-fat diet such as keto can improve blood sugar levels over a long period of time.
  3. Improved blood pressure.
  4. Improved heart health and reduced risk of heart disease. Omega-3 fatty acids in high-fat foods such as fish and nuts can improve heart health.
  5. Reduced inflammation.
  6. Improved cognitive function. People with neurological disorders may eat healthy high-fat foods to improve brain function and restore neurological damage.

There are also risks to following the Mediterranean ketogenic diet. Those could include:

  • Nutrient deficiencies. Eliminating major food groups, such as high-carb foods, can lead to potential nutrient deficiencies.
  • Long-term compliance. Following any diet, including keto and Mediterranean diets, can be difficult to maintain when off-diet foods such as your favorite dessert or pastry are sitting at the front of the grocery store.
  • Limited food choices. While few food restrictions exist, eating similar foods daily can get boring and repetitive.
  • Potential for adverse health effects. Fatty liver disease and high cholesterol levels are two potential adverse health effects of a diet high in saturated fat.
  • Cost and affordability. The Mediterranean keto diet includes a lot of fish/seafood and high-quality fats. These items can be more expensive at the grocery store.

The Mediterranean keto diet may be beneficial for most people. Still, just like any diet, it can negatively affect the body. For example, while on the keto diet, there is a risk of nonalcoholic fatty liver disease, increased LDL cholesterol levels, and ketoacidosis. 

Mediterranean Keto Food List

We know that the Mediterranean keto diet includes an extensive list of foods. This is not a typical Western diet filled with processed, sugary snacks. Regardless of the types of foods you eat, it is important to focus on total daily consumption of healthy fat sources, wild and sustainable protein sources, and limiting carbohydrate consumption.

Mediterranean keto diet foods.

Prioritizing nutrient-dense, low-carb, whole-food sources increases the likelihood of seeing and feeling the benefits of the Mediterranean keto diet. 

To get you started on the Mediterranean keto diet, we’ve compiled a list of some of the best options to look for when grocery shopping or dining out. Your grocery list should include some of these staples:

  • Oils – avocado oil, olive oil
  • Nuts and nut butter – almonds and almond butter, walnuts, pecans
  • Seeds – flax seeds, chia seeds, pumpkin seeds
  • Seafood – shrimp, lobster
  • Fish – salmon, tuna, cod, mahi-mahi 
  • Poultry – chicken and turkey 
  • Grass-fed red meat
  • Eggs
  • Cruciferous veggies – broccoli, cauliflower, cabbage
  • Leafy greens – spinach, kale, arugula
  • Other non-starchy vegetables – cucumber, zucchini, eggplant, asparagus
  • Fruits – all berries, avocado, olives
  • Herbs and spices – basil, oregano, rosemary, thyme, garlic, ginger 

Health Benefits of the Mediterranean Keto Diet

When deciding to go on any diet, it is crucial to research the pros and cons. If the benefits outweigh the cost, it may be worth trying out. If followed correctly, the Mediterranean diet can be beneficial to people for these reasons:

  1. May reduce the risk of heart disease. The Mediterranean keto diet is most often recommended for heart disease patients because it is high in omega-3 fatty acids and monounsaturated fats, including salmon, seeds, and nuts. Omega-3 fats have been shown to help prevent heart disease and may play a role in protecting against certain types of cancers. 
  2. May improve brain function. A 2009 study showed that including ketones in the diet can improve cognitive brain function among those with neurodegenerative diseases. 
  3. May reduce the risk of type 2 diabetes. Consuming less refined carbohydrates and sugar can improve blood glucose and blood sugar levels, lower LDL cholesterol levels, and reduce the risk of developing type 2 diabetes. 
  4. May reduce inflammation. Anti-inflammatory foods such as olive oil, fish, nuts, and leafy greens combat inflammation and may lead to weight loss.
  5. May improve digestive health. When focusing on high-fiber foods, you can see improvements in gut health. The Mediterranean ketogenic diet may help reduce inflammation in the gut and improve overall health. 

Mediterranean Keto Diet Sample Menu

To gain some perspective on the types of meals eaten while following the Mediterranean keto diet, we created a sample menu below: 


Breakfast: Greek Yogurt With Berries

Lunch: Vegetable Salad With Chicken Breast

Dinner: Cod Fillet With Vegetable Salad


Breakfast: Smoked Salmon, Cream Cheese, and Cucumber Roll-Ups

Lunch: Greek Salad With Grilled Chicken and Olive Oil Dressing

Dinner: Grilled Shrimp Skewers With Veggies


Breakfast: Mediterranean Omelet With Feta, Olives, Tomatoes, and Onions 

Lunch: Egg, Shrimp, and Avocado Salad

Dinner: Pesto Shrimp With Zucchini Noodles


Breakfast: Homemade Chia Seed Pudding With Strawberries 

Lunch: Shrimp and Avocado Salad With Olive Oil

Dinner: Meatballs With Tzatziki and Mixed Greens


Breakfast: Avocado Toast on Whole-Grain Bread

Lunch: Tuna Salad Lettuce Wraps

Dinner: Homemade Roasted Red Pepper Soup 


Breakfast: Breakfast Salad With Cucumbers, Tomatoes, and Hard-Boiled Eggs

Lunch: Kale Caesar Salad With Grilled Chicken

Dinner: Lemon and Thyme Baked Salmon (or a similar fatty fish) With Roasted Eggplant


Breakfast: Shakshuka 

Lunch: Cucumber Ginger Salad With Ahi Tuna

Dinner: Grilled Lamb Chops With Vegetable Kabobs

Mediterranean Keto Diet Recipes

To get you started on your journey, here are 5 easy recipes to add to your Mediterranean keto meal plan: 

  1. Vegetable Salad With Chicken Breast – A colorful salad featuring a bed of fresh arugula, juicy tomatoes, perfectly ripe avocado, and seasoned grilled chicken breast. 
  2. Cod Filet With Vegetable Salad – Golden pan-seared cod served over a fresh bed of cucumber, bell peppers, tomatoes, and fresh basil splashed with lime juice and olive oil. 
  3. Scrambled Eggs With Salad – Creamy scrambled eggs with a fresh and bright avocado tomato salad, topped with fresh parsley, is the perfect way to start your day. 
  4. Grilled Shrimp Skewers With Veggies – This easy-to-prepare dish features perfectly seasoned and grilled shrimp with a medley of fresh vegetables and a hint of sesame and lemon. 
  5. Egg, Shrimp, and Avocado Salad – This quick and straightforward salad combines rich avocado, perfectly cooked shrimp, and hard-boiled egg into a tangy, nutritious lunch or dinner. 

Frequently Asked Questions

Is the Mediterranean diet low-carb? 

The Mediterranean diet is a lower-carb diet. While whole grains are a part of the Mediterranean diet, the amount you consume will determine whether the diet is low-carb. It can be adjusted to fit a low-carb lifestyle by reducing whole grains and increasing high-fiber fruits and vegetables. 

Can you lose weight on Mediterranean keto? 

Weight loss is possible while following both the Mediterranean diet and the keto diet. A 2013 study shows that a long-term combination of the two diets led to significant weight loss. 


The Mediterranean keto diet focuses on nutrient-dense, whole foods, and monounsaturated and polyunsaturated fats. Limiting carbohydrate intake and focusing on food quality may reduce the risk of heart disease, improve blood glucose levels and control, lower cholesterol, and support weight loss. If you’re ready to begin your Mediterranean keto diet journey, take this quiz for your personalized Mediterranean keto diet meal plan and journey support. 

keto quiz


Category: Diets Compared, Meal Plans