Is Keto or Mediterranean Diet Better For Diabetes?

When it comes to the Mediterranean diet vs Keto diet, there are a few stand-out points that make one diet better in the long run. In a study done a few years ago by Stanford Medicine, blood-glucose levels were maintained similarly between the two, but one diet was much easier to follow, and much less restrictive. So let’s jump into whether the Keto or Mediterranean diet is better for diabetes!

• I want to note that I am not a doctor or a dietitian, so please consult with yours before making any changes to your diet.

The Mediterranean diet is generally not considered a super low-carb diet due to its encouragement to eat a variety of legumes, fruits, and whole grains. Super low-carb diets, like the keto diet, are frequently recommended to people with type 2 diabetes and prediabetes.

Unfortunately, there is not a lot of readily available information on how our bodies respond to the Mediterranean diet vs Keto diet. So a super low-carb Keto diet free from fruit, legumes, and whole grains has widely been encouraged by doctors over the years.

A trial done at Stanford Medicine is helping to change that misconception. 40 adults with Type 2 diabetes or prediabetes were put in a study to compare the Ketogenic diet vs Mediterranean diet and their individual effects on blood glucose, cardiovascular factors, and weight loss, as well as how easily people can stick to these diets.

Each person was given 4 weeks of prepared meals in their chosen diet, and then spent 8 weeks preparing their own foods to help researchers determine how easy it was to adhere to the diets in the real world. After 12 weeks, the participants switched and did the other diet.

After 24 weeks, the results were very telling!

A Low-Carb Diet For Diabetes

In type 2 diabetes, the body struggles with managing proper blood glucose levels after consuming foods with sugar and carbohydrates. When you eat or drink foods that have carbohydrates, your body breaks those carbs down into glucose, which is a type of sugar.

• After your body turns carbs into glucose, your pancreas releases insulin to help your cells absorb that glucose. People with type 2 diabetes make insulin, but their cells don’t respond to it properly. When their cells don’t properly absorb the glucose in their blood, this causes blood sugar levels to rise. This is called insulin resistance, and it causes the pancreas to work extra hard.

Over time, the pancreas just can’t keep up with the demand for insulin, and blood sugar levels remain high for longer periods of time. This is type 2 diabetes and pre-diabetes.

Can You Lower Type 2 Diabetes With Diet Alone?

While many people require medication to help their bodies deal with diabetes, some people are able to reverse diabetes with a diet and lifestyle change. Of course, this should be fully discussed with your doctor to decide the best course of action for your body’s individual needs.

To help manage or prevent diabetes, the American Diabetes Association (ADA) recommends the Mediterranean diet, as it encourages a significant decrease in refined sugars and processed foods. Other low-carb diets are also encouraged, as long as they minimize sugars and include non-starchy vegetables.

The Difference Between Keto And Mediterranean Diet

• In a nutshell, the MedDiet is just eating the diet that people eat in the Mediterranean! It involves eating a large variety of fruits and vegetables every day, including healthy grains and legumes in your meals, and trying to have a few meatless meals a week.

  Fish is encouraged to be consumed twice a week, and red meats and sweets should only be enjoyed on occasion (notice how I didn’t say never!). It is a low-carb, moderately high-fat diet that is plant-forward.

• The Ketogenic diet is an ultra-low-carb diet that focuses on fat, which supplies as much as 90% of daily calories. Most people on the keto diet aim to consume less than 50 grams of carbs a day, which is equivalent to three slices of bread or a cup of white rice.

When it comes to restrictiveness, the Ketogenic diet is extremely restrictive and involves reading labels, counting carbs, and eliminating entire food groups like legumes, fruits, and whole grains, while the Mediterranean diet is less of a “diet” by the terms that we usually know it, and it is much more of a lifestyle change. Nothing is completely off-limits, but healthy eating habits are highly encouraged.

If you are interested in more information about the Mediterranean diet, I have a great YouTube video that goes over it all!

The Results Of The Stanford Study

Since all of the participants participated in both diets, the crossover design of the experiment allowed participants to act as their own controls.

When following the Ketogenic diet, participants followed a version known as the well-formulated ketogenic diet, where they were advised to limit carbs to 20-50 grams/day and proteins to 1.5 grams per kilogram of their ideal body weight per day, and to consume as much as they wanted in fats. They were asked to consume at least three servings of non-starchy vegetables a day.

When following the Mediterranean diet, participants were advised to limit added sugars and processed foods, and to follow a mostly plant-based diet that included vegetables, legumes, fruits, whole grains, nuts, and seeds, as well as fish for animal protein and olive oil for fat.

The Results

• HbA1c levels (a measure of average blood sugar levels over the past 3 months) dropped in both groups, with the Mediterranean diet dropping 7% and the Ketogenic diet dropping 9%.

• When following the Ketogenic diet, weight loss was 8%, compared to 7% on the Mediterranean diet.

• Both diets had similar improvements in fasting insulin and glucose, HDL cholesterol, and the liver enzyme ALT.

• LDL cholesterol (the bad cholesterol) increased on the Keto diet and decreased on the Mediterranean diet.

• Triglyceride (a lipid fat that circulates in the blood) decreased more on the Keto diet.

Did the Keto Diet Offer Additional Health Benefits From Eliminating Legumes, Fruits, and Whole Grains?

When it comes to nutrient levels, the Ketogenic diet was shown to offer less fiber; thiamin; vitamins B6, C, D, and E; and phosphorus. Vitamin B12, which is naturally found in animal products like meat and poultry, was higher on the Ketogenic diet.

3 months after the trial, on average, participants reported that they had maintained lower blood glucose levels and weight loss. Notably, almost all participants were eating closer to a Mediterranean diet than to a keto diet.

So what diet is best for diabetics?

First and foremost, both diets had very similar results when it came to maintaining healthy blood glucose levels, which was the goal for the participants with type 2 diabetes. So cutting out whole food groups of legumes, fruits, and whole grains proved no added overall health benefit to these patients.

Furthermore, the Mediterranean diet proved to be easier to follow and stick to in the long run. So for people with diabetes or prediabetes, the less restrictive Mediterranean diet was more sustainable and offered similar effectiveness in controlling blood glucose levels.

My Personal Experience With Gestational Diabetes

When I was pregnant with my first child, I was extremely surprised to find out that my body could no longer control my blood glucose levels. This is known as gestational diabetes, and I ultimately had it again when I was pregnant with my second baby. It is due to the hormones in the placenta and the CDC reports that about 2-10% of all pregnancies will develop GDM.

Interestingly enough, it goes away immediately after you deliver the placenta.

In my experience, the Ketogenic diet was the only way to prevent blood sugar spikes. This was determined by meticulous food tracking and 4 blood sugar checks a day. My body could barely have any carbs without spiking my blood sugar for a long period of time, and since those blood sugar spikes are very dangerous for the baby, the Keto diet and medication were the best course of action for me, as determined by me and my doctor.

• In this respect, I am very grateful for the Keto diet since it helped keep me and my babies safe and healthy. But I will say, it was REALLY difficult to follow, and this is coming from someone with a background in physical therapy and extensive personal knowledge about nutrition.

And while a lot of my Mediterranean diet recipes are Keto-friendly, I think it would be extremely difficult to have to follow a keto diet for years.

Since gestational diabetes has a 50% chance of returning as type 2 diabetes later in life, I am really excited and relieved to hear that the Mediterranean diet was just as beneficial at controlling blood glucose levels as the Ketogenic diet was in people with type 2 diabetes!

Mediterranean DIet Recipes

If you liked this post about the Keto vs Mediterranean diet for diabetics, check out some of my healthy Mediterranean diet recipes!