Mediterranean Diet & Keto Diet for Polycystic Diseases
I don’t know if you’ve been paying attention to the results of the US News & World Report’s “Best Diets of the Year Rankings” for the year 2024, but it’s a no-brainer that the Mediterranean Diet has won again.
In stark contrast, the low carb ketogenic diet’s ranking has remained in the 20s and 30s year after year, and has remained remarkably stable.
Regardless of the authority of USNEWS as a media company, let’s dig down to the roots and take a look at the 43 judges who participated in this ranking of the best diets.
Looking at their resumes and backgrounds, it’s interesting to note that most of the judges are supporters of low-fat or plant-based diets.
This is very interesting. It’s like a “Best Pet” contest where most of the judges are die-hard dog fans, so wouldn’t it be hard for cats, rabbits, parrots, etc. to make the cut, even if they’re strong enough to do so?
Among the judges are also some Internet celebrity nutritionists, such as Steph Grasso, who has 2.2 million followers and was reported by the Washington Post in September 2023 to have been involved in a private deal to “get paid to say good things about sweeteners.
Doesn’t it feel pretty funny to see that? Well, if someone wants the Mediterranean Diet to take first place, then let’s give it this gorgeous stage.
We know that data and research are often a better guide to life, so what happens when you seriously put the ‘low carb ketogenic diet’ and the ‘Mediterranean diet’ on the same pedestal?
Study: Ketogenic Beats Mediterranean Diet
Polycystic Ovary Syndrome (PCOS) is the most common female endocrine disorder characterized by polycystic ovaries, hyperandrogenism, irregular menstruation, infertility and more.
In polycystic ovary syndrome, obesity, low-grade chronic inflammation, and insulin resistance (IR) often coexist.
This study, published in November 2023, looked at the metabolic and endocrine effects of a ketogenic diet, and a low-calorie Mediterranean diet, in women with polycystic ovary syndrome.
Eighty participants were divided into 2 groups, with group 1 adopting the ketogenic diet and group 2 practicing the Mediterranean diet for 9 weeks, and what were the results?
→ Blood glucose changes before and after the experiment
As clearly shown in the graph below, the ketogenic diet group showed an improvement in average blood glucose (mg/dl) that was significantly better than the Mediterranean diet group.
→ Insulin levels and insulin resistance before and after the experiment
The average insulin level (mg/dl) in the ketogenic diet group, also improved more significantly at the end of the trial.
Turning to the average HOMA IR level (mg/dl), which is an indicator used to assess insulin resistance with a normal reference range of 0.7 to 2.0, the ketogenic diet group’s values, at the end of the trial, had normalized.
In addition, the researchers also tested, including total lipid profile, body weight, C-peptide (which reflects pancreatic beta cell function), etc. Overall, the ketogenic diet was effective and significantly better than the Mediterranean diet.
And it’s not just polycystic ovary syndrome; in another study on Feb. 20, scientists once again compared the ketogenic diet to the Mediterranean diet for its effects on psoriasis (also known as psoriasis, a chronic, noninfectious skin disease) and psoriatic arthritis.
Twenty-six patients, were randomly assigned to begin either the Mediterranean diet or the ketogenic diet for 8 weeks.
After a 6-week washout interval (participants were not exposed to any study interventions at this stage), patients in the 2 groups switched to the other dietary pattern for another 8 weeks to see the surprising results:
→ Clinical Markers of Disease Activity
As seen in the graph, the ketogenic diet group showed a higher improvement than the Mediterranean diet in both the psoriasis area and severity index and the psoriatic arthritis disease activity index.
→ Biochemical markers of inflammation
Compared to baseline, patients practicing the ketogenic diet had greater reductions in the inflammatory markers IL-6 (interleukin-6) and IL-17 (interleukin-17) than the Mediterranean diet group.
The researchers also examined data on patient weight, waist circumference, and visceral fat, and at the end of the day highly recognized the positive effects of the ketogenic diet.
The fact that the ketogenic diet outperformed the Mediterranean diet in both studies doesn’t mean that the Mediterranean diet doesn’t have its merits, but in fact, the so-called ‘Mediterranean diet’ is already dying out.
The Fading Mediterranean Diet
The Mediterranean Diet, is a type of diet characterized by the traditional eating patterns of the Mediterranean region, especially in reference to the Mediterranean coastal countries such as Greece, southern Italy, and Spain.
It actually reflects the dietary patterns of the inhabitants of the Mediterranean region in the 1960s (note the key: not modern times), and is one that has a lot to offer, such as:
→ focus on the intake of healthy fats and oils
The traditional Mediterranean diet is very much focused on consuming healthy fats and oils, which is connected to the ketogenic diet, and is mostly based on olive oil, which is rich in monounsaturated fatty acids, with the French favoring butter.
A 2018 study, for one, specifically explored the anti-inflammatory activity of extra virgin olive oil, affirming its efficacy in areas such as rheumatoid arthritis, inflammatory bowel disease, and multiple sclerosis.
→ Favors fish and all kinds of seafood
The Mediterranean diet emphasizes the intake of fish and a variety of other seafood, which inadvertently increases the intake of omega-3 fatty acids.
It’s important to realize that Omega-3s have numerous benefits for the human body, including but not limited to repairing retinal damage, inhibiting inflammation, and also improving sleep quality, boosting immunity, and more.
→ Add fermented foods
Fermented foods, especially yogurt and cheese, are also a standout in the traditional Mediterranean diet, as a 2021 study by Stanford Medical School found that fermented foods increase the diversity of the gut microbiome and reduce inflammation.
→ Avoid processed foods, foods that are nutrient dense and highly anti-inflammatory and antioxidant
The true Mediterranean diet is based on the region’s seasonal, traditional vegetables, fruits, legumes, nuts, seafood, olive oil, and dairy products, which are very nutrient dense and mostly rich in antioxidants.
While red wine is also an important part of the traditional Mediterranean diet, as it is rich in beneficial polyphenols, it is not mentioned here given the potential dangers of alcohol.
The Keto Diet Upgrades the Mediterranean Diet
As mentioned earlier, the ketogenic diet and the traditional Mediterranean diet, have a lot of similarities, such as emphasizing healthy fats and oils, such as not consuming processed foods, such as eating nutrient-dense foods, and so on, but there are also a lot of differences:
→ A wider range of healthy fats and oils
It’s not just olive oil, but also highly stabilized fats like butter, lard, coconut oil, and so on.
But try to avoid polyunsaturated fatty acid-rich seed oils, which are very unstable, easily oxidized, and many are rich in omega-6 fatty acids, which are highly inflammatory.
→ Emphasize the intake of high-quality proteins
Animal proteins are highly nutrient dense and very bioavailable, so the ketogenic diet is recommended for meats including chicken, fish, pork and beef.
Moreover, high-quality protein can play a positive role in ensuring muscle mass, strengthening immunity, optimizing blood sugar, and providing adequate satiety.
→ Avoid high-carbohydrate type intake, recommend high-quality low-carbohydrate
The carbohydrates eaten on the traditional Mediterranean diet have redeeming qualities, such as avoiding a lot of refined rice and pasta sugars, but the amount of carbon and water consumed is still high.
Ketogenic, on the other hand, emphasizes low and more high-quality carbohydrates, such as leafy greens, sprouts, broccoli, mushrooms, and more.
This greatly reduces the impact of food on blood sugar, keeping it in a calm and stable state over time, with great benefits for overall metabolic health.
The macronutrient percentages in a ketogenic diet are typically 70% fat, 25% protein, and 5% carbohydrates.
Many people may not find it easy to stick to, but in fact, for similar benefits, it is possible to practice a low-carb diet, such as the ratio of 55% fat, 25% protein, and 20% carbohydrates.
In 2020, a study from Italy used this ratio, with 22 obese people (without diabetes or other metabolic diseases) as subjects.
After 6 weeks on the low-carb diet, the subjects lost an average of 4 kilograms of body weight and 3 kilograms of fat, and their waistlines were reduced by 2.5 inches (6cm).
Their blood pressure also improved, insulin levels dropped from 8.7 to 4.9 µIU/mL, and triglycerides dropped from 99 to 70 mg/dl.
Total cholesterol dropped from 199 to 182 mg/dl, and the insulin resistance index, HOMA-IR, dropped from 1.8 to 1.1.