- Hypertension, or high blood pressure, can be managed through a number of lifestyle changes, including eating a healthy diet.
- Past studies have linked the Mediterranean and ketogenic diets as a way to help lower blood pressure.
- A new study offers further evidence that both the Mediterranean and keto diets can help lower a person’s blood pressure and improve cardiovascular health measurements in people who have obesity or overweight.
Clinically known as hypertension, this medical condition occurs when the force with which blood flows through the arteries is too high.
A study published in April 2024 reported that following the Mediterranean diet was linked to a lower risk for high blood pressure. Another study published in July 2019 showed that following a low carbohydrate diet like the keto diet helped lower blood pressure readings in people with type 2 diabetes.
Now, a new study offers further evidence that both the Mediterranean and keto diets can help lower a person’s blood pressure and improve cardiovascular health measurements in people who have obesity or overweight.
The findings were published in the journal Nutrients.
Eleven of the study participants were randomly assigned to follow the Mediterranean diet, and the remaining 15 followed the keto diet over a period of three months.
At the study’s conclusion, researchers found that participants in both diet groups experienced a decrease in blood pressure and weight loss after three months.
There was one area where researchers reported a difference between the Mediterranean and keto diets. They reported that participants following the keto diet had a higher level of “nocturnal dipping” than those in the keto group.
“Nocturnal dipping refers to the natural decrease in blood pressure that occurs when we sleep,” Cheng-Han Chen, MD, a board certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA — who is not associated with this study — told Medical News Today.
“It is a measure of healthy blood pressure regulation, and abnormal nocturnal dipping patterns have been associated with increased risk of heart disease,” he said.
A 10-20% dip in blood pressure while you sleep is considered normal.
Past studies show that not experiencing nocturnal dipping, or the reverse of it, known as nocturnal hypertension, can increase a person’s risk for cardiovascular disease.
When asked about his reaction to this study’s findings, Chen commented that while the Mediterranean and keto diets are somewhat different in their food restrictions, the study results suggest that there may be different dietary techniques that can achieve the same beneficial outcome, depending on the food preferences of an individual.
“Metabolic syndrome — including high blood pressure, abdominal obesity, high blood sugar, and disordered lipids — remains a significant risk factor for cardiovascular disease,” he explained. “Lifestyle modification, such as diet improvements, will be essential in order to help control the burden of heart disease in our society.”
“Further research including larger controlled studies with a more diverse population will be necessary to confirm these findings, and to evaluate for any potential benefit to clinical outcomes,” Chen added.
MNT also spoke with Mir Ali, MD, a board certified general surgeon, bariatric surgeon, and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, about this research, who commented that its findings are in line with what he recommends to patients.
“Both the keto and the Mediterranean diets emphasize a reduction in carbohydrate and sugar intake, and that’s what we found is the best way to kind of shift the body into burning fat is by reducing all the carbohydrates and sugars.”
— Mir Ali, MD
“Unfortunately, obesity is an increasing problem in the U.S. and other westernized countries, so the more we can find ways to combat that, find foods that are going to help people lose weight and head to a healthier diet, then maybe some of these larger food manufacturers will start shifting their focus to foods that just taste good to foods that may actually be helpful,” Ali continued.
Because this was a smaller study, Ali suggested expanding it to a larger patient base or population to refine it further.
“What is it about these two types of diets that are helpful?,” he asked. “Is it reducing processed foods or is it more reducing the carbohydrates and sugars? So there are some differences between the diets, and trying to define further what is optimal between these two diets.”
While both the Mediterranean and keto diets are popular dietary plans for people to follow, they may not be right for everyone. We asked Monique Richard, MS, RDN, LDN, a registered dietitian nutritionist and owner of Nutrition-In-Sight, for her top tips for readers on how to decide which diet is personally best for them to follow if they want to lose weight and lower their blood pressure.
“Meeting with a registered dietitian nutritionist (RDN) is recommended to further explore which dietary pattern may be most appropriate for an individual’s needs, current health condition, preferences, goals, genetics and lifestyle,” Richard said. “RDNs are trained to bridge the gap between science and everyday life. If you’re looking to manage weight or blood pressure in a way that’s realistic and sustainable, working with an RDN can be a game-changer.”
“It is also important to consider if the specific dietary pattern is sustainable for a long period of time and can be a lifestyle versus a controlled experiment or ‘temporary fix’,” she continued. “Think of dietary patterns like a playlist — the right mix can set the tone for a healthier rhythm in your body and the days ahead.”
Richard suggested honing in on increasing foods rich in nutrients with many health benefits, such as:
- Healthy fats like olives, extra-virgin olive oil, avocados, nuts, and seeds.
- Non-starchy vegetables such as leafy greens, beets, peppers, onions, garlic, scallions, tomatoes, cabbage, and Brussels sprouts.
- Herbs such as chives, basil, mint, rosemary, thyme, and sage.
- Proteins from plants and animals, such as goat cheese, yogurt, beans and lentils, fish, hummus, and tzatziki.
- High fiber foods from whole grains like oats, whole wheat, and rye, and fresh fruits in season such as peaches, plums, apples, grapes, berries, pears, oranges, figs, dates, and cherries.
- Incorporation of green, black, white, or herbal teas.
“There’s no ‘one-size-fits-all’ when it comes to dietary patterns — unless it’s a kitchen apron. I encourage clients and patients to try to move away from chasing labels —‘Mediterranean,’ ‘low-carb,’ ‘plant-based’— and move toward tuning into how food functions for our unique needs.”
— Monique Richard, MS, RDN, LDN