Keto vs. Paleo: Meat Heavy Diets, With Major Differences

Though vegetarian and flexitarian diets have been on the rise for years, meat-heavy regimens — such as keto and paleo — have also gained popularity. The keto diet, which is low-carb, high protein and high fat, is often praised for its quick results. Paleo, on the other hand, homes in on foods that humans would have consumed during the Stone Age, so there is slightly more leniency for those who adhere to it.

Stacey Antine, MS, RDN, of HealthBarn USA defines the two diets, explaining that both are low carb. However when you compare keto vs. paleo, you find keto is high-fat and moderate protein; while paleo is high-protein and moderate in fat: “The ketogenic or “keto” diet consists of a strict diet, with high percentage of fat, low percentage of carbohydrates, and moderate protein,” she explains.

“The Paleolithic or “Paleo” diet is designed to follow what our Paleolithic ancestors ate, meaning you restrict processed foods, including grains, legumes, dairy and sugar. Paleo is low carb, but it’s moderate in fat and high in protein.”

Main Similarities and Differences of Keto vs. Paleo Diets

	Keto	Paleo
What Dieters Can Eat	Low-carb vegetables, dairy, meat, eggs, fish; dark chocolate, alternative flours, nuts, seeds, coffee and tea, olive oil	Grass-fed meats, fish, fresh fruits and vegetables, eggs, nuts and seeds, olive oil
Restrictions	Starchy vegetables and grains, refined sugars, chips and crackers, baked goods, sweetened beverage, sugar in any form (including natural sweeteners)	Refined sugar, processed foods, salt, vegetable oil, artificial sweeteners, legumes, cereal grains, sweetened beverages
Side Effects	Sometimes energized/sometimes keto flu: headache, dizziness, indigestion, mood swings, body aches, bad breath	Headaches, fatigue, weakness, brain fog
Short-Term Effects	May see quick weight loss results, but also may experience keto flu	Weight loss; improved cholesterol levels; reduced blood sugar levels; reduced inflammation
Long-Term Advantages/Disadvantages	Can aid with weight loss and blood pressure, can also be difficult to adhere to long-term; potential kidney issues and heart disease	Though weight loss improves heart, blood and cholesterol health, low calcium can lead to osteoporosis and fractures; cholesterol can also increase over time
Accessibility	Quality meats/less processed ingredients drive up prices	Healthier food (i.e. fresh ingredients and grass-fed meat) is often notably more expensive
Cost Per Year	$2,444, as per Finder	$2,977.30, according to Finder
Cheat Days	Not recommended, as it can throw the body out of ketosis	Some suggest up to three cheat meals per week, while others encourage one every week
Calories/Day	1,500 to 1,800 for women; 1,800 to 2,200 for men	1,200 to 1,500 calories per day for women looking to lose weight; 1,500 to 1,800 calories daily, for men looking to lose weight

Getting Started on Keto Can Be Difficult

Keto is highly desirable among weight loss diets, not only for the potential results, but also for the high-fat, tasty foods it permits. However, getting started can be tricky.

Eliminating carbohydrates and eating large amounts of fat and protein puts the body into “ketosis.” This is when the body starts burning fat stores as opposed to carbohydrates.

And while that is the ultimate goal, it can come with unpleasant side effects. People have reported symptoms of what’s been coined the “keto flu:” Bad breath, indigestion, dizziness, headache and more. But short-term, keto is often accompanied by quick weight loss. Some people drop up to 10 pounds in two weeks.

Getting Started With Paleo Can Be Similarly Hard

Diabetes UK’s breakdown of the paleo diet notes that those on the paleo diet can feel effects similar to the keto flu. In the first few weeks of the diet, people often experience low blood sugar, the “low carb flu,” low energy, smelly breath, indigestion and constipation.

Paleo’s short term results are similar. Lose It! notes that people lose nearly eight pounds during the first two weeks, on average.

The Longterm Effectiveness of Keto Is up in the Air

Although keto often results in quick weight loss, Harvard University suggests it may not be a smart long-term plan. Because it’s so restrictive, it’s hard to stick with for long periods of time. Some people also disagree with the idea that the diet burns through carb stores and then fat; some evidence suggests it just burns carbohydrates and water weight. Ya’el Courtney, a neuroscience PhD candidate at Harvard, writes that this would mean people adhering to the diet aren’t actually losing any fat.

While keto dieters often experience a satisfying initial weight loss, this is a short-term result from the loss of body water that accompanies lower carbohydrate intake, not fat loss. This is because when we eat carbs, the energy that we do not use immediately is stored as glycogen molecules, and each gram of glycogen is stored with three grams of water attached to it. When you cut down on carbs, you quickly use up your glycogen stores, losing that water weight.

Ya’el Courtney

The Longterm Effectiveness of Paleo Is Comparable to Keto

Like keto, the the initial weight loss for the paleo diet can be pretty drastic, too. However, it may not be long-lasting. Everyday Health reported on a study looked at two groups of postmenopausal women with obesity after six, 12, 18 and 24 months. Some were paleo, and some weren’t. The first six months showed significant weight loss in the paleo group, many of them gained some back after 24 months.

However, others at the end of the two years lost more fat and had lower sugar levels. Many were also no longer obese.

The Advantages of Keto Make It Appealing

While it is somewhat controversial, the keto diet may come with a slew of health benefits. In addition to possible weight loss, Duke University praises keto for helping to control diabetes, lowering blood pressure, treating epilepsy, preventing fatty liver disease, and reducing heartburn PCOS and irritable bowel syndrome.

Physical and Mental Disadvantages of Keto Show It Isn’t Right for Everyone

There’s no denying the keto diet works for some, but it isn’t for everyone. Yale New Haven Health Network speculates that — aside from having controversial impact on long-term health — keto comes with nutrient deficiencies. With a diet predominantly of meat and dairy, it can be difficult for people to get the vitamins they need, as well as fiber that keeps their digestion moving. The restrictiveness can also cause people to yo-yo diet, which is a form of disordered eating.

Paleo Has Physical and Mental Advantages

Like keto, there are good and bad aspects of paleo. In terms of advantages, however, Paleo is high in antioxidants, fiber and potassium — all necessary supplements. UC DavisHealth says that the diet also emphasizes the importance of non-processed, local foods, which benefit both the human body and the planet. It can also lead to short-term weight loss. And acidic and alkaline foods supposedly increase bone health.

Disadvantages of Paleo Can Include Vitamin Deficiencies

UC Davis also speculates that — similar to the keto diet — a surplus of meat and fat can lead to heart problems, cancer and kidney issues. A lack of calcium and vitamin D can also lead to osteoporosis and bone density issues.

Costs of Keto vs. Paleo Diets Are Similar

According to a cost breakdown from Healthline, the diet’s abundance of animal fats, meats, and dairy is more costly than adhering to the average American diet. Opting for cheaper proteins like eggs and tinned fish, as well as frozen vegetables will lower the grocery bills.

Similarly, Paleo is all about local meats and fresh produce. Since cheaper processed foods aren’t an option, it makes grocery shopping extremely hard. But taking the same steps as one might to reduce costs on the keto diet will lower that grocery bill instantly.

So, Which Diet Is Better?

While different experts may have opposing feelings, Stacey Antine says that between the two diets, she would opt for prescribing paleo over keto, because it doesn’t “demonize” as many foods. But in general, she says, wouldn’t pick either: “I’d lean towards Paleo because it’s less restrictive and highlights eating whole foods.  Eating less processed foods is always a good way to go,” she says.”

Overall, any diet where an entire food group is demonized and/or eliminated, or that is overly restrictive, is both not sustainable long-term, nor is it desirable for optimal health outcomes. Instead, I recommend following a balanced, healthful eating pattern more similar to the Mediterranean diet, which incorporates lean meats, fish, nuts, legumes, whole grains, healthy fats, plus fruits and vegetables.

Stacey Antine

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.