Comparing LCHF and the Mediterranean diet

Spot the difference

By Helen Kilding and Grant Schofield

We’ve been hearing quite a lot about how healthy the Mediterranean diet is.  So what is it, and how does it compare with the Low Carb, High Fat (LCHF) approach that we talk about on here?  How different are they and why would you choose one over another?
Let’s find out.
The traditional Mediterranean diet is characterised by a high intake of olive oil, fruit, nuts, vegetables, and cereals; a moderate intake of fish and poultry; a low intake of animal products like dairy, red meat, processed meats, sugar and sweets; and wine in moderation and consumed with meals.
The LCHF diet is characterised by a high intake of natural fats (including olive oil, but also other healthy fats such as butter and coconut oil), a similarly high intake of vegetables, but limited fruit and no cereals. Why limited fruit? Fruit is nature’s candy, with a medium sized apple containing the equivalent of 3 teaspoons of sugar. Sure, in it’s natural form, fruit is a good source of fibre and some vitamins, but so too are vegetables, and with less of the sugar hit. 
And why no cereals? Well despite what we’ve been lead to believe, there is no good reason to eat cereals, even wholegrain. The fibre argument and the vitamin and mineral argument just don’t stack up – a plate of salad or veggies packs a much bigger and better fibre and vitamin/mineral punch than any cereal. And whether we need more fibre in our diet is debatable anyway. But cereals are cheap and highly lucrative. The corn industry has a lot to lose if/when the truth gets out. As Christine Cronau (author of The Fat Revolution) nicely describes, “a breakfast of eggs and butter is packed full of Vitamins A, B, D, E and K, along with iron, zinc, calcium, lecithin, iodine and more. Adding some unrefined salt adds a further 84 minerals and a fried tomato a healthy dose of vitamin C”. Beat that cereal!
The fact is humans are not adapted to consuming cereals and they are full of toxic anti-nutrients (lectins, gluten and phytates) that we don’t have the ability to deal with. Lectins bind to insulin receptors and the human intestinal lining and cause leptin resistance, which as regular readers of this blog will know, accelerates metabolic syndrome independently of obesity. Gluten (found in wheat, rye and barley) might be even worse and certainly is more widely known. Around 1% of the population are celiacs (completely intolerant of gluten) but it’s not just celiacs who suffer the damaging effects of gluten. And finally phytates, make the very minerals that whole grains and cereals supposedly provide us with, bio-unavailable. Awesome!
But getting back to our comparison, a moderate intake of fish and poultry is common to both diets, as is a low intake of processed meat, and wine in moderation. So the last big difference really is in the red meat, cheese, eggs and sugar. Whereas the Mediterranean diet supports low intake of all four, LCHF promotes unlimited consumption of meat, eggs and cheese and no consumption of sugar.
The health concerns around meat and eggs, particularly in relation to cholesterol, are unfounded and indeed animal proteins and fats, like eggs and butter, contain many of the nutrients missing in modern Western diets. With the Mediterranean diet, around 25-35% of calories come from fat (8% or less from saturated) compared to around 70-80% on LCHF. With the latter, the body learns to use fat for fuel instead of sugar (read more about fat adaptation here). If fat intake is too low, this cannot occur, so regardless of whether you are carbohydrate sensitive or not, if you want to become a fat burning machine, for endurance performance, weight management or improved cognitive function, LCHF rather than the Mediterranean diet is the way to go. Remember though, fat intake should only be high if carb intake is low – high intake of both is not OK! 

8 Comments on “Comparing LCHF and the Mediterranean diet

  1. Thank you for a timely article, as a colleague just
    challenged me as to why LCHF instead of the MD.

  2. Very relevant post and I’m really enjoying your observations. I see several posts about fat adaptation for endurance events but I’d be very interested to see a post on it’s value and/or impact for someone whose passion is more for heavy carb-burning activity such as weightlifting and sprinting. I can see the value for everyday health, but I’ve found a number of discussions here and elsewhere for the endurance people but nothing for us with a anaerobic focus. Thanks for the great work!

  3. The Mediterranean diet came into prominence after a study of longevity showed Med countries eating traditionally had long-lived populations, especially Crete and Sardinia.
    However, the Med diet touted by nutritionists bears little relation to these actual diets. The islands (like Okinawa) were surveyed immediately after World War 2 when meat and dairy production hadn’t recovered to pre-war levels.
    If you want to know what the long-lived Sardinians really ate, read “Sea and Sardinia” by DH Lawrence where he details every food sold in the markets there, as well as the affordability, when he visted in the mid-20’s.
    Poor people ate a lot of eggs, bread was expensive and hard-to-get, there was a wide range of vegetables and mainly citrus fruit. Sausages, butter, cheese were common items. I imagine from the meals Lawrence describes that most of the veges would have been properly cooked, not always eaten in salads. As is normal everywhere people eat tradition diets.
    Turkey is on the Mediterranean and many of the Med diet countries had history of Turkish domination and influence; here is a modern low-carb blogger’s delicious description of staple Turkish foods:

    • I am so glad you point this out. I worked in Greece as a chef and spent several summers there in the 80’s and I have known there is a huge variation in what people eat between countries in the Med and how much it has been changing rapidly over the last decades. I have not seen grains playing a major part of the diet in the traditional Greek diet or the amount of fruit sometimes stated in the literature of 400 – 500 g per day. I often say to clients that we have taken the message that the Mediterranean diet means olive oil, garlic, pasta and red wine!

  4. Hi Grant,
    What do you think is a reasonable carb intake if eaten with fat in one sitting?

    The question of “if carbs, then fat?” is one I come back to regularly. Basically because I do like to treat myself to some carbs on approximately a weekly basis, after weight training. This tends to be accompanied by a nice fatty piece of pastured lamb!

    Some people would advise eating fat if you’re eating carbs to blunt the insulin response by delaying gastric emptying. But others would suggest avoiding it entirely due to the potential of raising blood lipid and glucose levels concurrently (although my understanding is the increase in blood lipids would come approximately 4 hours after the meal, when the glucose peak has been and gone). A big part of me thinks that if the majority of the time I am eating low carb, this weekly post-workout treat is no big deal as I am still way ahead of people who would eat high carb every day of the year, in terms of inflammation, glycation etc.

    Any thoughts? Do you occasionally treat yourself with carbs, and if you do, do you try to combine them with fat or try to avoid it in the same meal?

    • Yes I think you are on the right track. There is some (very limited evidence) that long term without any extra carbs might cause down regulaiton of leptin and metabolism including thyroid issues for some. I tend ot have a bigger carb meal or two onc eor twice a week which I rtpicaly follow with some fasting. Works well for me and several others

  5. Very interesting article. I have been some months investigating about the LCHF diet and its pros and cons. The last studies point out the benefits that LCHF diet has for the body and specially for the brain (it was already discovered in the middle of 20th century that a LCHF diet was good for kids with epilepsia). So I am wondering if I should give a try to the LCHF diet (ketogenic diet).

    I have always followed a Mediterranean diet combined with sports and I have always felt great. Regarding the Mediterranean diet, I think that it must be good since people from Spain are people who die older (after Japanese people), so diet must have something to do with that.

    I assume that the key is not about LCHF or Mediterranean diet but the intake of carbohydrates itself. Carbohydrates gives a lot of energy and I think that the problem comes up when you don´t spend this energy coming from the carbohydrates. People who are old in Spain now followed a Mediterranean diet during their lives, however, when they were younger, they made a stronger physical activity than people nowadays, so they burnt all this energy, plus they didn´t eat so much as we do eat today (plus didn´t eat the processed food and sweets that we eat today), you just have to watch the TV shows in the 60’s or 70’s, and see that people were thinner than people today.

    So in my opinion, both diets are good because all of them has the nutrients that body needs, but if one follows the Mediterranean diet, they should reduce (moderate) the carbohydrates intake, especially grain or bread if one doesn´t do any sport.

    Unfortunately, there are no enough studies about many people who are now old who followed a LCHF diet. I think we will see that in some years.

    HEre there is a link about a study about the intake of carbohydrates:

    “Is there a role for carbohydrate restriction in the treatment and prevention of cancer?”

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