What’s The Difference Between The Ketogenic Diet and Paleo Diets?

Two diets…

Two nutritional philosophies and plans which share a lot in common. But they also have many differences between them.

And within both these diets, there are variations and different versions!

“Let food be thy medicine and medicine be thy food.” – Hippocrates

What we put in our body has the most incredibly profound affect. Paleo diets have many supporters proporting their health benefits and healing properties. And the ketogenic diet itself was initially developed as a therapeutic treatment for epilepsy in the young.

Both are well-researched.

So let’s look at Paleo diets

Dr Cordain introduced the ‘Paleo’ diet to the world in 2002.

The ‘Paleo diet’ is built on what scientists believe the hunter-gatherers from the Paleolithic era ate, and on the study of modern-day hunter-gatherers.  The foundational belief being that we are genetically wired to eat this way, and therefore our bodies thrive.

A huge weight of research supports this way of eating and nourishing our bodies. And while it is true to say that rarely does one-size-fit-all, Paleo diets seem beneficial for a lot of people.

Here is Dr. Sarah Ballantyne‘s definition of what it is

‘The Paleo diet is a nutrient-dense whole foods diet based on eating a variety of quality meat, seafood, eggs, vegetables, fruits, nuts, and seeds.  It improves health by providing balanced and complete nutrition while avoiding most processed and refined foods and empty calories.’

And what it isn’t (which is just as important)

‘At the same time, it omits foods known to be inflammatory, disrupt hormones, or negatively impact the health of the gut, including all grains, most legumes, conventional dairy products, and all processed and refined foods. Yes, this is the Paleo template.’

The Paleo diet is about eating a certain way, avoiding certain food groups, and eliminating processed foods. It involves eating foods which could have been hunted or gathered as a hunter-gatherer.

Interestingly Dr Ballaatyne calls it a plant-based diet

‘At it’s core, the Paleo diet is a plant-based diet, with two thirds or more of your plate covered with plant foods and only one third with animal foods.’

The Paleo diet is about

  • Eating nutrient dense foods… Real food to nourish and promote healing and health to the body
  • Flexibility in the proportions of macronutrients eaten
  • Indeed flexibility allowing for the odd inclusion of an otherwise non-paleo food
  • A way of life rather than ‘a diet’

Dr Axe here discusses here that while he eats predominantly Paleo, he doesn’t eat certain foods from the paleo diet. He omits bottom-feeders, for example shellfish, meat known to carry parasites, like pork. He also adds in fermented dairy products including kefir, because of it’s incredible health benefits.

He discusses how he eats this way, not because of holding with the evolutionist’s theory, (he is a creationist) but because it does, in his opinion, benefit our bodies.

 Paleo diet can be helpful in the following ways

  • Improves the ratio of omega-6 : omega-3 fatty acids through foods eaten… vital for cell health
  • Omega-3 fatty acids also key for brain health, eye and heart
  • Helps to stabilise blood sugar
  • Weight loss due to increased satiety and more stable blood sugar
  • This improves energy levels
  • Anti-(chronic) inflammatory… so reduces risk of certain diseases including rheumatoid arthritis, some cancers, autoimmune disorders

Ketogenic diet

Dr Perlmutter, an eminent neurologist, states here that

‘A ketogenic diet is one that derives around 80% or more of of its calories from fat, and the rest from carbs and proteins.’

Variations exist and tend to be high fat, moderate protein, low carb.

The goal of the ketogenic diet is to put the body into fat-burning (ketone-burning) mode, ketosis, as opposed to glucose-burning mode.

This is the ‘unique selling point’. It shifts the biochemistry of the body. Herein lies the therapeutic value, the pros and the cons, the side-effects and the controversy!

Historically, ketogenic diets were developed in the 1920s as therapeutic treatment for children with epilepsy. They have been researched for decades. Research focuses on mainly their therapeutic value, particularly in the treatment of specific types of disorders, including neurodegenerative and brain disorders, cancer and obesity.

What is a healthy fat?

Healthy fats, included in the ketogenic diet are

  • Nuts and seeds, nut butters (but bare in mind the carb content)
  • Organic grass-fed butter, ghee
  • Cheese (except blue cheese Dr Perlmutter), soft-organic cheeses only (Dr Kane)
  • Extra-virgin olive oil
  • Coconut oil
  • Sesame oil
  • Avocado

They consist of a fairly rigid food list and particular ratios of fat to carbs and proteins. So while the foods on the list may look quite similar to Paleo the actual day-to-day diet is vastly different.

Ketogenic diet – the controversy

Dr Perlmutter has devised his own version of the ketogenic diet detailed in Grain Brain. See a previous blog post here.

Dr Patricia Kane is using her version with incredible therapeutic impact, helping patients suffering from neurological issues including Parkinsons and dementia, Alzheimers. I hugely respect these pioneers and learned practitioners. They are bringing hope and advances to a hugely important field of medicine.

However I also read cautionary tales from Dr Sarah Ballantyne and value her tenacity to study the research and call attention to the adverse affects reported.

Working with a practitioner knowledgeable in the diet is advisable (in my opinion) because

  1. This is a therapeutic intervention. I believe it should be treated with the respect other therapeutic treatments are awarded. I found this discussion to be pretty balanced and helpful.
  2. It is possible to become deficient in some essential nutrients whatever diet is eaten if it is not well-designed.

Dr Axe (article link here) discusses in this video his very positive views about the ketogenic diet but also his suggestions regarding the long-term.

Foods on a ketogenic diet list

Please remember my opening comment! There a variations in both these diets and food allowed.

So what foods can you eat? In Dr Perlmutter’s version the following can be consumed liberally, local and organic where possible

  • Healthy fats
  • Herbs and seasonings
  • Low-sugar fruit for example, avocado, cucumber and lemons
  • Protein – meat, fish and eggs
  • Vegetables – green, low carb

Small amounts of the following once a day or less

  • Carrots and parsnips (Dr Kane removes carrots and carrot juice)
  • Cottage cheese, kefir and yogurt
  • Cow’s milk or cream… sparingly only
  • Legumes, except chickpeas as hummus is not limited
  • Non-gluten grains – amaranth, rice, millet, buckwheat (it should be noted that strict ketogenic diets exclude all grains)
  • Sweeteners – natural stevia and chocolate (at least 70% cocoa)
  • Whole sweet fruit, berries best as low sugar
  • Wine, one glass a day if you desire, red is best

What are the similarities between the Ketogenic and Paleo diets?

  1. Focused on real foods, unprocessed and similar food groups
  2. Focus on health and healing
  3. Research backs up benefits for some people
  4. Have many supporters but also much controversy

And the differences?

  1. They have a very different origin. Keto from a therapeutic birth, Paleo from a evolutionary belief
  2. Vastly different proportions, and manipulation, of the macronutrients – carbohydrates, fats and proteins
  3. Different goals, i.e. ketogenic diet is seeking to put the body into ketosis while the Paleo diet does not
  4. Paleo is probably easier to follow long-term as opposed to strict keto. However variations on the keto theme have been successfully developed to make it easier while still maintaining the benefits (I am thinking particularly of Dr Kane’s work)
  5. Some supporters of the ketogenic diet suggest it should be more of a short term therapeutic intervention, while Paleo is more widely believed by supporters to be a long-term lifestyle

As people we are so unique in many ways, and in many ways so similar.

We thrive on natural, unprocessed food… which is fresh, organic, and non-GMO, balanced to include the vital nutrients we require.

I love that there is so much pioneering work and research into the power of what we put into our bodies and how it can heal them.

We have come full circle back to Hippocrates and his now famous quote…

“Let food be thy medicine and medicine be thy food.”



The information provided in this blog post is designed to provide helpful information regarding lifestyle, health and wellness; for educational purposes only. The information is not meant to be used, nor should it be used, to diagnose or treat any medical condition. For diagnosis and treatment of any medical condition please consult your medical professional. 

Always consult your healthcare professional for your individual needs, and it is also recommended to do so before starting any new dietary or exercise program.

About the author

Judith Ansty

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