Adherence
External provision of all food significantly improves adherence to both ketogenic and Mediterranean diets compared to self-provided food, although adherence drops for both when participants must source and prepare their own meals.
If you are trying to follow a specific diet like Keto or Mediterranean, your environment matters more than you think. The study shows that providing all meals for the first month significantly boosts adherence for both diets. When you switch to buying and cooking your own food, adherence drops for everyone, regardless of the diet type. To succeed, consider using meal delivery services or heavy pre-preparation for the first few weeks to build the habit and knowledge, rather than relying on willpower alone to source specific foods from scratch.
While receiving food deliveries, adherence to both study diets increased and was similar for both diet patterns. Adherence for both diets decreased by a similar amount for both diet patterns during the self-provided food phase, and, again, the scores were similar.
Why this rating
Randomized crossover trial with objective adherence scoring, though limited by small sample size (n=40) and COVID-19 disruptions.
Source
Adherence to Ketogenic and Mediterranean Study Diets in a Crossover Trial: The Keto–Med Randomized Trial
Matthew J. Landry et al. · Nutrients · 2021
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