U.S. News ranks best diets for 2019

The U.S. News & World Report rounded up its annual list of best overall diets, best diets for weight loss, and more in a report released late last week, with some findings that may surprise members of the integrative healthcare community.

A panel of appointed health experts evaluated 41 of the most popular diets and identified the best according to nine categories: overall, weight-loss, commercial, diabetes, healthy eating, fast weight-loss, heart-healthy, plant-based, and easiest diets to follow. Each diet is assigned seven scores on a five-point scale for how easy it is to follow, its ability to produce short-term and long-term weight loss, its nutritional completeness, its safety, and its potential for preventing and managing diabetes and heart disease.

Note, we at Integrative Practitioner believe nutrition protocols must be personalized and are not in support of one “plan” over another. However, these rankings can be particularly useful when working with savvy clients who many mention or follow one of these programs. There's a lot of information to parse through, so we broke it down to the highlights:

Mediterranean takes first place

The Mediterranean diet took the top spot overall, while the government-endorsed Dietary Approaches to Stop Hypertension (DASH) diet came in second. Last year, the two programs tied for first, but the Mediterranean pushed ahead this year with 4.2 overall, 3 for weight loss, and 4.9 for overall health. DASH received 4.1 overall, 3.1 for weight loss, and 4.8 for health.

The Mediterranean diet is an eating pattern that emphasizes eating fruits, vegetables, whole grains, beans, nuts, legumes, olive oil, and flavorful herbs and spices. Additionally, the Mediterranean diet pyramid suggests fish and seafood at least a couple of times a week, and poultry, eggs, cheese, and yogurt in moderation, while saving sweets and red meat for special occasions. While not required, a glass of wine a day for women and two for men is allowed on this program.

DASH is promoted by the National Heart, Lung, and Blood Institute to stop or prevent hypertension. It emphasizes fruits, veggies, whole grains, lean protein, and low-fat dairy, which are high in blood pressure-deflating nutrients like potassium, calcium, protein, and fiber. It also discourages foods that are high in saturated fat, such as fatty meats, full-fat dairy foods, and tropical oils, as well as sugar-sweetened beverages and sweets. Following the diet also requires capping sodium at 2,300 milligrams to start, while eventually lowering to about 1,500 milligrams.

Both diets are balanced and can be followed long-term, the key reasons why they are consistently highly ranked neck and neck.  

Flexitarian comes in third

With a 0.1 point difference, the Flexitarian diet took home third place for overall effectiveness and efficiency. Created more than a decade ago by Dawn Jackson Blatner, RDN, the plan combines "flexible" and "vegetarian" for a protocol aimed at improving weight loss and optimal health. Blatner emphasizes adding five food groups, rather than taking any away, which include "new meat" like tofu, beans, and lentils; whole grains; dairy, and "sugar and spice," which ranges from dried herbs to agave.

The diet uses a five-week standard meal plan with breakfast, lunch, dinner, and snacks following a three-four-five regimen—breakfast choices are around 300 calories, lunches 400 calories, and dinner 500 calories. Snacks average about 150 calories and two are allowed per day for an average daily caloric intake of 1,500.

The meals focus heavily on plant-based proteins and Blatner offers recipes, tips, and guidance for food preparation. The plan can be followed verbatim or customized with various recipe selections. The program is affordable in terms of food, though you will need to purchase "The Flexitarian Diet" book.

WW, Volumetrics, Flexitarian

When it comes to weight loss diet plans, the newly rebranded WW (formerly Weight Watchers), along with Volumetrics and Flexitarian, snagged the top three spots.

Weight Watchers boasts to participants a 2-pound weekly weight loss, so long as you follow the point-based food ranking system, which assigns value to various foods based on its nutrition. Successful adherence results in consuming overall fewer calories, less saturated fat and sugar, and more protein. The newest program also expands dietary options that are 0 points from only fruits and vegetables to more than 200 foods. However, the cost and potential confusion of calculating points gave it a lower scorecard (the plan ranks fourth overall, tied with the MIND diet). 

Volumetrics focuses on loading your plate with nutrient-dense (low-density), low-calorie foods, which are grouped in four categories (category one, low-density through category four, high-density). The focus is on "swapping" out high-density foods for low-density options—say, a pound of high-density peanuts for a pound of low-density carrots. The idea is getting more energy out of what you eat. It's very easy to follow, but requires lengthy meal preparation and a lot of fruits, vegetables, and soups. 

Nordic and Ornish for plant-based

Along with Mediterranean and Flexitarian, for plant-based dieters, the Nordic Diet incorporates aspects of Scandinavian tradition and culture. The Nordic diet, which placed third for best plant-based programs, calls for a lifestyle that embraces a return to relaxed meals with friends and family, centered on seasonal, locally-sourced foods, combined with concern for protecting the environment.

In fourth place, clinical professor of medicine Dean Ornish's program, the Ornish Diet, offers customizable approaches based on specific conditions, priorities, taste preferences, and level of commitment. Ornish is best known for his program to reverse heart disease, which limits calories from fat to 10 percent and bans most foods with any cholesterol, refined carbohydrates, oils, caffeine, and nearly all animal products except for egg whites and one cup per day of nonfat milk or yogurt. Nuts and seeds are allowed, and fiber and complex carbs are encouraged. Up to two ounces of alcohol is permitted per day. Ornish also incorporates stress-management, exercise, and social support into his programs. 

Honorable mentions

Tied for fourth place overall, the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet incorporates aspects of DASH and Mediterranean and zeroes in on foods that affect brain health and lower risk of mental decline. The program features healthy staples such as leafy greens, nuts, and berries, which may lower a person’s risk of developing the progressive brain disorder, and was developed by Martha Clare Morris, ScD, a nutritional epidemiologist at Rush University Medical Center. In a study funded by the National Institute on Aging and published online February 2015, Morris and colleagues found the MIND diet lowered Alzheimer's risk by about 35 percent for people who followed it moderately well and up to 53 percent for those who adhered to it rigorously. While more research is needed to better understand the long-term impact of the diet, her team’s second paper on the MIND diet notes that it’s superior to the DASH and Mediterranean diets alone for preventing cognitive decline.

Also ranking in the top ten are the Mayo Clinic Diet (sixth place overall) and the Therapeutic Lifestyle Changes (TLC) (eighth place overall).

The Mayo Clinic diet aims to make healthy eating a lifelong habit and earned praise for its nutrition and safety. Participants recalibrate their eating habits by replacing bad habits with good ones using the Mayo Clinic’s unique food pyramid. The pyramid emphasizes fruits, vegetables, and whole grains, which have low energy density, meaning you can take in fewer calories. By sticking with the Mayo Clinic Diet, individuals are expected to shed 6 to 10 pounds in two weeks and continue losing 1 to 2 pounds weekly until they’ve hit their goal weight.

The TLC diet was created by the National Institute of Health’s National Cholesterol Education Program with the goal of cutting cholesterol as part of a heart-healthy eating regimen. It calls for eating plenty of vegetables and fruits, breads, cereals and pasta, and lean meats. The guidelines are broad enough that for plenty of mealtime flexibility.

Where’s the ketogenic diet?  

In the integrative community, it seems we can’t escape the ketogenic diet in the great nutrition debate. In fact, prominent integrative and functional medicine doctors recommend the ketogenic diet as the primary protocol for reducing inflammation, preventing disease, and slowing cognitive decline.

But when it comes to overall diets, at least according to U.S. News & World Report, the ketogenic diet scores towards the bottom, placing 38 out of 41 (the Whole30, Body Reset, and Dukan diet programs rank 39, 40, and 41, respectively).

Based on the scorecards, experts say the ketogenic diet is not easy to follow nor ideal for long-term weight-loss. It also received a low health score, meaning experts found it wasn’t beneficial for long-term health and wellness. However, for fast weight loss, ketogenic diet scored second place.

Click here to view the complete list of Best Diets Overall.