Rating the Diets

Rating the Diets--Can we describe the best dietary pattern?

Teenagers are often concerned about their diets because they want to gain or lose weight, seek improved athletic performance or think a better diet will improve a health condition such as acne.  Of the myriad nutritional patterns and thousands of diets that have been and are still being promoted, many can best be described as diets with unproven claims and poorly understood effects on health.  These diets often have the singular goal of weight loss and have little regard for their impact on other aspects of health, particularly their long-term implications for cardiovascular health.  Unfortunately, because nutrition research is so difficult, we do not have definitive evidence about what constitutes optimal nutrition. 

To help the public choose the best diet, with the help of a panel of health experts, in 2020, U.S. News & World Report ranked diets in nine categories, such as best plant-based diet, best for weight loss, or just eating for good health.1  Of the 35 diets evaluated, the Mediterranean Diet was number one, and the similar DASH Diet and the Flexitarian tied for second in the Best Diet Overall category.  Other top-ranked diets were the Weight Watchers diet, the Mayo Clinic diet, and the Volumetrics diet.  The top-ranked diets emphasize fruits, vegetables, whole grains, and plant-based protein. 

The Weight Watchers Program was tops in the Weight Loss Diet category, Vegan and Volumetrics were tied in second place.  Other highly ranked weight-loss diets were the Flexitarian, Jenny Craig, and Ornish diets.  The ultra-low-fat vegetarian Ornish diet was ranked the best Heart Healthy Diet, followed in second place by the Mediterranean Diet, and the DASH diet ranked third.  In the best Plant-based Diet category, the Mediterranean Diet was ranked first, the Flexitarian second, and the Nordic, Ornish, and vegetarian diets tied for third.  Significantly, the popular Paleo diet was ranked near the bottom at number 29 in the Best Diet Overall category.  And the  Keto Diet, a low-carb, high-fat regimen, was ranked number 35, in last place, in the Best Diet for Healthy Eating category.2

Studies of indigenous hunter-gatherers from many parts of the world indicate that there is likely no singular diet optimal to provide excellent metabolic health and freedom from chronic diseases such as heart disease, diabetes, and obesity.3  Populations, such as the Hadza in Tanzania, Shuar, hunter-gatherer/farmers in the rainforest of Ecuador, and the Tsimane in Bolivia eat a variety of diets.  They all have a lifestyle characterized by very high physical activity levels, and all are mostly free from the degenerative diseases that afflict Americans and other people in industrialized countries.  They rely on subsistence hunting, gathering, and farming, and a high proportion of the foods they eat are plant-based.  They do not lead sedentary lives or consume processed foods loaded with fat, salt, highly refined carbohydrates, and added sugars.  In general, hunter-gatherers do not have convenient access to large amounts of food, and any calorie-restricted diet, regardless of the proportion of carbohydrates, fats, and protein, improves metabolic biomarkers––but some weight-loss diets are not healthy for long-term consumption. 

Most of us will not want or have a lifestyle similar to that of hunter-gatherers, so more attention to diets in the context of modern living is warranted.  Our choices have important health implications, and knowledge of the health implications of individual nutrients can help guide food choices.  But nutrients are consumed in the form of foods that are made up of many complex constituents, and their interactions and health effects are not fully understood.  Since we eat food, our focus should be on the selection and consumption of healthy foods.  There is substantial evidence that adopting several overall dietary patterns can improve health, prevent some cancers, improve multiple cardiovascular risk factors, and prevent or even reverse CVD.  The 2015 Dietary Guidelines Advisory Committee (DGAC) Report concluded that healthy eating patterns could be achieved with a variety of eating styles, including the "Healthy U.S.-style Pattern," the "Healthy Mediterranean-style Pattern," and the "Healthy Vegetarian-style Pattern."4

Note: This timely topic presents opinions and ideas and is intended to provide helpful general information, and is not for the purpose of rendering advice or services to the individual reader. The ideas, procedures, and suggestions that are presented are not in any way a substitute for the advice and care of the reader's own physician or other medical professional based on the reader's own individual conditions, symptoms, or concerns. If the reader needs personal medical, health, dietary, exercise, or other assistance or advice, the reader should consult a physician and/or other qualified health professionals. Catalyst for Children specifically disclaims all responsibility for any injury, damage, or loss that the reader may incur as a direct or indirect consequence of following any directions or suggestions given in this report or participating in any programs described in this report. For additional information, please consult the book: The Building Blocks of Health––How to Optimize Your Health with a Lifestyle Checklist by J. Joseph Speidel MD, MPH, available in print or downloaded at Amazon, Apple, Barnes and Noble and elsewhere.

Building Blocks of Health book

1U.S. News, Best Diets Rankings for 2020. https://health.usnews.com/best-diet
2The best (and worst) diets of 2018. University of California, Berkeley Wellness Letter. April 2018.

3 Pontzer, Wood BM, Raichlen. Hunter‐gatherers as models in public health. Obesity Reviews. 2018;19(S1):24-35. https://doi.org/10.1111/obr.12785

4Scientific Report of the 2015 Dietary Guidelines Advisory Committee. Advisory Report to the Secretary of Health and Human Services and the Secretary of Agriculture.


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