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U.S. News & World Report Ranks 25 Diets
Mediterranean Diet Tops My List
Ever wonder what diet is best? Many diets are good, according to a comprehensive survey by U.S. News & World Report. Some diets are better than others for specific purposes, but there are many healthy diets. In their second annual survey, U.S. News ranked 25 (up from 20 in 2011) well-known eating plans for nutrition and safety, short and long term weight loss, heart health, for diabetes, and ease of compliance. Scores were based on reviews by 22 experts in diet and nutrition. The “Best Diets Overall” category combined the ratings in all categories. The magazine also asked readers whether the diets would work for them. (Readers and experts didn’t always agree.) The bottom line is that there is no one best diet; there are many that are good. You are most likely to follow the diet pattern that appeals to you. Your job is to choose wisely.
Full details are in the magazine and online. I’m going to discuss some things I believe are important in choosing a diet. The Mediterranean Diet (Med Diet), ranked third overall, is my favorite. You’ll see why as we go along. (One reason is the emphasis on fish.) We’ll end with two new peer-reviewed studies that drive home the benefits of the Mediterranean Diet.
While the primary focus of the U.S. News ranking is on food, almost all of the diet plans recommend exercise; some give it serious attention and others only lip service. That’s an important clue. Any diet plan that down-plays exercise is subject to serious challenge; it may be long on hype and short on sustainable results. No matter what the diet, regular exercise significantly increases the odds of success. Diet and exercise are a winning combination.
Nutritional completeness is another key factor. U.S. News looked to the federal government’s Dietary Guidelines for Americans 2010 as the benchmark for its “healthy eating” rating. (Keep in mind that government guidelines are based on consensus and not always current on the latest findings.) Most diets passed muster in this category, but a few were taken to task; two or three in particular that I’ll tell you about. Any diet that short-changes fruits, vegetables, or whole grains is suspect. These are the foods that give us the vitamins and minerals we need to be healthy—without over-shooting our calorie needs. Protein is another essential nutrient, but most diet plans provide more than enough. Few Americans are deficient in protein; the problem is usually the saturated fat and salt that come along with it. Finally, good fat is an important dietary component, which is often overlooked or misunderstood.
Now, let’s talk about some of the top ranked diets, and then a few that didn’t fare so well.
The Top Five
The top five “Best Diets Overall” have much in common; the difference is mainly one of emphasis. Four of the five are balanced diets.
The DASH Diet is ranked # 1 overall; it’s a balanced diet aimed at preventing and lowering high blood pressure. DASH stands for Dietary Approaches to Stop Hypertension. By emphasizing fruits, vegetables, whole grains, lean protein, and low-fat dairy it provides potassium, calcium, protein, and fiber, which are needed for fighting high blood pressure. It also stresses cutting back on salt. Balanced diets are usually best for health and long-term weight control. The DASH Diet is no exception; it also ranked first for healthy eating and diabetes, sixth for heart health, and ninth for short- and long-term weight loss. Importantly, it was also third in the “Easy to Follow” category. U.S. News gave it an overall score of 4.1 out of a possible 5.0. No diet is perfect.
In second place, with an overall score of 4.0, was the Therapeutic Lifestyle Changes Diet. The TLC Diet plan was created by the National Institutes of Health for the purpose of cutting high cholesterol and promoting cardiovascular health. Interestingly, it was ranked second for heart health, behind the notoriously rigorous Ornish Diet. The TLC Diet is a low-fat version of the DASH Diet. It has no major weaknesses, according to U.S. News. One expert described it as a “very healthful, complete, safe diet.”
The Mayo Clinic Diet and the Mediterranean Diet tied for third with combined scores of 3.9. Once again, they resemble the DASH Diet; all three are termed “balanced.” Notably, both the Mayo and Med diets strive to make healthy eating a lifelong habit. The Mayo Clinic Diet is aimed at weight loss (where it ranked ninth), with two parts: “Lose it” and “Live it.”
What sets the Med Diet apart is that it isn’t a diet in the usual sense of the word; it’s an amalgam of the tastes of people in the countries bordering the Mediterranean Sea. The cultures eating this diet are known for their health and longevity. U.S. News lauds the diverse foods and flavors. Fruits, vegetables, whole grains, beans, nuts, legumes, olive oil, and flavorful herbs and spices are all emphasized. Fish is eaten several times a week. Poultry, eggs, cheese, and yogurt are taken in moderation, while sweets and red meat are saved for special occasions. Wine (in moderation) is optional. Physically activity is an important part of the lifestyle.
The aim of the Med Diet, as seen by proponents, is comprehensive in scope. U.S. News says it “may include weight loss, heart and brain health, cancer prevention, and diabetes prevention and control.” U.S. News calls the Med Diet “eminently sensible,” adding that the “experts’ assessment of it were resoundingly positive, giving this diet an edge over many competitors.” (What’s not to like?)
Finally, the Weight Watchers Diet is ranked # 5 overall. With the same overall score as the Mayo Clinic and Med diets, it tops the list of the commercial diet plans. Also classified as balanced, U.S. News called it “a smart, effective diet.” It was the top ranked diet for weight loss.
Unfortunately, some high profile diets ended up at the bottom of the list.
The Bottom Four
The Atkins Diet and the Raw Food Diet tied for 22nd place, with overall scores of 2.3. Ranked 11th among the commercial diet plans, the Atkins Diet didn’t stack up with the experts; they agreed that it outperformed most of its competitors for short-term weight loss, but gave it “unfavorable marks” for long-term weight loss, nutrition, safety, and heart health. Readers concurred, with 18,697 saying this diet didn’t work for them, compared to 3,699 who said it did. The Raw Food Diet ranked second for both short- and long-term weight loss. The rap against it is that it’s “all but impossible” to follow. “Doing it well involves considerable commitment and effort, knowledge, and sacrifice,” one expert told U.S. News. The Raw Food Diet ranked dead last (# 25) for ease of compliance. Readers voted thumbs down by a 3-to-1 margin.
The Dukan Diet (named for its creator, French physician Pierre Dukan) lined up with the Paleo diet, at the bottom of the ranking list, with overall scores of 2.0. The Dukan Diet avows that protein, not calories, is the key to weight loss. You can eat all you want of approved foods—beginning with pure protein—progressing in carefully-defined phases to “Permanent Stabilization.” Promising loses of up to 10 pounds in the first week, the Dukan Diet is loaded down with rules one expert described as “idiotic.” (It reminds me of Archie Moore’s much ballyhooed pre-fight diet: he chewed meat, extracting the juice, and spit out the rest.) Moreover, “there’s no evidence it works,” says U.S. News. Rated last for heart-health and diabetes, and second only to the Raw Food Diet for ease of compliance, the Dukan Diet, nevertheless, garnered 443 favorable votes from readers, compared to only 74 nay sayers.
The Paleo Diet, likewise, occupied the bottom in virtually every category, including weight loss, heart health, diabetes, and nutritional adequacy. The experts were loath to accept that dairy and grains are excluded in the Paleo Diet, saying that puts dieters at risk of missing out on important nutrients. “It’s one of the few diets that experts actually considered somewhat unsafe and only somewhat complete nutritionally,” U.S. News reported. Readers voted better than 3-to-1 that the diet would not work for them. “A true Paleo Diet might be a great option: very lean, pure meats, lots of wild plants,” one expert told U.S. News. He quickly added, however, that “duplicating such a regimen in modern times would be difficult.”
Colorado State University Professor (health and exercise science) Loren Cordain, a leading proponent of the Paleo Diet, was one of several to offer a rebuttal to the negative report from U.S. News & World Report: “It is obvious that whoever wrote this piece did not do their homework and has not read the peer reviewed scientific papers which have examined contemporary diets based upon the Paleolithic food groups which shaped the genomes of our ancestors.”
U.S. News responded that “the studies were small and short, making strong conclusions difficult.”
Again, choose wisely.
Top and bottom comparisons behind us, let’s talk fish, a mainstay of the Mediterranean Diet—and the benefits of that diet.
Fish and Med Diet Benefits
A mounting array of evidence shows “that eating more fish is one of the healthiest changes you can make to your diet,” Tufts Health & Nutrition Letter wrote in a special supplement dated February, 2012.
The 2010 Dietary Guidelines for Americans, I believe for the first time, recognized the health benefits of fish by recommending eating two servings per week, about eight ounces total. Fish deliver lean protein and are good sources of omega-3 fatty acids. This change is especially helpful if fish replaces red meat and other foods high in saturated fat. Unfortunately, most Americans eat a minimal amount of fish; and what they do eat is likely to be breaded or deep fried, adding calories and saturated fat.
The best-known connection between fish consumption and health dates from the 1970s, when scientists found a low rate of heart attack in Eskimos eating lots of fish. That led to the realization that omega-3 fatty acids could help protect the heart and arteries. Later research found that omega-3 fats may lower triglycerides, improve blood pressure, prevent blood clots, and reduce heart arrthymia, the leading cause of sudden cardiac death.
The two new studies referred to earlier put participants into groups based on how closely they adhered to an ideal Mediterranean diet. Following up some years later, they calculated the relationship between adherence to the Med Diet and certain disorders, cardiovascular in one study and brain damage in the other.
The first study, published in The American Journal of Clinical Nutrition on November 9, 2011, included 2,568 people 69 years of age, give or take 10 years. They found that even modest adherence to the Med Diet may protect against vascular events (stroke, heart attack, and death). Over a follow up period of nine years, subjects with the highest Med Diet scores had a 33 percent lower risk of vascular death, compared to those with the lowest scores. Moderate alcohol consumption and eating fish containing omega-3 fatty acids and legumes (peas, beans, and lentils), which reduce cholesterol, appeared to have the greatest protective effect against vascular death, according to the study.
“Results support the role of a diet rich in fruit, vegetables, whole grains, fish, and olive oil in the promotion of cardiovascular health,” lead author Hannah Gardener and her colleagues concluded.
The second study, published in the February, 2012, Archives of Neurology, followed 1,000 people, average age 70. They analyzed the relationship between the Med Diet and damage to small blood vessels in the brain. Using MRI brain scans, they looked for markers indicating damage to small blood vessels. Such damage can cause small silent strokes with no immediate symptoms, but over time can affect cognitive performance. Hannah Gardener, also the lead researcher in the second study, and her colleagues found that the people with the highest Med Diet scores had the lowest blood vessel damage. Senior researcher Clinton B. Wright, MD, said the study indicates that the Med Diet might be protective of small blood vessels in the brain. More research with more people is needed to be sure, he added.
Another study, described in the Tufts Letter special supplement on fish consumption, involved actual brain function. Focusing on only 260 people, average age 70, it was a small study with a big result. About 60% of the participants ate fish at least once a week at the beginning of the study. A repeat survey five years later showed little change in fish consumption. After 10 years, participants underwent an MRI scan to measure their brain volume; five years after that, they had followup cognitive testing.
The MRI scans revealed that people eating broiled or baked fish, not fried, on a weekly basis had greater volume in areas of the brain responsible for memory and learning. That was impressive, but the big news was to come in the cognitive testing. “Only 3.2% of those with the highest fish intake and greatest preservation of gray matter were found to have developed mild cognitive impairment or dementia,” the Tufts Letter related. “That was in stark contrast to the 30.8% of non-fish eaters who’d suffered cognitive decline.” In short, the study suggested that fish consumption reduced the risk of cognitive impairment or dementia by almost 10 times. Pretty darn impressive.
While the study has not yet been published in a peer-reviewed journal, lead researcher Cyrus Raji, MD, PhD, of the University of Pittsburg, felt confident enough to conclude: “Consuming baked or broiled fish promotes stronger neurons in the brain’s gray matter by making them larger and healthier. This simple lifestyle choice increases the brain’s resistance to Alzheimer’s disease and lowers risk for the disorder.”
* * *
I eat fish about four times a week and follow a diet much like the Mediterranean Diet. I can tell you first hand that eating that way is filling, satisfying, and easy to follow. U.S. News rated the Med Diet # 3 for ease on compliance. The Med-type diet is a delight. It's my choice.
Now it’s your turn to decide what diet pattern is best for you. Choose wisely.
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