Mediterranean Diet Wins Threepeat as the Best Overall of 2020

For the third year in a row, the Mediterranean diet has been named the best diet overall in the U.S. News & World Report annual rankings.  In 2018, the Mediterranean diet shared top honors with the DASH (Dietary Approaches to Stop Hypertension) diet. Both focus on fruits, vegetables, and whole grains. The ketogenic diet, one of the most popular, again fared well in the annual survey.

Angela Haupt, managing editor of health for the publication, says this year’s list has ”no surprises,” as it includes many diets that have been named outstanding before. Trendy diets typically won’t be found on its list, she says, explaining that its experts look for plans that have solid research and staying power.

Experts gathered by U.S. News this year ranked 35 diet plans, compared to 41 last year. Besides the best overall diet category, they ranked:

• Best diets for weight loss
• Best commercial diets
• Best diets for fast weight loss
• Best diets for healthy eating
• Easiest diets to follow
• Best diets if you have diabetes
• Best diets if you have heart disease
• Best plant-based diets

The expert panel included nationally recognized experts in diet, nutrition, obesity, food psychology, diabetes, and heart disease. They considered seven criteria, including how easy a plan 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. The experts were also asked to add any specific advice or comments they viewed as helpful.

Winners for 2020:

Best Overall: The Mediterranean diet took first place, followed by:

• The flexitarian (mostly plant-based) and DASH diets tying for second place
• WW (formerly Weight Watchers) in fourth place. It assigns point values to foods, with more nutritious choices having fewer points.

Best Weight Loss Diets: WW got first, followed by:

• Volumetrics (emphasis on low-calorie but filling foods) and a vegan diet (no meat, no dairy) tying for second.
• Flexitarian took fourth.

Best Commercial Diets: WW took first, followed by:

• Jenny Craig (prepackaged, low-cal meals, along with consultation and support)
• Nutritarian diet (foods high in nutrients, low in calories)

Best Fast Weight Loss Diets: HMR (meal replacement shakes, along with fruits and vegetables) took first, followed by:

• Optavia (a mix of healthy foods and products called “Fuelings”)
• Four diets tied for third place: WW, Jenny Craig, Atkins (low-carb) and ketogenic, or “keto,” diet (high-fat, very low-carb).

Best Diets for Healthy Eating: Mediterranean and DASH tied for first, followed by:

• Flexitarian diet
• MIND diet (combines DASH and Mediterranean plans; aims to boost brain health).

Easiest Diets to Follow: Mediterranean diet got first, followed by:

• Flexitarian
• WW and MIND diets tying for third.

Best Diets for Diabetes: Mediterranean diet took first, followed by four diets tying for second place:

• DASH
• Flexitarian
• Mayo Clinic Diet (emphasizes fruits, vegetables, movement)
• Vegan diet

Best Heart-Healthy Diets: Ornish Diet (low in fat, refined carbs, and animal protein) took first, followed by:

• Mediterranean
• DASH

Best Plant-Based Diets: Mediterranean diet took first, followed by:

• Flexitarian
• Ornish, vegetarian, and Nordic diets tying for third. Nordic, a recent addition to the list, focuses on fish, vegetables, and whole grains.

Lower on the List

No. 35 on the overall list was the Dukan Diet, which limits carbs and emphasizes protein. Even though ketogenic won a spot on the list for best fast weight loss, it came in at 34th place on the best overall. Whole 30 was 33rd. Whole 30 prohibits added sugar, alcohol, grains, and dairy for 30 days. Experts called these diets too restrictive and not sustainable over the long term.

WebMD reached out for comment on the promoters of all three diets ranked at the bottom. Only a representative of the ketogenic diet responded.  Many people are doing keto wrong, says Molly Devine, director of nutrition for trumacro Nutrition, a representative for KetoLogic, and founder of Eat Your Keto. “The ketogenic diet has gained popularity in the past year due to its rapid results for weight loss and improved energy,” she says “Unfortunately, due to its popularity through internet blogs, Facebook groups, and media influencers, many people are approaching this highly beneficial way of eating in the wrong way.

“A properly formulated ketogenic diet does not mean NO carbs ever, NO vegetables, unlimited amounts of saturated fat, or unlimited amount of artificial sweeteners. As a registered dietitian, I would agree that this pop culture approach to a ketogenic diet is not sustainable or healthy in the long run.”

However, she says “a well-formulated ketogenic dietary intervention with the help of a medical professional, such a registered dietitian, can be quite effective at improving health, reducing weight, improving cognitive function, and is sustainable in the long term. …While the “internet fad” version of the ketogenic diet may not be sustainable for the long term, a well-formulated ketogenic nutrition plan, through the help of a registered dietitian, can produce long-term and sustainable results, not just rapid weight loss.”

WebMD asked two registered dietitians without ties to any of the diets to comment on the findings and the rankings.  “I was pleased but not surprised,” says Connie Diekman, a registered dietitian, food and nutrition consultant in St. Louis, and former president of the Academy of Nutrition and Dietetics. “We all know that the diets that are going to keep you healthy are the ones that are balanced, and that is what you see at the top of the list.”

The list for 2020 ”has no big changes from last year,” says Jocelyn Harrison, a registered dietitian nutritionist in the Los Angeles area. What the top-ranked diets have in common, she says, is that many emphasize plant foods as well as plenty of fruits and vegetables.

Making Sense of the List

“People should use our rankings and in-depth information to find the best diet for them,” Haupt says. “There is no such thing as one-size-fits-all.” She advises people to think about their goal — whether it’s wanting to look good before an upcoming event or wanting to prevent disease, for example.  Pay attention to the diet specifics before committing, she says. Can you eat out on the plan you are considering? Do you have to buy a lot of fancy equipment to prepare the foods on the plan? Is alcohol allowed?

Read about the plan to see how restrictive it is, she says. “You don’t need to cut out entire food groups,” she says, as some diets advise. And “in many of our top-performing diets, you absolutely do have the freedom to have that cookie when you want to.”  Trendy diets aren’t necessarily healthy ones, she says. The ketogenic diet, for instance, ”remains extremely trendy. And our experts say it’s an extremely bad choice.” It is based on eating high amounts of fat and low amounts of carbohydrates. “As one of our experts put it, any diet in which snacking on bacon is OK is not going to be OK.”

Harrison’s advice for choosing a plan: “You have to pick the plan that is going to make you happy, and that fits your taste preferences, lifestyle, and goals.” Ask yourself what program you could stick with long-term, she says. She suggests picking a few, then meeting with a nutrition expert for input.  Diekman says: “Look at the top 10” on the lists. “The bottom [diets] will get you the weight loss piece, but you are not going to have a healthy body.”

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