Which Diets Are Best In 2021?

Which Diet Should You Choose?

Emoticon-BadMany of you started 2021 with goals of losing weight and/or improving your health. In many cases, that involved choosing a new diet. That was only 2 months ago, but it probably feels like an eternity.

For many of you the “bloom” has gone off the new diet you started so enthusiastically in January.

  • Perhaps the diet isn’t working as well as advertised…
  • Perhaps the diet is too restrictive. You are finding it hard to stick with…
  • Perhaps you are always hungry or constantly fighting food cravings…
  • Perhaps you are starting to wonder whether there is a better diet than the one you chose in January…
  • Perhaps you are wondering whether the diet you chose is the wrong one for you…

If you are rethinking your diet, you might want to know which diets the experts recommend. Unfortunately, that’s not as easy as it sounds. The diet world has become just as divided as the political world.

Fortunately, you have an impartial resource. Each year US News & World Report invites a panel of experts with different points of view to evaluate popular diets. They then combine the input from all the experts into rankings of the diets in various categories.

If you are still searching for your ideal diet, I will summarize the US News & World Report’s “Best Diets In 2021”. For the full report, click on this link.

How Was This Report Created?

Expert PanelUS News & World Report recruited panel of 25 nationally recognized experts in diet, nutrition, obesity, food psychology, diabetes, and heart disease to review the 39 most popular diets.  They rated each diet in seven categories:

  • How easy it is to follow.
  • Its ability to produce short-term weight loss.
  • Its ability to produce long-term weight loss.
  • its nutritional completeness.
  • Its safety.
  • Its potential for preventing and managing diabetes.
  • Its potential for preventing and managing heart disease.

They converted the experts’ ratings to scores 5 (highest) to 1 (lowest). They then used these scores to construct nine sets of Best Diets rankings:

  • Best Diets Overall combines panelists’ ratings in all seven categories. However, all categories were not equally weighted. Short-term and long-term weight loss were combined, with long-term ratings getting twice the weight. Why? A diet’s true test is whether it can be sustained for years. And safety was double counted because no diet should be dangerous.
  • Best Commercial Diets uses the same approach to rank 15 structured diet programs that require a participation fee or promote the use of branded food or nutritional products.
  • Best Weight-Loss Diets was generated by combining short-term and long-term weight-loss ratings, weighting both equally. Some dieters want to drop pounds fast, while others, looking years ahead, are aiming for slow and steady. Equal weighting accepts both goals as worthy.
  • Best Diabetes Diets is based on averaged diabetes ratings.
  • Best Heart-Healthy Diets uses averaged heart-health ratings.
  • Best Diets for Healthy Eating combines nutritional completeness and safety ratings, giving twice the weight to safety. A healthy diet should provide sufficient calories and not fall seriously short on important nutrients or entire food groups.
  • Easiest Diets to Follow represents panelists’ averaged judgments about each diet’s taste appeal, ease of initial adjustment, ability to keep dieters from feeling hungry and imposition of special requirements.
  • Best Plant-Based Diets uses the same approach as Best Diets Overall to rank 12 plans that emphasize minimally processed foods from plants.
  • Best Fast Weight-Loss Diets is based on short-term weight-loss ratings.

Which Diets Are Best In 2021?

The word WInner in white letters surrounded by a burst of colorful stars in 3d

Are you ready? If this were an awards program I would be saying “Envelop please” and would open the envelop slowly to build suspense.

However, I am not going to do that. Here are the top 5 and bottom 5 diets in each category (If you would like to see where your favorite diet ranked, click on this link). [Note: I excluded commercial diets from this review.]

Best Diets Overall 

The Top 5: 

#1: Mediterranean Diet

#2: DASH Diet (This diet was designed to keep blood pressure under control, but you can also think of it as an Americanized version of the Mediterranean diet.)

#3: Flexitarian Diet (A flexible semi-vegetarian diet).

#4: Mayo Clinic Diet

#5: MIND Diet (This diet is a combination of Mediterranean and DASH but is specifically designed to reduce cognitive decline as we age.)

The Bottom 5: 

#35: Modified Keto Diet

#36: Whole 30 Diet

#37: GAPS Diet (A diet designed to improve gut health).

#38: Keto Diet

#39: Dukan Diet

Best Weight-Loss DietsWeight Loss

The Top 5: 

#1: Flexitarian Diet

#2: Vegan Diet

#3: Volumetrics Diet (A diet based on the caloric density of foods).

#4: Mayo Clinic Diet

#5: Ornish Diet

The Bottom 5: 

#35: Fertility Diet

#36: Whole 30 Diet

#37: Alkaline Diet

#38: AIP Diet (A diet designed for people with autoimmune diseases)

#39: GAPS Diet

Best Diabetes Diets

The Top 5: 

#1: Flexitarian Diet

#2: Mediterranean Diet

#3: DASH Diet

#4: Mayo Clinic Diet

#5: Vegan Diet

The Bottom 5: 

#35: The Fast Diet

#36: AIP Diet

#37: GAPS Diet

#38: Whole 30 Diet (A diet designed for people with autoimmune diseases)

#39: Dukan Diet

strong heartBest Heart-Healthy Diets 

The Top 5: 

#1: DASH Diet

#2: Mediterranean Diet

#3: Ornish Diet (A diet based on the caloric density of foods).

#4: Flexitarian Diet

#5: Vegan Diet

The Bottom 5: 

#35: Keto Diet

#36: AIP Diet

#37: Whole 30 Diet

#38: Modified Keto Diet

#39: GAPS Diet

Best Diets for Healthy Eating

The Top 5: 

#1: DASH Diet

#2: Mediterranean Diet

#3: Flexitarian Diet

#4: TLC Diet (A diet designed to promote heart health)

#5: MIND Diet

The Bottom 5: 

#35: Atkins Diet

#36: Raw Food Diet

#37: Modified Keto Diet

#38: Dukan Diet

#39: Keto Diet 

Easiest Diets to FollowEasy

The Top 5: 

#1: Mediterranean Diet

#2: Flexitarian Diet

#3: MIND Diet

#4: DASH Diet

#5: Fertility Diet

The Bottom 5: 

#35: Keto Diet and Modified Keto Diet (tie)

#36: Whole 30 Diet

#37: Dukan Diet

#38: GAPS Diet

#39: Raw Foods Diet 

Best Fast Weight-Loss Diets

The Top 5 (Excluding Commercial Diets): 

#1: Atkins Diet

#2: Biggest Loser Diet

#3: Keto Diet

#4: Raw Food Diet

#5: Volumetrics Diet

Which Diets Are Best For Rapid Weight Loss?

Happy woman on scaleLet me start with some general principles:

#1: If you are looking for rapid weight loss, any whole food restrictive diet will do.

  • The Atkins and keto diets are meat heavy, low carb diets. They restrict fruits, some vegetables, grains, and most legumes.
  • The Biggest Loser diet relies on restrictive meal plan and exercise programs.
  • The restrictions of the raw food diet are obvious.
  • The volumetrics diet restricts foods with high caloric density.
  • The vegan diet, which ranks #7 on this list, is a very low fat diet that eliminates meat, dairy, eggs, and animal fats.
  • I did not include commercial diets that rated high on this list, but they are all restrictive in one way or another.

#2: Restrictive diets ultimately fail.

  • The truth is 90-95% of people who lose weight quickly on a restrictive diet regain most of that weight in the next two years. The pounds come back and often bring their friends along as well. Many people regain more weight than they lost. This is the famous “Yo-Yo Effect”.
  • If dieters paid for one of the commercial diets, they may as well have burned their money.
  • When I talk with people about weight loss, many of them tell me the Atkins diet is the only one they can lose weight on. That would be impressive if they were at a healthy weight, but most are not. They are overweight. I am starting to see the same thing from overweight people who have used the keto diet to lose weight and have regained their weight.

#3: We should ask what happens when we get tired of restrictive diets and add back some of your favorite foods.

  • If you lose weight on a vegan diet and add back some of your favorite foods, you might end up with a semi-vegetarian diet. This is a healthy diet that can help you maintain your weight loss.
  • If you lose weight on the Atkins or keto diets and add back some of your favorite foods, you end up with the typical American diet – one that is high in both fat and carbs. This is not a recipe for long-term success.
  • Long term weight loss is possible if you transition to a healthy diet after you have lost the weight. In a recent article in “Health Tips From The Professor” I wrote about an organization called the National Weight Control Registry. These are people who have been successful at keeping the weight off. For purposes of this discussion, two points are important.
  • They lost weight on every possible diet.
  • They kept the weight off by following a healthy reduced calorie, low fat diet. (For what else they did, click here).

Which Diet Should You Choose?

Which Diet Is BestWith rapid weight loss out of the way, let’s get back to the question, “Which Diet Should You Choose?” My recommendations are:

  • Choose a diet that fits your needs. That is one of the things I like best about the US News & World Report ratings. The diets are categorized. If your main concern is diabetes, choose one of the top diets in that category. If your main concern is heart health… You get the point.
  • Choose diets that are healthy and associated with long term weight loss. If that is your goal, you will notice that primarily plant-based diets top these lists. Meat-based, low carb diets like Atkins and keto are near the bottom of the lists.
  • Choose diets that are easy to follow. The less-restrictive primarily plant-based diets top this list – diets like Mediterranean, DASH, MIND, and flexitarian.
  • Choose diets that fit your lifestyle and dietary preferences. For example, if you don’t like fish and olive oil, you will probably do much better with the DASH or flexitarian diet than with the Mediterranean diet.
  • Finally, focus on what you have to gain, rather than on foods you have to give up.
    • On the minus side, none of the diets include sodas, junk foods, and highly processed foods. Teose foods should go on your “No-No” list. Sweets should be occasional treats and only as part of a healthy meal. Meat, especially red meat, should become a garnish rather than a main course.
    • On the plus side, primarily plant-based diets offer a cornucopia of delicious plant foods you probably didn’t even know existed. Plus, for any of the top-rated plant-based diets, there are websites and books full of mouth-watering recipes. Be adventurous.

The Bottom Line 

For many of you the “bloom” has gone off the new diet you started so enthusiastically in January. If you are rethinking your diet, you might want to know which diets the experts recommend. Unfortunately, that’s not as easy as it sounds. The diet world has become just as divided as the political world.

Fortunately, you have an impartial resource. Each year US News & World Report invites a panel of experts with different points of view to evaluate popular diets. They then combine the input from all the experts into rankings of the diets in various categories. In the article above I summarize the US News & World Report’s “Best Diets In 2021”.

There are probably two questions at the top of your list.

#1: Which diets are best for rapid weight loss? Here are some general principles:

  • If you are looking for rapid weight loss, any whole food restrictive diet will do.
  • Restrictive diets ultimately fail.
  • We should ask what happens when we get tired of restrictive diets and add back some of our favorite foods.
  • Long term weight loss is possible if you transition to a healthy diet after you have lost the weight.

#2: Which diet should you choose? Here the principles are:

  • Choose a diet that fits your needs.
  • Choose diets that are healthy and associated with long term weight loss.
  • Choose diets that are easy to follow.
  • Choose diets that fit your lifestyle and dietary preferences.
  • Finally, focus on what you have to gain, rather than on foods you have to give up.

For more details on the diet that is best for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

Why Do Most Diets Fail?

How To Lose Weight And Keep It Off

New Year DietTomorrow is the official start of another dieting season. Millions of Americans will be making a New Year’s Resolution to lose weight. The top three reasons for these weight loss resolutions are:

1)    Reduce disease risk (73%). After all, we are being told those excess pounds increase our risk of diabetes, heart disease, cancer, and just about every other disease known to man.

2)    Improve self-esteem (61%). Some of this may be due to the social stigma associated with obesity, but many people simply want to improve the image they see in the mirror every morning when they get out of the shower.

3)    Boost energy (49%).

Those are all good reasons for losing weight. But before you make your New Year’s resolution to embark on another weight loss journey, you should ask yourself “Do weight loss diets work?” If you look at the statistics, they aren’t very encouraging:

1)    45 million Americans go on a weight loss diet every year.

·       50% go on fad diets.

·       They spend $33 billion on weight loss products.

·       90% regain almost all the weight. That’s called the yo-yo effect.

·       On average, Americans gain 11 pounds on every diet yo-yo.

o   They might as well have thrown that $33 billion to the wind.

2)    228,000 Americans get gastric bypass surgery.

·       80% regain almost all the weight.

o   Their digestion and their health will never be the same.

As if those statistics weren’t bad enough, the obesity epidemic gets worse year after year (see the graphic on the Obesity Epidemicright). Americans keep getting fatter. What we are doing clearly isn’t working.

You are probably saying to yourself: “I know that, but this year I’m going to try a new diet.” As the saying goes “Hope springs eternal in the human breast”, but is it realistic to think this time will be different?

Let me share a quote from a book and TV series called “The Weight Of the Nation” by John Hoffman & Dr. Judith Salerno”:

“First we blamed fat – low fat diets didn’t work! Then we blamed carbs, eggs, red meat, dairy, white flour, sugar, juices, sodas, high-fructose corn syrup, & partially hydrogenated fats. One by one, we replaced the evil food du jour…and watched our collective waistlines grow.”

In other words, they are saying it’s not just low-fat diets that don’t work. None of the popular diets work long term. I come across lots of people who tell me the Atkins weight-loss diet works best for them. That would be convincing if they were slender, but they aren’t! They gained it all back and then some. Now that the keto diet has been around for a few years, I am starting to see the same pattern there as well.

Clearly, the problem isn’t losing the weight. Any diet can help you lose weight. The problem is keeping the weight off. Let’s look at why this is.

Why Do Most Diets Fail?

WhyTo understand the answer to this question, let’s start with another quote from “The Weight Of the Nation”: “Our bodies were designed to store fat in times of plenty and retain fat in times of famine”

Essentially, the authors were saying when our ancestors were hunters and gatherers, there were times when food was abundant, and times when food was scarce. In order to survive, our bodies had to store energy in its most efficient form when food was abundant and hold on to those energy stores as long as possible when food was scarce.

Fat provides more than twice as many calories per gram as either carbohydrate or protein. Additionally, our ability to store carbohydrate is limited. And we don’t really have protein stores. All the proteins in our body have essential functions. However, our ability to store fat is unlimited. Now you understand why fat is the preferred energy store in times of plenty and our bodies try to hold on to it as long as possible in times of famine.

With that perspective in mind, there are three reasons why most diets fail:

1)    Most dieters are looking for rapid weight loss (at least 2-5 pounds/week). That is a problem because “Our bodies were designed to…retain fat in times of famine”. When we lose weight quickly, our bodies interpret that as famine. Our bodies respond by decreasing our metabolic rate so we can hold on to those fat stores.

The solution to this problem is to set more reasonable weight loss goals. If we keep the rate of weight loss in the 1-2 pound/week range (0.5-1 pounds/week is even better), we can largely avoid this famine response. You should ask yourself, “What’s the rush?” After all, the average American only gains 1-2 pounds/year. Why do we need to get rid of that excess weight in just a few weeks?

2)    Most dieters are looking for significant weight loss (more than 20 pounds). That is a problem because our bodies are designed to retain fat stores, not protein stores. When our bodies sense a famine they burn our protein stores (lean muscle mass) to spare as much of our fat stores as possible. The longer the diet (famine) lasts, the more muscle mass we lose.

That’s a problem because muscle burns calories much faster than fat. The more muscle we lose, the more our metabolic rate decreases. It gets harder and harder to lose weight, and eventually we reach a plateau. Most people get discouraged at that point and go off their diet.

That’s where the other part of the quote from “The Weight Of The Nation” kicks in: “Our bodies are Yo-Yo with Boydesigned to store fat in times of plenty”. Once again, it is fat we store, not protein. Most people never regain the protein stores they lost, so their metabolic rate remains low. They regain most of the weight they lost, and then some. This is the origin of the yo-yo effect.

There are two solutions to this problem:

·       Increase your resistance exercise and your intake of protein with high levels of the essential amino acid leucine. I have covered this in a previous issue of “Health Tips From The Professor”.

·       Set more reasonable weight loss goals. It is possible to lose more than 20 pounds without losing muscle mass. We just need to think in terms of reaching those weight loss goals in years rather than in months. Once again, remember it took us years to gain the weight. Why not think in terms of years to lose the weight?

3)    Most dieters think in terms of diets rather than lifestyle change. Diets have an expiration date. Then most people just drift back to “the way they really live”. Lifestyle change, on the other hand, is permanent. Once we change to a healthier lifestyle, we no longer need to focus on weight loss. The weight comes off automatically.

To better understand the power of lifestyle change let’s look at something called “The National Weight Control Registry”.

How To Lose Weight And Keep It Off

Happy woman on scaleRather than focus on the abysmal statistics for long-term weight loss, doctors Rena Hill and James O Wing decided to focus on the characteristic of people who manage to keep their weight off. They founded something called “The National Weight Control Registry” and invited people who were successful at keeping the weight off to participate in their program.

Currently, the National Weight Control Registry is tracking over 10,000 individuals who have lost 30 pounds or more and have kept it off for long periods of time. They use detailed questionnaires and annual follow-up surveys to study the behavioral and psychological characteristics and the strategies of weight loss maintainers.

When you look at how they lost weight, they are a very diverse group:

·       They lost weight on every possible diet – from vegan to keto to just plain crazy.

·       50% lost weight on commercial diet programs. 50% lost weight on their own.

·       Some lost weight quickly. Some lost weight slowly.

When you look at weight maintenance, you realize that the dismal weight maintenance statistics don’t have to apply to you. The good news is:

·       On average, people in The National Weight Control Registry have lost 66 pounds and have kept it off for 5 years or more.

·       12-14% of them have maintained a weight loss of 100 pounds or more for 5 or more years.

·       Even better, once they maintained their weight loss for 2-5 years, it became easy.

They no longer had to battle hunger and a sluggish metabolism. They no longer had to think about the lifestyle changes they were trying to maintain. Their new lifestyle became what they did automatically, without even thinking about it. Their weight loss had become permanent.

By now, you are probably wondering how they do it. Here are the top 7 characteristics of those who are successfulhealthy living at keeping the weight off:

1)    They consumed reduced calorie, low-fat, healthy diets.

2)    They had internalized their eating patterns. It had become how they ate every day without even thinking about it.

3)    They monitored their weight regularly. This allowed them to make adjustments whenever they saw their weight start to creep up.

4)    They ate breakfast on a regular basis.

5)    They got lots of exercise (on average, about 1 hour/day).

6)    They watched less than 10 hours of TV/week. If you were wondering where you would find the time to exercise an hour/day, this is probably your answer.

7)    They were consistent. They had no planned “cheat days”. This doesn’t mean they were purists. They still allowed themselves to eat some of their favorite unhealthy foods on an occasional basis. They just didn’t set aside regular times when they planned to “pig out”.

There was one other interesting observation from this study:

·       Those who used meal replacement shakes as part of their weight loss, focused more on diet and included meal replacement shakes as part of their maintenance program.

·       Those who lost weight on their own, also followed healthy eating habits, but put a bit more emphasis on exercise to keep themselves on track.

·       Both approaches were effective.

The take-home message of the National Weight Control Registry is clear. There is no magic diet that guarantees you will keep the weight off. The “secret” to keeping the weight off is a healthy eating pattern and a healthy lifestyle.

In short, if your resolution is to lose weight next year, don’t focus on the diet you will follow to lose the weight. Instead, focus on the healthy lifestyle you will follow to keep the weight off.

Of course, you will be most successful if the diet you are following to lose weight incorporates the healthy lifestyle you plan to follow to maintain your weight loss.

What Role Do Habits Play In Weight Loss?

Habits-Old-vs-NewFinally, I would like to share a recent study (G Cleo et al, International Journal of Obesity, 43: 374-383, 2019) that puts the whole issue of weight loss and weight maintenance in a different perspective. This study looked at the role that habits play in weight loss.

In short, the study enrolled 130 participants who wanted to lose weight. All the participants were told this was a weight loss study, but none of the participants were given detailed diet and exercise recommendations to follow. The study had a 12-week intervention phase followed by a 12-month follow-up phase. The participants were divided into three groups.

1)    Group 1 received no advice during the intervention phase. This was the control group.

2)    Group 2 focused on breaking old habits. During the intervention phase they were sent daily tests suggesting new habit patterns. These were suggestions like “Drive a different route to work today”. None of the texts had anything to do with diet or lifestyle.

3)    Group 3 focused on creating new healthy habits. They were given a list of 10 healthy habits. During the intervention phase they were asked to log how many of these habits they implemented each day. The 10 healthy habits were:

#1: Keep to a daily meal routine.

#2: Choose reduced fat versions of foods.

#3: Walk off the weight (aim for 10,000 steps/day).

#4: Pack a healthy snack (Choose healthy options such as fruits, nuts, or low-fat yogurt).

#5: Read labels.

#6: Be cautious with your portions.

#7: Break up your sitting time (Stand for 10 minutes every hour).

#8: Think about your drinks (Choose water instead of sodas and fruit juices).

#9: Focus on your food (Slow down. Don’t eat while watching TV).

#10: Don’t forget your 5 servings of fruits and vegetables a day.

The results were:

·       People in both habit change groups lost significantly more weight than people in the control group.

·       People in the habit change groups continued to lose weight for 12 months after the intervention ended.

·       Weight loss was essentially identical in the two habit change groups.

The last observation is particularly interesting. Remember that one of the habit change groups was simply focused on breaking old habits, yet people in this group did just as well as people who were taught healthy lifestyle habits. This implies that people already know about healthy lifestyle habits. They just don’t know how to break their old habits. Once they become comfortable breaking old habits, they find it easy to adopt healthier lifestyle habits.

In short, change your habits, change your lifestyle. Change your lifestyle, control your weight.

What Does This Mean For You?

why-do-most-dirts-failI covered a lot of information in this article. Let me sum it up by giving you my top 10 tips for losing weight and keeping it off.

1)    You don’t need to achieve your “ideal weight”. Losing 5-10% of your body weight may be enough.

2)    Ditch diets. Focus on lifestyle change.

3)    Slow and steady wins the day.

4)    Change your habits, change your weight.

5)    Long-term weight loss is possible.

6)    Low-fat, healthy eating patterns are best.

7)    Once you have internalized healthy habits, they become automatic.

8)    If you stick with a healthy lifestyle long enough, keeping the weight off becomes easy.

9)    Focus on all the healthy food choices you have, not what you have to give up. There is a cornucopia of great tasting, healthy foods to choose from.

10)  Never say never. Allow yourself to enjoy your old favorite foods on occasion. Just don’t make it a habit.

The Bottom Line

I cover a lot of information in this article. Let me sum it up by giving you my top 10 tips for losing weight and keeping it off.

1)    You don’t need to achieve your “ideal weight”. Losing 5-10% of your body weight may be enough.

2)    Ditch diets. Focus on lifestyle change.

3)    Slow and steady wins the day.

4)    Change your habits, change your weight.

5)    Long-term weight loss is possible.

6)    Low-fat, healthy eating patterns are best.

7)    Once you have internalized healthy habits, they become automatic.

8)    If you stick with a healthy lifestyle long enough, keeping the weight off becomes easy.

9)    Focus on all the healthy food choices you have, not what you have to give up. There is a cornucopia of great tasting, healthy foods to choose from.

10)  Never say never. Allow yourself to enjoy your old favorite foods on occasion. Just don’t make it a habit.

For more details on how to lose weight and keep it off, read the article above. In fact, if you plan to lose weight in the coming year, you should really read this article first.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

 

Health Tips From The Professor