vegetarian diets Archives - Health Tips From The Professor

Which Diets Are Best In 2021?

March 16, 2021 by Dr. Steve Chaney

Which Diet Should You Choose?

Many 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?

US 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 Diets

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

Best 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 Follow

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?

Let 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?

With 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.

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.

Do Vegetarians Have A Higher Risk Of Stroke?

December 10, 2019 by Dr. Steve Chaney

What Are The Benefits And Risks Of A Vegetarian Diet?

Vegetarian diets are thought to be very healthy. Clinical studies show that vegetarian diets are associated with decreased risk of heart disease, diabetes, cancer, Alzheimer’s disease, and much more. What’s not to like?

That’s why the recent headlines claiming that vegetarian diets may increase the risk of stroke were so surprising. Advocates of meat-heavy diets like the Paleo and Keto diets were overjoyed. These results fit in with their view that we should be eating more meat protein and less plant protein. Nutrition experts, on the other hand, were asking: “What’s going on?” “How can this be?”

Those of you who are regular readers of “Health Tips From the Professor” know that I am an advocate of primarily plant-based diets. Thus, I felt a responsibility to analyze the study (TYN Tong et al, British Medical Journal, 366: 14897, 2019) behind the headlines impartially and give you, my readers, clear guidelines for the healthiest possible diet.

How Was The Study Done?

Let’s start with some background:

· A major study called the “European Prospective Investigation Into Cancer and Nutrition” (EPIC) has been underway since the early 90’s.

· The British component of this study is known as the EPIC-Oxford study.

· While the study has “cancer” in it’s title, it was designed to measure the impact of nutrition on many diseases. In this case, the study focused on heart disease and stroke.

· Finally, enrollment in the EPIC-Oxford study was designed to give a high proportion of vegetarians in the study population.

The EPIC-Oxford study enrolled 48,188 participants with no previous history of heart disease, stroke, or angina between 1993 and 2001. A detailed diet analysis was performed upon enrollment and again in 2010. Based on these data, the participants were divided into three groups:

1) Meat eaters (24,428 participants).

2) Fish eaters (7,506 participants). This group consumed fish but no other meats. People with this eating style are often called pescatarians.

3) Vegetarians (16, 254 participants). This group consumed dairy and eggs, but no meat. People with this eating style are often called lacto-ovo vegetarians.

4) The diet analysis also identified participants who were vegans (no animal foods). However, this group was too small to obtain statistically significant comparisons, so they were included with the lacto-ovo vegetarians in the vegetarian group.

Data on heart disease and stroke were obtained from the UK’s health service records through March 31st, 2016. The average time of follow-up for participants in the study was 18.1 years.

Without going into greater detail, this was a very large, well-designed study.

How Did The Diets Of The Three Groups Compare?

The first step in analyzing this study is to ask how the diets of the three groups compared.

Compared to meat eaters, the fish eaters consumed:

· No meat other than fish.

· Slightly less milk and significantly more cheese.

· Slightly more fruits & vegetables.

· Significantly more legumes & soy foods, nuts & nut butter.

· Slightly more carbohydrate and slightly less protein.

· Slightly less saturated fat and slightly more polyunsaturated fat.

· Around 260 fewer calories per day.

Compared to fish eaters, the vegetarians consumed:

· No meat.

· Slightly less milk & cheese.

· About the same amount of fruits & vegetables.

· Significantly more legumes & soy foods, nuts & nut butter.

· Slightly more carbohydrate and slightly less protein.

· About the same saturated and polyunsaturated fat.

· Around 125 fewer calories per day.

On average, the vegetarians consumed about 1 cup of milk and one ounce of cheese per day. The fish eaters consumed 1.4 ounces of fish per day.

In terms of comparisons:

· The biggest differences were between the fish eaters and the meat eaters. It would be fair to say that the fish eaters consumed a primarily plant-based diet with added fish and dairy.

· The biggest differences between the vegetarians and fish eaters was that the fish eaters got a significant percentage of their protein from fish, while the vegetarians got a significant amount of their protein from plant sources. Otherwise, their diets were fairly comparable.

Finally, the 10-year follow-up diet analysis showed that most participants stuck with their initial diet.

Do Vegetarians Have A Higher Risk Of Stroke?

Now, for the study results:

· Compared to meat eaters, fish eaters had 13% lower risk of heart disease, and vegetarians had a 22% lower risk of heart disease.

o For vegetarians this corresponds to 10 fewer cases of heart disease per 1,000 people over 10 years.

· Compared to meat eaters, vegetarians had a 20% higher risk of stroke, mostly due to an increased risk for hemorrhagic stroke.

o For vegetarians this corresponds to 3 additional cases of stroke per 1,000 people over 10 years.

· The risk of stroke was essentially identical for fish eaters and meat eaters.

In many other aspects, vegetarians were healthier than meat-eaters. For example, they:

· Weighed less.

· Had lower blood pressure.

· Had lower total and LDL cholesterol.

· Were less likely to have developed diabetes during the study.

· Were less likely to have required long-term treatment for other illnesses.

What Are The Strengths And Weaknesses Of The Study?

The strength of this study is obvious. It was a very large, well-designed study. The study also lasted a long time. Participants in the study were followed for almost 20 years.

There are two clear weaknesses, however:

1) Numerous previous studies have confirmed that vegetarian diets decrease heart disease risk by about 20%. However, none of those previous studies have reported an increase in stroke risk. This study is an outlier.

2) There is no clear mechanism that explains why a vegetarian diet might increase stroke risk. Based on previous observations that statin drugs increase the risk of hemorrhagic stroke, the authors suggested the increased stroke risk might be due to lowered LDL cholesterol levels.

This mechanism is speculative at present. Furthermore, if true, it would suggest that any intervention (drug or nutritional) that lowers LDL cholesterol would increase stroke risk.

In the words of the authors:

· “The present study has shown that British adults who were fish eaters or vegetarians had lower risks of heart disease than meat eaters, but that vegetarians had higher risks of stroke.

· Future work should include further measurements…to identify which factors may cause the observed associations. [In plain English: We need to understand how vegetarian diets might increase stroke risk before we put too much weight on the results of this study.]

· Additional studies in other large-scale cohorts with a high proportion of non-meat eaters are needed to confirm the generalizability of these results and assess their relevance for clinical practice and general health.” [In plain English: More studies are needed to confirm this observation before we start changing our recommendations about what constitutes a healthy diet.]

What Are The Benefits And Risks Of A Vegetarian Diet?

Let’s assume for a minute that the results of this study are accurate and take a closer look at the benefits and risks of a vegetarian diet. Here is my assessment:

1) This report is troubling, but it may not be correct. The association of vegetarian diets with a slight increase in stroke risk has only been seen in a single study. This study needs to be confirmed before we become too concerned about vegetarianism increasing stroke risk.

2) On the balance, vegetarian diets should still be considered very healthy. They lower the risk of heart disease, high blood pressure, diabetes, some cancers, inflammatory diseases and possibly even Alzheimer’s disease.

3) However, I have often said that we have 5 food groups for a reason, and it is not a good idea to eliminate whole food groups. In the past, I have used that statement to critique diets that leave out important plant food groups like fruit, whole grains, and legumes.

If the data on stroke risk in this study are true, it suggests it might also not be a good idea to leave out meat. However, you don’t need a lot of meat. The fish eaters in this study were consuming 1.4 ounces of fish per day. That was enough to eliminate the increased risk of stroke.

4) In addition, you don’t have to be a vegan purist to enjoy the health benefits of a primarily plant-based diet. As I describe in my book, “Slaying The Food Myths”, primarily plant-based diets ranging from vegan through pescatarian and semi-vegetarian to Mediterranean and DASH are all incredibly healthy.

I personally follow a semi-vegetarian diet but often recommend Mediterranean and DASH diets to others because they are the easiest primarily plant-based diets for the average American to follow.

5) Finally, if you have a family history, or are at high risk, of stroke, I recommend prudence until we know more. You may wish to adopt a version of primarily plant-based diets that incorporates some meat (That would be in the pescatarian to DASH range of primarily plant-based diets). Your heart will thank you, and you won’t increase your risk of stroke.

The Bottom Line

A recent study enrolled 48,188 British adults; divided them into meat eaters, fish eaters, and vegetarians; followed them for 18.1 years; and looked at their risk for heart disease and stroke. The results were:

· Compared to meat eaters, fish eaters had 13% lower risk of heart disease, and vegetarians had a 22% lower risk of heart disease.

o For vegetarians this corresponds to 10 fewer cases of heart disease per 1,000 people over 10 years.

· Compared to meat eaters, vegetarians had a 20% higher risk of stroke, mostly due to an increased risk for hemorrhagic stroke.

o For vegetarians this corresponds to 3 additional cases of stroke per 1,000 people over 10 years.

· The risk of stroke was essentially identical for fish eaters and meat eaters.

Here is my perspective:

4) In addition, you don’t have to be a vegan purist to enjoy the health benefits of a primarily plant-based diet. As I describe in my book, “Slaying The Food Myths” (https://slayingthefoodmyths.com), primarily plant-based diets ranging from vegan through pescatarian (the fish eaters in this study) and semi-vegetarian to Mediterranean and DASH are all incredibly healthy.

I personally follow a semi-vegetarian diet but often recommend Mediterranean and DASH diets to others because they are the easiest primarily plant-based diets for the average American to follow.

For more details on the study and what it means 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.