Jan. 2, 2019 -- The Mediterranean diet has earned the top spot as the best overall diet in the 2019 U.S. News & World Report annual diet rankings. Last year, the perennial favorite tied for top place with the DASH (Dietary Approaches to Stop Hypertension) diet, but this year, it bumped DASH to second.
Both diets emphasize fruits, vegetables, and whole grains.
"This is the first year that the Mediterranean diet ranked first all by itself," says Angela Haupt, assistant managing editor of health at U.S. News. The publication's panel of experts ranked 41 diet plans, including a newcomer to the list that's gotten a lot of buzz: the Nordic diet.
The experts ranked the 41 plans by nine categories. Besides best overall, the categories are:
- Best commercial diets
- Best diets for weight loss
- Best diets for fast weight loss
- Best diets for healthy eating
- Easiest diets to follow
- Best diets for diabetes
- Best heart-healthy diets
- Best plant-based diets.
The panel, including top nutritionists, dietary consultants, and doctors specializing in weight loss, heart health, and diabetes, evaluated and scored the 41 diets in seven areas. They considered:
- How easy it is to follow
- Likelihood of losing significant weight in the first 12 months
- Likelihood of losing significant weight for 2 years or more
- How well it helps prevent and manage cardiovascular disease
- How well it helps prevent and manage diabetes
- Nutritional completeness
New Diet on the List
The attention the Nordic diet has been gaining from health experts led to its ranking, Haupt says. "It's quite similar to the Mediterranean diet," she says. It recommends plenty of fish, vegetables, and whole grains. It tied for third place as the best plant-based diet.
Haupt sees a trend in people asking more about these kinds of regional diets. "We see people interested in adopting the eating habits of these places where we know people are healthier," she says.
Like the Mediterranean diet, the Nordic plan emphasizes barley and other whole grains, berries, veggies, fish, and beans. Instead of the olive oil the Mediterranean diet recommends, the Nordic diet uses canola oil.
The Rest of the Winners
Best Overall: After the Mediterranean and DASH, best overall third place is the Flexitarian Diet. It is mostly a plant-based plan, with meat in moderation. The MIND Diet and WW (formerly Weight Watchers) tied for fourth place. MIND combines part of the DASH and Mediterranean plans and aims to boost brain health. WW assigns points and a daily total to aim for, with more nutritious foods having fewer points.
Best Commercial Diets: WW took the top spot, followed by:
- Jenny Craig (prepackaged low-calorie foods, plus a consultant)
- Nutritarian Diet (high-nutrient, whole-plant foods)
- South Beach Diet (modified low-carb)
- Biggest Loser, Nutrisystem, and Zone in a tie for fifth place
Best Weight-Loss Diets: WW took first, followed by:
- Volumetrics (emphasis on low-cal but filling foods)
- Flexitarian, Jenny Craig, and vegan in a tie for third
Best Fast Weight-Loss Diets: First place went to the HMR Diet, which uses meal replacement shakes and emphasizes fruits and vegetables. Other winners:
- Atkins (low-carb), keto diet (very low-carb, high-fat), OPTAVIA (low-calorie plan using its products), and WW tied.
Best Diets for Healthy Eating: Winners are Mediterranean and DASH, respectively. Tied for third were Flexitarian, MIND, and TLC Diet. TLC (Therapeutic Life Changes) aims to lower cholesterol for better health.
Easiest Diets to Follow: Mediterranean came in first, with Flexitarian and WW tying for second. Then came MIND, DASH, and Fertility Diet. The Fertility Diet limits red meat and focuses on getting protein from nuts and vegetables.
Best Diets for Diabetes: Mediterranean is No. 1, and then a tie for DASH, Flexitarian, Mayo Clinic Diet, and Volumetrics.
Best Heart-Healthy Diets: Mediterranean and Ornish tied for first. The Ornish Diet is low in fat, refined carbs, and animal protein. DASH is next, followed by a three-way tie for MIND, TLC, and vegan diet.
Best Plant-Based Diets: Mediterranean is first, followed by Flexitarian, and then a tie between Nordic and Ornish for third place.
Among the diet plans that ranked much lower was the Dukan Diet, named for the doctor who created the plan, which limits carbs and emphasizes protein. It ranked last for both best overall plans and best heart-healthy diets.
The Dukan plan has many strengths, spokeswoman Simone Gloger says. It takes into consideration weight maintenance, is high in vegetables, and emphasizes drinking plenty of water and getting moderate exercise. It is low in fat, but ''we emphasize good fats from grass-fed meat and wild fish," she says.
In the first two of four phases, she says, you lose weight quickly, so people keep their motivation.
The Body Reset Diet, from celebrity fitness trainer Harley Pasternak, is a 15-day plan that emphasizes smoothies. It got last place for the weight loss category and for diabetes. Body Reset representatives did not respond to a request for comment.
The Nordic diet has been discussed in medical literature for a couple of years, says Connie Diekman, a registered dietitian and director of university nutrition at Washington University in St. Louis. She reviewed the findings but was not involved in the rankings. She, too, sees a growing interest in going back to nature and adopting the eating styles of places where people live a long time, such as the Mediterranean.
Some of the other winners are familiar plans, she says.
"I think the rankings continue to demonstrate what the body of evidence is continuing to tell us -- that is, we need to eat more plant foods,'' she says. The rankings seem to reflect diet plans that urge us to choose healthier fats and eat more plant foods.
Putting the Rankings to Work
"Our rankings provide exhaustive information," Haupt says. She urges dieters to look at the plan descriptions and see how well they fit with their needs and lifestyle. Among the details to consider, she says, are whether you can eat at restaurants and drink alcohol, and whether you’ll have to follow complex recipes every day.
"Study the diets, become familiar with them,” she says. “Think hard about your own preferences.'' Decide what your goal is. Then pick one that matches.
Diekman agrees. Choose from the top of the rankings, and take your preferences into account. "If you like Volumetrics better than Flexitarian, go for it."