A new list places the Keto and Whole30 diets at the bottom and the DASH and Mediterranean diets at the top. What the experts think about the gap.
Have you decided to eat healthy in 2018? Some approaches to eating may be more sustainable or healthy than others.
In its latest annual assessment of the best diets of the year, U.S. News & World Report ranked the Whole30 and Keto diets at the bottom of the list.
Of the 40 plans valued, the Whole30 plan was ranked among the last three.
The Keto regime was tied with the Dukan regime for last place.
In contrast, the DASH and Mediterranean regimes were tied for first place.
According to the recent press release from the press office, the rankings were conducted by a panel of nutritionists, dietary advisors and doctors specializing in diabetes, heart health and weight loss.
The organization has also published rankings of the best commercial diets, weight loss diets, herbal diets and several other categories of diets.
Why DASH and Mediterranean are well ranked?
The DASH and Mediterranean regimes have been consistently well ranked by the U.S. News & World Report for several years.
The DASH diet was designed to prevent and lower high blood pressure, a risk factor for heart disease and stroke.
The Mediterranean has also been associated with a lower risk of cardiovascular disease and a lower incidence of cancer.
Both diets consist of diets that focus on vegetables, fruits, whole grains, lean protein and low-fat dairy products.
Similarly, both diets limit saturated fats and refined sugars.
“I think the great thing about the DASH diet – and it will actually be true for the first three or four diets – is that there is a huge amount of evidence behind it for its ability to reduce chronic disease,” Kristin Kirkpatrick, MS, RD, LD, a registered dietitian who is the manager of wellness nutrition services at the Cleveland Clinic Wellness Institute, called Healthline.
“It’s also very durable,” added Kirkpatrick. “I’m talking about someone’s ability to stay there for more than 30 days.”
Similarly, Katie Ferraro, MPH, RD, CDE, Registered Dietitian and Clinical Assistant Professor at the University of San Diego and the University of California at San Francisco, highlighted the reduced incidence of chronic diseases associated with the DASH and Mediterranean diets.
“If you look at these diets, the best ones overall will help you prevent a majority of chronic diseases, and one thing they have in common is a strong dependence on products,” Ferraro told Healthline.
“One of the things I like about the DASH diet is that it contains between 7 and 10 servings of fruits and vegetables a day,” she added. “You’re so busy eating fruits and vegetables that you don’t have room to eat more shitty stuff.”
Although Kirkpatrick and Ferraro agreed that the DASH and Mediterranean diets would be healthy choices for many people, they noted that no diet is perfect for everyone.
For example, the top two diets are high in carbohydrates, which may not be ideal for some people trying to lose weight or manage their insulin resistance.
“If I look at something like the Mediterranean diet, for some people with type 2 diabetes, their carbohydrates tend to go much too high. It doesn’t always help them,” Kirkpatrick said.
Dr. Priyanka Wali, a Californian doctor certified by the Board of Directors, expressed even stronger reservations about the relevance of a Mediterranean diet for people with diabetes.
“If someone has a history of diabetes, they should follow a diet that is very low in carbohydrates,” she told Healthline.
“I could never, in all good conscience, tell a person with diabetes to eat brown rice, which is part of the Mediterranean diet,” she continues, “because brown rice, regardless of its glycemic index, is loaded with carbohydrates. And if you have diabetes, you are very sensitive to carbohydrates.”
Whole30, Keto diets may be difficult to follow
This can make them more difficult to monitor in the long term.
“It is too restrictive and, in that sense, it is not sustainable,” Ferraro said of the Whole regime30.
“Maybe you could make it through 30 days, but if you think about all the data we have on behaviour change and the effect on weight loss, you need to start a lifestyle change if you want to achieve long-term results,” she continued.
Ferraro and Kirkpatrick suggested that the Keto diet can also be difficult for many people to follow, partly because of the extreme restrictions it imposes on carbohydrate consumption.
Both also raised concerns about the high fat content of the Keto diet and the lack of high-quality evidence on its use outside certain patient subgroups.
Studies have shown that a ketogenic diet is useful in controlling seizures in patients with epilepsy.
But less research has been done on many other groups of people for whom a ketogenic diet may be of interest.
“I found this when I talked to doctors across the country. They are dying to get the evidence, but we don’t have it yet,” Kirkpatrick said.
“If you have type 2 diabetes, will the Keto diet reverse it? It is possible, but we do not yet have enough studies to prove it,” she continued.
In contrast, Wali expressed more support for the Keto diet in people with diabetes and other conditions associated with insulin resistance.
“I think it is actually a very important tool, especially for people with medical problems such as diabetes, prediabetes, polycystic ovary syndrome, and fatty liver. These are all indications that you basically have insulin resistance, which means that the hormone levels in your body are unbalanced because of your diet,” Wali said.
Wali noted that other factors can also contribute to insulin resistance, including genetic predisposition, sleep patterns, and stress. She said that many of her patients have successfully followed a ketogenic diet for years.
To support its use, she referred to a review article published in 2015 in the journal Nutrition, according to which carbohydrate restriction reduces hyperglycemia in people with type 2 diabetes.
Another review article recently published in BMJ Open Diabetes Research & Care found that low and moderate carbohydrate diets have a greater effect on glycemic control in type 2 diabetes than carbohydrate-rich diets.
“But again, that doesn’t mean that Keto is for the world because not everyone has these conditions. Some people can eat a ton of carbohydrates and have no side effects,” Wali added.
Plans must be individualized
Kirkpatrick, Ferraro, and Wali presented different views on the U.S. News and World Report’s food ranking.
Ferraro suggested that ranking can provide useful advice to patients and caregivers.
On the other hand, Wali argued that “the idea of classifying diets is in fact completely bogus”.
However, everyone agreed on one point: There is no one-size-fits-all approach to healthy eating.
They suggested that it is better to limit the consumption of sugar and other refined carbohydrates.
In addition, they encouraged readers to make an appointment with their doctor or dietitian to develop a food plan that is appropriate for them.
This plan should take into account their individual medical history, chronic disease risk factors, food preferences and goals.