For the fourth year in a row the Mediterranean diet ranked first in overall best diets, according to U.S. News & World Report’s annual list. DASH and flexitarian diets tied for second place in overall diets; the former focuses on lowering blood pressure and the latter is a modified vegetarian diet. The experts say such rankings aren’t surprising as all three diets share similarities: They’re easy to follow and focus on what foods people can include, not exclude.
“The Mediterranean pattern of eating is that it’s really centered around what are the foods that you add in as opposed to the foods you take away,” Maya Feller, a registered dietician in Brooklyn, told TODAY. “What you see with that pattern of eating is that it is supportive of multiple cultures and foods, where sometimes a ‘conventional diet’ means you have to eat this specific way and doesn’t allow for that flexibility and individualization.”
Here are the top diets of 2021, according to U.S. News & World Report's panel of nationally recognized health experts:
- Mediterranean diet
- Flexitarian diet and DASH diet (tied)
- MIND diet, volumetrics, Mayo Clinic diet, TLC diet (tied)
- Ornish Diet, vegetarian diet, Nordic diet (tied)
What is new in 2021?
For the first time, the publication examined Noom, which offers support for its members through its app. Noom tied Jenny Craig for third in the best commercial diet category and ranked No. 12 in overall diets.
As for commercial diets, WW (formerly Weight Watchers) ranked first while the Mayo Clinic diet came in second.
“That’s a really good showing (for Noom). It’s been a long time since we had a new diet that came in and really performed so well in its very first year,” Angela Haupt, managing editor of health at U.S. News & World Report, told TODAY. “That’s been one of the highlights for me, to get to learn more about a new diet and see it rank so well. It’s a good diet that will be a smart choice for a lot of people.”
Extra support might be more important than ever when one considers changing eating habits.
“There's a strong psychological component to Noom, which isn't necessarily in other eating patterns. That can be helpful,” Leslie Bonci, a registered dietitian and owner of Active Eating Advice, told TODAY, adding this is essential “especially right now when people are feeling so incredibly isolated because of the pandemic.”
Diets like Whole30 (focused on whole foods) and ketogenic diet (a moderate protein, high-fat, low-carb diet), which are popular, continue to perform poorly because they can be difficult to follow. The publication examined the modified keto diet for the first time, but it also fell toward the bottom of the list, coming in at 35 on the overall diets, tied with Whole30. Keto was ranked 37 out of 39 diets.
“It did not have the absolute bottom-of-the-barrel showing, but it also did not perform quite as well as I wondered if it might,” Haupt said. “This is a healthier version of keto … It's a less drastic form of that classic keto diet, which has never ranked well for us.”
The publication also looked at meal delivery kits, which have become more popular during the pandemic.
"We explored meal kits, but in terms of matching them to the best diet," Haupt said. "If you are somebody who likes to get your food delivery kits when you're thinking about which diet is best for you in 2021, I do think you want to take a look at what those options are."
Is anyone even thinking of dieting in 2021?
After lockdowns, social distancing and an ongoing pandemic, many don’t even want to think about weight loss or dieting. And experts say they shouldn’t. Instead they should think about eating for health.
“This year has had so much negativity in so many ways that when people think about diets, it's very negative: 'What do I have to give up?'” Bonci said. “It becomes one more negative thing in all of the things we're not doing. So we're judging ourselves on what we could be doing better. And that doesn't necessarily promote good mental health, nor does it necessarily promote good physical health.”
Feller said right now she tells her patients to forget about the numbers on the scale.
“In terms of our conversation, that's not what we're talking about. We're talking about specific metabolic markers: Where is your blood sugar? What does your blood pressure look like? What does your lipid profile look like? Where's your cholesterol?” she said. “What I found with my patients is that those numbers are much more predictive of their health outcomes. When we're thinking about those numbers, it then becomes how do you modify your nutrition pattern and your lifestyle?”
Like the three top ranking diets encourage, incorporating more fruits, vegetables and whole grains into one’s diet doesn’t make healthy eating odious. And it can have a real impact on one’s overall health — that might coincidentally lead to some weight loss.
“Those patterns of eating are really reasonable, right? They are sustainable. They are customizable. They allow for flexibility. They allow for religious and cultural variation,” Feller said. “For the average person who's trying to impact their metabolic health, there will probably be great clinical outcomes.”
These eating patterns are also compatible with different budgets. Due to the COVID-19 crisis, more than 50 million Americans, which includes 17 million children, are facing food insecurity, according to Feeding America. The nation’s largest anti-hunger organization said that is an increase of 50% from last year.
“The number of people experiencing food insecurity has increased very dramatically since the start of the pandemic,” Feller said. “We’re going to have to think about accessibility. If you can get dry beans and if you have dry beans you can make a million dishes and that falls into all three of those patterns of eating.”
Stocking up on something like dry beans or whole grains can also reduce the number of trips one takes to the grocery store, reducing their risk of COVID-19 exposure, too.
Focus on overall health
When people consider changing eating habits, Feller recommends they think about their overall health and ability to follow it.
“Once you restrict to the point that you're not able to include certain foods, then a psychological component is born out of that, that's an adverse outcome. If we start to see a shift in your lipids or how your body is metabolizing sugars, then that could be an adverse outcome,” she said. “(Good health should be) the guiding beacons for people. So what's happening? Do you feel good on energy? Are you able to engage in activities of daily living? Is it sustainable? How are your labs? And how's your mental health around it?” The answers to these questions have much greater significance than a number on a scale.