For the sixth year in a row, the Mediterranean diet — a way of eating focused on whole grains, fruits, vegetables, lean protein and healthy fat — is the best overall diet, according to U.S. News & World Report’s annual ranking. The DASH diet, which aims to lower blood pressure, and the flexitarian diet, a modified vegetarian pattern of eating, tied for second place to round out the top three best overall diets.
“The reasons (that the Mediterranean diet is popular) are fairly simple. You’re eating delicious whole foods. It’s backed by decades of research showing its health benefits for a variety of conditions,” Gretel Schueller, managing editor of health at U.S. News & World Report, tells TODAY.com. “It’s healthy. It doesn’t cut out any food groups or specific foods. So, it allows it to be sustainable.”
The five best overall diets are:
- Mediterranean diet
- DASH diet and flexitarian diet (tie)
- MIND diet
- TLC diet
The Mediterranean diet also ranked first in several other categories, including best diet for bone and joint health, best family-friendly diets, best diet for healthy eating and best plant-based diet. WeightWatchers ranked first in best weight loss diets and best diet programs.
“When we talk about the Mediterranean diet, it’s more of a lifestyle and, therefore, we can talk about how to apply it to a variety of cuisines,” Schueller says. “You’re looking at foods that are high in fiber and whole grains, and (it) includes a lot of whole foods and moderate amounts of healthy fats.”
What’s new for 2023
This year, the publication's panel of 30 experts evaluated 24 different diets and eating plans in how they perform in 11 categories. In the past, they examined 40 diets, but that number changed for a variety of reasons.
“If you actually look at the lists of diets, you’ll see that many of the ones that we had ranked last year actually still exist. They’ve been incorporated into one of the 24 ranked diets. For example, vegan and vegetarian we used to always have them as separate ranked diets,” Schueller says. “There are a variety of reasons why we wove them into all our diets, and I think the big reasons are one, there’s been an increasing move toward plant-forward eating.”
Other diets fell out of favor.
“(The Health Management Resources Program) no longer exists, and then there’s some commercial diets where the founders of the companies no longer support the diet,” Schueller says. “We felt it didn’t make sense to rank them anymore.”
U.S. News included two new categories in which they rank diets: best family-friendly diets and best diets for bone and joint health.
“We’re always looking for new health conditions that make sense to examine. And the reality is the population is aging, and bone and join health basically addresses conditions like osteopenia and osteoporosis, as well as arthritis,” Schueller says. “Diets that ranked well for bone and joint health provide adequate calcium, vitamin D and vitamin K, and they also promote physical activity.”
When it comes to family-friendly diets, the experts considered budget and how easy it is to find enjoyable ingredients that fit within certain diets.
“You want to make sure that the eating plan offers the right nutritional value for different calorie and nutritional needs for different people of different ages, different activity levels, different health conditions,” Schueller says.
What makes eating sustainable
Diets that performed poorly, including the raw food diets (No. 24 in overall diets), keto (No. 20 overall) and Atkins (No. 21 overall) require people to cut out foods and often include a lot of rules. That makes it tough for people to sustain them for the long run.
“These very low carbohydrate diets are very popular because people can have pretty significant results really quickly,” Camila Martin, a nutritionist at UW Health in Madison, who wasn’t involved in the U.S. News rankings, tells TODAY.com. “We’ll see really quick weight loss. But a lot of that really is because of fluid shifts not because of actual changes in the body composition.”
While people might feel pleased with their initial weight loss, experts say it’s often not long lasting.
“They’re not sustainable,” Martin says. “Carbs are things that people find bring them a lot of comfort. They are the base of a lot of traditional diets and in a lot of different cultures. They’re easy to grow and (offer) a very nurturing feeling.”
She also notes that because of the complexity of these diets, people often take short cuts that can be unhealthy.
“A lot of times people will do keto and just eat bacon five times per day, and that’s really high amounts of meat,” Martin says. “It can actually lead to an increase in cardiovascular disease. So, we might see some weight loss pretty quickly. But we could potentially be putting our heart health in harm’s way.”
Diets that perform well, including Mediterranean, TLC, flexitarian and DASH, remain popular because they’re more intuitive for people to follow.
“What’s nice is Mediterranean is relatively user friend. How it’s structured is similar to the (U.S. Department of Agriculture) healthy eating plan,” Martin explains. “It’s very modifiable based off what people have access to even with limited resources.”
That means these diets appeal to a large swath of the population. Eating specially made snacks or buying shakes or meal plans can be difficult for people with budget constraints, she says. What’s more, these diets encourage people to move their bodies.
“They will have a focus on regular exercise,” Martin says. “The diets that end to be the best are all things like how accessible it’s going to be and how much people can modify it to fit in their lifestyles and how can we make this into something positive.”