Need a Pandemic Change? Go Mediterranean

If the pandemic has you feeling restless, locked down, eager for adventure, here's an idea: Go Mediterranean.

While the idea of a trip there may be too arduous, with testing and the spread of the Omicron variant, the Mediterranean diet could be the change of pace you need. It promises to help you live longer and ward off chronic diseases. And it's just been named the No. 1 best diet overall ― for the fifth straight year ― in the U.S. News & World Report annual rankings of diet plans.

It earned the top spot in multiple categories, including easiest diets to follow, best for healthy eating, best for diabetes, best plant-based diets, and best heart-healthy diets (tied for first in that one).

For this year's rankings, the 12^th annual for the report, US News ranked 40 diet plans in all.

"There are no huge surprises in the winners," says Gretel Schueller, US News's managing editor of health. The Mediterranean diet, she says, "has been our long-ranging champion for a long time."

To determine the rankings, US News gathered an expert panel of top specialists in nutrition, diabetes, heart health, and weight loss. The experts praised diets that provide adequate calories, modest lean protein, and the occasional treat, Schueller says.

The panel ranked the 40 plans across nine categories. Besides best diet overall, the categories are:

Best diet plans (formerly best commercial diets)
Best weight loss diets
Best fast weight loss diets
Best diets for healthy eating
Easiest diets to follow
Best diets if you have diabetes
Best diets if you have heart disease
Best plant-based diets

And the Other 2022 Winners Are...

Best overall: After the Mediterranean diet, which focuses on fruits, vegetables, whole grains, and olive oil:

The flexitarian (mostly plant-based) and the DASH diet tied for second place. The flexitarian is a plan that could work for the entire family, one expert on the panel says. DASH stands for Dietary Approaches to Stop Hypertension and includes fruits, vegetables, whole grains, and low-fat dairy foods. Experts say it is nutritionally complete and can help prevent or control diabetes.

Best diet plans:

The Mayo Clinic Diet and WW tied for first place. The Mayo Clinic Diet emphasizes fruits, vegetables, and whole grains. It helps people change their eating habits and replace bad habits with good ones. WW (formerly known as Weight Watchers) focuses on not just weight loss but healthier eating and living. Its Points program is more personalized now, taking into account users' preferences.
Jenny Craig came in third. It offers meals and recipes, and it emphasizes healthy eating and an active lifestyle, along with changing your behavior.

Best weight loss diets: This was a three-way tie for first place:

Flexitarian
Volumetrics, which is more of an approach to eating than a structured diet. It helps users cut the energy density of meals and make choices that fight hunger.
WW

Best fast weight loss diets:

Atkins took the top spot. Atkins was created by Robert Atkins, MD, a cardiologist who proposes four phases to the diet, beginning with very few carbs and then progressively eating more until you reach the weight you want. Two other diets tied for second place:

HMR Program (Health Management Resources Program), a weight loss system and lifestyle-change program meant to reduce calories with meal replacement with added fruits and vegetables
OPTAVIA diet, which was developed by the experts behind Medifast. The focus is also on healthy habits to improve weight loss.

Best diets for healthy eating: The Mediterranean was first, followed by a tie for second with:

DASH diet
Flexitarian diet

Easiest diets to follow: The Mediterranean was first, followed by flexitarian; then a three-way tie for third:

MIND diet, which blends the DASH and Mediterranean and focuses on foods that improve brain health
Fertility diet, which suggests that tweaking parts of your diet, from fats to beverages, can increase ovulation and improve pregnancy chances
WW

Best diets for those with diabetes: Mediterranean is best, followed by a tie for second:

Flexitarian diet
Vegan diet, which goes beyond a traditional vegetarian diet, with followers excluding all animal products, including dairy and eggs

Best heart-healthy diets: Again, Mediterranean took the top spot, tied with the Ornish Diet, which is heart-healthy but not easy for everyone to follow due to its restriction of fats. Next up was the DASH diet.

Best plant-based diets: Mediterranean, flexitarian, and vegetarian came in first, second and third, respectively.

Low on the List

On the overall list, the Dukan Diet was last, at No. 40. Last year, it was ranked 39^th overall. It limits carbs and emphasizes protein. The Whole 30 did poorly, too, tied for 35. The keto diet, while extremely popular with consumers, came in at No. 37. But it is ranked fourth (tying with others) for best fast weight loss.

Efforts to reach officials with Whole 30 and Dukan Diet for response were unsuccessful.

Addressing the Diet du Jours

Two new diets were evaluated, Schueller says: the Sirtfood Diet, the plan that reportedly helped singer Adele lose 100 pounds, and intermittent fasting, an approach where users fast for various periods of time each day or on specific days of the week.

The Sirtfood Diet Gets its name from a group of proteins called sirtuins, found in plant foods. The diet claims to mimic the effects of fasting and exercise to help the body burn more energy.

On intermittent fasting plans, Schueller says, followers may choose not to eat during a window of 12 or 16 hours, or they may fast a couple days a week.

Neither of these ranked well, Schueller says. Sirtfood came in 17^th in the weight loss category, and intermittent fasting was at 20^th place or below for the categories it placed in.

Healthy Trends

Dieters want support or built-in community, Schueller says. For instance, part of the appeal of the Noom diet, she says, is that members are assigned a coach and placed in a support group. The idea is to motivate the person to stick with the plan.

Community support, in the form of either in-person or virtual meetings, has long been a draw of the WW program. Noom also encourages users to focus on foods with lower calories, and also encourages self-awareness about why people eat what they do.

To highlight the community aspect, the report includes information on support provided by various diets. For instance, for the WW plan, support is available with activity trackers, a restaurant database, more than 10,500 recipes, on-demand workouts, coaches, online and in-person workshops, and online support groups, among other resources.

The report includes information on how effective the diet is and how easy it is to follow, among other details.

This year, US News is also offering a free, 7-day healthy eating course that people sign up for by email, Schueller says. Concepts that can be applied to any plan are described, she says.

Registered Dietitians' Perspective

WebMD asked two registered dietitians to review the rankings and comment.

"It is not surprising to me that the Mediterranean diet is once again the top-rated diet," says Christine Rosenbloom, PhD, a registered dietitian, nutrition consultant, and retired professor at Georgia State University in Atlanta. "It is backed by research, specifically research to lower cardiovascular disease risk. Since 60% of adults have at least one or more diet-related chronic condition, this plan can be used to get healthy and stay healthy."

But, she stresses, it's important to understand that the Mediterranean diet is not all pizza, pasta, and olive oil, "along with endless salad bowls and all-you-can-eat breadsticks."

Rather, the diet is rich in seafood, vegetables, nuts, grains, and yes, olive oil, she says.

What Rosenbloom wishes wasn't in the report: the category for quick weight loss diets. Losing weight quickly is often followed by gaining it back once dieters go off the plan, she says.

Another tip: She wishes people would think of 'diet" as a noun, as in the usual food pattern you eat, instead of a verb meaning to restrict calories to lose weight.

'Because from the Dietary Guidelines for Americans to every other health organization, the recommendation is to eat a healthy pattern of foods versus restrictive eating to lose weight," Rosenbloom says. 'Many of the diets reviewed for this report emphasize healthy eating patterns that one can customize, reflect one's cultural values, respect one's personal choice, and consider budgetary constraints."

Also crucial, she says, is to consider if the diet is one that can be sustained.

"A healthy diet should be one that can be followed for life ... not just to fit into a certain dress size or pants for a family wedding or high school reunion," she says.

It's also important to look at how restrictive a diet is, says Connie Diekman, a registered dietitian and nutrition consultant in St. Louis.

Adding restrictions makes it less likely someone will follow the plan long-term.

"The more restrictive an eating plan, the harder it is to follow for any longer than the short term," Diekman says. "As a registered dietitian, my goal is to guide consumers to eating plans they enjoy and that they can maintain."

Behavior change is also key to a healthful eating plan, she says, and diets in the top spots reflect that.

"If people are looking to develop a better eating plan choosing either the Mediterranean diet, number one on the list, or any of the others in that top category, they will have chosen a plan that provides a variety of food choices, a balance of needed nutrition, and the flexibility that we all need to maintain an eating plan," she says.

Sources

U.S. News & World Report: "Best Diet Rankings for 2022."

Gretel Schueller, managing editor of health, U.S. News & World Report.

Connie Diekman, registered dietitian; food and nutrition consultant; former president, Academy of Nutrition & Dietetics, St. Louis.

Christine Rosenbloom, PhD, registered dietitian and nutrition consultant; retired professor, Georgia State University.

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