Diet Dilemmas: Did US News & World Report Get it Wrong?

The US News & World Report just unleashed their list of top diets (spoiler alert: I don’t agree with everything). With all the diets and food confusion out there, many people are simply looking for answers to fight weight loss, detox or jumpstart their New Year. It can be overwhelming, and a list like this can add to the confusion. All of these diets have their pros and cons – take Keto for example, it’s great if it’s paired with the right individual who can handle a high-fat diet. And I’m confused why Whole 30 didn’t make it higher on the list? Especially since it changes the way you think about, feel about, and taste food, and most importantly – your habits and cravings. Learn more about the Whole 30 here.

Here is the rundown on the US News Report and my take on each of these diets.

Mediterranean
Hands down this is a # 1 favorite on this list, and I would have to agree. Part of the success of a Mediterranean diet is that it isn’t really a diet that you go “on” or “off,” at all. This is a lifestyle way of living and eating, which is part of its success and what makes it a great starting point for the majority of patients I meet. If you were to look at a Mediterranean food pyramid the widest base isn’t food at all—it’s having a physically active life and frequent family meals. The focus of the Mediterranean diet is on reducing inflammatory foods and increasing plant-based foods and healthy fats.
Sample foods
At the top of the list are whole fresh fruits and vegetables including red grapes, citrus, berries, avocados, leafy greens, fresh herbs, garlic, and more; whole grains (think brown rice, quinoa, and cous cous); beans, extra virgin olive oil, and nuts and seeds; fish and seafood such as Bluefin tuna, yellowtail, sardines, mussels, shrimp, and so on; and some plain Greek yogurt, eggs, and chicken.
Sample Menu
Breakfast: Make a quick yogurt bowl, or container if you don’t have time to eat at home in the mornings. It’s simple. Just put ¾ cup plain Greek yogurt, a handful of berries, and a couple tablespoons of raw pumpkin seeds in a bowl or container. You can add a teaspoon drizzle of honey if you like, and a dash of cinnamon is always yummy.
Lunch: Another meal that is easy at home or on the road is a mason jar salad. You can set these up the night before so your midday meal is ready to go when your tummy starts rumbling. There are endless variations, as long as you follow the layering rule: dressing first, then the most sturdy vegetables and fruit (carrots, celery, apples), then the leafy veggies and tomatoes, and finally your protein (tuna, chicken, chickpeas). Here’s one of my favorites: In a 16 ounce mason jar (you can also use a plastic container). Add each ingredient in the following order layer:

  • ½ teaspoon each extra virgin olive oil and balsamic vinegar, ½ teaspoon salt, dash pepper
  • ¼ cup each grated carrot, chopped cucumber, and diced apple
  • 1 cup spinach or kale, chopped
  • 2 tablespoons feta cheese, crumbled (substitute raw sesame seeds for vegan)
  • ½ cup chickpeas, 5 ounces chicken, or 1 hard-cooked egg (choose one)

Seal your container and store in the fridge. When you are ready to eat, dump it all into a bowl and mix. You can make five of these variations on a Sunday and be set for the week.
Dinner: For a super delicious dinner that incorporates many Mediterranean superfoods including almonds, fresh parsley, fresh salmon, and extra virgin olive oil, try my recipe for Almond-Encrusted Wild Salmon Fillets. Pair this with a green salad and some brown rice and you are good to go.
Pros: It’s simple. This diet focuses on eating real foods and avoiding processed ones. It limits red meats and refined sugars and flours to a special treat, not an everyday habit.
Cons: Since this is a pattern of eating it doesn’t come with detailed portion control guidelines, which can make it difficult especially for those looking to shed excess weight. Also, if you aren’t a fan of fish, you’ll probably have to make a dedicated effort at this eating style.

Dash
Running a close second comes the Dietary Approaches to Stop Hypertension (DASH) diet, which was initially designed by The National Heart, Lung, and Blood Institute for patients with hypertension (high blood pressure). This diet focuses first on reducing sodium intake and optimizing potassium, calcium, protein, and fiber intake. Don’t worry. This doesn’t mean that you’ll be counting every ounce of each micronutrient you put in your mouth. You just focus on maximizing healthy foods including whole (fresh or frozen) fruits and veggies, whole grains, lean protein, low fat dairy, and healthy fats.

Sample foods: Whole wheat grains, cereal grains (oatmeal, grits), brown rice, broccoli, carrots, leafy greens, sweet potatoes, apples, apricots, bananas, dates, mangoes, low fat or fat free dairy products, lean meats (poultry and fish), almonds, hazelnuts, peanuts, peanut butter, vegetable oils, and minimal sweets.

Sample Menus:
Breakfast: Mix 2/3 cup plain cooked oatmeal with ½ cup plain Greek yogurt, 2 teaspoons almond butter, and half a banana, diced. Top with a half-cup of thawed or fresh mixed berries.
Lunch: Make an easy Salmon Salad:
The Dressing – In a small container or jar with a lid add: 1 tablespoon fresh lemon juice, ½ teaspoon Dijon mustard, 2 teaspoons extra virgin olive oil, and a dash of salt and pepper. Put on lid and shake well. Set aside.
The Salad– In a large bowl add 2 cups of greens (I like an equal mix of chopped baby kale, spinach, and arugula); 8 grape tomatoes, sliced in half; 3 ounces cooked salmon fillet (can used canned), ½ tablespoon Parmesan cheese, grated. Pour dressing over your salad and toss.
Note: If you’ll be packing ahead, keep the dressing in its container and transfer the salad to another container. Mix when you are ready to eat.
Dinner: Keep it simple, especially during the week days. I like to bake, roast, or grill a batch of chicken breasts ahead of time. Ditto for some roasted veggies and brown rice. With these items prepped ahead of time I can have a hot meal ready for myself and family in no time. I portion out 3 to 4 ounces of chicken; a cup of veggies, roasted or steamed, and a ½ cup of brown rice. You can get creative by making a fast “fried” rice variation by dicing up the chicken and veggies, using a little soy sauce. Just toss it all together and heat till warm. Voila!

Pros: As with the Mediterranean diet, DASH maximizes natural and whole foods and limits inflammatory culprits. In addition, DASH gives general and practical calorie-need recommendations for men and women based on age and activity, which allows you to corral in any over-the-top portions. DASH also suggests a gradual incorporation of their eating style, rather than a cold-turkey approach. I find that my patients do much better with this type of program than one that has them make drastic changes all at once. The DASH diet also offers free links to tracking tools, food lists, sample menus, and more that are available as an in-depth or an in-brief format.

Cons: I’m not a fan of some the things listed on the DASH diet, even in sparing amounts. These include pretzels, margarine, fruit punch, fruit juice (whole fruit is always better), hard candy, and sugar. Even in limited amounts these foods are just empty calories, and there are much better and more satisfying options (see the sample menu above). Finally, the DASH diet can lean a little too heavily on processed grains. You’ll see granola bars and boxed cereals as a regular appearance on their menus. Plus, even if you choose whole grain breads, English muffins, and bagels these can have many hidden ingredients and sweeteners—and the actual whole grains can be overly-processed and exposed to pesticides! That’s why I’m a fan of eating grains that are organic and as near to coming out of the ground as possible—think oats, bulgur, and brown rice.

Flexitarian
Coming in at #3, the Flexitarian diet, like the previous two eating strategies, focuses on plant based foods. The name refers to a blend of vegetarian and flexible—in other words—some animal protein, fish, poultry, and meats allowed, but with an emphasis on vegetarian and vegan eating. It all boils down to an “eat more plants” mantra. Maybe you’ll eat vegan on Monday through Thursday, and then have a meat-based meal or two over the weekend. There are several variations of this diet available today, but the term was coined by registered dietitian Dawn Jackson Blatner, author of The Flexitarian Diet.

Sample Foods: Proteins include mostly tofu, legumes, lentils, peas, nuts and seeds, and eggs; fruits, veggies, dairy, and grains are the same as I’ve already covered; and they include dried herbs, salad dressing, and agave nectar sweetener.

Sample Menus:
Breakfast: Mix 1 tablespoon almond butter, ½ diced banana, and ½ diced apple into 2/3 cup hot cooked plain oatmeal, add a splash of unsweetened almond milk.
Lunch: 2 slices sprouted grain or gluten-free bread, topped with 1 vegetarian burger (cooked according to package directions), Lettuce, tomato, mashed ¼ avocado with salt and pepper to taste.
Dinner: Stir fry for two, made with 4 ounces chicken, 2 cups stir-fry veggies, 2 teaspoons peanut oil, ¼ ground ginger, ½ teaspoon granulated garlic, 1 to 2 tablespoons soy sauce, and 1 cup brown rice.
Snacks: The Flexitarian Diet typically includes two snacks a day that consist of items such as a piece of whole fruit and 1 tablespoon raw pumpkin seeds, or 1 tablespoon nutbutter on celery sticks.

Pros: Research consistently finds that vegetarians and vegans tend to have fewer rates of overweight and obesity than meat lovers. Also, while you have a better chance of lightening up, your wallet may stay heavy. Less animal protein, and more legumes equals a diet that’s budget-friendly. Plus, plant-based eating is easier on your heart because it favors healthy fats and more fiber.

Cons: In Blatner’s Flexitarian plan, the majority of daily menus come in at 1300 to 1600 calories, which might tad light for those who are highly active (and most men in general), so it’s good to check and track what you are eating.

Paleo
The Paleo diet, highly trendy in recent years, may be less visible in 2018. With a protein heavy, no grain focus, Paleo has been helpful in reversing autoimmune disease and weight gain in many patients.

Sample Foods: Lean proteins: grass-fed meat and poultry, eggs, and wild caught fish. Whole complex carbs. Limited fruit. Non-starchy veggies including: cauliflower, kale, and squash. Nuts and seeds. Healthy fats.

Sample Menus:
Breakfast: Paleo Pancake Imposters (my kids love these): In a medium bowl mix together ½ cup paleo pancake mix, 4 eggs, and 1 tablespoon coconut oil. In a small bowl mix together 1 tablespoon dark chocolate chips, 1 tablespoon chopped walnuts, and 1 teaspoon unsweetened coconut flakes. Heat up a nonstick skillet or griddle over medium heat, and pour batter into 3” to 4” circles. Sprinkle on equal portions of toppings from your small bowl. Turn over pancakes when top is covered with bubbles on surface. Continue cooking until bottom is brown. Divide between two plates and drizzle each portion with ½ teaspoon honey.
Lunch: Keep it easy with a straight forward spinach salad, chopped red bell pepper, oil and vinegar, and diced chicken.
Dinner: Try my version of Pancit Paleo Style (makes four servings). If you’re not familiar, Pancit is an insanely easy Filipino noodle dish, traditionally made with rice noodles, whatever meat, fish, or poultry you have leftover or on hand, and veggies. Here is my version (just swap out the rice noodles with zucchini ones), and you can have this dinner on the table in less than an hour. To throw this together you’ll need:

  • 1 teaspoon peanut oil, organic and cold-pressed
  • 2 to 3 cups of spiralized zucchini noodles (if you don’t have a spiralizer, you can find these already prepped in many health food stores)
  • ½ onion, diced
  • 1 teaspoon granulated garlic powder
  • 2 cups diced cooked chicken breast, shrimp, or grass-fed beef
  • 1 cup frozen peas and carrots, thawed
  • 2 tablespoons soy sauce
  • ¼ cup fresh cilantro, chopped
  • 2 lemons or limes, cut into wedges
  1. Heat peanut oil in a large nonstick skillet or wok, and add onion and “noodles.” Stir fry on medium high for five minutes stirring frequently.
  2. Add meat, veggies, and soy sauce, and continue to stir until heated through.
  3. Split into four equal portions and serve with cilantro garnish and citrus wedges.

Pros: Paleo diets, like all that make the top rating on this report, focus on whole foods, but they are especially adamant about eliminating processed and refined sugars and flours. I also am a fan of grass-fed animal meats, eggs, and dairy products that paleo diets prioritize.

Cons: While many of my patients come to me excited about a new paleo diet, after a while they tend to come back saying that it didn’t last. The reasons vary. It was too strict, they miss yogurt and cheese, or they gave into a bread-basket binge. This is one of the problems with diets that radically exclude a major food group. That said, not all paleo diets are like this, and you can apply some flex-paleo strategies (to riff on flexitarians) to make this type of eating work in a more moderate fashion (see my sample menu above for examples).

Ketogenic
The newest diet trend on the market, the ketogenic diet has gained popularity with its focus on fat burning by putting the body into a state known as ketosis. This metabolic process occurs when the body lacks glucose to the point where it can no longer break it down for use as an energy source. The result of ketosis is a body that burns fats instead of sugars. This is a strategy that may be successful for those who struggle with stubborn excess weight challenges, especially those rooted in insulin and blood sugar regulation. Similar to Paleo, but with even fewer options of having carbohydrates. To put it another way, like Atkins, but more intense, keto diets require severe restrictions of carbohydrates, keeping them at 5 percent, while eating 60 percent of your daily calories in fats, and 35 percent in protein.

Sample Foods: Your proteins will be similar to those listed under the paleo diet above. There will be minimal servings of fresh berries and avocados (they are a fruit, remember). Vegetables tend to be green and more green, from leafy greens to broccoli, asparagus, Brussels sprouts, and so on. Nuts and seeds as on the paleo plans. Dairy is okay with keto eating, so expect to see cheese, Greek yogurt, sour cream, butter, and heavy cream. Fats include flaxseed, butter, sesame, olive oil, and almond oil. You won’t see any grains.

Sample Menus:
Breakfast: Scrambled eggs and spinach with some sliced avocado.
Lunch: Bluefin Tuna salad with oil and vinegar dressing.
Snack: Raw Pumpkin seeds and some Greek yogurt.
Dinner: Grass-fed steak with steamed asparagus and butter, and a kale salad on the side.

Pros: Can be especially helpful for those who struggle with long term overweight and obesity, especially related to insulin and blood sugar regulation. This is another diet that relies on whole foods and avoids processed ones.

Cons: The strict and limited nature of the ketogenic diet can make it a tricky to navigate and more difficult to follow. You also need to be extremely careful to eat only the healthiest of fats, especially since you’ll be eating such a high proportion of your calories from these highly dense nutrients. Finally, be warned that if you start a ketogenic diet you may experience something referred to as “keto flu,” during the first week or two of eating this new way. These side effects can include feeling fatigued, having headaches, and maybe some stomach upset.

Weight Watchers
This world-famous diet still ranked high on this year’s report and I still like Weight Watchers for its attention to customizing calorie needs, but it falls sort when it comes to looking closely enough at specific sources and recommendations for nutrients such as healthy fats, carbohydrates, sugars, and so on.

What is the best diet in 2018?
With an abundance of diets to choose from and conflicting information everywhere, here are my absolute food rules that work for everyone.

Dr. Taz Food Rules

  1. Lose the sugar. It is our #1 enemy—look for it in all its hidden forms—sweets, drinks, dressings, and sauces. Your number: Under 3 teaspoons or 25 grams per day.
  2. Lose the salt. Dash or no dash, salt is affecting insulin as much as sugar, according to recent research. Your number: under 1500 mg per day.
  3. Keep a fasting interval. Not eating for a certain number of hours is a good thing. This allows the gut to rest and prevents calorie overload. Your number: Maintain an interval where you don’t eat for 12-14 hours. Think about closing the kitchen at 6 pm and not opening it again until 6 to 8 am.
  4. Eat more fat. Healthy fats that is. It keeps you feeling full! Your number: Aim for 20-30 grams per day.
  5. Eat those veggies. It’s a constant among all winning diets. Your number: At least 6 servings per day. Choose your favorite veggies and have fun with them.

While every diet needs to be tailored and individualized to you, follow these food rules to get a jumpstart on the New Year. Try working with a physician well-versed in nutrition, gut function, and hormones so that you can uncover any “chemistry” blocks to your best health. Happy New Year!!!