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Experts say the Mediterranean and DASH diets have the best foundations and are among the easiest to follow. Linda Raymond/Getty Images
  • The Mediterranean and DASH diets are once again at the top of an annual list of best diets.
  • Nutritionists say that’s because they have the best foundations and are among the easiest to follow.
  • They advise people trying to eat healthier to be flexible with their favorite diet and try not to change too many things at once.

The Mediterranean diet has been ranked first in best overall diets for the fourth year in a row with the DASH diet coming in a close second.

That’s according to U.S. News & World Report’s annual list.

This is no surprise to nutrition experts.

“These diets are ranked so high because they not only have the most data behind them, but the data is strong,” Kristin Kirkpatrick, MS, RDN, the author of “Skinny Liver,” told Healthline.

“They are both well researched and have been proven to improve health outcomes in select populations,” added Caroline West Passerrello, MS, RDN, LDN, CLT, a spokesperson for the Academy of Nutrition and Dietetics.

“They are certainly among the most researched and scientifically well-supported styles of eating, which plays a big role,” Andy De Santis, RD, a weight-loss specialist, told Healthline.

“There are endless studies at this point demonstrating the health benefits of both the DASH and Med diet in terms of reducing risk of all sorts of negative health outcomes like certain types of cancer, heart disease, and diabetes,” he added.

In one recent study, researchers analyzed 121 trials that enrolled nearly 22,000 adults who were overweight or obese.

The participants followed one of 14 popular diets, including the DASH and the Mediterranean diets, for an average of 6 months with a follow-up at the 1-year mark.

While overall health improvements in blood pressure and cholesterol levels were not found to be sustainable in the long term, there was one notable exception: Reduced LDL (“bad”) cholesterol levels while on the Mediterranean diet persisted at one year.

Nutrition experts suggest the Mediterranean and DASH diets see greater success long term because they are easier to follow.

“Both diets (as well as their combination, the MIND diet) are found to be easy to sustain long term and associated with reduction of chronic disease,” said Kirkpatrick. “The MIND diet has so much strong data and tends to be easier to follow for so many of my patients.”

“It’s a combination of Med and DASH with a high attention on plants, lean poultry, olive oil, etc. (10 healthy foods) and 5 unhealthy foods to nix which are sweets and pastries, fried foods, butter, cheese, and meat,” Kirkpatrick added.

Adding certain foods such as fresh fruits, whole grains, and fatty fish to your diet is a more sustainable strategy than eliminating and restricting items, say experts.

“The DASH and Mediterranean diets both involve changes to eating patterns and are flexible to meet the needs of many individuals,” said Passerrello. “They also align with an assets-based approach, what foods and habits can we focus on to improve health, which makes them easier to follow and more appealing than a deficit approach, or foods to avoid.”

De Santis agrees.

“They are among the least convoluted, least restrictive, and most sustainable ‘diets’ just simply because they are based on logical foundations and incorporate, rather than restrict, a wide array of food groups,” he said.

“The Med diet is essentially the halfway point between the ‘average American’ diet and veganism,” says De Santis.

“No one says you have to be vegan, vegetarian, or even pescatarian, but if you eat more like one (like the Med diet prescribes), it will be to your benefit,” said De Santis.

Long-term changes don’t happen overnight, though.

“Take it slow,” advises Kirkpatrick. “Making too many changes all at once can be hard to sustain.”

She recommends sticking with a whole foods diet and determining what the one thing is that you should change the most.

“Then, focus on that for the next 6 weeks before moving onto another behavior change,” she said.

When it comes to the DASH diet and reducing alcohol consumption in particular, Kirkpatrick has her clients limit the days of consumption (for example, only drink on weekends), and to try non-alcoholic and lower-alcohol options such as mixing seltzer water with white wine instead of an entire glass of white wine.

You can also find support by following the slogan for National Nutrition Month 2021 and “Personalize your Plate,” says Passerrello.

“Everyone’s plate is going to look different from each other and our own plates will look different day-to-day and meal-to-meal, which is expected,” she said.

“Check out the newly revamped MyPlate website where you can access a plan that provides recommendations for food groups to include, and you can choose what foods meet those recommendations,” she added.

Still not sure how to make lasting changes?

“Meet with a registered dietitian or nutritionist that aligns with your philosophy of eating if you aren’t sure how to personalize your plate,” said Passerrello.

Beyond specific dietary patterns, nutrition experts are seeing emerging health trends toward less meat, less alcohol, and less sugar consumption.

Experts say people are taking positive actions in these areas despite the lack of backing from dietary guidelines.

In late December, federal officials released the 2020-2025 Dietary Guidelines for Americans. They did not include a reduction in the recommended intake of alcohol and sugar, a move criticized by some organizations.

“The scientific report from the Dietary Guidelines Advisory Committee found that the current evidence justifies tightening the alcohol guideline for men to no more than one drink per day, to match the recommended limit for women,“ a statement from the American Institute for Cancer Research says. “AICR recommends that, for cancer prevention, it is best not to drink alcohol.”

While these changes were not implemented, and industry pressures are cited as an explanation, experts are nonetheless noticing gaining interest in plant-based, lower-sugar, and alcohol-free lifestyles.

“I’m seeing a trend with my patients to drink less,” said Kirkpatrick. “Intermittent fasting, and specifically, time-restricted eating, has also been trending.”

“Trends focus on foods and patterns of eating to support our immune function and improve both our mental health and gut health,” explains Passerrello.

“Consumers are still interested in eating less sugar and red meat, but they are approaching it differently. Focusing on more unsweetened beverages (like sparkling water) and a flexitarian approach that has them eating more meatless meals,” she said. “I also see a welcome trend toward rebuking diet culture.”

“My clients, and consumers alike, are focusing on their overall health and well-being more than a specific weight,” Passerrello added. “Unless there is a life threatening reason to avoid a food, like a food allergy, all foods can fit.”