Top Diets' for 2022 Aren't Really Diets

— U.S. News & World Report rankings may only tell part of the story

Each year, in a flurry of New Year's resolutions, Google searches spike reliably for the search term "best diets." And each year, the U.S. News & World Report delivers.

For 2022, its top rankings for categories like "Best Diets Overall," "Easiest Diets to Follow," "Best Diets for Diabetes," and "Best Heart-Healthy Diets" reflect a long-term trend toward eating patterns and flexibility and away from crash diets.

Perhaps, experts suggest, a reckoning with the concept of a "diet" altogether is underway, although some familiar brand-names (Atkins, Keto) retained some top slots.

In six out of nine categories, the "Mediterranean diet" -- which emphasizes whole grains, fruits and vegetables, and fats from sources like nuts and seeds -- came out on top, including for the best overall diet.

"A lot of people, when they're trying to pick a 'diet,' that usually means short term, it means not sustainable, it means that it could wreak havoc on the body if it's not sustained," said Fatima Cody Stanford, MD, MPH, MPA, MBA, of Massachusetts General Hospital and Harvard Medical School in Boston.

"The Mediterranean 'diet,' is not a diet, it's just a way of eating," said Stanford, who was one of 27 experts selected by U.S. News this year to rank the 40 "diets" considered in the running.

Tied for second and third overall were the DASH (Dietary Approaches to Stop Hypertension) and Flexitarian diets, which appear toward the top in six other categories as well. The DASH diet also emphasizes vegetables, fruits, and whole grains but is geared specifically toward reducing hypertension by lowering sodium. The Flexitarian "diet" is similar but framed as vegetarianism with some flexibility.

What do rankings like these mean within the context of professional dietary advice?

Kevin Klatt, PhD, RD, of Baylor College of Medicine in Houston, who serves on the editorial board for the American Journal of Clinical Nutrition, says the definition of "diet" is a sticky one. "It's a misnomer. It shouldn't really [mean] a dietary pattern. 'Diet' is like a four letter word in the nutrition space, like a crash diet sort of thing."

It's unlikely, he and Stanford said, that medical and nutrition specialists would recommend a specific "brand name" diet anyway. This is because how an individual approaches heath through dietary changes is highly variable -- everything from one's psychology, income, genetics, and the built environment affects eating -- and different bodies may respond differently to the same diets. One size does not fit all.

And diets only tend to work for the period of time you're on one. People don't tend to stick to a highly regimented diet for long. Commercial, weight-loss programs like WW (formerly Weight Watchers) and Jenny Craig, Klatt noted, have high recidivism rates.

"A lot of people aren't prescribing named dietary patterns all that much. Like it is wholly useless to tell somebody, 'Yeah, eat a Mediterranean diet,'" Klatt said. "Most people, you're just seeing where they're at, what their goals are with their current eating patterns, and recommending things that they can tweak and try out. That varies based on what their blood chemistry might look like, or what their current weight and body composition is."

According to these experts, healthy eating is less about the name of the diet one chooses to follow and more about a personal approach that takes into account specific desired health outcomes, environment and culture. In many cases, Klatt and Stanford said, it comes down to what a person is already familiar with and can afford, as well as trying out changes in diet that can reliably be sustained.

What's more, diets selected as contenders by U.S. News and its selected panelists, including big names in nutrition, diabetes, heart health, and obesity, skewed heavily toward a particular demographic.

"Mediterranean tends to come out on top year after year after year, but if you look at it, it's pretty Eurocentric. The process, the people that research [the diets], tend to be white investigators," Stanford said. "It is something I consider as someone who works with a very diverse patient population."

"It goes back to that personalization. I'm not going to tell a 12-year-old, transgender male who is being raised by people from Afghanistan the same thing that I tell a 55-year-old white woman who is an heir to billions," said Stanford. "There's nothing about those conversations that will really go the same other than I will say 'lean protein, whole grains, fruits, vegetables.'"

Following is a list of the diet rankings in nine categories, after expert panelists ranked 40 diets on a scale of one to five for seven categories like "Long-term weight loss," "Ease of compliance," "Health risks," and "Nutritional completeness."

Best Diets Overall

1. Mediterranean Diet

2. DASH Diet (tie)

2. Flexitarian Diet (tie)

4. MIND Diet

5. TLC Diet (tie)

5. Mayo Clinic Diet (tie)

5. Volumetrics (tie)

5. WW (Weight Watchers) (tie)

Best Diet Programs

1. Mayo Clinic Diet (tie)

1. WW (tie)

3. Jenny Craig

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4. Noom Diet

5. Nutritarian Diet

Best Weight-Loss Diets

1. Flexitarian (tie)

1. Volumetrics (tie)

1. WW (tie)

4. Vegan Diet

5. Mayo Clinic Diet (tie)

5. Ornish Diet (tie)

5. Jenny Craig (tie)

5. Raw Food Diet (tie)

5. Vegetarian Diet (tie)

Best Fast Weight-Loss Diets

1. Atkins

2. HMR Diet (tie)

2. OPTAVIA (tie)

4. Biggest Loser Diet (tie)

4. Keto Diet (tie)

4. WW (tie)

Best Diets for Healthy Eating

1. Mediterranean Diet

2. DASH Diet (tie)

2. Flexitarian Diet (tie)

4. MIND Diet

5. TLC Diet (tie)

5. Nordic Diet (tie)

5. Volumetrics (tie)

5. WW (tie)

Easiest Diets to Follow

1. Mediterranean Diet

2. Flexitarian Diet

3. Fertility Diet (tie)

3. MIND Diet (tie)

3. WW (tie)

Best Diets for Diabetes

1. Mediterranean Diet

2. Flexitarian Diet (tie)

2. Vegan Diet (tie)

4. Mayo Clinic Diet

5. DASH Diet (tie)

5. MIND Diet (tie)

5. Vegetarian Diet (tie)

Best Heart-Healthy Diets

1. Mediterranean Diet (tie)

1. Ornish Diet (tie)

3. DASH Diet

4. Flexitarian Diet (tie)

4. TLC Diet (tie)

4. Vegan Diet (tie)

Best Plant-Based Diets

1. Mediterranean Diet

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2. Flexitarian Diet

3. Vegetarian Diet

4. Nordic Diet (tie)

4. Ornish Diet (tie)

U.S. News & World Report defines "diet" as a guideline around eating according to a particular set of guidelines with the goal of losing weight or improving health.

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