The Pros and Cons of Different Diets

What is the healthiest diet you can eat? Is it keto? Mediterranean? Low fat? Vegan? 

This is one of the most common questions that I'm asked as a Doctor of Clinical Nutrition.

I've spent my entire career staying up-to-date, learning, and evolving to find the healthiest diet. In this blog, we will walk through what works and what doesn't work in each of today's trending diets and how to solve the confusion that each one presents in science. Then, we'll discuss what is truly the healthiest diet and how to eat in a way that works just for you.

Because, believe it or not, you can eat well and love it. 

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One Size Does Not Fit All 

What diets have you tried? What have you heard? The truth is, when we find something that works for one person, they tell five people who tell five people. We love to spread good news. We find that most nutrition bias becomes viral because one doctor or one person had great results.

We unknowingly assume that if keto or gluten-free worked for Susie and now it works for an influencer, it must be the “right diet for me.” 

An important note: when we say a diet works, we often only mean the diet is good for weight loss. 

When I say a diet works, I mean we’re eating foods that defeat disease, boost our immune system, change genetic expression, boost our metabolism, help us reach our healthy body weight, AND crush hunger and keep us feeling full and satisfied.

Let's look at a few popular diets together as we explore if they meet these criteria for the healthiest diet. 

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The Keto Diet

Keto is a low-carb, high-fat, and moderate-protein diet focused on eating high-fat animal foods and low-carb vegetables. In this lineup, carbs are bad. There seems to be a new low-carb diet with a different name every ten years, like the Atkins diet created by Dr. Atkins in the 80s featuring low-carb, high-fat, and high protein. 

Dr. Atkins was a cardiologist, and his focus was weight loss, which was the driver for the number one disease in America: cardiovascular disease.  His goal was to help people lose excess body weight; he believed that carbohydrates were the problem in our overweight society leading to cardiovascular disease.

So, what is the best that we can learn from the keto low-carb diet? 

Low-carb diets help us better understand the role of insulin in losing weight, hunger and fullness cues, and improving overall health. We also learn that eating meals that force the body to utilize fat for fuel, putting it into a keto physiologic state, is very effective for weight loss, especially for the extremely obese and those very resistant to traditional weight loss diets.  

So, if weight loss is your only goal, and insulin resistance is what’s stopping your weight loss, you may find success on a keto diet. 

But what about health benefits beyond weight loss? According to Dr. William W. Li, MD, the keto diet has shown value recently in improving some types of brain tumors that thrive on sugar.

As a researcher and health professional, I wanted to know whether there was another way to achieve the results that a ketogenic state can achieve in our bodies while still including all the foods proven to turn on healing in the body, even if they stop that ketogenic state.

This would give us all the health benefits needed to live a healthy weight without constant hunger and cravings, improve insulin resistance and eat foods that beat disease, burn fat, heal the body, boost our metabolism, and help us live longer.

This question has led to much of my research and clinical application in the last 15 years.   I want all the benefits of the keto diet plus all the health benefits of the most healing foods in one healthy-eating lifestyle plan. 

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The Mediterranean Diet

Next, we have the Mediterranean diet. The Mediterranean diet has earned the title of "Best overall diet in the world for 2023" by US News and World Report and by CNN and has held this title for the last six years.   

The Mediterranean diet gained widespread popularity in the 1990s, even though it was first publicized in 1975. The Mediterranean diet has been tested on 1.5 million healthy people and has demonstrated a reduced risk of cardiovascular risk factors and all causes of mortality with significant overall health improvements.

 The Mediterranean diet is high in healthy fats from food sources like olive oil and nuts, with lots of fruits and vegetables, and red wine. This diet is also rich in whole grains, potatoes, beans, and legumes.

In this diet, fat is not feared, but rather the focus is on the type of fat. This diet focuses on the health benefits of monounsaturated fats found in olives and extra virgin olive oil replacing butter, and omega-3 fatty fish like salmon replacing high intakes of red meats and processed meats.  This diet has less saturated animal fats and more monounsaturated and essential omega-3 fats.     

The carbohydrates in the Mediterranean-style diet are mostly unprocessed, fiber-rich whole grains, beans, and lots of fruits and vegetables, with 50-60% of calories coming from carbohydrates, 15-20% from protein, and 30-35% from fat.

We learn from the Mediterranean diet that the type of fat matters when we want to design our perfect diet. The Mediterranean diet has been shown to lower total cholesterol and decrease LDL cholesterol, which is the cholesterol that puts us at greater risk for cardiovascular disease. This diet is very popular because of the large body of research supporting lower cardiovascular disease risk, improvement in brain health, a decrease in inflammation, and all causes of mortality - meaning improved longevity.

Doctor Mike, a popular YouTube physician, recommends the Mediterranean diet in many of his YouTube episodes as he explores the healthiest diet.  He features his own personal diet rich in salmon and essential omega-3 fats and mostly whole plant foods.

What we learn in the Mediterranean diet cannot be ignored, and components of this diet are included in the ideal diet that I recommend.

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The Vegan Diet

The vegan diet is high in carbs and typically low fat. In this diet, animal foods are avoided, including dairy products and eggs.

A whole-food, plant-based diet is also a type of vegan diet; this diet includes generous amounts of whole carbohydrates that are unprocessed and loaded with fiber.

The high carb, very low fat, mostly plant-based diet is currently promoted by Dr. Dean Ornish, MD from the University of California, San Francisco as a means to reverse heart disease, reverse cancer, reverse diabetes, reverse prostate cancer, and lose weight.  Dr. Ornish authored UnDo It!: How Simple Lifestyle Choices Can Reverse Most Common Diseases, published in 2019, in which he recommends that less than 10% of our daily calories come from fat.   

The whole food, plant-based diet has generous amounts of current research supporting the powerful benefits of a diet that is very low in fat.

This is an all-you-can-eat, high-carb, low-fat diet that works very well for many people. In this diet, dairy products, eggs, meats, poultry, and fish are avoided, but healthy plant fats like avocado, seeds, nuts, and even peanut butter and omega-3 fats are also restricted.

The challenge with the research on vegan diets is the large range of foods eaten and still considered “vegan.” There’s the refined vegan diet that simply avoids animal foods, there is the 100% whole plant food diet that includes fiber-filled foods, and then there is the variation of a vegan diet that is low fat.  Each of these diets results in different outcomes. 

What we can learn from this diet is that the type of carbs matters. Processed carbs drive up blood sugar and lead to cravings and addictions to processed sugars that can drive a cycle of hunger, cravings, and snacking. 

However, unprocessed whole carbs like whole fruit and whole grains filled with fiber give the opposite results with improved gut health and balanced blood sugars.

So here we see why carbs can get a bad rap; we need to define the type of carb we are talking about since all carbs are really not equal. What we learn here is that whole-carb foods like apples and whole grains can be part of a healthy diet and still help you lose weight.

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The Dr. Jenkins Plant Protein Research Diet

The Dr. Jenkins research diet looks at the role of protein in optimal health. For this diet, it's all about the type of protein. 

Dr. Jenkin's dietary research added plant protein - via soy or pea protein - and supplemented it with soluble fiber at each meal.

Fat and carbohydrates were not adjusted in his research diet plan.  His goal was only to change protein to plant protein with soluble fiber supplementation and see the effect on cardiovascular risk factors just from the type of protein consumed. 

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So Which Diet is Best?

Here is what I conclude: each one of these diets has a specific health goal and something we can learn as we create the healthiest diet that is a lifestyle and not simply a weight loss diet. A diet that helps us live our healthiest life today and live longer at our healthiest weight.

We can start by breaking down the good and the baggage that comes with these popular diets and explore foods that turn on the body's natural healing mechanisms as we explore the diet that wins my “healthiest diet award” and help you find the healthiest diet that works for you.

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Breaking Down Food Baggage

Cheese is a protein coming from dairy milk and comes loaded with calcium. Pork is a meat that is rich in protein. Beef gives us iron. Omega-3-rich fish gives us lean protein and the fats essential for our body and helps reduce inflammation.

But what about the “baggage” that comes along with these foods? 

Estrogen and progesterone hormones come with cheese and all dairy products. These hormones are transferred to humans when eating these foods. Dairy products inflame and add unhealthy bacteria to the gut, but they are loaded with protein and calcium.   

You get a dose of lard and saturated fats from pork and beef that is shown in research to increase inflammation. Red meat is classified by the World Health Organization as a moderate carcinogenic food, and processed meats hit the top of the list for highly carcinogenic foods.       

King salmon from the coldest water is a great source of omega-3 fats essential for our body, but can also come loaded with mercury.  In fact, it can be difficult to find quality sources of salmon that are low in mercury and from cold water and that are affordable for many families. 

Food is a package deal. You can't say, “hold the mercury” when you order fish in a restaurant or say, “hold the saturated fat in my steak” or “hold the estrogen hormones” when eating dairy or cheese.  

Dairy, for example, is the number one source of calcium in the United States, but whole-fat dairy, including cheese and yogurt, is also the number one source of saturated fat in the American diet.

And remember that dairy comes from a female milk-producing cow, which contains estrogen and progesterone that we ingest with dairy products.

Now let's talk about dark green, leafy vegetables, beans, and nuts. You get fiber, calcium, folate, iron, and many antioxidants in these unprocessed whole plant foods.  Some of these are the very nutrients that are lacking in milk.  Plus, these foods feed healthy gut bacteria and reduce inflammation in the body, and don't come with the baggage of estrogen and progesterone hormones and harmful gut bacteria.

And we can't forget the gluten-free diet. Gluten is a plant protein that comes from wheat. 

There is much demonization of gluten, claiming it inflames the gut and destroys healthy bacteria.      

For some, gluten triggers a severe autoimmune response called Celiac Disease that damages the small intestine. It is estimated that 0.5% to 1% of the worldwide population has Celiac Disease, and only 1.4% of Americans have Celiac Disease, so this is a very small percentage of the population. 

But for the rest of the population, which is ~95%, gluten is a plant protein that is very good in health. It is by eating whole grains that we can get the unprocessed form of gluten, which is the preferred way to eat gluten versus high intakes of processed gluten foods.    

However, there can be baggage with whole grains, wheat, and gluten, and that baggage is called “glyphosate,” a pesticide in Roundup that has been classified as a probable carcinogenic.  To speed up the drying time of wheat just before harvesting, Roundup is sprayed on the wheat daily.  

Because of this, I recommend organic wheat to many patients that have been told they are gluten or wheat intolerant or allergic, and when changing to organic whole wheat gluten sources, there is typically no negative reaction.    

So when you choose gluten, choose organic whole wheat that isn't sprayed with glyphosate pesticides and eat whole wheat mostly unprocessed to enjoy the health benefits, including the plant protein gluten.  In summary, organic, whole wheat grains have all the health benefits and fiber without the baggage of pesticides.

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Whole Package Foods: Whole Fruit

Sometimes, food's natural packaging can work to our benefit.

Fruits that are stripped of their natural packaging lose the valuable fibers that slow and delay the blood sugar response from eating the sugars found naturally in the fruit that give its sweet, delicious flavor. 

Like when we make apple juice from apples.  Apple juice is fruit sugar without the fibers and results in a rapid spike in blood sugar response, which in turn triggers a spike in insulin that, over time, can lead to insulin resistance and weight gain.    

So when we choose whole fruit, it comes naturally packaged with fiber and resistant starches that create a gel-like substance that slows the absorption of fruit sugar in the apple.

So whole, unprocessed fruit comes without any baggage, only health benefits.

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Whole Package Foods: Beans and Nuts

When we choose beans and nuts, this plant protein comes packaged with soluble fiber, insoluble fiber, and resistant starches.

We know our gut microbes thrive on these foods. Nuts also come packaged with healthy fat and even add the essential fats that our body needs. 

What about flaxseed? Flaxseed comes packaged with essential fats plus fiber, lignans, and antioxidants. Some of the very nutrients that are lacking in fish. We need these every day. 

When we choose avocado, it comes naturally packaged with fiber as well, and the oils in avocados are slowly delivered to the body so we don't surge our body with fats and drive up triglycerides.   The natural packaging of fiber and healthy plant fats in avocados gives us the benefits of avocados without the risk.  We get fiber, healthy plant fat, and the flavor of a smooth, buttery texture that we love to eat, adding satisfaction and fullness to our meals.

After a surge of refined fats from a meal, the avocado is loaded with antioxidants, and it gives a smooth, buttery texture that we love to eat. 

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Whole Plant Foods Versus Animal Foods

Whole plant foods are the highest source of antioxidants, and animal foods are the lowest. 

Whole plant foods come loaded with fiber and resistant starch to feed the healthy bacteria in our gut and boost our immunity. They also turn off hunger and keep us full. 

Animal foods all have zero fiber. In fact, that is why I refer to animal foods as processed foods. 

The cow eats the plant. They refine it by excreting the fiber. We eat the stored fat and muscle from the cow's body, along with the hormones and antibiotics left behind in the meat. Plant foods that are processed would include white flour, sugar, fruit juice, and even Oreo cookies.

Eating these foods in the typical Western diet can destroy our good gut flora.   

Remember our gut flora is made up of what we eat.  We have trillions of bacteria living in our bodies, and most of these bacteria live in our gut.  When we eat unprocessed plant foods, we are eating meals loaded with fiber.  This fiber feeds and multiplies the bacteria that are anti-inflammatory, anti-cancer, and immune boosting and in contrast, when we eat less fiber and more animal foods, our fiber-fed health bacteria are starved.     

So when we explore whole plant foods versus animal foods, whole plant foods bring all the health benefits without the unhealthy baggage. 

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Let’s Talk About Carbs

Carbs get a bad rap because of the confusion about processed versus unprocessed carbs. Carbs are only in plant foods other than dairy products. On the other hand, meat, poultry, fish, and eggs come without carbohydrates. 

The keto camp thinks that not having these carbs is a benefit. So we don't get the surges of energy and become insulin resistant. 

But there is an answer to this: carbs that come packaged as whole plant foods are called “whole carbs,” like oatmeal, beans, wheat, nuts, seeds, and even broccoli and whole fruits and vegetables. These are all foods with fiber and resistant starches and provide the antioxidants and nutrients our bodies crave to heal while also giving us the fuel our bodies and brains need for energy.  

Whole carbs deliver these starches and sugars slowly to the blood because the fibers and resistant starches have not been stripped through processing.  This helps us slow and reduce the blood sugar response, balance our blood sugar, improve insulin resistance while sustaining energy, and keep us full and satisfied after meals.

And that's a big win. Remember, carbs are not just in bread. The research is very consistent with the health benefits seen from whole plant foods loaded with carbohydrates. Again, it's the packaging, but all carbs are not equal.

If you eat a lot of refined carbs like sugar, soda, fruit juice, white bread, chips, and Oreo cookies, you will spike your blood sugar response, and your insulin will spike to help drive these sugars into the cells and store the excess sugars as fat.   

The problem is these processed carbs, when eaten alone, don't keep us full and satisfied and lead us to snack more throughout the day to sustain our energy and stop the mid-meal energy slumps. This cycle leads many people to be addicted to processed sugar and can lead to insulin resistance and diabetes for some.     

The food industry understands this well and creates meals that are high in refined sugars, like soda and white bread and desserts, and adds high-protein meats and high-fat foods. 

Think about McDonald's meals, the double cheeseburger on a bun pairs with the french fries and 48 oz sugar soda. This combination keeps people feeling full and satisfied for four hours eating foods that do not trigger healing and destroy our good gut flora. Remember, red meat and processed meats destroy good gut flora, and meals loaded with refined, processed sugars like sugar sodas increase inflammation and damage healthy gut bacteria.

When we consider the baggage that comes with the food and how it's packaged, a diet with whole carbs from plant foods is important for a healthy diet.   You get all the health benefits from whole-carb plant foods without the baggage that can come from refined, processed carbs and added sugars.

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So, How Do We Determine the Healthiest Diet?

First, a healthy diet should include all the foods that have been shown to turn on the body's natural healing.  

Foods that boost the immune system, foods that build a healthy gut flora, foods that repair oxidative stress and reduce inflammation, foods that repair genes and lengthen telomeres - the tips of our genes that slowly shorten with aging - and repair and maintain healthy blood vessels and circulation.  Dr. William Li discusses these foods in his book Eat to Beat Disease: The New Science of How Your Body Can Heal Itself.   

Second, a healthy diet should help us burn fat, turn off hunger and cravings, boost our metabolism, and turn on the body's healing which helps us reach our healthy body weight.  Remember that most diets focus their success only on weight loss and give up all the benefits of eating foods that heal our body three times per day, letting us live our healthiest lives and live longer.    

So, losing weight shouldn't be our only goal when choosing a healthy diet.  We are looking for a healthy diet that is a lifestyle and not simply a weight loss diet.    

Beware that most weight loss diets claim to be based on science and promise easy, permanent weight loss.  Their claim to having health benefits can simply be based on weight loss. When we lose weight, many of our risk factors for disease can show improvement in short-term studies. 

But, we also need to consider the proven long-term research showing what foods the body needs daily to optimally turn on natural healing, boost metabolism, and live longer. If these foods and lifestyle habits are not part of the short-term weight loss diet that someone is trying, this would not be a diet I would recommend because it is simply another quick-fix diet, and we are looking for a diet that includes all the best of the foods we love, give us optimal health, and help us live longer.   

Third, a perfect diet should fill you up and make you feel satisfied, turning off hunger cues and making us feel full longer without cravings between meals. Diets should not be highly restrictive and make you feel deprived. 

Fourth, a perfect diet needs to be personalized to fit your preferences, your tastes, and your goals. Simply put: you should enjoy your food. 

The perfect diet won't work if it doesn't include giving up all your favorite foods. Research shows that when people are on a restrictive diet, they feel hungrier, and this makes them feel less happy and more anxious. While this doesn't sound like an ideal diet to me, we know that food is the number one barrier to why people do not choose a healthy lifestyle before they get a diagnosis.

And some never do. They don't want to give up all their favorite foods for a lifetime. Enjoying the food you eat is huge. It makes you happier, and happier makes you healthier. This is a lifestyle and not a diet.

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What Diet Wins My Vote as the Healthiest Diet?

A diet made from "mostly" whole plant foods is the clear winner for me when it comes to the healthiest diet that turns on the body's ability to heal and improves our performance and longevity.    

I choose this diet because it comes without baggage and all the greatest health benefits.   

Be sure to notice the word "mostly."

Mostly is where your favorite foods come in, your story, your tastes, and your preferences. This is where you make the diet yours.

We applied this healthy diet in my 10-day TakeTEN^Ⓡ retreat with over 2,000 people. We provided participants with my winning diet of mostly whole-plant foods three times per day for ten days.   

All meals were made using my recipes prepared by our chefs following my nutritional guidelines and including all the foods and meal combinations that I have found had the greatest impact on improving health in as quick as 10 days.

This diet and lifestyle approach was tested in a real-life situation on real people from diverse geographic locations around the world and from ages 18 to 95 years of age.   

Some participants came to reduce their need for medications to treat diseases or health conditions like high blood pressure or high cholesterol. Some participants came to prevent getting the diseases they saw their parents suffer from. Some participants came to lose weight.  Others came to treat diabetes with lifestyle and diet. Some came to reduce inflammation and pain.   

People who came took my Daily Wellness Quiz, a 20-point scale made up of the 10 foods and 10 lifestyle habits shown to turn on the body's natural healing.  The average score on day one of the program was 9.5 points; scores increased to 19+/20 points for 10 days.     

Participants who had scores of 18+ out of 20 points for ten days had these results: 

• Blood pressure dropped by 15%. 
• Triglycerides reduced by 39%. 
• Waist circumference dropped by an average of one inch.
• For both men and women, body weight dropped by 5.2 pounds in those with a BMI of 30 or greater. 
• Blood sugar dropped by 23% in those with type 2 diabetes while reducing the need for medication.  Fasting insulin dropped by 31% in those with high fasting insulin. Inflammation dropped by 34%. 

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So What's the Perfect Diet?

Here it is in one simple sentence: The more whole plant foods on your plate, the better. 

With this diet, you're setting yourself up for optimal physical and mental health, a lowered risk of disease, and healthy weight loss. 

So what exactly do you make for dinner? Let's get started and check out the next video on your perfect plate to see what to start eating today. 

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