The 2019 rankings include 41 of today’s most popular diets. New to the list this year is the Nordic Diet, a plant-heavy eating plan that incorporates Scandinavian traditions and ranked 9th best overall. Here’s how the rest of the rankings shook out this year, and what experts have to say about the good, the bad, and the trendy. (Here’s a hint: They’re still not crazy about keto.)
If you’re on the ketogenic diet, be sure to test blood sugar levels throughout the day to make sure they are within their target range. Also, consider testing ketone levels to make sure you’re not at risk for DKA. The American Diabetes Association recommends testing for ketones if your blood sugar is higher than 240 mg/dL. You can test at home with urine strips.
Also worth noting is that low-carbohydrate, low-GI, and Mediterranean diets led to significant improvements in blood lipids with up to a 4–10% increase in HDL (4% in the Mediterranean, 5% in low-GI, and 10% in low-carbohydrate diets), 1–4% reduction in LDL (1% in low-carbohydrate, 3% in low-GI, and 4% in Mediterranean diets), and 9% reduction in triglycerides. 
Prior to the advent of exogenous insulin for the treatment of diabetes mellitus in the 1920's, the mainstay of therapy was dietary modification. Diet recommendations in that era were aimed at controlling glycemia (actually, glycosuria) and were dramatically different from current low-fat, high-carbohydrate dietary recommendations for patients with diabetes [1,2]. For example, the Dr. Elliot Joslin Diabetic Diet in 1923 consisted of "meats, poultry, game, fish, clear soups, gelatin, eggs, butter, olive oil, coffee, tea" and contained approximately 5% of energy from carbohydrates, 20% from protein, and 75% from fat . A similar diet was advocated by Dr. Frederick Allen of the same era .
I have multiple autoimmune diseases. I fought 4 doctors, all of whom told me that adults can’t get type 1. I finally went to the Jefferson Diabetes Center. Yup! Type 1 diabetes. I’m slender, do marathons, bp 100/60, triglyceride/HDL ratio 1.08. And I STILL fought 4 doctors because of the ADA misinformation. All it takes is a simple blood test to look at antibodies. That’s all it takes, but the test is almost never run.
Essentially, the Nordic Diet is based on 10 core concepts: eating more fruits and vegetables every day; eating more whole grains; eating more seafood; choosing high-quality meat, but less meat overall; seeking out food from wild landscapes; using organic produce whenever possible; avoiding food additives; basing more meals on seasonal produce; consuming more home-cooked food; and producing less waste.
One of the keto researches commented, (I think it was Steve Phinney) that change will come about only because enough of the the public will be become educated about this and will demand that the ADA change their recommendations because those recommendations are just wrong. What is the proof they are wrong? If you eat 45-60 g of carb daily, you will continue to have diabetes, and the epidemic will continue as it has for the last 25 years.
Implementing the diet can present difficulties for caregivers and the patient due to the time commitment involved in measuring and planning meals. Since any unplanned eating can potentially break the nutritional balance required, some people find the discipline needed to maintain the diet challenging and unpleasant. Some people terminate the diet or switch to a less demanding diet, like the modified Atkins diet (MAD) or the low-glycaemic index treatment (LGIT) diet, because they find the difficulties too great.
The only limitations: processed foods, and excess intake of fats, sugars, and sodium. And, yes, nixing processed foods pretty much takes care of the fat, sugar, and sodium problem, Srinath says. Research published in BMJ Journal shows that ultra-processed foods make up 58 percent of all of the calories and 90 percent of the added sugars that the average American consumes in a given day. And 75 percent of the average American’s sodium consumption (which is about 1.5 times the RDA of sodium per day, according to the Centers for Disease Control and Prevention) comes from processed foods, per Harvard University.
Our bodies are incredibly adaptive to what you put into it – when you overload it with fats and take away carbohydrates, it will begin to burn ketones as the primary energy source. Optimal ketone levels offer many health, weight loss, physical and mental performance benefits.1There are scientifically-backed studies that show the advantage of a low-carb, ketogenic diet over a low-fat diet. One meta-analysis of low-carbohydrate diets showed a large advantage in weight loss. The New England Journal of Medicine study resulted in almost double the weight loss in a long-term study on ketone inducing diets.
“So many of us sacrifice this for work, family, or social experiences, but sleep is a basic tenet of health; you will not function properly, cognitively or physically, without adequate sleep,” Moreno explains. "Adequate usually means at least 8 hours. Set strict sleep time rules and practice good sleep hygiene. When you prioritize sleep, other aspects of good health may line up more easily.”
As far as the Ketogenic Diet is concerned, I think I am going to have to make a full about-face. As you said, for some people like yourself, you were unable to eat in moderation and feel it is due to your genetic makeup. This is probably true…to add insult to injury, in addition to genetics, it could also be an inflammatory process going on due to the sugary drinks and processed foods we are eating causing obesity and a host of other issues.
WOW. I guess I must be a very special, highly motivated patient then. I, of course, would never have said that about myself. My high motivation is trying to get over the hatred of food that being Diabetic gave me. I don’t feel that way anymore, and am finally happy cooking, again. (My doctor DID tell me exactly that, BTW. Even to the extent of telling me to not include the tsp of agave that I was having in my coffee once a day because sugar is sugar.)
Yes, peanut butter is high in calories, but if you stick the real stuff—a tasty combo of peanuts and maybe a touch of salt—the legumes can work their weight loss magic. In addition to providing you with belly-slimming monounsaturated fats, tummy-filling fiber, and metabolism-boosting protein, peanuts also contain genistein, a compound that helps turn down the genes for obesity and reduces your body’s ability to store fat.
It's important to note that the drop-out rate was substantial and reports of symptomatic hypoglycemia 1-5 episodes) were experienced by 69% of those in the study. The mean carbohydrate intake was 35 grams (+/- 15) daily. Based on self-reported results, the change in HbA1c was -1.45% (+/- 1.04, P < 0.001) with an average HbA1c of 7.2% associated with greater hypoglycemia; yet, these results are comparable to other study findings. The average blood glucose levels were 104 mg/dL (+/- 16). 2 Final lipid profiles were mixed. The results were similar for adults and children.
Cons: That same study on the perks of being a keto athlete also found those same dieters had a lower exercise economy (how efficiently you use oxygen while moving). And whereas pretty much every other diet offers flexibility in the macro range, eating a few too many grams of carbs or protein will knock your body out of ketosis, so you have to be pretty committed to see the perks of this one. Lastly, the low protein count required to stay in ketosis may be holding you back here: A study analysis in Nutrition, Metabolism, and Cardiovascular Diseases found upping protein on a keto diet by just 5% tripled fat loss.
I am sorry you had this experience. I feel that this educator was not giving you good advice. All my women who want to lose weight are recommended to consume 30 grams of good carbohydrates at each meal, and 15 at each snack. If you were not trying to lose weight, I would have recommended 45. I find this is all it usually takes to begin to lose some weight as you start to get active. Patients set their own goals with motivational help from their Certified Diabetes Educator. Our intent is never to insult, and you should not have gone through that. It sounds that you have now found the right path. There are many CDEs who could help you, so see what tools and motivation others may offer. I wouldn’t let one bad apple spoil the whole bunch. Many CDEs are also diabetic.
When the data were examined, it was clear that people who ate a diet where fruits and vegetables, grains, beans, and ﬁsh were the basis of daily meals were healthiest. Topping the chart were residents of Crete. Even after the deprivations of World War II – and in part, perhaps, because of them – the cardiovascular health of Crete residents exceeded that of US residents. Researchers attributed the diﬀerences to diet.
WH Verdict: Not all lectins are created equal and research into their impact on the body is ongoing. In fact, to date, there are no human studies linking the dietary lectins with a harmful immune response in healthy people. A lectin-free diet is also incredibly restrictive, with the list of foods you can’t eat reading like a typical shopping list for your average nutrition-conscious foodie, making it unsustainable and putting you at risk of nutritional deficiencies.
Meh. This book is more fad diet than anything else, which I might have judged from the cover, if I was that type of person. When I read that DASH stood for Dietary Approaches to Stop Hypertension I was hopeful, but the reasonably good information could have been delivered more concisely in a pamphlet. Aside from that, Heller actually points out that the previous DASH diet recommendations have basically been recalled; as early as pg. 4 the author says that the earlier DASH plan recommended far mo ...more
I’m sorry…no we don’t. Sure, more studies will happen, and more information is always good. But, we KNOW that keto works. You can argue that all you want…but in truth, facts don’t care about your feelings. There are plenty of studies, both in groups and in individuals, that prove beyond any reasonable doubt that going on a proper keto diet WILL improve your life as a diabetic, and will often allow the person to reverse diabetes completely (type 2, obviously). Not to mention the weight loss and the myriad of other health benefits it provides.
Short-term results for the LGIT indicate that at one month approximately half of the patients experience a greater than 50% reduction in seizure frequency, with overall figures approaching that of the ketogenic diet. The data (coming from one centre's experience with 76 children up to the year 2009) also indicate fewer side effects than the ketogenic diet and that it is better tolerated, with more palatable meals.
But the best part about the Mediterranean diet isn't that it's a concrete plan or dedicated to helping you drop pounds; rather, it's a way of eating that incorporates healthy fats, lots of fresh produce, and whole grains. Translation: You can do it for your entire life and never feel like you're actually dieting. (In fact, studies show you can lose weight on the Mediterranean diet without cutting any calories.)
My Husband and I started doing Keto July 2018. We got over weight after we got out of the Marine Corps. It has been hard to workout because I became disabled, but my diet was not good. After our friend Amber recommended your site and support group, we found a lot of helpful information to get us started on a successful journey. So far it’s been one month and we have lost 18 pounds each!
It sounds as if you may have been following a very strict keto protocol. I’m not, and have not followed a ketogenic diet, but am interested in it. I’ve been reading up on it a bit on the blog called Mark’s Daily Apple.* I’ve been following it for several years now, even before Mark tried keto. Based on some of his blog post, both keto related and otherwise, it seems that women do better with slightly more carbs than men. He’s written several blog post specifically for women, including one called 7 Keto Tips for Women, which you may want to read. https://www.marksdailyapple.com/7-keto-tips-for-women/ Then there is this one Where I Part Ways with the Popular Keto Movement https://www.marksdailyapple.com/where-i-part-ways-with-the-popular-keto-movement/ Perhaps the problem wasn’t the keto diet in and of itself, but that you went too low carb for you. It’s worth considering. I’ve also found this site to be pretty interesting https://peterattiamd.com/ Here’s a link to his section on keto https://peterattiamd.com/category/ketosis/ He followed a ketogenic diet for a number of years, though as of 2016 was no longer ketogenic, but definitely eating lower carb than most. (That is under Articles, on the drop down menu, click on Personal.)
I suffered through a year on 20 grams of carbs per day and it was the worst year of my life. Yep, I lost weight, but at my current weight of 130 lbs and eating 30 carbs per meal and remaining in a prediabetes state for 15 years, I am healthy AND happy now. None of us know the long term effects of most of what is offered to us…medications, diet drinks, processed foods, restrictive diets. The point I was trying to make was eating healthier, more natural foods will be better in the long run, I believe we all have the common sense to agree on that, even if we can’t agree on how many carbs we will eat!
Klein S, Sheard NF, Pi-Sunyer S, Daly A, Wylie-Rosett J, Kulkarni K, Clark NG. Weight management through lifestyle modification for the prevention and management of type 2 diabetes: rationale and strategies. A statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition. Am J Clin Nutr. 2004;80:257–263. [PubMed]
He has been on keto diet for at least 3 years now. I think that he is some proof that yes, it does work. And it may be that some people do need keto. However, I don’t believe that everyone needs keto diet to get reversal. I have had reversal with regular ADA diet in my clinic. Not just a few! Many have reversed. However, I just want for keto dieters to find a clinical trial. We do need more information. We must understand what happens in the long term on keto diet. I personally did Atkins years ago, which was 20 grams. I had a very hard time to stay on it. I lost 20 pounds, and then I did gain it back. I just could not live without some more carbohydrates than this allowed. I don’t know about being on 60 to 70 carbs, and staying in ketosis. It seemed I was out of it at 22 carbs. Anyway, this was not for me. Maybe it is for you. No one is saying that one should never go on a keto diet, but we are wary of it. We need more science behind it. Therefore, I am just going to put this out here now. I will paste it down the page so that others may see it. They are taking participants. If you fit the criteria, please help us to get more than people’s opinion about this diet. Then we can be more positive about it, and recommend it if the science is there. Here is the link to the clinical trial. Thanks for your comments:
“The alkaline diet often has a focus on eating lots of fresh produce and unprocessed foods, which could be a good thing,” says Hultin. “However, keep in mind that this is not an evidence-based therapeutic diet. When people take it too far — for instance, drinking baking soda — or become too restrictive or obsessive over food choices, it can definitely turn negative.”
One aspect that is not often mentioned is carb cravings. Before I started a keto diet, every day I would have serious starchy- or sweet- carb cravings that were uncontrollable and HAD TO BE satisfied. The high-fat keto diet has pretty much eliminated those carb cravings. It is wonderful to not be under the control of those cravings anymore. I think the high success rate of keto diets is that you are not hungry and have no cravings.
Recently, four studies have re-examined the effect of carbohydrate restriction on type 2 diabetes. One outpatient study enrolled 54 participants with type 2 diabetes (out of 132 total participants) and found that hemoglobin A1c improved to a greater degree over one year with a low-carbohydrate diet compared with a low-fat, calorie-restricted diet [5,6]. Another study enrolled 8 men with type 2 diabetes in a 5-week crossover outpatient feeding study that tested similar diets . The participants had greater improvement in glycohemoglobin while on the low-carbohydrate diet than when on a eucaloric low-fat diet. The third study was an inpatient feeding study in 10 participants with type 2 diabetes . After only 14 days, hemoglobin A1c improved from 7.3% to 6.8%. In the fourth study, 16 participants with type 2 diabetes who followed a 20% carbohydrate diet had improvement of hemoglobin A1c from 8.0% to 6.6% over 24 weeks . Only these latter three studies targeted glycemic control as a goal, and two of these were intensely-monitored efficacy studies in which all food was provided to participants for the duration of the study [7,8]. Three of the studies [6,8,9] mentioned that diabetic medications were adjusted but only one of them provided detailed information regarding these adjustments . This information is critical for patients on medication for diabetes who initiate a low-carbohydrate diet because of the potential for adverse effects resulting from hypoglycemia.
Full disclosure: I have followed a low-carb diet for nearly a decade and find no problem adhering to it. I’ve lost weight and all my cardiovascular biomarkers have improved. Moreover, I’ve studied the science and history behind low-carbohydrate diets, so beyond my personal experience, I bring an evidence-based perspective. (Previously, for 25+ years, I adhered faithfully to a “mostly plants” regimen of fruits, veggies, and whole grains, including my own homemade 7-grain bread, while exercising religiously. Yet during that time my blood lipids were unhealthy, and I never could shake an extra 10-20 pounds.)
One thing you’ll find people love about the Mediterranean diet is the allowance of moderate amounts of red wine. “Moderate” means 5 ounces (oz) or less each day for women (one glass) and no more than 10 oz daily for men (two glasses). (1) Above all else, these meals are eaten in the company of friends and family; strong social ties are a cornerstone of healthful lives — and a healthful diet. Here, food is celebrated.
Imagine your body is a home with a fireplace in the middle and the heat required to keep it at a comfortable\livable temp is keeping the fireplace burning at a manageable and constant pace. To do this you have two fuel-types at your disposal: Kerosene and Charcoal. (in this analogy Kerosene is carbohydrates and coal is fat). American diets are high in carbs, which is like throwing a bucket full of kerosene on that fire. Will it keep the house warm? Sure, but it burns down fast so you have to keep throwing bucket after bucket on it to keep it going, consuming tons of kerosene, and you get these huge spikes in heat. It is much harder to control the strength of the flame, and thus much harder to keep the house at a constant, comfortable temp.
Hi Cyn, The numbers are general guidelines but will vary depending on many factors, such as activity level, insulin resistance, weight and more. There is no single magic number, just conventional recommendations that are a good starting point. I will have a macro calculator coming soon that will help determine what is best for each person, but even then it’s an approximation. The only way to know for sure is to test. If keto is your goal, it’s usually best to start lower and then see if you can stay in ketosis when increasing.
Although many hypotheses have been put forward to explain how the ketogenic diet works, it remains a mystery. Disproven hypotheses include systemic acidosis (high levels of acid in the blood), electrolyte changes and hypoglycaemia (low blood glucose). Although many biochemical changes are known to occur in the brain of a patient on the ketogenic diet, it is not known which of these has an anticonvulsant effect. The lack of understanding in this area is similar to the situation with many anticonvulsant drugs.
Salmon boasts significant anti-inflammatory properties thanks to its rich omega-3 fatty acid content, meaning it’s an excellent source of protein for those looking to jumpstart their weight loss. In fact, one study that examined the effects of weight loss and seafood consumption showed wild salmon to be the most effective at reducing inflammation—better than lean white fish and a fish-free diet. According to a study published in The Journal of Nutritional Biochemistry, fishy fatty acids may also signal thyroid cells in the liver to burn more fat.
If not managed correctly, high blood sugar in diabetics can damage blood vessels and lead to a variety of illnesses. Unmanaged diabetes doubles the risk of cardiovascular diseases such as coronary artery diseases and stroke. [3, 4] Diabetes can damage small vessels in the eyes, kidneys, and nerves and lead to complications such as blindness and kidney disease. 
4. Better eyesight. The diet could help stave off or prevent macular degeneration, the leading cause of vision loss after age 54. The condition, which affects more than 10 million Americans, destroys the part of your retina responsible for the clear central vision you need to read, drive, and recognize faces. A recent study linked eating fish and vegetables to a reduced risk of getting it early, and the omega-3 fatty acids in fish can lower the risk of the disease altogether. What's more, the lutein in green leafy vegetables cuts your chance of cataracts and boosts retinal health, says Dr. Willett.
To get the most benefit from the Keto diet, you should stay physically active. You might need to take it easier during the early ketosis period, especially if you feel fatigued or lightheaded. Walking, running, doing aerobics, weightlifting, training with kettlebells or whatever workout you prefer will boost your energy further. You can find books and online resources on how to adapt Keto meals or snacks for athletic training.