CNN
 — 

It’s a winning streak that just won’t quit. For the fifth year in a row, the Mediterranean diet was first across the finish line in the annual race for best diet, according to ratings announced Tuesday by U.S. News & World Report.

Tied for silver was the DASH diet, which stands for dietary approaches to stop hypertension, and the Flexitarian diet, which encourages being a vegetarian most of the time, but is flexible enough to allow a burger now and again.

“We’re always looking for more health conditions that we can address. But often there’s not enough scientific data examining diet X and condition X,” said Gretel Schueller, managing editor of health for U.S. News & World Report, who oversees the annual diet ranking.

“However, bone and joint health is an area where there’s a fair amount of scientific literature,” Schueller said. “We also recognize our population is aging so focusing on diets that can increase the quality of life among older individuals is an important element.”

Also new this year: Reviewers only ranked 24 diets instead of the 40 or so diets analyzed in past years. Five diets from the original list — vegetarian, vegan, Nordic, the traditional Asian and the glycemic index — were integrated by judges into the Mediterranean and other diets due to their underlying plant-based principles.

“The take-home message here is the recognition that the Mediterranean diet is really not just about the foods around the Mediterranean,” Schueller said. “You can take the the lessons and the approach of the Mediterranean eating pattern and apply it to any cuisine in any country.”

That approach is reflected within two new diets — Keyto and Pritikin — that were added to the review for 2023, Schueller said. (Yes. that’s Keyto with a Y.)

“We recognize that more and more people are eating sort of a plant-forward or plant-based diet or at least trying to,” she said. “The keto with a Y diet is supposed to be a flexible, low-carb Mediterranean plan.

“The Pritikin diet focuses on low-fat, high-fiber eating of whole foods, and is fairly flexible,” she added. “We are seeing a push towards eating more whole, unprocessed foods, which I think is a great thing.”

Numerous studies have found the Mediterranean diet can reduce the risk for diabetes, high cholesterol, dementia, memory loss, depression and breast cancer. The diet, which is more of an eating style than a restricted diet, has also been linked to stronger bones, a healthier heart and longer life.

The diet features simple, plant-based cooking, with the majority of each meal focused on fruits and vegetables, whole grains, beans and seeds, with a few nuts and a heavy emphasis on extra-virgin olive oil. Fats other than olive oil, such as butter, are consumed rarely, if at all, and sugar and refined foods are reserved for special occasions.

Red meat is used sparingly, usually only to flavor a dish. Eating healthy, oily fish, which are packed with omega-3 fatty acids, is encouraged, while eggs, dairy and poultry are eaten in much smaller portions than in the traditional Western diet.

Social interactions during meals and exercise are basic cornerstones of the Mediterranean style of eating. Lifestyle changes that are part of the diet include eating with friends and family, socializing over meals, mindfully eating favorite foods, as well as mindful movement and exercise.

Just as they did in 2022, the DASH and the flexitarian diet tied for second place in best overall diet. Similar to the Mediterranean style of eating, these diets reduce or eliminate processed foods and stress packing your plate with fruits, vegetables, beans, lentils, whole grains, nuts and seeds.

The DASH diet emphasizes limiting salt intake in its goal to reduce blood pressure, while the flexitarian diet, true to its name, allows an occasional indulgence of meat or poultry.

A panel of 27 experts examined 40 diets and ranked them on several categories: How easy is the diet to follow; how likely is a person to lose significant weight, both in the short and long term; how effective the diet is in preventing cardiovascular disease or diabetes; and the diet’s nutritional completeness.

“We focused on quality over quantity,” Schueller said. “Our reviewers felt there are some diets out there that are so wacky they’re not worth giving time to, such as the Dukan diet, which we no longer rank.”

The worst diet award went to the raw foods diet this year, at least in part due to the lack of nutritional completeness, which has raised safety concerns among the reviewers. Because followers can only eat unprocessed foods that haven’t been cooked, microwaved, irradiated, genetically engineered or exposed to pesticides or herbicides, reviews consider the diet almost impossible to follow.

The popular keto diet, along with the modified keto, was ranked 20 out of the 24 diets, followed by Atkins, SlimFast and Optavia. These diets emphasize eating high-protein or high-fat foods with minimal carbohydrates and receive low rankings because they are extremely restrictive, hard to follow and eliminate entire food groups.

Despite keto’s low overall rating, reviewers gave the keto diet first place for best short-term weight loss diet, Schueller said, quickly adding that these diets are not considered healthy as a lifestyle.

“These are the diets for someone who’s got a wedding or an event they want to go to in the next few months,” she said. “Will you lose weight in the short term? Absolutely. Will you keep it off for the next two years? Probably not.”

The Dukin, Whole30 and keto diets, which emphasize eating high-protein or high-fat foods with minimal carbohydrates, are typically rated poorly by experts because they are extremely restrictive, hard to follow and eliminate entire food groups, which is not recommended by dietary guidelines.

Flexitarian and TLC shared the gold in the category of easiest diet to follow, while the Mediterranean and DASH diets tied for third.

The DASH diet took top honors as best diet for heart health and for people with diabetes, followed by the Mediterranean, flexitarian and Ornish diets. The Ornish diet was created in 1977 by Dr. Dean Ornish, founder of the nonprofit Preventive Medicine Research Institute in California.

The Ornish diet is combined with stress-management techniques, exercise, social support and smoking cessation, and according to Ornish is the only scientifically proven program to reverse heart disease without drugs or surgery

Want to make the Mediterranean diet one of your goals this year? Get started by cooking one meal each week based on beans, whole grains and vegetables, using herbs and spices to add punch. When one night a week is a breeze, add two, and build your non-meat meals from there.