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Every year, a list of the most popular diets is released, ranked based on how well they align with certain guidelines to improve health and prevent chronic conditions. In some cases, the evidence comes from decades of randomized trials, population studies, and other research.

This is true for the Mediterranean and DASH diets, which have topped the list of best diets for years. These diets have inspired global dietary guides as well as the American Heart Association (AHA) guidelines, which recommend limiting saturated fats and excess carbohydrates, especially refined carbohydrates and sugary drinks.

It’s not surprising that all top-ranked diets are primarily plant-based with the addition of a variety of antioxidants, such as fish, which is a good source of fat, and healthy proteins.

In this article, we will briefly analyze the main differences between each diet, taking into account their benefits and, above all, their sustainability.

Mediterranean diet

The Mediterranean diet is recommended to promote heart, bone, and joint health and manage blood sugar levels.

• Encourages eating fruits, vegetables, whole grains, nuts, legumes, olive oil, herbs, and spices every day.
• Eat fish and seafood at least twice a week.
• Chicken, eggs, cheese, and yogurt are okay, as long as they are eaten in moderation.
• Save red meat and sweets for special treats.
• The occasional glass of red wine is allowed.

DASH diet

DASH, which stands for Dietary Approaches to Stop Hypertension, is a flexible, balanced, and heart-healthy dietary plan aimed at stopping (or preventing) high blood pressure.

• Based on vegetables, fruits, and whole grains.
• Nuts, legumes, chicken, low-fat or fat-free dairy products, and fish can also be included.
• Use herbs and spices to add flavor to food without needing to use salt.
• Foods high in saturated fat, such as fatty meats and full-fat dairy products, are strictly limited or, better yet, avoided altogether.

MIND diet

MIND, which stands for Mediterranean-DASH Intervention for Neurodegenerative Delay, takes the two above diets and focuses on foods that improve brain health to potentially lower the risk of mental decline.

• Green leafy vegetables and whole grains should be eaten every day.
• Nuts and legumes should be included most days.
  
• Chicken and fish should be eaten twice a week.
  
• You can substitute olive oil for butter, margarine, and sunflower oil.
  
• Limit full-fat dairy products and red meat to one or two portions a week.

Flexitarian diet

This semi-vegetarian diet is primarily based on vegetables, but meat, eggs, dairy products, and fish are allowed every once in a while. It improves overall health and reduces the risk of chronic diseases.

• Focuses on non-meat proteins from legumes and eggs.
• Includes fruits, vegetables, whole grains, and dairy products.
• Aimed at gradually reducing meat portions and increasing meat-free days per week.

These diets each have their own characteristics and nuances that can make them difficult to implement in certain countries or regions because of various factors, such as cost or access to key ingredients like olive oil, fish, and avocado.

But you can make substitutions to obtain the benefits those foods provide. If extra virgin olive oil is too costly, replace it with high-oleic canola or sunflower oil, both of which are rich in monounsaturated fats that benefit the heart.

Salmon is an excellent sources of omega-3 fatty acids but can be expensive in some regions. Canned fish, like sardines, herring, and tuna, is an affordable option. If you don’t want to eat fish in general for other reasons, nuts and seeds offer many of the same benefits.

As for fruits, the best fruits for these diets are berries like raspberries, blueberries, and strawberries, thanks to their high antioxidant content. But you can opt for seasonal fruits that are more affordable, such as apples, oranges, and bananas.

Pillars of a healthy diet

In conclusion, aside from a few differences, these diets share the basic principles of a beneficial and sustainable eating plan, the pillars of which are summarized below:

• Focus on vegetables, legumes, whole grains, and nuts because they are high in vitamins, minerals, fiber, and antioxidants.
• Include protein in moderation, with an emphasis on lean protein from fish, poultry, legumes, and low-fat dairy products.
• Replace saturated or trans fats, which are primarily found in red meat or full-fat dairy products, with unsaturated fats from olive oil, avocado, nuts, and seeds.
• Limit or avoid added sugars, which are usually found in sugary drinks, energy drinks, sweets, and refined products.
• Pay special attention to drinking enough water to stay hydrated.
  
• Emphasize the importance of regular physical activity in conjunction with diet to obtain different health benefits.

Sources: American Heart Association (AHA); U.S. News and World Report 2024; Harvard Medical School; National Institutes of Health.