Is It Too Late To Save Your Mind?

What Does A Brain Healthy Diet Look Like?

Author: Dr. Stephen Chaney 

Memory loss due to Dementia and Alzheimer’s disease with the medical icon of a tree in the shape of a human head and brain losing leaves.

Age-related cognitive decline is increasing at an alarming rate. For example:

  • Newly diagnosed cases of Alzheimer’s disease in Americans over 65 reached 6.5 million in 2022.
  • That’s expected to double by 2060.

We have known for years that a whole food, primarily plant-based diet significantly reduces the risk of cognitive decline and Alzheimer’s.

But in our 20s and 30s we tend to ignore that advice. We feel immortal. Aging is something that affects our grandparents – not us.

When we reach our 40s and 50s reality kicks in. Some of our parents, aunts, and uncles start to show symptoms of cognitive decline. Some of our grandparents are suffering from dementia and Alzheimer’s. Maybe we aren’t immortal.

We start to think about changing to a healthier diet and lifestyle. But then the troubling thoughts creep in. “Is it too late? Should I have made those changes in my 20s? Has that ship already sailed?”

A recent study (Y Song et al, Alzheimer’s & Dementia, 2023) was designed to answer that question

How Was This Study Done?

clinical studyThe authors used data from the New York University Women’s Health Study. They studied 5116 women (average age = 46) who enrolled in the study between 1985 and 1991 and were followed for an average of 33 years (average age at the end of the study = 79).

At the beginning of the study, each participant filled out a questionnaire about demographics (age, gender, ethnicity, income, education, and marital status), physical activity, reproductive history, cancer history, and medication use. They also filled out a food frequency questionnaire.

Using the foods reported in the food frequency questionnaires, the scientist rated each woman with respect to adherence to the DASH diet. The women were then separated into quartiles based on their adherence to the DASH diet.

The participants filled out follow-up questionnaires every 3-5 years. Those who did not return the questionnaires were contacted by phone. The last two follow-up questionnaires included a survey of subjective cognitive complaints (SCCs) such as:

  • Recent changes in the ability to remember things.
  • Difficulty remembering recent events.
  • Difficulty remembering a short list of items, such as a shopping list.
  • Difficulty understanding or following spoken instructions.
  • Difficulty following a group conversation or a plot in a TV program.
  • Difficulty navigating familiar streets.

Previous studies have shown that the SCCs survey is an accurate predictor of future dementia and Alzheimer’s.

Finally, the scientists looked at the correlation between adherence to the DASH diet at age 46 with the number of subjective cognitive complaints at age 79.

Is It Too Late To Save Your Mind?

This is what the authors reported:

  • There was an inverse association between adherence to foods in the DASH diet (which was called “DASH adherence” by the authors of this study) at age 46 and subjective cognitive complaints (SCCs) at age 79.
  • Women in the highest quartile of DASH adherence at age 46 had a 17% reduction in 2 or more SCCs at age 79.
  • Every quartile increase in DASH adherence increased the risk of 2 or more SCCs by 7%.

The most frequently reported SCCs were:

  • Recent changes in the ability to remember things (40%).
  • Difficulty remembering a short list of items (19%).
  • Difficulty remembering recent events (17%).

When they looked at the effect of different foods on SCCs (subjective cognitive complaints):

  • Consumption of sweets, red meat, and processed meats were associated with an increased risk of SCCs, with sweets having the largest effect.
  • Consumption of fruits, vegetables excluding potatoes, legumes and nuts were associated with a decreased risk of SCCs at age 79, with fruits having the largest effect.

There were two other findings of interest:

  • The effect of DASH adherence was stronger for Black women than for White women.
  • The protective effect of DASH adherence was stronger in women with no previous history of cancer.

The authors concluded, “We found that a higher level of adherence to the DASH diet in mid-life was associated with lower SCCs later in life among women. These findings suggest that improvements in diet quality in mid-life…may have a role in maintaining an optimal subjective cognition among women…”

What Does This Study Mean For You? 

Questioning WomanLet me start by putting this study into perspective:

  • The strength of this study is that it has the longest follow-up period (33 years) and most diverse population of any study on this topic.
  • It is consistent with several previous studies with shorter follow-up periods, including the Nurses Health Study which also looked at the effect of DASH adherence at mid-life on SCCs later in life.
  • Several studies have shown that the Mediterranean diet protects against cognitive decline. And one recent study showed that mid-life adherence to the Mediterranean diet also offers similar protection against late-life cognitive decline in men.
    • This suggests that any whole food, primarily plant-based eating pattern, is likely to offer similar benefits. That is important because most of us find it easier to focus on foods rather than rigid diets.
  • Three studies that just compared DASH adherence and SCCs when subjects were already in their 60s to 90s, found no protective effect of DASH adherence.
    • This suggests that if we wait until old age and are already starting to experience mental decline, switching to a healthier diet may not be as beneficial for protecting our mind as we would like it to be. However, I would never advise anyone to just throw up their hands and say, “I might as well eat what I like and die happy.” That’s because:
      • Healthy dietary patterns have a multitude of health benefits. Cognitive benefits are just the tip of the iceberg.
      • Statistics report averages, and none of us are average. Some people will experience much better cognitive benefits than others by switching to a healthier diet, even if they wait until their “golden years” to do so.
  • There aren’t any clinical studies looking at adherence to a healthy diet in our 20s or 30s and cognitive outcomes in our 70s. The time span is just too great for clinical studies.
    • So, while we can confidently say, “It’s not too late to save your mind” by switching to a healthier diet pattern like DASH or Mediterranean in middle age, there are no clinical studies showing we might get even better results if we started eating healthy in our 20s or 30s. However, logic tells us that is a likely outcome.
  • This and most studies on this topic have been done with women. That’s because two thirds of Alzheimer’s patients are women.
    • However, the few studies that have been done with men have reported similar results. So, guys, this affects us too.
  • Finally, the fact that DASH adherence was more effective in women who have not had a cancer diagnosis is interesting.
    • In my opinion this is likely because many cancer treatments leave residual “brain fog” and increase the risk of cognitive decline as we age. As someone who spent his life in cancer research, I consider a healthy diet and healthy lifestyle vitally important in helping the body recover from the ravages of cancer treatment.

What Does A Brain-Healthy Diet Look Like? 

According to the most recent US News & World Health ratings of the best diets in various categories, the top 4 diets for brain health are:

  • MIND diet (The MIND diet combines the best of the Mediterranean and DASH diets with an emphasis on brain healthy foods such as berries.)
  • Mediterranean diet.
  • Flexitarian diet (a flexible version of a semi-vegetarian diet).
  • DASH diet.

My Comments:

  • All four diets are whole food, primarily plant-based diets.
  • Although the MIND diet was specifically designed for brain health, it does not perform significantly better than the Mediterranean and DASH diets in slowing cognitive decline.

Of course, most people prefer to think in terms of foods rather than diets. In terms of brain-healthy foods, a recent Harvard Health Review suggests these are the foods we should emphasize for brain health:

  • Green Leafy Vegetables: Kale, spinach, broccoli, and collards are rich in brain-healthy nutrients like vitamin K, lutein, folate, and beta-carotene.
  • Fatty Fish: Salmon, trout, sardines, and mackerel provide omega-3 fatty acids, which are crucial for brain function and for reducing dementia risk.
  • Berries: Blueberries, strawberries, and blackberries contain antioxidants that have been shown to delay cognitive decline.
  • Nuts and Seeds: Walnuts are high in omega-3 fatty acids (ALA), while others provide vitamin E.
  • Healthy Fats: Olive oil is recommended as the primary cooking fat.
  • Whole Grains and Legumes: Oats, quinoa, beans, and lentils provide a steady, slow release of glucose for brain energy. Plus, their fiber supports the growth of friendly bacteria that produce brain-healthy nutrients (This is sometimes referred to as the gut-brain axis).
  • Other Foods: Avocados (monounsaturated fats), beets (nitrates for blood flow), and cocoa (flavonoids) are beneficial.

The Bottom Line 

A recent study showed that adherence to a healthy eating pattern like the DASH diet at middle age can help protect our brain from cognitive decline 30 years later.

For more information on this study and what it means for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

_______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 _______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 54 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Can You Cut Your Risk Of Heart Disease By 90%?

The Effect Of Ultra-Processed Foods On Heart Disease Risk
 

Author: Dr. Stephen Chaney

strong heartHeart disease is a killer. It continues to be the leading cause of death – both worldwide and in industrialized countries like the United States and the European Union. When we look at heart disease trends, it is a good news – bad news situation.

  • The good news is that heart disease deaths are continuing to decline in adults over 70.
    • The decline among senior citizens is attributed to improved treatment of heart disease and more seniors following heart-healthy diets.
  • The bad news is that heart disease deaths are starting to increase in younger adults, something I reported in an earlier issue of “Health Tips From the Professor.”
    • The reason for the rise in heart disease deaths in young people is less clear. However, the obesity epidemic, junk and convenience foods, and the popularity of fad diets all likely play a role.

Everyone has a magic diet to reduce the risk of heart disease. The American Heart Association tells us to avoid fats, especially saturated fats. Vegans tell us to avoid animal protein. Paleo and Keto enthusiasts tell us carbs are the problem.

But what if we eliminated junk and convenience food AND switched to a really healthy diet? How much would that reduce heart disease risk? A recent study (Y Willett et al, The American Journal of Medicine, in press, 2026) looked at the first part of that question. It looked at the effect of ultra-processed food (what we call junk and convenience foods) consumption on the risk of developing heart disease.

How Was This Study Done?

Clinical StudyThe scientists analyzed data from 4787 participants in the most recently published (2021 to 2023) National Health and Nutrition Examination Survey (NHANES). The average age of participants in the survey was 55 years, with 56% of them being women.

All the participants in this study had completed a dietary survey of everything they ate over the last two days. They also reported whether they had ever experienced a heart attack or stroke.

Ultra-processed foods were defined as foods that are industrially modified and loaded with added fats, sugars, starches, salts, and chemical additives.

The percentage of ultra-processed foods in their diet was calculated, and the participants were divided into quartiles based on the percentage of ultra-processed foods they consumed.

Participants with the highest quartile of ultra-processed food consumption were compared to those in the lowest quartile with respect to the risk of cardiovascular disease (self-reported heart attack or stroke). The data were corrected for age, sex, race, ethnicity, smoking status, and income.

The Effect Of Ultra-Processed Foods On Heart Disease Risk

Fast Food DangersThe results were striking:

  • The participants in the highest quartile for ultra-processed food consumption had a 47% higher risk of heart disease compared to those in the lowest quartile for ultra-processed food consumption.

The authors concluded, “Adults who consumed the highest amount of ultra-processed foods had a statistically significant 47% increased risk of heart disease. Large scale randomized trials are needed, but in the meantime, health care providers should advise patients to decrease consumption of ultra-processed foods in addition to adopting other therapeutic lifestyle changes and adjunctive drug therapies of proven benefit.”

The authors recognized the difficulty of making those changes in a world where ultra-processed foods are ubiquitous and cheap.

However, they drew parallels to tobacco use in this country. They said, “Just as it took decades for the dangers of smoking to become widely accepted, reducing reliance on ultra-processed foods may take time. This is partly due to the influence of large multinational companies that dominate the food market. In addition, many people face limited access to healthier food options.”

They went on to say, “Addressing ultra-processed foods isn’t just about individual choices – it’s about creating environments where the healthy option is the easy option.”

Can You Cut Your Risk Of Heart Disease By 90%?

The short answer is, “probably not”. But you can reduce the risk of heart disease by a lot – and probably by a lot more than 47%.

That’s because this study did not look at what the participants were replacing the ultra-processed foods with. Some participants may have replaced them with whole food, primarily plant-based diets. Others may have replaced ultra-processed foods with whole food, meat-based diets high in saturated fats.

So, let’s look at the other side of the equation – how much you can reduce your risk of heart disease by eating a healthier diet. In a recent issue of “Health Tips From The Professor”, I reviewed a meta-analysis published in 2022 that looked at 99 clinical studies with tens of thousands of participants that measured the associations between foods or food groups and heart disease risk.

That study reported that:

  • Processed Meat: A single serving of processed meat increased heart disease risk by 27% to 44%.
  • Red Meat: Unprocessed red meat increased heart disease risk by as much as 27% – but only at ≥3 servings per day. The results with lower intakes were inconsistent – some studies showed increased risk, but others did not.
  • Poultry, Eggs, and Dairy Foods: They did not appear to affect heart disease risk.
  • Fish: Two to four servings per week of fatty fish decreased heart disease risk by around 12%.
  • Fruit: Two servings per day of fruit reduced heart disease risk by 21-32%.Vegan Foods
  • Vegetables: Two servings of vegetables per day reduced heart disease risk by 18-21%.
  • Legumes (beans and peas): Four servings per week reduced the risk of heart disease by around 14%.
  • Nuts: One serving (a handful) per day reduced the risk of heart disease by around 25%. 
  • Whole Grains: Two servings of whole grains per day reduced the risk of heart disease by 25%-34%.
  • Overall: When heart-healthy foods were consumed as part of the Mediterranean diet heart disease risk was reduced by 47%. Similar overall reductions in heart disease risk are likely with other heart-healthy diets like DASH, MIND, Flexitarian (flexible semi-vegetarian), and vegan diets.

In summary:

  • The first study shows that eliminating ultra-processed foods (junk and convenience foods) from your diet can decrease heart disease risk by 47% – but doesn’t tell us what the ultra-processed foods were replaced with. And it would take a much larger study to determine which food swaps were most effective at reducing heart disease risk.
  • The second study was a meta-analysis that told us that eating more fish and plant foods in the context of a heart-healthy diet can decrease your risk of heart disease by 47% – but doesn’t tell us what those healthy foods were replacing. And many of the individual studies included in the meta-analysis were conducted when ultra-processed food consumption was much less than it is today.

It would be tempting to add 47% plus 47% and conclude that eliminating ultra-processed food consumption and replacing ultra-processed foods with heart-healthy foods could decrease your risk of heart disease by 94%. But it’s not that simple. There are too many unanswered questions from these studies.

But it is safe to say that if we eliminated ultra-processed foods AND replaced them with heart-healthy foods in the context of a heart-healthy diet, we should be able to reduce our heart disease risk by more than 47% – perhaps much more.

What Do These Studies Mean For You?

There are two important lessons from these studies:

#1: Eliminating ultra-processed foods from your diet will significantly decrease your risk of heart disease.

And it isn’t just heart disease. Other recent studies have shown that eliminating ultra-processed foods from your diet helps you:

  • Control your weight (It is perhaps the most important lifestyle change to make if you want to maintain GLP-1-aided weight loss).
  • Reduce your risk of cancer.
  • Reduce your risk of diabetes.
  • Reduce your risk of inflammatory diseases.
  • Reduce anxiety and depression.
  • Increase your healthspan (your healthy years).

In short, ultra-processed foods are killers.

#2: Replacing ultra-processed foods with heart-healthy foods (fruits, vegetables, legumes, nuts, whole grains, and fish) in the context of a healthy diet (Mediterranean, DASH, MIND, Flexitarian, and vegan, for example) is likely to decrease your risk of heart disease even more.

  • And if your diet consists of mostly heart-healthy foods, you can add moderate amounts of heart-neutral foods (poultry, eggs, and dairy).
  • And the latest evidence suggests that you can even add small amounts of red meat in the context of a heart-healthy diet (As I have said in previous issues of “Health Tips From the Professor”, plant foods contain the antidotes to all the bad things about red meat.)

Finally, you might ask why I emphasize both heart-healthy foods and heart-healthy diets. There are two reasons:

  • Most of us think in terms of foods rather than diets.
  • The food industry is only too happy to provide us with ultra-processed foods for “heart-healthy” diets like the vegan and Mediterranean diet.

The Bottom Line

Two recent studies have shown how each of us can dramatically reduce our risk of heart disease.

  • The first study showed that eliminating ultra-processed foods from our diet can significantly decrease our heart disease risk – but didn’t tell us what the ultra-processed foods were replaced with.
  • The second study showed that eating more heart-healthy foods in the context of a heart-healthy diet can significantly decrease our risk of heart disease – but didn’t tell us what those healthy foods were replacing.

Taken together, those studies show us a clear path for dramatically decreasing our heart disease risk.

For more details about these studies and what they mean for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 _____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

_______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

Give Your Heart A Valentine

How Can You Give Your Heart A Valentine?

Author: Dr. Stephen Chaney

Happy valentines day

Valentine’s Day is just around the corner. You have probably already selected Valentine Day cards and gifts for those nearest and dearest to you. But what about your heart. It’s your most trusted companion. Doesn’t it deserve a valentine?

The best Valentine’s gift you could give your heart would be a heart healthy diet. But what is a heart-healthy diet?

You may remember the nursery rhyme, “Jack Sprat could eat no fat. His wife could eat no lean…” You may know people who fit these extremes. And in terms of diets these extremes might represent the vegan and keto diets in today’s world.

The nursery rhyme assures us that, “…between them they licked the platter clean.” But were their diets equally heart-healthy? Which of them would have been more likely to live a long and healthy life, free of heart disease?

If you search Mr. Google – even with AI assist – you might be confused. That’s because AI bases its recommendations on the quantity of posts, not the accuracy of posts. And lots of media influencers recommend both diets, and just about every popular diet in between for heart health.

But what does good science say on the topic of heart healthy diets? Fortunately, a recent comprehensive review and meta-analysis (G. Riccardi et al, Cardiovascular Research, 118: 1118-1204, 2022) has answered that question.

How Was The Study Done?

clinical studyThe investigators reviewed 99 clinical studies with tens of thousands of participants that looked at the associations between foods or food groups and heart disease risk.

Most of the studies were “prospective cohort” studies in which:

  • Populations are divided into groups (cohorts) based on the foods they consume…
  • …and followed for a number of years (this is where the term “prospective” comes from)…
  • …and at the end of the study, the association between food and heart outcomes is measured.

However, the review also included several major randomized controlled clinical trials, including:

  • The DASH diet study.
  • The Lyon Diet Heart study.
  • The PREDIMED study.

Give Your Heart A Valentine

What is a heart-healthy diet? Here are the findings of the study. Most will sound very familiar. But you will note strong heartsome subtle differences based on recent data.

The overall summary was that for a healthy adult population:

  • Low consumption of salt and foods of animal origin…
  • …and increased intake of plant foods…
  • …are associated with reduced heart disease risk.

Of course, we have known that for years. It’s when they broke the data down further that it became more interesting.

Foods Of Animal Origin:

  • Processed meats increase heart disease risk. A single serving of processed meat is associated with a 27% to 44% increased risk of heart disease. This is not new.
  • Unprocessed red meat is also associated with increased risk of heart disease, but this association is not as consistent as for processed meats. The authors noted that some of this may be due to differences in saturated fat content or cooking methods of the red meats included in individual studies.

But this analysis also showed that the effect of red meat on heart disease risk may be dose dependent. For example:

    • The studies they reviewed suggested that consuming ≥3 servings per day of red meat is associated with a 27% increased risk of heart disease. However, consuming <3 servings per week may not increase risk, especially when consumed in the context of an otherwise heart-healthy diet.
  • White meat such as poultry does not appear to affect heart disease risk. This has been predicted by earlier reports, but this analysis strengthens those predictions.
  • Fish consumption decreases heart disease risk. This is not new. But this review added precision about recommended fish intake (2-4 servings/week) and a couple of caveats:
    • The heart benefits of fish may be due to their omega-3 content and may not apply equally to fish with lower omega-3 content.
    • The authors also expressed concerns about the sustainability of high-omega-3 fish populations. I would also add that our oceans are increasingly polluted, so contamination is another concern.
  • Egg consumption up to one egg/day does not appear to increase heart disease risk. This is consistent with the current American Heart Association recommendations.

However, the authors noted that the effect of eggs on serum cholesterol, and hence heart disease risk depends on several factors.

    • Genetics, obesity, and diabetes can make it more difficult to regulate serum cholesterol levels. For these individuals, eggs may need to be eaten only sparingly.
    • Diets low in saturated fat and high in fiber from plant foods help the body regulate serum cholesterol. Several studies suggest that eggs may decrease heart disease risk in the context of this type of a heart-healthy diet.
  • Dairy: Neither low-fat nor high-fat dairy foods appear to influence heart disease risk. This is different from the standard recommendation to consume low-fat dairy foods. But it is in line with the trend of recent research studies on dairy and heart disease.

Once again, there were a couple of caveats:

    • There is increasing evidence that fermented dairy foods may decrease heart disease risk which may explain why certain high-fat cheeses and other high-fat fermented dairy foods appear to have a neutral or slightly beneficial effect on heart disease risk.
    • As with eggs, the effect of high-fat dairy foods on heart disease risk may be influenced by genetics and diet context.

Vegan FoodsFoods Of Plant Origin: The effects of plant foods on heart health have been known for some time, and the most recent studies included in this analysis have not changed those conclusions.

  • Fruits and Vegetables consistently reduce heart disease risk in multiple studies. In each case, the optimal intake appears to be about 2 servings of each per day which provides an 18-21% risk reduction for vegetables and a 21-32% risk reduction for fruits.
  • Legumes (beans and peas) also consistently reduce heart disease risk in multiple studies. At the optimal intake of around 4 servings per week the risk reduction is around 14%.
  • Nuts also consistently reduce heart disease risk. At the optimal intake of around one serving (a handful) per day, the risk reduction is around 25%.
  • Cereals (grains) were divided into 3 categories:
    • Refined carbohydrates with a high glycemic index (e.g., white rice, white bread) are associated with increased heart disease risk in multiple studies probably due to their effect on blood sugar levels. And the increased risk is significant (Around 66% higher risk for every 2 servings).
    • Refined carbohydrates with a low glycemic index (e.g., pasta, corn tortillas) show an inconsistent effect on heart disease risk.
    • Whole grains are consistently associated with a lower heart disease risk. Two servings of whole grains per day are associated with a 25%-34% decreased risk.

Miscellaneous Foods:

  • Soft Drinks are associated with increased heart disease risk. One serving per day increases the risk by around 15-22% and recent evidence suggests that artificially sweetened soft drinks offer no heart health benefits compared to sugar sweetened soft drinks.
  • Coffee and Tea are both associated with decreased heart disease risk. For coffee the optimal benefit may occur at around 3 cups/day. Higher levels may have an adverse effect on heart disease risk.

Summary of Heart Health Recommendations

ScientistIf you think that was a lot of information, the authors provided a numerical summary of their recommendations for a heart-healthy diet. They are:

  • Two servings per day of vegetables, fresh fruits, and whole grains.
  • One serving per day of nuts and seeds, low-glycemic index refined cereals, extra-virgin olive oil or non-tropical vegetable oils, and yogurt.
  • Four servings per week of legumes and fish.
  • No more than 3 servings per week of white meat, eggs, cheese, and milk.
  • No more than 2 servings per week of high-glycemic index refined starchy foods, red meat, and butter.
  • Only occasional consumption of processed meats.

How Can You Give Your Heart A Valentine?

Of course, nobody wants to follow a “diet by the numbers”. If you are like most of us, you want flexibility and you Questionswant to be able to eat some of your favorite foods. So, let me put these recommendations into a more “user friendly” form.

If you want to give your heart a valentine:

  • Whole, unprocessed or minimally processed, plant foods are your heart’s best friends.
  • Your heart-healthy foundation should be fruits, vegetables, whole grains, nuts and seeds, healthy plant oils, and legumes.
    • Your heart-healthy foundation can also include fermented dairy foods and low-glycemic index refined grains.
    • Your “go-to” beverages should be water, tea (both caffeinated and herbal teas), and coffee. You should avoid soft drinks and other sugar-sweetened or artificially sweetened beverages.
  • Once you have achieved a heart-healthy foundation you can add a few servings per week of white meat, eggs, cheese, and dairy, even high-fat dairy.
    • If you have good adherence to the heart-healthy foundation described above and no genetic or health issues that increase your risk of heart disease, you can probably eat more of these foods.
    • Conversely, if your adherence to the heart-healthy foundation is poor and/or you are at high risk of heart disease, you may wish to consume less of these foods.
  • If you have good adherence to the heart-healthy foundation, you can also add up to 1-2 servings of high-glycemic index refined carbohydrates, red meat, or butter per week. With red meat, you may want to consider it as a garnish that adds flavor to a plant-based meal rather than the centerpiece of the meal.
    • You should eat processed meats seldom or never.

This would be the best Valentine’s gift you could possibly give your heart.

The Bottom Line

For those of you who might want to give your heart a valentine, a new comprehensive review and meta-analysis of 99 clinical studies with tens of thousands of participants has updated the correlation between foods and heart disease risk.

Many of the recommendations based on this analysis are identical to previous recommendations for a heart-healthy diet.

But there are some subtle changes to those recommendations based on the latest data.

For more details about this study and what a heart-healthy diet might look like for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 54 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

 

 

Is The New Food Guide Pyramid Healthy?

A Brief History Of USDA Food Guides

Author: Dr. Stephen Chaney

Unless you have cut yourself off from all outside media, you already know the USDA has just released new “Dietary Guidelines For Americans” and a new, upside down, food pyramid.

Both the AMA and AHA have endorsed the new guidelines with some reservations. But like everything else in today’s world they have become both political and controversial.

  • Some experts are saying, “The new guidelines are fantastic. They will make Americans much healthier. It’s about time the government caught up with the latest scientific advances.
  • Others are saying, “The new guidelines are terrible. They will set medicine back 20 years.”

As usual, the truth lies somewhere in the middle. I will explore that middle ground and discuss the pros and cons of the new dietary guidelines and food guide pyramid in this article.

But first we should start with something everyone can agree with, “What we are doing now isn’t working!” For example:

  • The percentage of Americans who are overweight or obese is approaching 70%.
  • The United States spends more on healthcare per person than any other country in the world. But we…
    • Rank 48th in life expectancy. We not only rank below every developed country, but we also rank below many 3rd world countries.
      • And we are losing ground. In 1990, we ranked 35th in life expectancy.
    • Rank 69th in health span (healthy life expectancy).
      • Again, we are losing ground. Our ranking was 42nd in 1990.
    • Rank dead last (183rd out of 183) in health span as a percentage of life expectancy.

In short, we are falling behind the rest of the world in terms of lifespan, health span, and percentage of healthy years.

And our deteriorating health is costly.

90% of our health care spending is for preventable diseases

A Brief History Of USDA Food Guides

The USDA introduced the first food guide pyramid in 1992 based on the best nutrition science of the time. You probably remember the mantra:

  • 2-3 servings of dairy, preferably low fat.
  • 2-3 servings in the protein category (lean meats, fish, dry beans, eggs, and nuts).
  • 2-4 servings of fruits and 3-5 servings of vegetables.
  • 6-11 servings of grains (bread, cereals, rice, and pasta).
  • Fats, oils, and sweets were at the top of the pyramid with the caption, “Use Sparingly”.

This pyramid and the accompanying dietary guidelines were publicized so much that practically everyone knew them by heart.

Ten years later the USDA did a nutrition survey to see if their guidelines had changed American’s eating behavior. The answer was a clear, “No”. Only 5% of Americans ate according to the food guide pyramid.

The Geniuses at the USDA concluded that the food guide pyramid must be too difficult for the average American, so they introduced a simpler version, My Pyramid in 2005.

Guess what! Only 5% of Americans followed those recommendations, so they went to the super simple My Plate. By now you have probably guessed that only 5% of Americans followed the My Plate recommendations.

It turns out Americans weren’t confused by the recommendations. The recommendations were just too different from the way they were used to eating.

So, one change you will see in the new food guide pyramid is it includes some of Americans favorite foods, such as red meat, butter, and full fat dairy. Is that sacrilege or is it smart? Only time will tell.

With that in mind, let’s discuss the new “Dietary Guidelines For Americans”.

#1: Eat Real Food

This is one recommendation that virtually everyone agrees with. The average American is getting 55% of their calories from highly processed foods. And the health consequences of that much processed food are devastating. Consumption of highly processed foods is linked to higher risk of:

  • Obesity.
  • Type 2 diabetes.
  • Heart attack.
  • Stroke.
  • Some cancers.
  • Depression and anxiety.
  • Dementia
  • Premature death.

If you are wondering how we got to this point, the answer is simple. It stems from the desire of Americans to eat a healthier diet without giving up their favorite foods and the willingness of Big Food Inc (the food industry) to give us exactly what we want. For example:

  • Some people want to eat a more plant-based diet, but don’t want to give up their favorite meats. Big Food Inc is only too happy to oblige. They mix some fat, salt, and a witch’s brew of chemicals to give us phony baloney, faken bacon, and everyone’s favorite, tofurkey.
  • Some people are convinced keto diets are healthy, but don’t want to give their favorite sweets. Again, Big Food Inc is only too happy to oblige. They mix up a witch’s brew of chemicals to give us keto cookies and keto pastries.

I’m being facetious, but you get my point.

Some representatives of Big Food Inc claim that the health risks of processed foods are unproven. They are lying!

If you would like to read my reviews of major studies showing the health risks of highly processed foods, just go to https://www.chaneyhealth.com/healthtips/ and put “processed foods” in the search box.

#2: Prioritize Protein Foods at Every Meal

protein foodsThis is one of the more controversial recommendations of the new food guide pyramid. The new USDA dietary guidelines increase the protein recommendation by 50-100% compared to previous versions…

  • From 0.36 grams of protein per pound of body weight to…
  • Between 0.54 and 0.72 grams of protein per pound of body weight.

[Note: If these numbers seem different from what you have seen, that is because the official recommendations are in grams of protein per kilogram of body weight. Since most Americans have no idea what their body weight is in kilograms, those numbers are useless.]

The main criticisms about the new protein recommendations are:

#1: “There isn’t solid evidence that most people need this much protein.”

My response is that anyone who makes that claim hasn’t kept up with the last two decades of protein research.

The old 0.36/pound standard is probably OK for the average middle-aged couch potato, but higher protein intakes are needed for people who are:

  • Active, especially if they are trying to increase muscle mass, strength, or endurance.
  • Over 50 and are trying to maintain muscle mass, strength, and mobility.
  • Trying to lose weight without losing muscle, especially if they are using GLP-1 drugs.
  • Trying to reduce the risk of type 2 diabetes and other chronic diseases.

In short, almost everyone except the couch potatoes will benefit from higher protein intakes. And, yes, the latest science shows that it is best to get at least 20 grams of protein with each meal.

You can find more information about the science behind increased protein recommendations by going to https://www.chaneyhealth.com/healthtips/ and putting “protein” in the search box.

#2: “The new guidelines don’t steer people towards plant proteins”. This is a subtle distinction. The new USDA dietary guidelines include plant protein sources. But they do not recommend that they replace some of the animal proteins in the diet, as did previous versions. This allows people to choose between animal and plant proteins based on their preferences.

Those of you who have been following my “Health Tips From the Professor” blog know that I am an advocate of primarily plant-based diets. I am fully in the “replace some animal protein with vegetable protein” camp.

  • But I acknowledge that is not the way most Americans eat. Perhaps it is time to make dietary recommendations that align more closely with the way people eat if we want to get above 5% acceptance.
  • It would also be difficult to meet the new protein guidelines with plant protein alone unless you add commercially available plant protein supplements.

#3: “Higher protein intakes may be harmful for some people”. Recent research has shown that this concern is overblown for most Americans. However, there are some people who should probably check with their doctor before they increase their protein intake.

  • People who have been diagnosed with kidney disease.
  • People with genetic conditions or diseases that predispose to kidney disease. One example would be poorly controlled diabetes. [Note: I do not mean to imply that higher protein intake is likely to cause kidney disease in these situations. I included this category because people in these situations may have undiagnosed kidney disease.]

In most of these cases, you have probably been warned by your doctor to be careful about excess protein intake. But if you are uncertain about your risk for kidney disease, it never hurts to check with your doctor before increasing your protein intake.

What About Red Meat?

SteakThe new dietary guidelines have been criticized for emphasizing red meat. That criticism is inaccurate. It’s a “tempest in a teapot”.

In fact, red meat is pictured in both the original and the most recent versions of the food guide pyramid. And red meat is mentioned as one source of protein in both the original and the latest versions of dietary guidelines. It is given no special emphasis over other protein sources in either version of the dietary guidelines.

However, I would like to share my perspective on red meat.

  • Diet context matters. As I have said in previous issues of “Health Tips From The Professor”, fruits, vegetables, whole grains, and beans are the antidotes to all the bad aspects of red meat.” And if you look at the new food guide pyramid, red meat and other proteins are in the same neighborhood as fruits and vegetables.
  • Amount matters. Think of red meat as a garnish – for example, 2-3 ounces of red meat as part of a steak salad or stir fry with lots of veggies rather than an 8-ounce steak with fries.

#3: Consume Dairy

dairy foodsThe new dietary guidelines differ from previous versions in both the amount and kind of dairy foods consumed. For example:

  • The old guidelines recommended 2-3 servings of dairy foods per day.
    • The new guidelines recommend 3 servings per day as part of a 2,000-calorie dietary pattern.
    • Since most Americans consume 3,600 to 3,800 calories per day that recommendation translates to at least 5 servings per day.
  • The old guidelines recommended choosing low fat dairy foods.
    • The new guidelines say, “When consuming dairy, include full-fat dairy with no added sugars.”

Since the full-fat dairy recommendation is the most controversial change, I will address it first.

Let me start by saying that I have been a traditionalist with respect to dairy foods. I have recommended low-fat dairy foods for years. But a good scientist must be willing to change their recommendations based on the latest research findings.

And new findings have clearly challenged our perspective on full-fat dairy foods. Several large, well-designed studies over the past decade have shown that full-fat dairy foods are just as healthy as low-fat dairy foods. I will make two comments about these studies.

  • I suspect that the studies may be skewed because much of the data on full-fat dairy comes from countries where most of full-fat dairy foods are fermented – and we know that fermented dairy foods are very healthy.
    • Admittedly, I have no data to back up my suspicion, but I recommend fermented dairy foods as part of your dairy intake. That’s a recommendation everyone can agree with!
  • One recent study has suggested that diet context is important. Specifically, the study suggests that the benefits of full-fat dairy foods are greatest in the context of a healthy, primarily plant-based diet.
    • Similar observations have been made for egg consumption. That suggests that full-fat dairy and eggs provide some important nutrients that may be missing in a vegetarian diet. But in a diet that is already high in saturated fat and cholesterol, the “bad” effects of full-fat dairy and eggs may outweigh the benefits.

You can find more information about full-fat dairy by going to https://www.chaneyhealth.com/healthtips/ and putting “dairy” in the search box.

As for the amount of dairy foods you should consume, I wouldn’t get hung up on the number of servings per day. I interpret the new guidelines as saying, “Don’t be afraid of dairy. It can be an important part of your diet.”

However, the servings of dairy products are more frequently determined by lactose intolerance or sensitivity to milk protein than by dietary guidelines. Many people, including myself, can only consume small, occasional servings of dairy without experiencing digestive distress.

#4: Eat Vegetables & Fruits Throughout The Day

Colorful fruits and vegetablesThe dietary guidelines say, “Eat a variety of colorful, nutrient-dense vegetables and fruits. Specifically, the recommendation is:

  • 3 servings/day of vegetables and 2 servings/day of fruits each day.
    • Once again, the number of servings are based on a 2,000-calorie diet.
    • When you take into account the actual caloric intake of Americans, the recommendations become 3-5 servings/day of vegetables and 2-4 servings/day of fruits.

These recommendations are not controversial. They are universally accepted.

#5: Incorporate Healthy Fats

The new dietary guidelines are:

  • “Healthy fats are plentiful in many whole foods, such as meats, poultry, eggs, omega-3 rich seafood, nuts, seeds, full-fat dairy, olives, and avocados.”
    • This recommendation is not controversial.
  • “When cooking with or adding fats to meals, prioritize oils with essential fatty acids, such as olive oil. Other options can include butter or beef tallow.”
    • This is the most controversial portion of the new dietary guidelines. The usual comment is something like, “How dare they include butter and lard as healthy fats!”

I’m not a fan of lard but let me make a couple of observations about butter.

  • Butter is a whole food. Its ingredient list is typically cream, milk, and salt. If you buy the unsalted version, the ingredient list is even shorter. Margarine and butter substitutes have much longer ingredient lists, often including some questionable ingredients.
  • The frequency of butter use is important. Let me share a personal example. We eat a whole food, primarily plant-based diet. We substitute almond butter for butter on toast and muffins. But there are certain foods like potatoes, winter squash, and corn on the cob that just aren’t the same without real butter. We buy 4 sticks of butter at a time, cut it into pats of butter, and freeze it. Four sticks of butter lasts us a year.

Finally, the critics who say that the new guidelines should not include foods that are high in saturated fat are ignoring the fact that the guidelines say, “Saturated fat consumption should not exceed 10% of total daily calories.” This statement has remained constant since the first food guide pyramid in 1992.

So, the new guidelines are not recommending that we eat more saturated fat as many critics have claimed. They are saying, “A little bit of saturated fat is OK in the context of a whole food diet with lots of fruits, vegetables, and whole grains.

#6: Focus On Whole Grains

The new dietary guidelines are:

  • “Prioritize fiber-rich whole grains.”
  • “Significantly reduce the consumption of highly processed, refined carbohydrates.”

These guidelines are unchanged from previous versions of the guidelines.

What is new is that the guidelines now recommend only 2-4 servings of whole grains per day. That’s a big change from the 6-11 servings per day recommended in the original food guide pyramid.

  • If the 6-11 servings per day were whole grains, the new recommendation would represent a significant decrease in fiber intake. But that’s not how most Americans eat.
  • Since most of the grains in a typical American’s diet are highly processed and refined, reducing the recommended intake to 2-4 servings per day is a step in the right direction.

#7: Limit Highly Processed Foods, Added Sugars, & Refined Carbohydrates

fast foodI call this, “Avoid the bad stuff”. Specifically:

  • Avoid highly processed foods with added sugar and sodium.
  • Limit foods and beverages that include artificial flavors, colors, preservatives, and sweeteners
  • Avoid sugar-sweetened and artificially sweetened beverages.

These recommendations are accepted by almost everyone except the food industry.

However, I should point out that there is also a slight difference in emphasis from previous versions of the USDA dietary guidelines:

  • The new guidelines are more restrictive for added sugars than previous versions of the dietary guidelines. For example, they say:
    • One meal should contain no more than 10 grams of added sugars.
    • Children under the age of 10 should not be given foods with added sugars (previous versions of the dietary guidelines recommend avoiding added sugars for children under the age of 2).

Given the wealth of evidence that added sugars are linked to increased risk of obesity and chronic diseases, these stricter restrictions on added sugars make good sense – especially because the USDA dietary guidelines form the basis for school lunch programs.

But these guidelines are very different from how the average American eats. I’m not sure how many Americans will follow them.

#8: Limit Alcoholic Beverages

The guidelines:

  • Say, “Consume less alcohol for better overall health”.
  • List people who should completely avoid alcohol.

The only controversy about this recommendation is that it is less specific than the previous guidelines that recommended no more than 1 alcoholic drink/day for women and no more than 2/day for men.

I recognize the desire for specificity. But alcohol tolerance depends on several factors such as body weight, genetics, and medication usage.

What Does This Mean For You?

Questioning WomanThe USDA just released a new version of the Food Guide Pyramid and accompanying “Dietary Guidelines For Americans”, and they are very different from previous versions. What do these changes mean for you?

While the AMA and AHA have both endorsed the new guidelines, they have been controversial. In the article above, I have summarized the pros and cons of every recommendation. There are lots of recommendations, so it was a long article.

To help you make sense of the article let me summarize the recommendations and criticisms by dividing the recommendations into 4 categories:

#1: Recommendations that are accepted by almost everyone except the food industry. These are non-controversial.

  • Eat real food
  • Eat vegetables and fruits throughout the day.
  • Focus on whole grains.
  • Limit highly processed foods, added sugar, and refined carbohydrates.

#2: Changes in recommendations that reflect recent scientific advances. Critics of these changes simply haven’t kept up with scientific publications over the past couple of decades.

  • Increasing the daily protein recommendations.
  • Including full-fat dairy as a healthy dairy food.

#3: Tempests in a teapot: There is a kernel of truth in these criticisms, but the changes are much more modest than the critics would have you believe.

  • Including red meat in the protein recommendations.
  • Including some saturated fats in the “healthy fats” category.
  • Not including specific limits on alcohol consumption, as the previous version had done.

#4: What I would have liked to have seen:

  • More emphasis on plant proteins.
  • Elimination of lard from the “healthy fat” category.
  • Inclusion of high-quality vegetable oils in the “healthy fats” category.

The Bottom Line

The USDA just released a new version of the Food Guide Pyramid and accompanying “Dietary Guidelines For Americans”.

While the AMA and AHA have both endorsed the new guidelines, they have been controversial.

In this article I describe the pros and cons of each dietary guideline and divide them into ones for which:

  • They are clearly an improvement over the previous guideline.
  • They are accepted by almost everyone.
  • The criticism is a “tempest in a teapot”.
  • The criticism is at least partially accurate.

For more information on the pros and cons of the new “Dietary Guidelines For Americans” and how these guidelines apply to you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 _____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

_______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading Biochemistry textbooks for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 55 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

Which Diets Were Best In 2025?

Which Diet Should You Choose For Good Health?

Author: Dr. Stephen Chaney

Question MarkMany of you started 2026 with goals of losing weight and/or improving your health. In many cases, that involved choosing a new diet.

And for many of you the “bloom” has already gone off the new diet you started so enthusiastically January 1st.

  • Perhaps the diet isn’t working as well as advertised…
  • Perhaps the diet is too restrictive. You are finding it hard to stick with…
  • Perhaps you are always hungry or constantly fighting food cravings…
  • Perhaps you are starting to wonder whether there is a better diet than the one you chose January 1st
  • Perhaps you are wondering whether the diet you chose is the wrong one for you…

If you are rethinking your diet, you might want to know which diets the experts recommend. Unfortunately, that’s not as easy as it sounds. The diet world has become just as divided as the political world.

Fortunately, you have an impartial resource. For 15 consecutive years US News & World Report has invited a panel of experts with different points of view to evaluate popular diets. They then combined the input from all the experts into rankings of the diets in various categories.

They did not rank diets this year but said that little has changed since their last rankings in 2025.

If you are still searching for your ideal diet, I will summarize the US News & World Report’s “Best Diets In 2026”. For the full report, click on this link.

How Was This Report Created?

Scientists-ConversingUS News & World Report recruited panel of 69 nationally recognized experts in diet, nutrition, obesity, food psychology, diabetes, and heart disease to review the most popular diets. This year they reviewed 38 diets in 21 different categories based on the most common reasons for choosing a specific diet.

Of course, fad diets come and go. Each year they drop diets that are no longer popular and add ones that are either new or have recently surged in popularity.

The panel rated diets based on:

  • Nutritional Completeness: The best diets include a variety of nutrient-dense foods that provide essential carbohydrates, protein, healthy fats, vitamins, and minerals.
  • Health Benefits and Risks: These diets are evidenced-based, promote health benefits, reduce disease risks, and focus on high-fiber, nutrient-rich, and antioxidant-packed foods.
  • Proven and Sustainable: These diets are supported by a large body of evidence that they protect against chronic disease and promote a long, healthy life. These diets also provide clear guidelines on what to eat more of and what to eat less of while allowing flexibility to suit personal preferences, including flavors, cultural cuisines and budget. Because these diets are adaptable, they are more sustainable in the long run and less likely to promote a rigid eating approach.

US News & World Report converted the experts’ ratings to scores 5 (highest) to 1 (lowest). They then used these scores to construct 21 categories of Best Diets rankings. I have included the following 8 categories in this Health Tips Blog.

  • Best Diets Overall ranks diets on several different parameters, including whether all food groups are included in the diet, the availability of the foods needed to be on the diet and the use of additional vitamins or supplements.

They considered if the diet was evidence-based and adaptable to meet cultural, religious, or other personal preferences.

In addition, the criteria also included evaluation of the prep and planning time required for the diet and the effectiveness of the diet for someone who wants to get and stay healthy.

  • Best Plant-Based Diets used the same approach as Best Diets Overall to rank the plans emphasizing minimally processed foods from plants that were included in this year’s ratings.
  • Best Healthy Weight-Loss Diet ratings were generated by combining the safety of the weight loss program and the likelihood of the plan to result in successful long-term weight loss and maintenance of weight loss.
  • Best Fast Weight-Loss Diets were scored on their effectiveness for someone who wants to lose weight in three months or less.
  • Best Diabetes Diet ratings were calculated equally from the effectiveness of the diet for someone who wants to lower risk factors for diabetes, the nutritional quality of the diet, and research evidence-based support for the diet.
  • Best Heart-Healthy Diet ratings were calculated equally from the effectiveness of the diet for someone who wants to lower risk factors for hypertension and other forms of heart disease, the nutritional quality of the diet, and evidence-based support for the diet.
  • Best Diets for Inflammation were diets of whole, minimally processed foods like vegetables, fruits, whole grains, healthy fats, nuts, seeds, beans, fatty fish and lean proteins that have been shown to decrease inflammation. 
  • Easiest Diets to Follow represents panelists’ averaged scores for the relevant lifestyle questions, including whether all food groups are included and if the recommended foods are readily available at the average supermarket.

Which Diets Were Worst In 2025?

Emoticon-BadI did not include the worst diets in each category I listed below, but the US News & World Report article gave clear guidelines on what to avoid when choosing a healthy diet. In their words:

  • Avoid processed foods and sugary snacks: Sure, they taste great, but these can leave you with energy crashes and cravings that lead to overeating.
  • Watch out for “diet” foods: Just because something says “low-fat” or “diet” doesn’t mean it’s healthy. These foods often have added sugars or artificial ingredients. It is worth checking the label.
  • Skip extreme restrictions: Cutting out entire food groups or drastically slashing calories might work short term, but it’s hard to stick with and usually leads to burnout or regaining weight.
  • Focus on progress, not perfection: The best weight-loss strategies are about balance and flexibility, not rigid rules. Life happens, so it’s better to aim for consistency over time than to stick to an overly strict plan you can’t keep up with.
  • Focus on lifestyle change, not a quick fix: Healthy weight loss isn’t about quick fixes. It’s about building a lifestyle you enjoy and change sustain. Small changes, like adding more veggies to your meals or choosing water rather than sodas, may not seem like much, but they add up to lasting results over time.
  • Consistency over time beats perfection: An occasional slice of cake or pizza with friends won’t ruin your progress.

Which Diets Were Best In 2025?

Are you ready? If this were an awards program, I would be saying “Envelop please” and would open the envelop slowly to build suspense.

However, I am not going to do that. Below I have listed the top 5 diets in each of the 8 categories I have chosen (If your favorite diet is not on the list and you would like to see where it is ranked, you will need to subscribe to US News & World Report).

Finally, I have excluded commercial diets from this review. I have focused on whole food diets based on foods you can easily find in your local grocery store or farmer’s market.

Best Diets Overall

The best overall diets were:

#1: Mediterranean Diet. The Mediterranean diet has been ranked #1 for 10 consecutive years.

#2: DASH Diet (This diet was designed to keep blood pressure under control, but you can also think of it as an Americanized version of the Mediterranean diet.)

#3: Flexitarian Diet (A flexible semi-vegetarian diet).

#4: MIND Diet (A combination of the Mediterranean and DASH diets with foods selected that support brain health).

#5: The Mayo Clinic Diet (A 12-week program based on evidence-based behavioral science to establish life-long healthy eating habits).

Best Plant-Based Diets 

plant-based diets vegetablesThe top diets in this category were:

#1: Flexitarian Diet.

#2: Mediterranean Diet.

#3: Vegan Diet (a plant-based diet that eliminates all animal products).

#4: MIND Diet

#5: Ornish Diet (A low-fat, plant-based diet designed by Dr. Dean Ornish as part of a heart-healthy lifestyle program that has successfully reversed atherosclerotic buildup in some patients).

Best Healthy Weight-Loss Diets

The top diets in this category are proven. They are associated with lower weight and a reduced risk of chronic Weight Lossdiseases in long-term clinical studies. The top diets are:

#1: Mediterranean Diet

#2: Volumetrics Diet (A diet based on the caloric density (calories per serving) of foods).

#3: Mayo Clinic Diet (A diet designed to establish lifelong healthy eating habits).

#4: Flexitarian Diet.

#5: DASH Diet.

Best Fast Weight-Loss Diets

weight lossOnce again, the report emphasized the dangers of quick weight loss diets. If you choose one of these diets to achieve a quick weight loss goal, the authors recommend you use these diets as a stepping stone toward a healthier lifestyle rather than a final solution.

Here are the rapid weight loss ratings:

#1: Keto Diet (A very low carb, high fat diet designed to produce ketosis in your body).

#2: South Beach Diet (A low carb, high protein approach to weight loss).

#3 Atkins Diet (The grandfather of the keto diet).

#4: Volumetrics Diet.

#5: Keyto Diet (A low-carb version of the Mediterranean diet).

Best Diabetes Diets

The key criteria for the best diabetes diets were that they were well-balanced, healthy diets that were designed to Diabetes and healthy diekeep glucose levels within the normal range throughout the day.

They are whole food diets that cut back on added sugars and refined carbs. The top diets in this category are: 

#1: Mediterranean Diet

#2: Flexitarian Diet

#3: MIND Diet

#4: DASH Diet.

#5: Mayo Clinic Diet.

#7: Vegan Diet.

Best Heart-Healthy Diets

strong heartThe top diets in this category were:

#1: DASH Diet

#2: Mediterranean Diet

#3: MIND Diet.

#4: Vegan Diet.

#5: Flexitarian Diet.

#6: TLC Diet. (The TLC (Therapeutic Lifestyle Change) diet was designed by the NIH to lower LDL cholesterol levels naturally.

Best Diets for Inflammation

The top diets in this category are:Flames

#1: Mediterranean Diet.

#2: Dr. Weil’s Anti-Inflammatory Diet.

#3: Flexitarian Diet.

#4: DASH Diet.

#5: MIND Diet.

#7: Vegan Diet.

Easiest Diets to Follow

EasyThe authors of this report considered easy diets to be ones that:

  • Fit into your lifestyle, letting you enjoy indulgences while still being wholesome and nutritious – whether you’re eating out or at home. They focus on building long-term habits, not quick fixes, making them easier to stick with daily.
  • Focus on filling, tasty meals instead of strict restrictions.

They only listed four diets that were healthy, based on whole foods that were readily available, offered easy to follow recipes, and fit the criteria listed above.

#1: Mediterranean Diet (For those who enjoy Mediterranean foods).

#2: Flexitarian Diet (For those who enjoy flexible, semi-vegetarian meals).

#3: DASH Diet (For those who prefer American foods).

#4: MIND Diet (For those who could go either Mediterranean or American and are concerned with brain health).

Which Diet Should You Choose For Weight Loss?

1) If you are looking for rapid weight loss, any whole food restrictive diet will do.

  • In previous year’s evaluations both vegan and keto diets ranked near the top of the rapid weight loss category. Keto and vegan diets are both very restrictive, but they are polar opposites in terms of the foods they allow and restrict.
    • The keto diet is a meat heavy, very low carb diet. It restricts fruits, some vegetables, grains, and most legumes.
    • The vegan diet is a very low-fat diet that eliminates meat, dairy, eggs, and animal fats.
  • Whole food, very low carb diets like Atkins and keto are good for rapid weight loss, but they rank near the bottom of the list for every healthy diet category.
    • If you choose to lose weight on the Atkins or keto diets, switch to a healthier diet once you reach your desired weight loss.

2) If you are looking for healthy weight loss or just a healthy diet, the Mediterranean diet tops the list year after year, followed closely by the DASH, MIND, and flexitarian diets.

  • They are all whole food, primarily plant-based diets, that are backed by dozens of clinical studies showing that they are associated with a healthy weight and low risk of chronic disease long term.

Of course, GLP-1 drugs are the “elephant in the room” when we talk about weight loss. GLP-1 drugs work, but:

  • They are associated with concerning side effects such as:
    • Anxiety, depression, and suicidal thoughts. This is particularly concerning for anyone who has a tendency for anxiety or depression.
    • Muscle loss. This is particularly concerning for seniors who are already prone to age-related muscle loss.
    • Rarer side effects include increased risk of pancreatitis, kidney problems, and some cancers.
  • Unless they are coupled with dietary and lifestyle changes, their effects are temporary. The weight comes roaring back as soon as they are discontinued.
    • This is a concern because of their expense and side effects. Long-term use of these drugs:
      • Increases the cost of healthcare which increases health insurance costs for all of us (a topic which is in the news lately).
      • Increase the risk of side effects.

Which Diet Should You Choose For Good Health?

Food ChoicesWith rapid weight loss out of the way, let’s get back to the question, “Which Diet Should You Choose For Good Health?”

The Mediterranean diet tops the list year after year, followed closely by the DASH, MIND, and Flexitarian diets. But how do you choose between them? My recommendations are:

1) Choose a diet that fits your needs. That is one of the things I like best about the US News & World Report ratings. The diets are categorized. If your main concern is diabetes, choose one of the top diets in that category. If your main concern is heart health… You get the point.

2) Choose diets that are healthy and associated with long term weight loss. If that is your goal, you will notice that primarily plant-based diets top these lists. Meat-based, low carb diets like Atkins and keto are near the bottom of the lists.

3) Choose diets that are easy to follow. The less-restrictive primarily plant-based diets top this list – diets like Mediterranean, DASH, MIND, and flexitarian. They are also at or near the top of almost every diet category.

4) Choose diets that fit your lifestyle and dietary preferences. For example, if you don’t like fish and olive oil, you will probably do much better with the DASH or Flexitarian diet than with the Mediterranean diet.

4) Finally, focus on what you have to gain, rather than on foods you have to give up.

  • On the minus side, none of the diets include America’s favorite foods such as sodas, junk foods, and highly processed foods. These foods should go on your “No-No” list. Sweets should be occasional treats and only as part of a healthy meal. Meat, especially red meat, should become a garnish rather than a main course.
  • On the plus side, primarily plant-based diets offer a cornucopia of delicious plant foods you probably didn’t even know existed. Plus, for any of the top-rated plant-based diets, there are websites and books full of mouth-watering recipes. Be adventurous.

The Bottom Line

For many of you the “bloom” has gone off the new diet you started so enthusiastically in January. If you are rethinking your diet, you might want to know which diets the experts recommend. Unfortunately, that’s not as easy as it sounds. The diet world has become just as divided as the political world.

Fortunately, you have an impartial resource. Each year US News & World Report invites a panel of experts with different points of view to evaluate popular diets. They then combine the input from all the experts into rankings of the diets in various categories according to individual health goals. In the article above I summarize the US News & World Report’s “Best Diets In 2025”.

There are probably two questions at the top of your list.

#1: Which diets are best for weight loss? Here are 2 general principles:

  • If you are looking for rapid weight loss, any whole food restrictive diet will do. The Keto diet tops this list but ranks near the bottom of the healthy diet categories.
  • If you are looking for healthy, long-term weight loss the Mediterranean diets tops the list followed by the Volumetrics, Mayo Clinic, Flexitarian, and DASH diets.

#2: Which diet should you choose for good health? Once again, the Mediterranean diet tops the list followed by the DASH, Flexitarian, MIND, and Mayo Clinic diets. The Vegan diet is the top 10 of most healthy diet lists, while the keto diet is near the bottom.

For more details on 2026 US News & World Report on Best Diets and my advice on how to choose a healthy diet that is best for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

_______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 _______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 54 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

Can A Healthy Diet Help You Lose Weight?

What’s New About This Study?

Author: Dr. Stephen Chaney 

fad dietsNew Year’s resolutions are just around the corner. Some of you will resolve to lose weight, and some of you will resolve to eat healthier. But can you do both?

Any restrictive diet will give you short-term weight loss. And weight loss will give you improvement in blood parameters that might signal a reduced risk of heart disease, stroke, and diabetes.

The operative word here is “might”. Long-term studies are required to determine whether a diet actually reduces the risk of chronic diseases.

So, the important question becomes, “Can weight loss diets be healthy long term”. For some of them, the answer is a clear no. Others are unlikely to be healthy but have not been studied long term, so we don’t know whether they are healthy or not.

That’s the dilemma most of you face this January. If most weight loss diets are unhealthy long term, do you have to choose between weight loss and good health when you make your New Year’s resolutions?

Maybe not. What if you started from the opposite perspective? What if you asked, “Can a healthy diet help you lose weight?” The study (S Schutte et al, American Journal of Clinical Nutrition, 115: 1-18, 2022)) I will review this week suggests it can.

How Was This Study Done?

clinical studyThis was a randomized controlled trial, the gold standard of clinical studies. The investigators recruited 100 healthy, abdominally obese men and women aged 40-70. At the time of entry into the study none of the participants:

  • Had diabetes.
  • Smoked
  • Had a diagnosed medical condition.
  • Were on a medication that interfered with blood sugar control.
  • Were on a vegetarian diet.

The participants were randomly assigned to:

  • A high-nutrient quality diet that restricted calories by 25%.
  • A low-nutrient-quality diet that restricted calories by 25%.
  • A continuation of their habitual diet.

The study lasted 12 weeks. The participants met with a dietitian on a weekly basis. The dietitian gave them all the foods they needed for the next week and monitored their adherence to their assigned diet. They were advised not to change their exercise regimen during the study.

At the beginning and end of the study the participants were weighed, and cholesterol, triglycerides, and blood pressure were measured.

Can A Healthy Diet Help You Lose Weight?

Vegetarian DietThis study compared a healthy diet to an unhealthy diet with the same degree of caloric restriction. And it compared both diets to the habitual diet of people in that area. This study was performed in the Netherlands, so both weight loss diets were compared to the habitual Dutch diet.

To put this study into context, these were not healthy and unhealthy diets in the traditional sense.

  • Both were whole food diets.
  • Both included fruits, vegetables, low-fat dairy, and lean meats.
  • Both restricted calories by 25%.

The diets were designed so that the “high-nutrient quality” diet had significantly more plant protein (in the form of soy protein), fiber, healthy fats (monounsaturated and omega-3 fats), and significantly less added sugars than the “low-nutrient-quality” diet.

When the investigators measured weight loss at the end of 12 weeks:

  • Participants lost significant weight on both calorie-restricted diets compared to the group that continued to eat their habitual diet.
    • That is not surprising. Any diet that successfully restricts calories will result in weight loss.
  • Participants on the high-nutrient quality diet lost 33% more weight than participants on the low-nutrient-quality diet (18.5 pounds compared to 13.9 pounds).
  • Participants on the high-nutrient quality diet lost 50% more inches in waist circumference than participants on the low-nutrient-quality diet (1.8 inches compared to 1.2 inches).
    • Waist circumference is a direct measure of abdominal obesity.

When the investigators measured blood pressure, fasting total cholesterol levels, and triglyceride levels at 12 weeks:

Prescription for good health overhead with stethoscope, healthy fresh food and exercise equipment, with copy space.
  • These cardiovascular risk factors were significantly improved on both diets.
    • Again, this would be expected. Any diet that causes weight loss results in an improvement in these parameters.
  • However, the reduction in total serum cholesterol was 2.5-fold greater in the high-nutrient quality diet group than in the low-nutrient-quality diet group.
  • The reduction in triglycerides was 2-fold greater in the high-nutrient quality diet group than in the low-nutrient-quality diet group.
  • The reduction in systolic blood pressure was 2-fold greater and the reduction in diastolic blood pressure was 1.67-fold greater in the high-nutrient quality diet group than in the low-nutrient-quality diet group.

The authors concluded, “Our results demonstrate that the nutrient composition of an energy-restricted diet is of great importance for improvements of metabolic health in an overweight, middle-aged population. A high-nutrient quality energy-restricted diet enriched with soy protein, fiber, monounsaturated fats, omega-3 fats, and reduced in fructose and other added sugars provided additional health benefits over a low-nutrient quality energy-restricted diet, resulting in greater weight loss…and promoting an antiatherogenic blood lipid profile.”

In short, participants in this study lost more weight and had a better improvement in risk factors for heart disease on a high-nutrient-quality diet than on a low-nutrient-quality diet. Put another way, a healthy diet can help you lose weight. Healthy eating helped them lose more weight and gave them greater improvement in their health.

What’s New About This Study?

Simply put this study confirms that:

  • Caloric restriction leads to weight loss, and…
  • Weight loss leads to improvement in cardiovascular risk factors like total cholesterol, triglycerides, and blood pressure.
    • This is not new. It is true for any diet that results in caloric restriction.

However, this study breaks new ground in that it shows a high-nutrient quality diet results in significantly better…

  • Weight loss and…
  • Reduction in cardiovascular risk factors….

…compared to a low-nutrient quality diet with the same degree of caloric restriction.

What Does This Study Mean For You?

As I said above, the distinction between a “high-nutrient-quality” diet and a “low-nutrient-quality” diet may not be Questioning Womanwhat you might have expected.

  • Both diets were whole food diets. Neither diet allowed sodas, sweets, and highly processed foods.
  • Both included fruits, vegetables, grains, and lean meats.
  • Both reduced caloric intake by 25%.
    • If you want to get the most out of your weight loss diet, this is a good place to start.

However, in this study the investigators designed their “high-nutrient-quality” diet so that it contained:

  • More plant protein in the form of soy protein.
    • In this study they did not reduce the amount of animal protein in the “high-nutrient-quality” diet. They simply added soy protein foods to the diet. I would recommend substituting soy protein for some of the animal protein in your diet.
  • More fiber.
    • The additional fiber came from substituting whole grain breads and brown rice for refined grain breads and white rice, adding soy protein foods, and adding an additional serving of fruit.
  • More healthy fats (monounsaturated and omega-3 fats) in place of saturated fats.
    • The additional omega-3s came from adding a fish oil capsule providing 700mg of EPA and DHA.
  • Less added sugar.

All these changes make great sense if you are trying to lose weight. 

ProfessorI would group these changes into 7 recommendations.

1) Follow a whole food diet. Avoid sodas, sweets, and highly processed foods.

2) Include all 5 food groups in your weight loss diet. Fruits, vegetables, whole grains, dairy, and lean proteins all play an important role in your long-term health.

3) Eat a primarily plant-based diet. My recommendation is to substitute plant proteins for at least half of your high-fat animal proteins. And this study reminds us that soy protein foods are a convenient and effective way to achieve this goal.

4) Eat a diet high in natural fiber. Including fruits, vegetables, whole grains, beans, nuts, seeds, and soy foods in your diet is the best way to achieve this goal.

5)  Substitute healthy fats (monounsaturated and omega-3 fats) for unhealthy fats (saturated and trans fats) in your diet. And this study reminds us that it is hard to get enough omega-3s in your diet without an omega-3 supplement.

6) Reduce the amount of added sugar in your diet. This is best achieved by eliminating sodas, sweets, and highly processed foods from the diet.

7) Finally, I would like to remind you of the obvious. No diet, no matter how healthy, will help you lose weight unless you cut back on calories. Fad diets achieve that by restricting the foods you can eat or the time you are allowed to eat. In the case of a healthy diet, the best way to do it is to cut back on portion sizes and choose foods with low caloric density.

The Bottom Line 

A recent study asked, “Can a healthy diet help you lose weight?” This study was a randomized controlled study, the gold standard of clinical studies. The participants were randomly assigned to:

  • A high-nutrient quality diet that restricted calories by 25%.
  • A low-nutrient-quality diet that restricted calories by 25%.
  • Continue with their habitual diet.

These were not healthy and unhealthy diets in the traditional sense.

  • Both were whole food diets.
  • Both included fruits, vegetables, low-fat dairy, and lean meats.
  • Both restricted calories by 25%.

The diets were designed so that the “high-nutrient quality” diet had significantly more plant protein (in the form of soy protein), fiber, healthy fats (monounsaturated and omega-3 fats), and significantly less fructose and other added sugars than the “low-nutrient-quality” diet.

At the end of 12 weeks:

  • Participants on the high-nutrient quality diet lost 33% more weight and had better cardiovascular markers than participants on the low-nutrient-quality diet.

The authors concluded, “Our results demonstrate that the nutrient composition of an energy-restricted diet is of great importance for improvements of metabolic health in an overweight, middle-aged population. A high-nutrient quality energy-restricted diet enriched with soy protein, fiber, monounsaturated fats, omega-3 fats, and reduced in fructose and other added sugars provided additional health benefits over a low-nutrient quality energy-restricted diet, resulting in greater weight loss…and promoting an antiatherogenic blood lipid profile.”

In short, participants in this study lost more weight and had a better improvement in risk factors for heart disease on a high-nutrient-quality diet than on a low-nutrient-quality diet. Put another way, a healthy diet can help you lose weight. Healthy eating helped them lose more weight and gave them greater improvement in their heart health.

For more details on this study, what this study means for you, and my 7 recommendations for a healthy weight loss diet, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

 _____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

_______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

How To Live To 117

The Secrets To A Long And Healthy Life

Author: Dr. Stephen Chaney

SecretsToday’s “Health Tip” is a bit unusual. It’s not based on a clinical study with thousands of participants. It’s not even a clinical study based on dozens of people. It’s a case study of one individual.

The study was published in Cell Reports Medicine, but I learned about it in our local newspaper (Yes, the professor still reads the newspaper in addition to published clinical studies. I don’t rely on the internet for all my information.)

I chose this case study because it was so interesting. It is based on the life of a woman, Maria Branyas Morera, who lived in good health to the age of 117. In her later years she asked her physician, Dr. Manel Estellar – chair of genetics at University of Barcelona’s School of Medicine, to study her and see if he could find out why she lived so long.

The results were fascinating. And while it could be argued that the data from a single individual may be misleading, the conclusions from her doctor’s investigation were consistent with the results of the much larger “Blue Zone” study of centenarians living in regions where a high percentage of people lived to 100 and beyond. I will talk about that study below.

How To Live To 117 

Maria Branyas was born in San Francisco in 1907 of Spanish immigrant parents. Her father died when she was 8 and her mother moved back to Spain to be with her family. She married and had a son who died at age 52 and two daughters who are now 92 and 94.

Part of the reason for her longevity was that she took good care of herself:

  • She followed a Mediterranean diet.
  • She did not smoke or drink.
  • She walked an hour every day until her 90s. Eventually she had to cut back because of physical limitations but remained as active as possible. When walking became difficult she entered a nursing home.
  • She kept mentally active. For example, she played the piano every day until she was 112.

Part of the reason was socioeconomic.

  • She and her family lived in the same town.
  • She had a close circle of friends and family for emotional support.
  • And as her friends died, she made new ones.
    • This is something that is often not discussed in the aging literature. As you age and your friends die off, it is easy to become isolated, which increases the likelihood of depression and death. The decision to make new friends in your latter years is a choice.

And part of the reason was genetic.

  • In the words of her doctor, “She won the genetic lottery with respect to genetic variants that protect against risk factors like high cholesterol, dementia, heart disease, and cancer.”
    • However, we need to remember that genetics is not everything. Other members of her immediate family shared the same genetic traits, yet died prematurely from Alzheimer’s, cancer, tuberculosis, and heart disease.
    • I like to say, “Genetics loads the gun. Lifestyle pulls the trigger”. In short, both contribute to longevity.

The final part of the puzzle goes beyond genetics.

  • She had an immune system that was unusually strong for someone her age and inflammation that was unusually low for someone her age. Those were probably due to:
    • Epigenetic modifications to her DNA that are associated with younger individuals.
      • Quick review: Epigenetic modifications affect gene activity and are controlled by diet, lifestyle, and the environment.
      • We can never know exactly what caused her youthful epigenetics, but she did have a very healthy diet and lifestyle.
    • She had a microbiome associated with low inflammation.
      • Quick Review: The term microbiome refers to all the microorganisms in our gut and elsewhere on our body. Our microbiome is strongly affected by what we eat and other lifestyle factors such as body weight.
      • In her case, one example of her anti-inflammatory microbiome was a high abundance of Bifidobacteria, probably a direct result of the three yogurts she ate each day.

The Secrets To A Long And Healthy Life 

blue zonesThis brings me to the “Blue Zone” study. I have talked about it in a previous issue of “Health Tips From The Professor”. Let me give you the short version here.

Dan Buettner is a journalist who was fascinated by the topic of longevity. He identified five regions from around the world where an unusually high percentage of people lived into their 100s. He then put together a team of top scientists in the fields of demographics, social anthropology and statistics to study the characteristics of centenarians in each of these regions and got National Geographic to fund the study.

You can see his book on the left, and I will summarize the main conclusions of his study below. Of course, the most important question is how the information garnered from Maria Branyas compares with the conclusions of the “Blue Zone” study. I will indicate that below.

#1: They engage in moderate intensity exercise every day. The answer for Maria is a clear, “Yes”.

#2: They stop eating before they are full. We don’t know this for sure, but she did appear to be at ideal weight towards the end of her life.

#3: They eat a mostly plant-based diet. She ate a Mediterranean diet which qualifies.

#4: They have a libation with their meals. For Maria, this is a “No”.

#5: They have a purpose in their life. We have no information on this aspect of Maria’s life.

#6: They set aside time for relaxation with friends and family. Clearly, this was important for Maria. As old friends died off, she searched for new ones.

#7: They participate in a spiritual community. We have no information on this aspect of Maria’s life.

#8: They put family first. Clearly, family was very important to Maria.

#9: They surround themselves with communities that share their values. It also appears that this was important to Maria.

In short, in his study of Maria’s secrets to longevity Dr. Esteller approached the question of longevity from a different perspective than Dan Buettner. It is regrettable that he didn’t use the data accrued by the “Blue Zone” study as a starting point for his study. But it is clear that Maria epitomized many of the longevity characteristics identified in the “Blue Zone” study.

And, of course, Dr. Esteller’s expertise is human genetics, and he added important information about the importance of genetics, epigenetics, and our microbiome in influencing longevity.

The Bottom Line

The world’s oldest human recently died at age 117. Before she died, gave her doctor permission to study her and determine how she was able to live so long. In short, she asked her doctor to use her life to understand how to help other people live a long and healthy life.

That study has recently been published. The results showed:

  • Her lifestyle mirrored many of the lifestyle characteristics that were associated with longevity in the previous “Blue Zone” study of centenarians (people living to 100 and beyond).
  • This study also identified genetic, epigenetic, and microbiome factors associated with longevity

For more details about the study, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

_____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

________________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

What Diet Is Best For Healthy Aging?

What About Primarily Meat-Based Diets?

Author: Dr. Stephen Chaney

Pinochio

It’s so confusing. Everyone claims they have clinical proof that their diet is the best. You will be healthier and live longer.

But the diets are so different. They range from vegan to keto. They can’t all be equally healthy. What is the truth?

To answer that question, we first need to understand how the proponents of each diet can claim theirs is the perfect diet for health and longevity. It’s because they base their claims on:

  • Short-term studies. Most of their claims are based on studies that range from a few weeks to a few months. You need 20- or 30-year studies to measure the effects of a particular diet on health outcomes.
  • Biological markers (Things like cholesterol and triglyceride levels, blood sugar control, and/or inflammation). Biological markers can predict possible health outcomes. But without long-term studies on actual health outcomes, you don’t know whether those predictions are accurate.
  • Comparisons with the typical American diet. Any diet looks good compared with the American diet.
  • Elimination of highly processed foods. While these diets emphasize different foods, they are all whole food diets. Again, any diet that eliminates processed foods is an improvement.
    • It doesn’t matter whether you restrict calories, restrict certain foods or food groups, or restrict the time you allow yourself to eat. You unconsciously eat less.
    • And when you eat less, you lose weight.
    • And when you lose weight, your cholesterol and triglyceride levels fall, your blood sugar control improves, and inflammation decreases.
    • That’s why short-term weight loss and improvement in biological markers are virtually identical with vegan and keto diets. Those diets are as different as any two diets could be. But they are both highly restrictive diets.

The take-home lesson is clear. Don’t be confused by claims based on short-term studies. What you should look for is:

  • Long-term studies (20 years or more)…
  • that look at the effect of diet on health outcomes, and…
  • do not compare their diet with the typical American diet.

When I first reviewed this topic 8 years ago, I could only find a few studies that met these criteria:

  • One study showed that people consuming primarily plant-based diets weighed less than people who consumed primarily meat-based diets for 20 years or more.
  • Other studies showed that people consuming primarily plant-based diets had a reduced risk of diabetes and heart disease compared to people consuming primarily meat-based diets for 20 years or more.

These are valuable observations, but they are limited. That’s why I was so excited when I came across a recent 30-year study (A-J Tessier et al, Nature Medicine, volume 31, pages 1644-1652, 2025) looking at the effect of 9 different diets on longevity and health outcomes. In short, this study looked at the effect of different diets on healthy aging.

How Was This Study Done?

Clinical StudyThe authors of this study used data from 105,015 participants in the Nurses’ Health Study (NHS) and Health Professionals Follow Up Study (HPFS). Both studies enrolled participants in 1986 and followed them through 2016. In short, they were both 30-year studies. Participants with preexisting chronic diseases were excluded from the study.

  • Lifestyle factors and medical histories were assessed every two years.
  • A detailed dietary assessment was conducted every four years. The assessments measured the intake of 152 foods. Food intakes were averaged over the duration of the study for each participant.

[Note: This study did not measure how the diets of participants changed between 1986 and 2016, although that is an interesting question. Perhaps a future study is planned.]

Based on the foods eaten, the diets of the participants were evaluated for adherence to 9 dietary patterns, which I have described in more detail below.

[Note: To be clear, the participants were not trying to follow these diets. They ate what they ate, and the investigators subsequently compared their dietary pattern with various healthy diets.]

For each of the diets included in this study, participants were divided into quintiles based on how closely their food intake adhered to the recommendations for that diet. Then the highest quintile was compared to the lowest quintile to determine how well that diet predicted “healthy aging” after a 30-year follow-up.

The term “healthy aging” was based on 5 criteria:

  • Longevity – achieving an age of 70 or more.
  • Absence of the top 11 major chronic diseases (cancer, diabetes, myocardial infarction (heart attack), coronary artery disease, congestive heart failure, stroke, Parkinson’s disease, multiple sclerosis, and ALS).
  • No impairment of cognitive function.
  • No impairment of physical health.
  • No mental health issues.

In other words, these were not just individuals who survived 70 years or more. They survived and thrived. They were enjoying their golden years because they still had good health and excellent quality of life.

Diets Included In This Study

The diets included in this study were:

  • AHEI – Alternative Healthy Eating Index (A scoring system developed by Harvard researchers to measure overall diet quality based on its ability to predict lower risks of heart attacks, strokes, and diabetes).
  • aMed – Alternative Mediterranean Diet Index (The aMed diet index differs from the original Med index by separating fruits and nuts into different groups, eliminating dairy, emphasizing whole grains, and excluding red and processed meats in favor of chicken and fish).
  • DASH – Dietary Approaches to Stop Hypertension (The name speaks for itself. But I also sometimes refer to this diet as “the Americanized version of the Mediterranean diet’ because it features foods more familiar to Americans. For example, it allows more red meat options than most of the other diets in this list.
  • MIND – Mediterranean-Dash intervention for Neurogenerative Delay (It is a dietary pattern designed to reduce the risk of Alzheimer’s disease and other forms of dementia. It combines elements of the Mediterranean and DASH diets but differs from both by emphasizing berries as a major fruit source, among other things.)
  • hPDI – Healthy Plant-Based Diet Index (It is a scoring system that measures adherence to a diet rich in healthy plant-based foods and lower consumption of less-healthy plant foods and animal foods.)
  • PHDI – Planetary Health Diet Index (It emphasizes foods (primarily plant foods) that are healthy and are good for the environment. Of the diets on this list, it is the most restrictive and closest to a vegan diet)
  • EDIH – Empirical Dietary Index For Hyperinsulinemia (It is a scoring system that measures the potential of a diet to cause chronically high insulin levels, which is associated with type 2 diabetes and certain cancers.)
  • EDIP – Empirical Dietary Inflammation Pattern (It is a scoring system that measures the inflammatory potential of a diet.)
  • UPF – Consumption of Ultraprocessed Foods (Since recent studies have shown that most Americans get between 55 and 70% of their calories from ultraprocessed foods, this is fast becoming a measure of the typical American diet.)

Note: Except for the UPF diet, these are all whole food, primarily plant-based diets.

What Diet Is Best For Healthy Aging?

Here are the results of the study (drum roll, please):

  • Of the 105,015 participants in this study, only 9.3% achieved healthy aging.
  • Adherence to any of the 8 healthy diets improved the probability of achieving healthy aging.
  • The odds of achieving healthy aging ranged from 1.45 for the Healthy Plant-Based Diet to 1.86 for the Alternative Healthy Eating Index.
  • If you were to pick one winner, it would be the Alternative Healthy Eating Index. And if you were to define healthy aging as achieving an age of 75 or more with the other 4 criteria, the odds increase to 2.24 (more than double) for the Alternative Healthy Eating Index.
  • As you might expect, adherence to a diet high in ultraprocessed foods had the opposite effect. It decreased the odds of achieving healthy aging by 32%.

When you look at each of the criteria for healthy aging individually, the results were a bit more nuanced:

  • For survival to 70+ years, the Alternative Healthy Eating Index and the Planetary Health Diet Index were tied. Both increased the odds of survival by more than 2-fold.
  • The Alternative Healthy Eating Index and the Planetary Health Diet Index were also tied for surviving to 70 with intake cognitive health and intact physical function.
  • The Empirical Dietary Index For Hyperinsulinemia edged out the Alternative Healthy Eating Index for freedom from 11 chronic diseases.

The effect of healthy diets on the odds of achieving healthy aging is independent from BMI, smoking, and physical activity. This means that:

  • The effects of healthy diets on healthy aging were not because people consuming healthy diets weighed less, smoked less, or exercised more.
  • Even if some of your lifestyle choices are suboptimal, choosing a healthy diet will increase your odds of surviving and thriving.

Finally, the study looked at the effects of individual foods on healthy aging. The results were:

  • Higher intakes of fruits, vegetables, whole grains, unsaturated fats, nuts, legumes, and low-fat dairy products increase your odds of healthy aging.
  • Higher intakes of trans fats, sodium, sugary beverages, and red or processed meats decrease your odds of achieving healthy aging.

The effects of these foods on healthy aging aren’t novel. They are consistent with dozens of other studies that have looked at the effect of individual foods on long-term health outcomes. In fact, the diets included in this study were chosen because they included foods that positively affect health outcomes and minimize foods that negatively affect health outcomes.

What About Primarily Meat-Based Diets?

the paleo dietI have good friends who advocate for primarily meat-based diets such as keto, paleo, and carnivore. I’m sure they are going to say, “This study is a sham. It only included primarily plant-based diets, so, of course, it is only going to show benefits for primarily plant-based diets.” I can hear their their questions now:

  • Why didn’t this study include any of the primarily meat-based diets? My answer is: “All the popular meat-based diets exclude one or more of the food groups associated with health and longevity and emphasize one or more of the food groups associated with a shorter, less healthy life. And these food associations are consistent among multiple long-term studies looking at the effect of various foods on health outcomes. 

The authors could have constructed a similar index for each of the popular meat-based diets. But they would have been the inverse of the plant-based diet indices because the foods included and excluded from plant-based and meat-based diets are opposite. Therefore, just like the UPF index, they would have been associated with a decreased probability of achieving healthy aging.”

  • Why did the scientists designing this study ignore the proven health benefits of primarily meat-based diets? My answer is: “The “proven benefits” of primarily meat-based diets are based on short-term studies showing the effects of those diets on biological markers. Long-term studies looking at health outcomes are lacking.”
  • But modern primarily meat-based diets are a special case because they limit carbohydrates and cause ketosis. Why weren’t they included in the study? My answer is: “The Atkins diet limits carbohydrates and causes ketosis. It has been around for more than 50 years. And, to my knowledge, there are no studies showing it is beneficial long term. If the Atkins diet cannot be shown to have long-term health benefits, it is unlikely that modern diets that mimic it are healthy long term.

What Does This Study Mean For You?

confusionThe answer is clear. If you want to survive and thrive in your 70s and beyond, choose a whole food, primarily plant-based diet.

If you want the absolute best diet, follow the Alternative Healthy Eating Index recommendations. There are many online resources to guide you.

However, any whole food, primarily plant-based diet will do. The ones with the most online resources are the Mediterranean, DASH, and MIND diets. Choose the one that best fits your food preferences and lifestyle.

If you want to go more vegetarian, the Healthy Plant-Based Diet is a bit easier than a strict vegan diet.

If you are concerned about the environment, the Planetary Diet is best for you.

If you have specific health issues like hypertension, diabetes, or inflammation, there are diets designed just for you.

And if following structured diets is not your style, just:

  • Eat more fruits, vegetables, whole grains, unsaturated fats, nuts, legumes, and low-fat dairy products.
  • Eat less trans fats, sodium, sugary beverages, and red or processed meats, and ultraprocessed foods.

Finally, even if some of your lifestyle choices are suboptimal, this study shows choosing a healthy diet will increase your odds of surviving to your 70s and thriving.

The Bottom Line

A recent 30-year study looked at the effect of 8 whole food, primarily plant-based diets on healthy aging defined as:

  • Achieving an age of 70 or more.
  • The absence of the top 11 major chronic diseases.
  • No impairment of cognitive function.
  • No impairment of physical health.
  • No mental health issues.

The key findings were:

  • Adherence to any of 8 whole food, primarily plant-based diets improved the probability of achieving healthy aging.
  • The odds of achieving healthy aging ranged from 1.45 for the Healthy Plant-Based Diet to 1.86 for the Alternative Healthy Eating Index.

For more information on this study, why primarily meat-based diets were not considered healthy enough to be included in this study, and what this study means for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 ____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 _______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading Biochemistry textbooks for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

The Low Carb Myth

The “Goldilocks Effect”

Author: Dr. Stephen Chaney

low carb dietThe low carb wars rage on. Low carb enthusiasts claim that low-carb diets are healthy. And they claim the lower you go, the healthier you will be. Let me start with some definitions:

  • The typical American diet is high carb. It gets about 55% of its calories from carbohydrates. [Note: The Mediterranean and DASH diets also get about 55% of their calories from carbohydrates. I’ll talk more about that later.]
  • Moderate carb diets get 26-46% of their calories from carbohydrates. Examples include the low carb Mediterranean diet and the Paleo, South Beach, and Zone diets.
  • Low carb diets get <26% of their calories from carbohydrates. The Atkins diet is the classic example of a low carb diet.
  • Very low carb diets get <10% of their calories from carbohydrates. Examples are the Keto and Carnivore diets.

And I don’t need to tell you that the Keto and Carnivore diets are receiving a lot of favorable press lately.

But some health experts warn that low carb and very low carb diets may be dangerous. For example, several studies have reported that low carb diets increase the risk of mortality (shorten lifespan).

As a consumer you are probably confused by the conflicting claims. Are low carb diets healthy, or is this another myth? In this issue of “Health Tips From the Professor” I am going to discuss two very large studies that came to opposite conclusions.

Both were what we call meta-analysis studies. Simply put, that means they combine the data from several smaller studies to obtain more statistically reliable data. But as Mark Twain said, “There are lies. There are damn lies. And then there are statistics.”

The first study, called the Prospective Urban Rural Epidemiology (PURE) study, was published a few years ago. It included data from 135,335 participants from 18 countries across 5 continents. That’s a very large study, and normally we expect very large studies to be accurate.

It showed a linear relationship between carbohydrate intake and mortality. Simply put, the more carbohydrate people consumed, the greater their risk of premature death. The results from the PURE study had low carb enthusiasts doing a victory lap and claiming it was time to rewrite nutritional guidelines to favor low carb diets.

SkepticWhenever controversies like this arise, reputable scientists are motivated to take another look at the question. They understand that all studies have their weaknesses and biases. So, they look at previous studies very carefully and try to design a study that eliminates the weaknesses and biases of those studies. Their goal is to design a stronger study that reconciles the differences between the previous studies.

And this study had two glaring weaknesses.

  • The percent carbohydrate intake ranged from 40% to 80%. It showed that a moderate carbohydrate intake might be healthier than a high carbohydrate intake, but it provided no information about low carb or very low carb diets.
  • The data was primarily from Asian countries. It was not clear whether it was relevant to the kind of diets consumed in North America and Europe.

A second study published a year later (SB Seidelmann et al, The Lancet, doi.org/10.1016/S2468-2667(18)30135-X) eliminated these weaknesses and resolved the conflicting data.

How Was The Second Study Done?

clinical studyThis study was performed in two parts. This first part drew on data from the Atherosclerosis Risk in Communities (ARIC) study. That study enrolled 15,428 men and women, aged 45-64, from four US communities between 1987 and 1989. This group was followed for an average of 25 years, during which time 6283 people died.

Carbohydrate intake was calculated based on food frequency questionnaires administered when participants enrolled in the study and again 6 years later. The study evaluated the association between carbohydrate intake and mortality.

The second part was a meta-analysis that combined the data from the ARIC study with all major clinical studies since 2007 that measured carbohydrate intake and mortality and lasted 5 years or more. The total number of participants included in this meta-analysis was 432,179, and it included data from previous studies that claimed low carbohydrate intake was associated with decreased mortality.

The Low Carb Myth

The results from the ARIC study were:

GravestoneThe relationship between mortality and carbohydrate intake was a U-shaped curve.

    • The lowest risk of death was observed with a moderate carbohydrate intake (50-55%). This is the intake recommended by current nutrition guidelines.
    • The highest risk of death was observed with a low carbohydrate intake (<20%).
    • The risk of death also increased with very high carbohydrate intake (>70%).
  • When the investigators used the mortality data to estimate life expectancy, they predicted a 50-year-old participant would have a projected life expectancy of:
    • 33.1 years if they had a moderate intake of carbohydrates.
    • 4 years less if they had a very low carbohydrate intake.
    • 1.1 year less if they had a very high carbohydrate intake.
  • And the risk associated with low carbohydrate intake was affected by what the carbohydrate was replaced with.
    • When carbohydrates were replaced with animal protein and animal fat there was an increased risk of mortality on a low-carb diet.

The animal-based low-carb diet contained more beef, pork, lamb, chicken, and fish. It was also higher in saturated fat.which low carb diets are healthy

    • When carbohydrates were replaced with plant protein and plant fats, there was a decreased risk of mortality on a low-carb diet. The plant-based low-carb diet contained more nuts, peanut butter, dark or whole grain breads, chocolate, and white bread. It was also higher in polyunsaturated fats.
  • The effect of carbohydrate intake on mortality was virtually the same for all-cause mortality, cardiovascular mortality, and non-cardiovascular mortality.
  • There was no significant effect of carbohydrate intake on long-term weight gain (another myth busted).

The results from the dueling meta-analyses were actually very similar in some respects. When the data from all studies were combined:

  • Very high carbohydrate diets were associated with increased mortality.
  • Meat-based low-carb diets increased mortality, and plant-based low-carb diets decreased mortality.
  • The results were the same for total mortality, cardiovascular mortality, and non-cardiovascular mortality.

The authors concluded: “Our findings suggest a negative long-term association between life-expectancy and both low carbohydrate and high carbohydrate diets…These data also provide further evidence that animal-based low carbohydrate diets should be discouraged.

Alternatively, when restricting carbohydrate intake, replacement of carbohydrates with predominantly plant-based fats and proteins could be considered as a long-term approach to healthy aging.”

Simply put, that means if a low carb diet works best for you, it is healthier to replace the carbs with plant-based fats and protein rather than animal-based fats and protein.

The “Goldilocks Effect”

Goldilocks EffectThis study also resolved the discrepancies between previous studies. The authors pointed out that the PURE study relied heavily on data from Asian and developing countries, and the average carbohydrate intake is very different in Europe and the US than in Asian and developing countries.

  • In the US and Europe mean carbohydrate intake is about 50% of calories and it ranges from 25% to 70% of calories. With that range of carbohydrate intake, it is possible to observe the increase in mortality associated with both very low and very high carbohydrate intakes.
  • The US and European countries are affluent, which means that low carb enthusiasts can also afford diets high in animal protein.
  • In contrast, white rice is a staple in Asian countries, and protein is a garnish rather than a main course. Consequently, overall carbohydrate intake is greater in Asian countries and very few Asians eat a truly low carbohydrate diet.
  • High protein foods tend to be more expensive than high carbohydrate foods. Thus, very few people in developing countries can afford to follow a very low carbohydrate diet, and overall carbohydrate intake also tends to be higher in those countries.

Therefore, in Asian and developing countries the average carbohydrate intake is greater (~61%) than in the US and Europe (~50%), and the range of carbohydrate intake is from 45% to 80% of calories instead of 25% to 70%. With this range of intake, it is only possible to see the increase in mortality associated with very high carbohydrate intake.ARIC Study

In fact, when the authors of the current study overlaid the data from the PURE study with their ARIC data, there was an almost perfect fit. The only difference was that their ARIC data covered both low and high carbohydrate intake while the PURE study touted by low carb enthusiasts only covered moderate to high carbohydrate intake.

[I have given you my rendition of the graph on the right. If you would like to see the data yourself, look at the paper.]

Basically, low carb advocates are telling you that diets with carbohydrate intakes of 26% or less are healthy based on studies that did not include carbohydrate intakes below 40%. That is misleading. The studies they quote are incapable of detecting the risks of low carbohydrate diets.

In short, the ARIC study finally answered the question, “How much carbohydrate should we be eating if we desire a long and healthy life?” The answer is “Enough”.

I call this “The Goldilocks Effect”. You may remember “Goldilocks And The Three Bears”. One bed was too hard. One bed was too soft. But one bed was “just right”. One bowl of porridge was too hot. One was two cold. But one was “just right”.

According to this study, the same is true for carbohydrate intake. High carbohydrate intake is unhealthy. Low carbohydrate intake is unhealthy. But moderate carbohydrate intake is “just right”.

What Does This Study Mean For You?

QuestionsThere are several important take-home lessons from this study:

1) All major studies agree that very high carbohydrate intake is unhealthy. In part, that reflects the fact that diets with high carbohydrate intake are likely to be high in sodas and sugary junk foods. It may also reflect the fact that diets which are high in carbohydrates are often low in plant protein or healthy fats or both.

2) All studies that cover the full range of carbohydrate intake agree that low and very low carbohydrate diets are also unhealthy. They shorten the life expectancy of a 50-year-old by about 4 years.

3) The studies quoted by low carb enthusiasts to support their claim that low-carb and very low carb diets are healthy don’t include carbohydrate intakes below 40%. That means their claims are misleading. The studies they quote are incapable of detecting the risks of low carbohydrate diets. Their claims are a myth.

4) Not all high carb diets are created equally. As I noted above, the Mediterranean and DASH diets are just as high in carbohydrates as the typical American diet, but their carbohydrates come from whole fruits and vegetables, whole grains, beans, nuts, and seeds. And multiple studies show that both diets are much healthier than the typical American diet.

5) Not all low carb diets are created equally. Meat-based low-carb diets decrease life expectancy compared to the typical American diets while plant-based low carb diets increase life expectancy.

6) The health risks of meat-based low-carb diets may be due to the saturated fat content or the heavy reliance on red meat. However, the risks are just as likely to be due to the foods these diets leave out – typically fruits, whole grains, legumes, and some vegetables.

7) Proponents of low-carb diets assume that you can make up for the missing nutrients by just taking multivitamins. However, each food group also provides a unique combination of phytonutrients and fibers. The fibers, in turn, influence your microbiome. Simply put, whenever you leave out whole food groups, you put your health at risk.

The Bottom Line

The low-carb wars are raging. Several studies have reported that low carb diets increase risk of mortality (shorten lifespan). However, a study published a few years ago came to the opposite conclusion. That study had low carb enthusiasts doing a victory lap and claiming it is time to rewrite nutritional guidelines to favor low-carb diets.

However, a study published a year later resolves the conflicting data and finally answers the question: “How much carbohydrate should we be eating if we desire a long and healthy life?” The answer is “Enough”.

I call this “The Goldilocks Effect”. According to this study, high carbohydrate intake is unhealthy. Low carbohydrate intake is unhealthy. But moderate carbohydrate intake is “just right”.

Specifically, this study reported:

  • Moderate carbohydrate intake (50-55%) is healthiest. This is the carbohydrate intake found in healthy diets like the Mediterranean and DASH diets, and is the intake recommended by current nutritional guidelines.
  • All major studies agree that very high carbohydrate intake (60-70%) is unhealthy. It shortens the life expectancy of a 50-year-old by about a year.
  • All studies that cover the full range of carbohydrate intake agree that low carbohydrate intake (<26%) is also unhealthy. It shortens the life expectancy of a 50-year-old by about 4 years.
  • The studies quoted by low carb enthusiasts to support their claim that low-carb diets are healthy don’t include carbohydrate intakes below 40%. That means their claims are misleading. The studies they quote are incapable of detecting the risks of low carbohydrate diets.
  • Meat-based low-carb diets decrease life expectancy while plant-based low carb diets increase life expectancy. This is consistent with the results of previous studies.

The authors concluded: “Our findings suggest a negative long-term association between life-expectancy and both low carbohydrate and high carbohydrate diets…These data also provide further evidence that animal-based low carbohydrate diets should be discouraged.”

Simply put, the latest study means that the supposed benefits of low carb diets are a myth.

For more details, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

___________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 ______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry textbooks for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Does Diet Matter For Weight Loss?

Who Benefits Most From A Healthy Diet?

Author: Dr. Stephen Chaney 

fad dietsFad diets abound. High protein, low carb, low fat, vegan, keto, paleo – the list is endless. They all claim to be backed by scientific studies showing that you lose weight, lower your cholesterol and triglycerides, lower your blood pressure, and smooth out your blood sugar swings.

They all claim to be the best. But any reasonable person knows they can’t all be the best. Someone must be lying.

My take on this is that fad diet proponents are relying on “smoke and mirrors” to make their diet look like the best. I have written about this before, but here is a brief synopsis:

  • They compare their diet with the typical American diet.
    • Anything looks good compared to the typical American diet.
    • Instead, they should be comparing their diet with other weight loss diets. That is the only way we can learn which diet is best.
  • They are all restrictive diets.
    • Any restrictive diet will cause you to eat fewer calories and to lose weight.
    • And as little as 5% weight loss results in lower cholesterol & triglycerides, lower blood pressure, and better control of blood sugar levels.

Simply put, any restrictive diet will give you short-term weight loss and improvement in blood parameters linked to heart disease, stroke, and diabetes. But are these diets healthy long term? For some of them, the answer is a clear no. Others are unlikely to be healthy but have not been studied long term. So, we don’t know whether they are healthy or not.

What if you started from the opposite perspective? Instead of asking, “Is a diet that helps you lose weight healthy long term?”, what if you asked, “Does the diet you choose matter for weight loss? Can healthy eating help you lose weight?” The study (S Schutte et al, American Journal of Clinical Nutrition, 115: 1-18, 2022)) I will review this week asked these question.

This was an excellent study. It compared a healthy diet to an unhealthy diet with the same degree of caloric restriction. And it compared both diets to the habitual diet of people in that area. This study was performed in the Netherlands, so both weight loss diets were compared to the habitual Dutch diet.

How Was The Study Done?

clinical studyThis was a randomized controlled trial, the gold standard of clinical studies. The investigators recruited 100 healthy, abdominally obese men and women aged 40-70. At the time of entry into the study none of the participants:

  • Had diabetes.
  • Smoked.
  • Had a diagnosed medical condition.
  • Were on a medication that interfered with blood sugar control.
  • Were on a vegetarian diet.

The participants were randomly assigned to:

  • A high-nutrient quality diet that restricted calories by 25%.
  • A low-nutrient-quality diet that restricted calories by 25%.
  • A continuation of their habitual diet.

The study lasted 12 weeks. The participants met with a dietitian on a weekly basis. The dietitian gave them all the foods they needed for the next week and monitored their adherence to their assigned diet. They were advised not to change their exercise regimen during the study.

At the beginning and end of the study the participants were weighed, and cholesterol, triglycerides, and blood pressure were measured.

Does Diet Matter For Weight Loss?

Vegetarian DietThis study compared a healthy diet to an unhealthy diet with the same degree of caloric restriction. And it compared both diets to the habitual diet of people in that area. This study was performed in the Netherlands, so both weight loss diets were compared to the habitual Dutch diet.

To put this study into context, these were not healthy and unhealthy diets in the traditional sense.

  • Both were whole food diets.
  • Both included fruits, vegetables, low-fat dairy, and lean meats.
  • Both restricted calories by 25%.

The diets were designed so that the “high-nutrient quality” diet had significantly more plant protein (in the form of soy protein), fiber, healthy fats (monounsaturated and omega-3 fats), and significantly less fructose and other added sugars than the “low-nutrient-quality” diet.

When the investigators measured weight loss at the end of 12 weeks:

  • Participants lost significant weight on both calorie-restricted diets compared to the group that continued to eat their habitual diet.
    • That is not surprising. Any diet that successfully restricts calories will result in weight loss.
  • Participants on the high-nutrient quality diet lost 33% more weight than participants on the low-nutrient-quality diet (18.5 pounds compared to 13.9 pounds).
  • Participants on the high-nutrient quality diet lost 50% more inches in waist circumference than participants on the low-nutrient-quality diet (1.8 inches compared to 1.2 inches).
    • Waist circumference is a direct measure of abdominal obesity.

When the investigators measured blood pressure, fasting total cholesterol levels, and triglyceride Heart Healthy Dietlevels at 12 weeks:

  • These cardiovascular risk factors were significantly improved on both diets.
    • Again, this would be expected. Any diet that causes weight loss results in an improvement in these parameters.
  • However, the reduction in total serum cholesterol was 2.5-fold greater and the reduction in triglycerides was 2-fold greater in the high-nutrient quality diet group than in the low-nutrient-quality diet group.
  • And the reduction in systolic blood pressure was 2-fold greater and the reduction in diastolic blood pressure was 1.67-fold greater in the high-nutrient quality diet group than in the low-nutrient-quality diet group.

The authors concluded, “Our results demonstrate that the nutrient composition of an energy-restricted diet is of great importance for improvements of metabolic health in an overweight, middle-aged population. A high-nutrient quality energy-restricted diet enriched with soy protein, fiber, monounsaturated fats, omega-3 fats, and reduced in fructose and other added sugars provided additional health benefits over a low-nutrient quality energy-restricted diet, resulting in greater weight loss…and promoting an antiatherogenic blood lipid profile.”

In short, participants in this study lost more weight and had a better improvement in risk factors for heart disease on a high-nutrient-quality diet than on a low-nutrient-quality diet. Put another way, diet does matter for weight loss. Healthy eating helped them lose more weight and gave them greater improvement in their health.

Who Benefits Most From A Healthy Diet?

obesity vs. overweightNone of the participants in this study had been diagnosed with diabetes when the study began. However, all of them were middle-aged, overweight, and had abdominal obesity. That means many of them likely had some degree of insulin resistance.

Because of some complex metabolic studies that I did not describe, the investigators suspected that insulin resistance might influence the relative effectiveness of the two energy-restricted diets.

To test this hypothesis, they used an assay called HOMA-IR (homeostatic model assessment of insulin resistance). Simply put, this assay measures how much insulin is required to keep your blood sugar under control.

They used a HOMA-IR score of 2.5 to categorize insulin resistance among the participants.

  • Participants with a HOMA-IR score >2.5 were categorized as insulin-resistant. This was 55% of the participants.
  • Participants with a HOMA-IR score ≤2.5 were categorized as insulin-sensitive. This was 45% of the participants.

When they used this method to categorize participants they found:

  • Insulin-resistant individuals lost about the same amount of weight on both diets.
  • Insulin-sensitive individuals lost 66% more weight on the high-nutrient-quality diet than the low-nutrient-quality diet (21.6 pounds compared to 13.0 pounds).

The investigators concluded, “Overweight, insulin-sensitive subjects may benefit more from a high- than a low-nutrient-quality energy-restricted diet with respect to weight loss…”

What Does This Study Mean For You?

Questioning WomanSimply put this study confirms that:

  • Caloric restriction leads to weight loss, and…
  • Weight loss leads to improvement in cardiovascular risk factors like total cholesterol, triglycerides, and blood pressure.
    • This is not new.
    • This is true for any diet that results in caloric restriction.

However, this study breaks new ground in that it shows a high-nutrient quality diet results in significantly better…

  • Weight loss and…
  • Reduction in cardiovascular risk factors….

…compared to a low-nutrient quality diet with the same degree of caloric restriction.

As I said above, the distinction between a “high-nutrient-quality” diet and a “low-nutrient-quality” diet may not be what you might have expected.

  • Both diets were whole food diets. Neither diet allowed sodas, sweets, and highly processed foods.
  • Both included fruits, vegetables, grains, and lean meats.
  • Both reduced caloric intake by 25%.
    • If you want to get the most out of your weight loss diet, this is a good place to start.

However, in this study the investigators designed their “high-nutrient-quality” diet so that it contained:

  • More plant protein in the form of soy protein.
    • In this study they did not reduce the amount of animal protein in the “high-nutrient-quality” diet. They simply added soy protein foods to the diet. I would recommend substituting soy protein for some of the animal protein in the diet.
  • More fiber.
    • The additional fiber came from substituting whole grain breads and brown rice for refined grain breads and white rice, adding soy protein foods, and adding an additional serving of fruit.
  • More healthy fats (monounsaturated and omega-3 fats).
    • The additional omega-3s came from adding a fish oil capsule providing 700mg of EPA and DHA.
  • Less added sugar.
    • While this study focused on fructose, their high-nutrient-quality diet was lower in all added sugars.

All these changes make great sense if you are trying to lose weight.

ProfessorI would group these changes into 7 recommendation

1) Follow a whole food diet. Avoid sodas, sweets, and highly processed foods.

2) Include all 5 food groups in your weight loss diet. Fruits, vegetables, whole grains, dairy, and lean proteins all play an important role in your long-term health.

3) Eat a primarily plant-based diet. My recommendation is to substitute plant proteins for at least half of your high-fat animal proteins. And this study reminds us that soy protein foods are a convenient and effective way to achieve this goal.

4) Eat a diet high in natural fiber. Including fruits, vegetables, whole grains, beans, nuts, seeds, and soy foods in your diet is the best way to achieve this goal.

5) Substitute healthy fats (monounsaturated and omega-3 fats) for unhealthy fats (saturated and trans fats) in your diet. And this study reminds us that it is hard to get enough omega-3s in your diet without an omega-3 supplement.

6) Reduce the amount of added sugar, especially fructose, from your diet. That is best achieved by eliminating sodas, sweets, and highly processed foods from the diet. I should add that fructose in fruits and some healthy foods is not a problem. For more information on that topic, I refer you to a previous “Health Tips” article.

7) Finally, I would like to remind you of the obvious. No diet, no matter how healthy, will help you lose weight unless you cut back on calories. Fad diets achieve that by restricting the foods you can eat. In the case of a healthy diet, the best way to do it is to cut back on portion sizes and choose foods with low caloric density.

Finally, I should touch briefly on the third major conclusion of this study, namely that the “high-nutrient quality diet” was not more effective than the “low-nutrient-quality” diet for people who were insulin resistant. In one sense, this was not news. Previous studies have suggested that insulin-resistant individuals have more difficulty losing weight. That’s the bad news.

However, there was a silver lining to this finding as well:

  • Only around half of the overweight, abdominally obese adults in this study were highly insulin resistant.
    • That means there is a ~50% chance that you will lose more weight on a healthy diet.
  • More importantly, because both diets restricted calories by 25%, insulin-resistant individuals lost weight on both diets.
    • That means you can lose weight on any diet that successfully reduces your caloric intake even if you are insulin resistant. That’s the good news.
  • However, my recommendation would still be to choose a high-nutrient quality diet that is designed to reduce caloric intake, because that diet is more likely to be healthy long term.

The Bottom Line 

A recent study asked, “Can healthy eating help you lose weight?” This study was a randomized controlled study, the gold standard of clinical studies. The participants were randomly assigned to:

  • A high-nutrient quality diet that restricted calories by 25%.
  • A low-nutrient-quality diet that restricted calories by 25%.
  • Continue with their habitual diet.

These were not healthy and unhealthy diets in the traditional sense.

  • Both were whole food diets.
  • Both included fruits, vegetables, low-fat dairy, and lean meats.
  • Both restricted calories by 25%.

The diets were designed so that the “high-nutrient quality” diet had significantly more plant protein (in the form of soy protein), fiber, healthy fats (monounsaturated and omega-3 fats), and significantly less fructose and other added sugars than the “low-nutrient-quality” diet.

At the end of 12 weeks:

  • Participants on the high-nutrient quality diet lost 33% more weight and had better cardiovascular markers than participants on the low-nutrient-quality diet.

The authors concluded, “Our results demonstrate that the nutrient composition of an energy-restricted diet is of great importance for improvements of metabolic health in an overweight, middle-aged population. A high-nutrient quality energy-restricted diet enriched with soy protein, fiber, monounsaturated fats, omega-3 fats, and reduced in fructose and other added sugars provided additional health benefits over a low-nutrient quality energy-restricted diet, resulting in greater weight loss…and promoting an antiatherogenic blood lipid profile.”

In short, participants in this study lost more weight and had a better improvement in risk factors for heart disease on a high-nutrient-quality diet than on a low-nutrient-quality diet. Put another way, diet does matter for weight loss. Healthy eating helped them lose more weight and gave them greater improvement in their heart health.

For more details on this study, what this study means for you, and my 7 recommendations for a healthy weight loss diet, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

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My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

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About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

Health Tips From The Professor