What Diet Plan Works Best?

 Jennifer Morris, MD PC

ABPN, ABOM, ABPM-add, ISSP

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With so many nutrition plans to chose from when it comes to losing weight, which plan works the best? Surely there is a standout?

In realty, the diet plan that works best is the nutrition plan that one can stick with for both the short and long-haul. This is due to the ongoing work involved in weight management. 

Weight loss is not a "spring" situation, as depicted the top of the graph. Rather, weight loss is a chronic pursuit of health, with components of weight loss, weight gain, and weight maintenance. 

While it is intuitive that there might be an energy balance consideration to weight loss (total energy expenditure >total energy intake) this formula becomes complicated as total energy expenditure becomes impacted by decreased metabolic rate, which can be a factor of weight loss and decreased weight. 

Nutrition plans that have been explored include:

• low calorie diets (1000-1600 kcal/day)
• macronutrient-focused diets including
• low carbohydrate diet (20 grams of carbohydrates/day)
• low  glycemic index diets (no standard definition exits)
• high protein diets (at least 20% of energy intake from protein)
• ketogenic diet
• low fat diet (no more than 30% of energy intake from fat)
• unique concepts such as the low energy density diet (Noom capitalizes on this...larger volumes of food required to attain energy input...celery vs a cookie)
• health specific diets
• DASH (for hypertension)
• Mediterranean
• low inflammation 
• time-focused interventions
• intermittent fasting

   

While the ketogenic diet shows more rapid onset of weight loss, at the one year endpoint, all of these diets were roughly equal in results. The low inflammation diet appears to confer broad benefits for mental health as well as inflammatory medical concerns, and overlaps broadly with the Mediterranean diet. Additionally, satiety appears improved with the low inflammation diet, which avoids processed foods in favor of natural ingredients. 

An interesting study shows that eating proteins or fats before carbohydrates in a meal reduces post-meal glucose spikes in vulnerable individuals (prediabetics and diabetics.) So...not only does WHAT you eat play a role, but how you eat it is impactful.  (Kubota)

Kubota, Sodai, Yanyan Liu, Katsumi Iizuka, Hitoshi Kuwata, Yutaka Seino, an Daisuke Yabe. A Review of Recent Findings on Meal Sequence: An Attractive Dietary Approach to Prevention and Management of Type 2 Diabetes." Nutrients 2020 Sept; 12(9): 2502. Published online 2020 Aug 19; doi 10.3390/nu12092502. Accessed 8/18/24.