logoThe People's Perspective on Medicine

What Is the Best Diet?

The best diet, according to researchers, is rich in produce, whole grains and unsaturated fats. Levels of fat and carbohydrate don't matter much.
Fresh organic artichokes on farmers market in Paris France

Battles have been waged online and even in the pages of nutrition science journals on whether low-fat or low-carb is the best diet. Now researchers have evaluated the correlation of such diets with mortality rates (JAMA Internal Medicine, Jan. 21, 2020). They concluded that what matters more than the proportion of fat or carbohydrate in the diet is the quality of the food.

How Can You Follow the Best Diet for You?

Harvard researchers and their colleagues analyzed data on more than 37,000 American adults from the US National Health and Examination Survey from 1999 to 2014. All of these people had filled out a 24-hour dietary recall questionnaire at the start of the study.

During the approximately 15 years of follow-up, almost 5,000 participants died. The analysis revealed no difference in mortality between people eating low-fat diets and those on low-carb regimens. But further analysis did show a difference. When the researchers factored in quality, they found that high-quality diets were associated with lower mortality.  The winning diets contained primarily whole rather than processed foods, protein mostly from plants rather than animals and unsaturated rather than saturated fats.

Pros and Cons of Low-Carb vs. Low-Fat:

This is not the first study to compare low-fat and low-carb diets. Previous research suggested that people with diabetes are more successful at controlling blood sugar and weight on a low-carb regimen. That appears to be the best diet for them. They still need to make sure that the carbs they do consume are from healthful sources such as low-starch vegetables. In addition, they should be choosing healthful sources of fat such as nuts or olive oil.

On the other hand, nutrition experts have long championed low-fat diets for people who need to control their cholesterol. To maximize the benefit, the person should choose primarily whole grains and produce rather than highly processed foods. Too often, people told to cut fat replaced it with cheap, readily available foods like cereal or snacks high in sugar and white flour. 

Have you found an eating plan that suits you? What principles do you follow? Let us know in the comments below. If you would like to learn more about some proven healthy diet plans, such as the DASH diet (Dietary Approaches to Stop Hypertension) or the Mediterranean diet, you’ll find useful information in our book, The People’s Pharmacy Quick & Handy Home Remedies.

Rate this article
4.2- 83 ratings
About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
The People’s Pharmacy Quick and Handy Home Remedies

Home remedies can be surprisingly effective for a number of common ailments. They're less expensive with fewer side effects than prescription drugs. Time-tested solutions for minor health problems.

The People’s Pharmacy Quick and Handy Home Remedies
  • Shan Z et al, "Association of low-carbohydrate and low-fat diets with mortality among US adults." JAMA Internal Medicine, Jan. 21, 2020. doi:10.1001/jamainternmed.2019.6980
Join over 150,000 Subscribers at The People's Pharmacy

We're empowering you to make wise decisions about your own health, by providing you with essential health information about both medical and alternative treatment options.

Showing 9 comments
Add your comment

Your conclusions contradict somewhat the findings of this Lancet paper: “Both high and low percentages of carbohydrate diets were associated with increased mortality, with minimal risk observed at 50–55% carbohydrate intake. Low carbohydrate dietary patterns favouring animal-derived protein and fat sources, from sources such as lamb, beef, pork, and chicken, were associated with higher mortality, whereas those that favoured plant-derived protein and fat intake, from sources such as vegetables, nuts, peanut butter, and whole-grain breads, were associated with lower mortality, suggesting that the source of food notably modifies the association between carbohydrate intake and mortality.”

A good place to start is simply to eliminate all white flour. That cuts out all pasta, most bread, most desserts. Then build from there: more fruit & vegetables to replace the calories. I keep no solid shortening in the house except butter. I was surprised at how easily I shed 20 lb, & eventually sweets stopped tempting me. My cardiac risk ratio is lower than the low category.

I was never heavier or less well than when I ate low-fat vegan in the 90s. I was eating lots of “healthy whole grains” and very little fat. And lots of soy protein products. Turned out I had gluten intolerance and a thyroid condition that made soy a poor choice for me.

For the last 10 years or so I’ve pretty much eliminated grains, seed oils, added sugars and refined carbs. I eat loads of veggies, extra-virgin olive oil, butter, high quality animal sources for protein and fat, nuts, avocados. My triglycerides went from 100+ to the 50-60 range on this diet. My total cholesterol went up slightly, but my “good cholesterol” is up considerably. I’m a happy camper eating this way.

I’ve been eating low-carb Paleo diet for about 10 years. Before I starting eating this way I was overweight even though I exercised regularly. I was also headed for knee replacements. I gradually became more and more low-carb while decreasing my use of seed oils (soy, canola, corn, etc.) and increasing my intake of olive and avocado oils and saturated fat from clean animal sources and coconut oil. I also added a collagen powder. I am happy to say my weight is normal, my knees have healed on their own, and at 64 years of age I can do more push-ups and pull-ups than I could at age 30. Paleo is actually a plant- based diet with sensible portions of pastured meat with little to no grains and dairy. I didn’t have to starve myself, and my sweet tooth has all but gone away.

Why are you still promoting the diet cholesterol hypothesis which has been disproven over and over?

Where? I couldn’t find a place where we promoted that.

I am a diabetic with a strong history of diabetes in my father’s & mother’s families. I have maintained an A1c between 5.3 – 5.6 for the past 4 years on a traditional Greek diet heavy on vegetables and extra virgin olive oil. I cook beans or lentils in an instant pot to replace animal protein meals. The animal protein that I do buy is grass-fed & grass finished beef, heritage pork, wild caught-sustainable seafood/fish. If I eat chicken or eggs, they are organic-pasture raised/free range. Animal protein makes up about 5-8 meals per week; legumes, cruciferous roasted vegetables, and green salads fill in the rest of my meals. The air fryer is fabulous for quickly roasting veggies and meat. I do find that the less animal protein I eat, the better my health is for glucose, blood pressure, cholesterol and triglycerides.

I guess I should add: I’m 67, obese, and healthy. All my labs are good. I take no chronic medications. I refuse to treat my “high” cholesterol (9 points over guidelines). I don’t exercise as much as I used to.

I eat a Mediterranean diet. My cookbook is from America’s Test Kitchen. I use whole grain rice and pasta in the recipes. Primary fat is either from olive oil, dairy or nuts. Most produce is fresh or dried. Some canned veggies. Lots of dried beans. They usually call for canned, but I typically buy them dried. When I’m ambitious, I grow my own herbs and veggies. (And some fruit).

* Be nice, and don't over share. View comment policy^