What’s the Best Diet? The One That Works for You.

As a physician, one of the most common questions I get is, “What’s the best diet for living longer and staying healthy?” It’s a fair question—and also one with no single answer.

Over the years, I’ve counseled hundreds of patients on nutrition. I’ve seen people thrive on Mediterranean diets, go plant-based and reverse chronic disease, and use intermittent fasting to overcome decades of weight struggles. The science is clear that several dietary patterns can improve health and extend lifespan—but the real key is figuring out which one fits you.

Let’s explore some of the most researched diets and what they might offer:

The Mediterranean Diet: A Heart-Healthy Classic

This is one of the most well-studied diets in the world. The Mediterranean diet focuses on whole foods: fruits, vegetables, whole grains, legumes, nuts, olive oil, and fish, with minimal red meat or processed foods.

In the landmark PREDIMED trial, participants at high cardiovascular risk who followed a Mediterranean diet supplemented with nuts or olive oil had a 30% lower risk of heart attack, stroke, or death from heart disease compared to those on a low-fat diet.

I've had many patients with high blood pressure or early signs of diabetes who see real improvements after just a few months on this diet—often without feeling like they're dieting at all.

The DASH Diet: Lowering Blood Pressure Naturally

The DASH (Dietary Approaches to Stop Hypertension) diet was specifically developed to help lower blood pressure, and it works. It emphasizes fruits, vegetables, whole grains, lean proteins, and low-fat dairy, while limiting sodium, added sugars, and saturated fats.

Numerous studies, including the original DASH trial, have shown that this diet can significantly reduce blood pressure—even without weight loss or medication. For patients with hypertension, I often recommend DASH as a starting point. I've had several patients that were able to get off of one or all of their all of their blood pressure medications, just by following this diet. It’s a great option for people who want structure but don't want to completely overhaul their eating habits.

Vegan & Vegetarian Diets: Plant-Powered Benefits

A growing body of evidence supports the health benefits of vegetarian and vegan diets, especially when they are well-balanced and emphasize whole foods over processed substitutes.

A 2016 meta-analysis published in JAMA Internal Medicine showed that plant-based diets are associated with a reduction in all-cause mortality, as well as lower rates of hypertension, Type 2 diabetes, and obesity.

It helps to think of plant content in your diet as a spectrum rather than a binary phenomenon (vegan vs non vegan). The more plant based you are, the more likely you are to live a longer and healthier life. There is a caveat: When you reach the far end of the spectrum that we call "strict veganism", you must take supplements to avoid developing certain nutritional deficiencies.

Pescatarian Diets: The Seafood Solution

The pescatarian diet, which is essentially a vegetarian diet that includes seafood, offers a great middle ground for many patients. It retains the benefits of plant-forward eating while offering high-quality protein and omega-3 fats from fish.

Research published in the American Journal of Clinical Nutrition found that pescatarians had a lower risk of ischemic heart disease and overall mortality compared to meat-eaters.

Reviewing the evidence, it appears that a pescatarian diet can offer similar health benefits to a vegetarian diet, and I regularly recommend this diet to my patients.

Intermittent Fasting: Time as a Tool

Intermittent fasting (IF) isn’t about what you eat—it’s about when. This style of eating cycles between periods of fasting and eating, and studies have shown it can help regulate insulin sensitivity, promote cellular repair, and even enhance longevity.

I’ve had several patients who struggled for years with portion control. They felt discouraged trying to track calories or follow complicated meal plans. But when they tried time-restricted eating—like the 16:8 method or alternate-day fasting—they finally felt a sense of control.

Several of my patients have found that eating just one satisfying meal a day (OMAD) helps them avoid snacking and eliminates the need to constantly think about food.

The 3 Cardinal Rules of Dieting

We've reviewed some of the most popular and evidence-based diets above. Though there is no one-size-fits-all approach to dieting, in my opinion there are 3 rules that every good diet should follow:

1. Choose Whole Foods Over Processed Products

This is the foundation of any good diet. Choose foods that look like they came from the earth, not from a factory. If a person from the middle ages could see what is on your plate, would they recognize it as food?

2. Make Plants the Star of Your Plate

You don’t have to go fully vegan, but shifting the balance toward more plant-based foods has major benefits. Plants are rich in fiber, antioxidants, and phytonutrients that support your body’s healing and protection mechanisms. Half or more of your plate should be made up of vegetables.

3. Balance Your Calories to Match Your Needs

A calorie is just a unit of energy—like an inch is a unit of length. If we consume more energy than we burn, our body stores it as fat. Excessive fat, especially around the abdomen, is linked to higher risk of almost every chronic disease. To manage calorie intake, you can count calories, control portion sizes, or use intermittent fasting as a structured tool. I’ll dive deeper into strategies for calorie control in a future blog post.

Conclusion

The truth is, there’s no one-size-fits-all diet. The Mediterranean diet might be perfect for one person, while another might thrive on plant-based meals, pescatarian choices, or intermittent fasting. What matters most is how well a diet fits your unique needs, goals, preferences, lifestyle, and personal tendencies. A diet is only effective if it’s sustainable, and the best results come when your plan feels natural, not forced. I do recommend everyone consult their doctor before making any changes to their diet. Happy dieting!

By Ziya Aktig, MD