Is There a Best Diet? Perspectives on Best Diets and Personalized Nutrition

As a cardiologist and lifestyle medicine physician, it doesn’t take long for someone in social or professional circles to pin me on a recommendation for the “best diet.” After I stop cringing about the word diet itself (I favor the term, “eating pattern”), I often answer, “Well it depends”. This might seem like a weak or squishy answer from an expert, but it represents my leaning toward personalized nutrition.

So, what is personalized nutrition? Well, it depends! To some, personalized nutrition is based on genetic, advanced blood, or fecal microbiome testing. I’m fascinated by the literature on these topics and keep a pulse on it all but I’m not convinced that the research is complete and cost effective for widespread use.

As a foundation of my recommendations, I support a predominantly whole food plant-based pattern of eating which has repeatedly been demonstrated to prevent, treat, and often reverse the trajectory of chronic disease, along with optimizing physical and mental performance at all ages.

Excusing the metaphor, a cookie-cutter approach to nutritional recommendations just doesn’t work for most people. Even without ordering a litany of other costly tests, nutritional personalization can go much further by including existing blood work and radiographs to identify cardiac and metabolic risk factors, a thorough understanding of an individual’s existing medical conditions and biometrics, and their family history. 

But let’s get it straight. We need to go further because food is extremely personal in a myriad of ways. For each person:

  • What flavors or food qualities do they love? Savory, sweet, salty, crunchy, smooth, spicy?

  • Do they cook or does someone else cook for them?

  • What is their work and travel schedule and how many meals are they able to eat at home, in takeout, or at restaurants?

  • What their emotional relationship is to food, and

  • What are their treasured family food traditions or customs?

Personalized nutritional recommendations can go even further by looking at ways to bring functional foods or recipe adaptations into someone’s daily eating pattern. For someone with hypertension who relishes salty characteristics, personalization with salt or spice substitutes or adaptations of favorite recipes is key. Knowing how to dose functional foods that have blood pressure-lowering effects such as nitrate-promoting foods is also important. Individuals with high cholesterol or lipids will benefit from foods with certain dietary fibers. For a person wanting to preserve or build muscle mass, solutions that involve the timing of certain foods may be advised. The examples are endless.

There are no “best diets” in the universe. However, there is a personalized eating pattern that will foster the best health outcomes and quality of life for each of us.  

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A Data-Informed Understanding of Mind-Body Medicine with Heart Rate Variability