Carnivore? Keto? Vegetarian or Vegan? What IS the best choice? What does the evidence show?

Dr. Retzler will often remind her patients there is no perfect diet and that each of us needs to develop our own ideal diet—in other words, she encourages her patients to determine their own ideal diet based on health goals and their current health status.

Ultimately, your "ideal diet" or "best choice" when it comes to diet should be a long-term, sustainable plan based on your biochemical individuality, disease risk, and personal preferences. There is no one-size-fits-all answer, as different diets work better for different people. Here are some factors to consider when determining what diet might be best for you:

1. Health Goals

• Weight Loss: A calorie-controlled, balanced diet that includes a variety of whole foods (like a Mediterranean or low-carb diet) might be effective for sustainable weight loss. The carnivore diet may offer short-term weight loss benefits, but its long-term safety is questionable.
• Improving Metabolic Health: For managing blood sugar, insulin resistance, or pre-diabetes, low-carb or ketogenic diets (which include both plant and animal foods) might be beneficial.
• Building Muscle: A high-protein diet, combined with strength training, helps support muscle gain. The carnivore diet is high in protein, but so are other balanced diets that include lean meats, legumes, and healthy fats.
• Improving Heart Health: Diets rich in fruits, vegetables, whole grains, and healthy fats, like the Mediterranean diet, have strong evidence supporting heart health. The carnivore diet, being high in saturated fats, may increase the risk of heart disease if followed long term.

2. Nutritional Balance

It’s essential to choose a diet that provides all the necessary nutrients:

• Micronutrient Variety: A balanced diet that includes a wide variety of foods (fruits, vegetables, whole grains, lean proteins, and healthy fats) ensures that you get a full range of vitamins, minerals, and antioxidants.
• Fiber Intake: Fiber is crucial for digestive health, gut microbiome balance, and reducing the risk of chronic diseases. Diets that include a variety of plant-based foods provide this important nutrient. The carnivore diet lacks fiber, which can lead to digestive issues over time.

3. Sustainability

The best diet is one that you can stick with in the long term. Consider:

• Enjoyment: Can you enjoy and maintain this diet without feeling deprived? If you find the carnivore diet too restrictive or crave plant-based foods, it may not be a sustainable option.
• Social Considerations: Some diets, like the carnivore diet, can be socially limiting, making it harder to eat out or share meals with others, especially family members. Time and again we often see food choice conflicts arise when one person in the family decides to make choices that are in alignment with their health goals but not that of their spouse or family.

4. Evidence-Based Approaches

Diets with strong scientific backing for overall metabolic health and longevity include the following:

• Mediterranean Diet: Rich in healthy fats (olive oil, nuts), lean proteins, fruits, vegetables, and whole grains, this diet is associated with reduced risk of heart disease, diabetes, and overall mortality.
• Whole-Food, Plant-Based Diets: These diets emphasize plant foods like vegetables, fruits, legumes, and whole grains and are associated with lower rates of heart disease, cancer, and other chronic diseases. They allow for flexibility in including some animal products as well.
• Paleo Diet: Focuses on whole foods like meats, fish, vegetables, fruits, and nuts, while avoiding processed foods. It’s less restrictive than the carnivore diet and may still offer some health benefits by emphasizing nutrient-dense, whole foods.

5. Consult a Healthcare Professional

Before making drastic dietary changes like going carnivore, it’s essential to consult with a healthcare provider or (knowledgable) nutritionist, especially if you have existing health conditions (e.g., diabetes, heart disease, or kidney issues). They can help tailor a diet plan to suit your specific needs and ensure you’re not at risk for nutrient deficiencies or long-term health issues.

Best Overall Choice:

If you're looking for a balanced, sustainable, and evidence-backed diet, the Mediterranean diet is often considered one of the best choices. It promotes heart health, supports weight management, and is nutritionally balanced. If you have more specific health goals (e.g., improving blood sugar control), a modified Mediterranean / low-carb or paleo approach might work well. 

Ultimately, the best choice is one that contains little or no added sugar (read labels), is not processed, aligns with your health goals, provides adequate nutrition, and is sustainable for your lifestyle.