Table 3

Eating patterns reviewed for this report

Type of eating patternDescriptionPotential benefits reported*
USDA Dietary Guidelines For Americans (DGA) (8)Emphasizes a variety of vegetables from all of the subgroups; fruits, especially whole fruits; grains, at least half of which are whole intact grains; lower-fat dairy; a variety of protein foods; and oils. This eating pattern limits saturated fats and trans fats, added sugars, and sodium.DGA added to the table for reference; not reviewed as part of this Consensus Report
Mediterranean-style (69,76,8591)Emphasizes plant-based food (vegetables, beans, nuts and seeds, fruits, and whole intact grains); fish and other seafood; olive oil as the principal source of dietary fat; dairy products (mainly yogurt and cheese) in low to moderate amounts; typically fewer than 4 eggs/week; red meat in low frequency and amounts; wine in low to moderate amounts; and concentrated sugars or honey rarely.• Reduced risk of diabetes
• A1C reduction
• Lowered triglycerides
• Reduced risk of major cardiovascular events
Vegetarian or vegan (7780,9299)The two most common approaches found in the literature emphasize plant-based vegetarian eating devoid of all flesh foods but including egg (ovo) and/or dairy (lacto) products, or vegan eating devoid of all flesh foods and animal-derived products.• Reduced risk of diabetes
• A1C reduction
• Weight loss
• Lowered LDL-C and non–HDL-C
Low-fat (26,45,80,83,100106)Emphasizes vegetables, fruits, starches (e.g., breads/crackers, pasta, whole intact grains, starchy vegetables), lean protein sources (including beans), and low-fat dairy products. In this review, defined as total fat intake ≤30% of total calories and saturated fat intake ≤10%.• Reduced risk of diabetes
• Weight loss
Very low-fat (107109)Emphasizes fiber-rich vegetables, beans, fruits, whole intact grains, nonfat dairy, fish, and egg whites and comprises 70–77% carbohydrate (including 30–60 g fiber), 10% fat, 13–20% protein.• Weight loss
• Lowered blood pressure
Low-carbohydrate (110112)Emphasizes vegetables low in carbohydrate (such as salad greens, broccoli, cauliflower, cucumber, cabbage, and others); fat from animal foods, oils, butter, and avocado; and protein in the form of meat, poultry, fish, shellfish, eggs, cheese, nuts, and seeds. Some plans include fruit (e.g., berries) and a greater array of nonstarchy vegetables. Avoids starchy and sugary foods such as pasta, rice, potatoes, bread, and sweets. There is no consistent definition of “low” carbohydrate. In this review, a low-carbohydrate eating pattern is defined as reducing carbohydrates to 26–45% of total calories.• A1C reduction
• Weight loss
• Lowered blood pressure
• Increased HDL-C and lowered triglycerides
Very low-carbohydrate (VLC) (110112)Similar to low-carbohydrate pattern but further limits carbohydrate-containing foods, and meals typically derive more than half of calories from fat. Often has a goal of 20–50 g of nonfiber carbohydrate per day to induce nutritional ketosis. In this review a VLC eating pattern is defined as reducing carbohydrate to <26% of total calories.• A1C reduction
• Weight loss
• Lowered blood pressure
• Increased HDL-C and lowered triglycerides
Dietary Approaches to Stop Hypertension (DASH) (81,118,119)Emphasizes vegetables, fruits, and low-fat dairy products; includes whole intact grains, poultry, fish, and nuts; reduced in saturated fat, red meat, sweets, and sugar-containing beverages. May also be reduced in sodium.• Reduced risk of diabetes
• Weight loss
• Lowered blood pressure
Paleo (120122)Emphasizes foods theoretically eaten regularly during early human evolution, such as lean meat, fish, shellfish, vegetables, eggs, nuts, and berries. Avoids grains, dairy, salt, refined fats, and sugar.• Mixed results
• Inconclusive evidence
  • *Source: RCTs, meta-analyses, observational studies, nonrandomized single-arm studies, cohort studies. USDA, U.S. Department of Agriculture.