US News & World Report recently came out with their list of the healthiest diets in 2021; the Mediterranean diet came out on top while the keto diet once again placed last. Their list is based on if the diet is easy to follow, nutritious, safe, effective for weight loss and protective against diabetes and heart disease. (1) So what is it about the Mediterranean diet that puts it on top? For starters it isn’t exactly a ‘diet’, it's more so a lifestyle that is based on the cultural diet of Mediterranean countries. It started in the 1960's when healthcare professionals noticed that heart disease wasn’t a top cause of death for Mediterranean countries like Italy and Greece. (2) After years of research on this it is now known that the Mediterranean diet is associated with an overall lower risk of heart disease. It includes consuming vegetables, fruits, whole grains and healthy fats like nuts, seeds and avocados daily, fish, poultry, beans and eggs weekly, and limiting intake of dairy and red meat. (3) You should aim for consuming 7-10 servings of fruits and vegetables a day, eating fish twice a week and replace butter with olive oil. (2) The diet also emphasizes being physically active and not being afraid to enjoy a glass of red wine every now and then. (2) The main point of this diet to try and live a plant based lifestyle using fresh, local foods when possible and to replace red meat with fish. Many critics of the Mediterranean diet point out that it is high in fats, and while this is true, it is high in healthy fats. Monounsaturated fat is the main fat in this diet, found in olive oil, nuts and seeds. It has been shown to lower total cholesterol and low-density lipoprotein (LDL) cholesterol which is commonly referred to as “bad” cholesterol. (2) Fish are also high in fat, but omega-3 fatty acids which are a type of polyunsaturated fat. Polyunsaturated fat has been shown to reduce inflammation and decrease blood clotting which in turn decreases risk of stroke and heart failure. (2) This diet can also be sustained long term as it doesn’t put your body in any harm and doesn’t require drastic changes. One down side noted is that the diet can be expensive depending on where you live. Getting fresh fish twice a week may not be possible in landlocked places in the US and buying fish is normally more expensive than buying meat. The other down side is this diet can be high in salt depending on the items you are consuming. (4) For example try to buy unsalted nuts and seeds and don’t add extra salt to your meals besides the salt used for seasonings before cooking. The Mediterranean diet works overall because it’s not so much a diet, as it is a healthy lifestyle change. It doesn’t just include watching what you eat, but also how you eat by putting importance on eating with family and friends and designating time for meals so you aren’t distracted by anything else during that time.