Generally speaking, the scientific community most highly lauds the Mediterranean diet as being best for general health:

The Mediterranean Diet: What Is It Good For? ← what isn’t it good for?!

However, even this can be tweaked with specific health considerations in mind, for example:

Four Ways To Upgrade The Mediterranean Diet ← these tweaks offer adjusted versions of the Mediterranean diet, optimized for anti-inflammation, gut health, heart health, or brain health

However, that doesn’t mean that your diet has to be “Mediterranean or nothing”, and let’s face it, most people’s diets are not optimal, even when we’re trying.

For example, this writer? Here I am at 10almonds, researching/thinking/writing about health science every day, very health-conscious as a person, and enjoying a diet that’s easily in the top percentile of healthy eating by European standards, and even my diet is not perfect!

So, what do things look like, on a national level, for older adults in the US?

The big 5

Researchers (Dr. Anniebelle Sassine et al.) did a nationwide analysis of 5,062 US adults aged 60+, which identified five real-world dietary patterns, and the health outcomes of each, as well as the factors that seem* to influence them.

^{*Because this is a retrospective analysis of observational population-based studies, so strictly speaking it cannot establish causality, even if sometimes it’s not tricky to see what’s going on from the data.}

When we say “identified five real-world dietary patterns”, we mean that the data clustered unbidden into 5 groups; it was not a matter of measuring adherence to a priori dietary patterns, so much as simply observing what is, and seeing how the data clusters.

The clusters were as follows:

1. Mediterranean-like: 7.0% scored higher than average on seafood and vegetables, producing one of the highest-quality diets on the Healthy Eating Index (HEI 70) and the lowest combined economic and physical food insecurity (0.5%), suggesting external factors that may affect being able to reliably eat this way.
2. Grains & fermented dairy: 10.8% followed a cooked cereals and yogurt pattern, which had the highest diet quality per the Healthy Eating Index (HEI 72), “healthy” BMI range, and more favorable overall health indicators.
3. Soft or liquid foods: this was the largest pattern, as 53.0% mainly consumed juices, smoothies, alcohol, and soups, with lower diet quality (HEI 66) and the lowest calorie and protein intake, associated with undernutrition, muscle loss, and vulnerability linked to both financial hardship and physical limitations.
   • You may be wondering “how can it be that more than half of the US population of in the the 60+ age range is having such a liquid diet?”, and the answer is that these are ranked per which items provide most calories, and a lot of drinks (especially juices and alcohol) are very high-calorie, so it’s easy to get a majority of one’s daily calories in liquid form without really thinking about it as such.
4. Western salty: 11.0% disproportionately consumed meats, alcohol, and quick breads; this group had the second-worst diet quality (HEI 58).
5. Western sweet: 18.1% enjoyed a lot of cured meats, sandwiches, and sweet bakery products, scoring the absolute lowest on the Healthy Eating Index (HEI 48).

The latter two categories were more likely to include younger older adults, men, smokers, and people with a high BMI.

One quick note: the “Healthy Eating Index” is a good tool, but it’s only a tool, not a sacred text. So, don’t fret over the 70 vs 72 scores for the healthiest two dietary patterns there. After all, the healthiest of those two patterns for you will be the one you most enjoy eating and therefore will actually find sustainable.

Another quick note: nor do you pressingly have to choose between them; just because the data clustered in those ways in the population study does not mean you have to aim to be average. The diet of your writer here doesn’t really fall into either of those (notwithstanding being broadly Mediterranean in pattern, it’s “whole foods plant-based”, and most calories come from olive oil and nuts, sometimes dried fruits, while most dietary bulk comes from vegetables/legumes and whole grains).

To read the paper in full, here it is: Dietary Patterns of U.S. Older Adults and Their Associations with Diet Quality, Health, and Food Insecurity ← if you want to see in more detail what foods and drinks make up each of the five patterns in what proportions, click on this link, then “Save PDF”, then “View PDF”, then scroll down to Table 1, which begins on page 24 (yes, the table stretches over multiple pages, because it’s long).

But, how to make the best personalized choices when it comes to diet?

Ask yourself one question

Do I feel lu—

No wait, that’s not it.

The question is: how will I get my nutrients?

And by nutrients we mean at the very least:

• sufficient calories, because you cannot run a high-end machine without enough fuel!
  • See: Are You A Calorie-Burning Machine?
• an adequate set of macros (carbs, fiber, protein, fats)
  • See also: What Macronutrient Balance Is Right For You?, of which…
    • Should You Go Light Or Heavy On Carbs?
    • What Do The Different Kinds Of Fiber Do? 30 Foods That Rank Highest
    • Protein: How Much Do We Need, Really?, of which…
      • Why You Can’t Skimp On Amino Acids
    • Saturated Fat: What’s The Truth?
    • What Omega-3 Fatty Acids Really Do For Us
• a full complement of vitamins (they are called that for a reason; you will die without them)
  • Being aware of such things as:
    • Which B Vitamins? It Makes A Difference
    • Are Your Vitamin D Supplements Working? Probably Not (Here’s Why & How To Fix It)
    • Vitamin K2 And The Calcium Paradox
• sufficient intake of minerals (or else a lot of things start breaking down and your body will start cannibalizing itself, e.g. taking phosphorus from your bones and teeth in order to maintain the phospholipid layer of cell membranes)
  • Especially bearing in mind: Which Magnesium? (And: When?) ← around 80% of people in the US do not meet the RDA for magnesium, so make sure that’s not you!

Want to learn more about different dietary approaches?

Check out:

Which Diet? Top Diets Ranked By Experts ← a panel of 69 doctors and nutritionists examine the evidence for 38 diets, and score them in 21 categories (e.g. best for weight loss, best for heart, best against diabetes, best for the liver, etc).

Choose wisely!