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. 2025 Jan 7;15(1):63.
doi: 10.3390/life15010063.

High and Low Adherence to Mediterranean and DASH Diet Patterns and the Risk of Heart Failure: A Meta-Analysis of Observational Studies

Mehmet Emin Arayici  1   2 , Mustafa Eray Kilic  3 , Mehmet Birhan Yilmaz  3
Affiliations

High and Low Adherence to Mediterranean and DASH Diet Patterns and the Risk of Heart Failure: A Meta-Analysis of Observational Studies

Mehmet Emin Arayici et al. Life (Basel). .

Abstract

Background: The relationship between heart failure (HF) and Mediterranean and DASH diets is not well delineated. This meta-analysis aimed to assess the effectiveness of high adherence to Mediterranean and DASH diets compared to low adherence in reducing the risk of incident HF (primary prevention of HF) and reducing all-cause mortality in patients with HF (secondary prevention of HF).

Methods: The reporting stages of this meta-analysis closely adhered to the PRISMA guidelines. A comprehensive literature search was undertaken for published papers in PubMed, Embase, EBSCO, ICTRP, and the NIH clinical trials databases.

Results: A total of 16 reports from 14 studies were included in this paper. A significant inverse association was identified between high adherence to the Mediterranean diet model (compared to low adherence) and the risk of incident HF (OR = 0.77, 95% CI: 0.63-0.93, p = 0.007) among patients without previous diagnosis of HF. Similarly, there was a significant and inverse relationship between high adherence to the DASH diet (compared to low adherence) and the risk of incident HF (OR = 0.83, 95% CI: 0.70-0.98, p = 0.03) among patients without previous diagnosis of HF. High adherence to the Mediterranean diet model (compared to low adherence) was associated with lower all-cause mortality (OR = 0.88, 95% CI: 0.78-0.99, p = 0.03) among patients with HF.

Conclusions: This paper demonstrated that high adherence to Mediterranean and DASH diets significantly reduced the risk of incident HF among individuals without a previous diagnosis of HF, whereas only high adherence to the Mediterranean diet was associated with lower all-cause mortality among patients with HF.

Keywords: DASH diet; Mediterranean diet; heart failure; meta-analysis.

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Conflict of interest statement

M.E.A. and M.E.K. declare that they have no conflicts of interest to be disclosed. M.B.Y. has received institutional research fees from Bayer Healthcare Pharmaceuticals, Amgen, Novartis, Dalcor Pharmaceuticals, Novo Nordisk, Astra Zeneca, and Boehringer Ingelheim.

Figures

Figure 1
Figure 1
Flow chart for the selection of studies included in the systematic review and the meta-analysis.
Figure 2
Figure 2
The forest plot of the effect of the Mediterranean diet and the DASH diet pattern on the risk of heart failure [15,16,18,19,26,29,30,31,32,33].
Figure 3
Figure 3
The forest plot of the effect of the Mediterranean diet and the DASH diet pattern on all-cause mortality in patients with heart failure [14,17,27,28].
See this image and copyright information in PMC

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