High and low adherence to Mediterranean and DASH diet patterns and the risk of heart failure

The relationship between heart failure (HF) and Mediterranean and DASH diets is not well delineated. A meta-analysis assessed 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).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 and atotal of 16 reports from 14 studies were included.
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) 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) 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) among patients with HF.
The findings of this meta-analysis suggest that high adherence to the Mediterranean and DASH diets is associated with a considerable reduction in the incidence of HF compared to low adherence. High adherence to the Mediterranean diet has also been related to decreased all-cause mortality among patients with HF compared to low adherence.
However, high DASH diet adherence did not yield a significant reduction in all-cause mortality among patients with HF. Of note, adherence to some components of both diets was more closely related to the lower risk, such as consumption of fruits, legumes, and moderate alcohol, which was linked to decreased incident HF, whereas only consumption of vegetables and less dairy persisted in decreasing mortality risk as a secondary prevention in patients with HF.
Source: Arayici, M.E., Kilic, M.E., Yilmaz, M.B. & High and low adherence to Mediterranean and DASH diet patterns and the risk of heart failure: A meta-analysis of observational studies. Life, 15:63, 2025;