Comparative effect of dietary patterns on selected cardiovascular risk factors: A network study.
Level 1 - systematic review of randomized trials
Network meta-analysis of randomized controlled trials
PubMed 40770255 · doi:10.1038/s41598-025-13596-x
What was done
A network meta-analysis of 21 randomized controlled trials including 1,663 participants systematically evaluated the comparative effectiveness of eight dietary patterns: low-fat, Mediterranean, ketogenic, low-carbohydrate, high-protein, vegetarian, intermittent fasting, and DASH diets. Using a random-effects model, investigators calculated mean differences (MD) for body composition (weight, BMI, waist circumference), lipid profiles (triglycerides, total cholesterol, HDL-C, LDL-C), glycemic markers (glucose), and blood pressure (systolic and diastolic), ranking interventions via Surface Under the Cumulative Ranking Curve (SUCRA) scores.
What was found
- Weight reduction: Ketogenic diet (MD -10.5 kg, 95% CI -18.0 to -3.05; SUCRA 99) and high-protein diet (MD -4.49 kg, 95% CI -9.55 to 0.35; SUCRA 71) showed superior efficacy. - Waist circumference: Ketogenic (MD -11.0 cm, 95% CI -17.5 to -4.54; SUCRA 100) and low-carbohydrate diets (MD -5.13 cm, 95% CI -8.83 to -1.44; SUCRA 77) achieved the greatest reductions. - Systolic blood pressure: DASH diet (MD -7.81 mmHg, 95% CI -14.2 to -0.46; SUCRA 89) and intermittent fasting (MD -5.98 mmHg, 95% CI -10.4 to -0.35; SUCRA 76) showed the largest reductions. - HDL-C: Low-carbohydrate (MD 4.26 mg/dL, 95% CI 2.46 to 6.49; SUCRA 98) and low-fat diets (MD 2.35 mg/dL, 95% CI 0.21 to 4.40; SUCRA 78) produced the greatest increases.
Why it matters
Different dietary patterns demonstrate distinct strengths across specific cardiovascular risk markers, supporting targeted, personalized dietary interventions rather than a uniform approach to CVD prevention.
Limits
The total sample size across 21 RCTs is relatively modest (1,663 participants across 8 dietary interventions), resulting in wide confidence intervals for several key outcomes. The abstract does not report study durations, adherence rates, baseline participant health status, adverse effects, or hard clinical cardiovascular endpoints.
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