Plain language summary
Diet is recognised as an important factor in the prevention of heart failure, however there is no consensus about which dietary protocol is the most effective. This systematic review aims to clarify links between different dietary measures and markers of heart failure. The review included 12 studies of different types (randomised controlled trials, cross-sectional studies and cohort studies), which examined the DASH diet, Mediterranean diet, high protein diet and low carbohydrate diet. The studies examining the DASH diet demonstrated improvements in various measures of cardiac function and may have benefits for secondary prevention of heart failure. The Mediterranean diet was associated with lower levels of inflammation and improved cardiac function in cross-sectional studies only. High protein and low carbohydrate diets also demonstrated positive effects on markers of heart function however, only one study for each was included. The authors conclude that the current science suggests a positive role for diet in relation to prevention of heart failure and call for further RCTs to be conducted to identify which elements of these different diets are impacting on markers of heart failure.
Abstract
BACKGROUND Diet is an important factor in secondary prevention of heart failure (HF) but there is still no consensus as to which dietary model should be adopted by this population. This systematic review aims to clarify the relationship between dietary patterns and secondary prevention in HF. METHODS We searched the Medline, Embase and Cochrane databases for studies with different dietary patterns and outcomes of secondary prevention in HF. No limitation was used in the search. RESULTS 1119 articles were identified, 12 met the inclusion criteria. Studies with Dietary Approaches to Stop Hypertension (DASH), Mediterranean, Hyperproteic and Low-carb diets were found. The DASH pattern showed improvement in cardiac function, functional capacity, blood pressure, oxidative stress and mortality. The Mediterranean diet had a correlation with inflammation, quality of life and cardiac function but just on cross-sectional studies. Regarding the Hyperproteic and Low-carb diets only one study was found with each pattern and both were able to improve functional capacity in patients with HF. CONCLUSIONS DASH pattern may have benefits in the secondary prevention of HF. The Mediterranean diet demonstrated positive correlation with factors of secondary prevention of HF but need more RCTs and cohort studies to confirm these effects. In addition, the Hyperproteic and Low-carb diets, despite the lack of studies, also demonstrated positive effects on the functional capacity in patients with HF.
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