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<p>This study aimed to quantify the associations between adherence to three dietary patterns—the Dietary Approaches to Stop Hypertension (DASH), Mediterranean diet (MED), and Alternative Healthy Eating Index (AHEI)—and the risk of heart failure (HF) through a dose–response meta-analysis. Prospective cohort studies evaluating the associations between these dietary patterns and HF incidence were systematically identified from the PubMed, EMBASE, Web of Science, Cochrane Library, Scopus, and ClinicalTrials.gov databases. Random-effects models were used to pool effect estimates. Generalized least squares regression and restricted cubic spline models were applied to explore potential dose–response relationships between dietary adherence and HF risk. Eleven independent cohorts (<i>n</i> = 450,451; ≥18,877 HF events) were included in the final analysis. Combined across patterns, the highest adherence group had a 25% lower risk of HF than the lowest adherence group did (hazard ratio [HR] 0.75; 95% confidence interval [CI]: 0.67–0.84; <i>P</i> &lt; 0.001). Subgroup analyses revealed significant inverse associations for the DASH (HR 0.81; 95% CI: 0.67–0.98; <i>P</i> = 0.034), MED (HR 0.74; 95% CI: 0.64–0.87; <i>P</i> &lt; 0.001), and AHEI (HR 0.75; 95% CI: 0.63–0.89; <i>P</i> &lt; 0.001) patterns, with no significant differences across patterns (<i>P</i> = 0.860). Dose–response analyses revealed linear associations between adherence to each dietary pattern and HF risk. High adherence to DASH, MED, and AHEI is associated with lower HF risk, with similar effects among the different dietary patterns and linear dose–response relationships. <b>PROSPERO registration: CRD420251024001</b></p><p></p>

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Dose‒response relationships of DASH, Mediterranean, and AHEI dietary patterns with heart failure incidence: a systematic review and meta-analysis of cohort studies

  • 期刊论文

  • 发表日期：

    2025年12月19日

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  • Fang Yan,
  • Lihua Fan,
  • Moqing Yin,
  • Longzhi Li,
  • Yunhu Chen,
  • Lijuan Zhao

摘要

This study aimed to quantify the associations between adherence to three dietary patterns—the Dietary Approaches to Stop Hypertension (DASH), Mediterranean diet (MED), and Alternative Healthy Eating Index (AHEI)—and the risk of heart failure (HF) through a dose–response meta-analysis. Prospective cohort studies evaluating the associations between these dietary patterns and HF incidence were systematically identified from the PubMed, EMBASE, Web of Science, Cochrane Library, Scopus, and ClinicalTrials.gov databases. Random-effects models were used to pool effect estimates. Generalized least squares regression and restricted cubic spline models were applied to explore potential dose–response relationships between dietary adherence and HF risk. Eleven independent cohorts (n = 450,451; ≥18,877 HF events) were included in the final analysis. Combined across patterns, the highest adherence group had a 25% lower risk of HF than the lowest adherence group did (hazard ratio [HR] 0.75; 95% confidence interval [CI]: 0.67–0.84; P < 0.001). Subgroup analyses revealed significant inverse associations for the DASH (HR 0.81; 95% CI: 0.67–0.98; P = 0.034), MED (HR 0.74; 95% CI: 0.64–0.87; P < 0.001), and AHEI (HR 0.75; 95% CI: 0.63–0.89; P < 0.001) patterns, with no significant differences across patterns (P = 0.860). Dose–response analyses revealed linear associations between adherence to each dietary pattern and HF risk. High adherence to DASH, MED, and AHEI is associated with lower HF risk, with similar effects among the different dietary patterns and linear dose–response relationships. PROSPERO registration: CRD420251024001