Efficacy of dietary intervention or in combination with exercise on primary prevention of cardiovascular disease: A systematic review

• Published in: Nutrition, metabolism, and cardiovascular diseases metabolism, and cardiovascular diseases, 2020-06, Vol.30 (7), p.1080-1093
• Main Authors: Abbate, Manuela, Gallardo-Alfaro, Laura, Bibiloni, Maria del Mar, Tur, Josep A.
• Format: Article
• Language: English
• Subjects: Cardiovascular diseases; Diet; Exercise; Lifestyle; Primary prevention
• ISSN: 0939-4753; 1590-3729
• DOI: 10.1016/j.numecd.2020.02.020

Lifestyle factors heavily influence the development of cardiovascular disease (CVD); therefore, interventions delivering adequate lifestyle changes may improve the prognosis among patients at cardiovascular (CV) risk. Recently published research on the effectiveness of dietary and exercise intervention programmes, alone or combined, on reducing risk factors associated with CVD as well as preventing CV events have been now assessed. Using the Medline database via PubMed, we searched for prospective studies published between January 2000 and January 2020 assessing the efficacy of dietary interventions alone or in combination with exercise on reducing CV risk factors or events in human adults at risk. Study quality was assessed using the American Dietetic Association Quality Criteria Checklist. From 934 articles, 21 prospective experimental design studies (15 randomized controlled trials (RCTs), one cluster RCT, and five quasi-experimental intervention studies with a control group) met inclusion and exclusion criteria. Most interventions improved at least some markers of CV risk and the most improvement was time devoted to physical activity increased. A low-fat intervention diet seemed to be effective only when coupled with moderate intensity exercise and weight loss, while a Mediterranean diet (MedDiet) intervention without physical activity, decreased both systolic and diastolic blood pressure, major CV events rate and risk of developing type 2 diabetes. The MedDiet appears to have the most beneficial effect on CV events and increased hours of physical training are strongly related to greater improvement of risk factors; nevertheless, adherence to intervention is fundamental as it directly relates to health outcomes. •Papers on effectiveness of dietary and exercise intervention programs on decrease or prevent CVD risk factors were assessed.•The Mediterranean Diet and increased physical activity have high benefits on improving CVD risk factors.•Diet and exercise interventions controlled modifiable factors in patients at CVD risk, reducing the risk for fatal CV events.•Personalized strategies and social support to adherence to an intervention is fundamental and directly related to health.