Cardiometabolic dietary patterns (DASH, Mediterranean, MIND, fibre)

What this protocol is

Cardiometabolic dietary patterns here means structured changes to habitual food patterns studied for blood pressure, lipids, glycaemia, vascular events, mood, or cognition—not single-nutrient supplements (see Marine omega-3), inorganic nitrate drinks (Dietary nitrate), or eating-window scheduling alone (Time-restricted eating).

Adjacent pharmacologic blood-pressure evidence (not a diet pattern)

Landmark systolic BP target trials that primarily titrated antihypertensive medications—for example SPRINT (wright-2015-sprint-intensive-standard-bp-nejm; PMID 26551272)—are linked here only because readers often search this hub for BP and hard cardiovascular outcomes. Those rows are not DASH/Mediterranean feeding studies; interpret effect sizes and adverse-event trade-offs on the PubMed page, not as proof that any single food pattern equals intensive pharmacologic titration.

Adjacent pharmacologic cardiovascular primary prevention (not a feeding study)

ASCEND aspirin in diabetes (ascend-2018-aspirin-primary-prevention-diabetes-nejm; PMID 30146931) is indexed here because readers often land on this hub when mixing CV prevention pills with diet-pattern questions—read the PubMed row for serious vascular events vs major bleeding trade-offs; it is not DASH/Mediterranean proof.

Intensive lifestyle coaching for incident type 2 diabetes

Diabetes Prevention Program (knowler-2002-dpp-lifestyle-metformin-t2dm-nejm; PMID 11832527) randomised 3,234 adults with impaired glucose tolerance to placebo, metformin, or lifestyle goals (≥7% weight loss, ≥150 min/week activity)—authors reported ~58% relative reduction in diabetes incidence with lifestyle and ~31% with metformin versus placebo over mean 2.8 years; interpret as structured behavioural + nutrition + activity package evidence, not a single branded diet trademark.

Intensive glycaemic policy in established type 2 diabetes (pharmacologic UKPDS 33; not a feeding study)

UK Prospective Diabetes Study (UKPDS 33) (ukpds-1998-intensive-glucose-t2dm-complications-ukpds33-lancet; PMID 9742976) compared intensive sulphonylurea or insulin (FPG target <6 mmol/L) with conventional diet-first care in 3,867 adults with newly diagnosed type 2 diabetes—over 10 years median HbA1c was ~0.9 percentage points lower on intensive policy, with a 12% relative reduction in any diabetes-related aggregate endpoint (95% CI 1–21%) largely explained by microvascular benefit, while macrovascular aggregates and all-cause mortality did not significantly differ in the primary abstract summary; hypoglycaemia and weight gain were worse on intensive therapy. Use this row as glycaemia–microvascular history when readers cross-search this hub; it is not DASH/Mediterranean evidence.

Variation kept under one slug (on purpose)

• DASH emphasises fruits, vegetables, low-fat dairy, and lower saturated/total fat with sodium often studied as an added factorial layer (DASH–Sodium).
• Mediterranean-style feeding trials vary by extra-virgin olive oil, nuts, and control-diet contrast; read each paper’s arms before merging effect sizes.
• MIND is a hybrid template (Mediterranean + DASH–style lists) sometimes tested with matched caloric restriction in the control arm—null primary cognitive outcomes still matter for calibration.
• Fibre / whole-grain evidence often comes from prospective cohorts plus shorter RCTs of risk factors bundled in umbrella reviews—GRADE and causality language differ from multi-year event trials.

Electrolyte / fat-quality anchors adjacent to DASH–sodium narratives (PubMed)

• Potassium dose–response on BP: Granal et al. 2025 (Clin Kidney J; PMID 40612568; granal-2025-potassium-intake-bp-dose-response-meta-ckj) — 10 RCTs (2000–2024) model 24 h urinary potassium vs BP; abstract highlights ~−5.3 / −3.62 mmHg SBP/DBP per 50 mmol/day urinary potassium rise in hypertensive strata versus minimal shifts without hypertension—not a DASH feeding duplicate.
• Saturated-fat reduction (long RCT Cochrane): Hooper et al. 2020 (Cochrane Database Syst Rev; PMID 32827219; hooper-2020-cochrane-saturated-fat-reduction-cvd-cd011737-pub3) — 15 RCTs (≥24 months); pooled RR ~0.83 on combined CV events with moderate GRADE while all-cause mortality stayed near null—read substitution strata before equating with any single branded diet.
• Dietary patterns ↔ CRP (umbrella): Tran et al. 2024 (Br J Nutr; PMID 39364652; tran-2024-dietary-patterns-crp-umbrella-bjn) recomputes RCT strata suggesting Mediterranean patterns rank strongest for CRP lowering versus other named patterns, with weak certainty—inflammation context only.
• Breakfast skipping ↔ mortality (cohort MA; confounded): Wang et al. 2024 (Food Funct; PMID 38738978; wang-2024-breakfast-skipping-mortality-cohort-meta-food-funct) pools HRs >1 for all-cause / CVD / cancer mortality with skipping versus regular breakfast but GRADE very low–low—file under meal-timing epidemiology, not proof that 16:8 windows are harmful by themselves.

Fibre, glycaemic quality, and beverage-tier supplements (PubMed)

• Fibre umbrella (observational meta-analyses): Veronese et al. 2025 (Clin Nutr; PMID 40651334; veronese-2025-dietary-fiber-health-umbrella-clin-nut) grades credibility classes across >17 million pooled participants—use for breadth, then open underlying cohort MA rows for each disease endpoint.
• GI / GL consortium pooling: Jenkins et al. 2024 (Lancet Diabetes Endocrinol; PMID 38272606; jenkins-2024-gi-gl-chronic-disease-richard-doll-lancet-diabetes) harmonises Richard Doll mega-cohorts for high-GI / high-GL patterns vs T2D, CVD, cancer, mortality—read alongside DASH feeding trials so whole-pattern advice is not reduced to GI labels alone.
• Whole-grain dose–response mortality (cohorts): Aune et al. 2016 (BMJ; PMID 27301975; aune-2016-whole-grains-mortality-dose-response-bmj) — 45 prospective studies; per 90 g/day higher whole-grain intake the summary RR for all-cause mortality was ~0.84 (95% CI 0.78–0.91) with parallel CVD and cancer mortality curves in the paper—observational evidence, not isocaloric feeding RCT proof.
• Fibre in diabetes (cohorts + trials): Reynolds et al. 2020 (PLoS Med; PMID 32142510; reynolds-2020-fibre-diabetes-management-plos-med) — combines prospective T1D/T2D cohort dose narratives with 42 higher-fibre trials (n ≈ 1,789) reporting pooled HbA1c, fasting glucose, lipid, weight, and CRP signals versus lower-fibre comparators with very high heterogeneity.
• Plant-based phenotypes (EPIC-Oxford): Key et al. 2022 (Proc Nutr Soc; PMID 35934687; key-2022-plant-based-diets-epic-oxford-proc-nutr-soc) orients vegetarian/vegan BMI, LDL, blood pressure, and micronutrient adequacy patterns from a mature UK cohort—risk-factor map, not a fracture/MACE substitute for Mediterranean-style RCTs.
• Green tea catechins (weight): Hursel et al. 2009 (Int J Obes; PMID 19597519; hursel-2009-green-tea-catechins-body-weight-meta-ijobesity) reports small pooled weight effects with caffeine/ethnicity moderators—supplement tier, not a substitute for Med / DASH feeding RCTs.
• Green tea + supervised exercise (body composition MA): Gholami et al. 2024 (JISSN; PMID 39350601; gholami-2024-green-tea-exercise-body-composition-meta-jissn) finds small additive SMD signals on weight/BMI/fat mass when catechins are added to exercise—lipid contrasts mostly null in the pooled abstract framing.

Umbrella and liver-exercise anchors

• Dinu et al. 2018 (Eur J Clin Nutr; PMID 28488692; dinu-2018-mediterranean-diet-umbrella-ejcn) is an umbrella review over 29 meta-analyses grading Mediterranean adherence vs many chronic-disease endpoints—use to map evidence tiers, then open the underlying RCT / cohort meta-analyses for numeric discipline.
• Yu et al. 2023 (Ir J Med Sci; PMID 35366201; yu-2023-exercise-nafld-comparative-sr-meta) pools 21 NAFLD exercise RCTs (weight, BMI, ALT/AST pooled MDs)—exercise-as-medicine stream adjacent to whole-diet metabolic liver workups; do not merge with time-restricted eating meal-window trials by default.

Evidence hygiene

• PREDIMED: the landmark programme had protocol deviations; this registry’s primary PubMed anchor is the 2018 corrected/republished analysis (PMID 29897866) rather than citing the retracted 2013 PDF in isolation.
• Look AHEAD is a combined diet + physical activity + weight-loss package in type 2 diabetes—null for the primary CV composite despite better HbA1c and weight; do not misread risk-factor gains as proven MACE reduction.
• SMILES used adjunctive dietitian-delivered counselling vs matched social support—large MADRS effect sizes warrant reading expectation-bias / small-n critiques linked in PubMed comments.

Related registry (distinct slugs)

• Marine omega-3 supplementation (marine-omega-3-supplementation) — EPA/DHA capsules and cardiovascular RCT pools.
• Dietary nitrate (beetroot juice) (dietary-nitrate-supplementation) — acute vascular / BP physiology with different food vehicles.
• Time-restricted eating (time-restricted-eating) — clock-time eating windows; complementary but not interchangeable with DASH composition trials.
• Mindfulness meditation (meditation-practice) — attention-training comparators sometimes overlap depression outcomes literature but are a different intervention class from dietitian dietary support.

Tertiary map

Wikipedia: DASH diet, Mediterranean diet, Dietary fibre, and Glycemic index articles help with consumer vocabulary—numeric HRs, mmHg, MADRS, and hazard curves stay on the PubMed-linked rows below.