Anti-inflammatory diets lower blood pressure and cardiometabolic risk markers

PATHOPHYSIOLOGY AND MECHANISMS

STUDY

• Type of study: meta-analysis of 18 randomized clinical trials.


• Population: more than 2,500 healthy participants with various conditions (diabetes, fatty liver, cardiovascular disease, etc.) from Europe, Asia, North America, and Oceania.


• Intervention: Dietary interventions consisted of anti-inflammatory patterns such as the Mediterranean, DASH, vegetarian, ketogenic, Atlantic, and traditional Korean diets.


• Duration: Between 3 months and 5 years, depending on the study.


• Comparators: conventional diets or other specific guidelines.


• Measures evaluated: Systolic and diastolic blood pressure, lipid profile, and high-sensitivity C-reactive protein as an inflammatory marker were evaluated, with different analyses performed for subgroups.




MAIN RESULTS

Anti-inflammatory diets significantly reduced systolic blood pressure (-3.99 mmHg) and diastolic blood pressure (-1.81 mmHg) compared to control diets. Subgroup analysis shows a reduction in systolic blood pressure in people with more severe conditions. A decrease in total cholesterol, LDL, and high-sensitivity C-reactive protein levels was also observed, although the latter finding was influenced by a single study with high statistical weight. Other aspects such as triglycerides and HDL were not significant.



CONCLUSION AND CLINICAL RELEVANCE

Overall, the findings reinforce the usefulness of anti-inflammatory dietary patterns for reducing blood pressure and markers related to cardiometabolic risk and all-cause mortality. The results are consistent with previous research linking the dietary inflammatory index to cardiovascular parameters. The results remain consistent after excluding some of the studies responsible for the high heterogeneity. The results of the clinical trials evaluated in the RoB with the lowest risk of bias remain consistent. The authors highlight the low adherence to traditional anti-inflammatory diets outside the Mediterranean and Nordic regions, attributed to cultural barriers and differences in local dietary practices.

Limitations include the heterogeneity of the interventions, the baseline characteristics of the participants, and the absence of a standardized quantitative assessment of the dietary inflammatory index in several studies, which makes it difficult to compare results. In addition, few trials measured C-reactive protein. Risks of bias related to blinding and randomization typical in this type of study persist, in addition to limitations in the reporting of the intention-to-treat analysis. Larger, more homogeneous trials are needed to identify subgroups of greatest benefit and adapt dietary recommendations to different cultural contexts. However, it is clear in clinical practice that well-targeted nutrition produces objective changes in blood pressure and other metabolic markers. Simply reducing ultra-processed foods and sugars and increasing the consumption of fresh vegetables and certain fats such as extra virgin olive oil has an anti-inflammatory effect, regardless of the formal name of the dietary pattern. If there is no significant initial response, dietary management can be tailored more specifically at the clinical nutrition level, targeting the underlying pathways that lead to poor metabolic health, rather than addressing symptoms or markers.