Efficacy of Dietary Interventions in the Management of Hyperlipidemia: A Comprehensive Systematic Review and Meta-Analysis

This systematic review and meta-analysis comprehensively assessed the effectiveness of structured dietary interventions on lipid profiles in adults with hyperlipidemia. A total of 11 randomized controlled trials, comprising 2,322 participants, were included, covering a range of well-defined dietary patterns such as Mediterranean, DASH, Portfolio, Legume-based, and Low-Carbohydrate diets. Overall, pooled analyses demonstrated statistically significant and clinically relevant improvements across all major lipid parameters, including reductions in low-density lipoprotein cholesterol, total cholesterol, and triglycerides, as well as an increase in high-density lipoprotein cholesterol. Despite the presence of substantial heterogeneity across studies, subgroup analyses highlighted differential effects by diet type, suggesting that dietary interventions may be tailored to specific lipid abnormalities. In particular, the Portfolio diet was associated with the greatest reduction in LDL cholesterol, whereas low-carbohydrate diets produced the most pronounced increases in HDL cholesterol. Assessment of publication bias indicated potential bias for HDL-C outcomes but not for other lipid measures. Collectively, these findings provide robust evidence that structured dietary interventions can achieve lipid-lowering effects comparable to mild-to-moderate intensity statin therapy. The results underscore the clinical value of integrating evidence-based dietary strategies into routine hyperlipidemia management, either as primary non-pharmacological interventions or as adjuncts to pharmacotherapy, especially for patients seeking personalized, sustainable, and lower-risk approaches to lipid control.