The Mediterranean diet and low-fat diet are widely used dietary strategies for cardiovascular disease (CVD) prevention, yet their relative effects on cardiovascular risk factors remain debated. A systematic review published in Medicine evaluated randomized controlled trials (RCTs) comparing the Mediterranean diet (MD) and low-fat diet (LFD) for their effects on CV risk factors and clinical outcomes. 

The analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was conducted across PubMed, Google Scholar, SCOPUS, and ScienceDirect to identify RCTs enrolling adults that directly compared MD and LFD and reported cardiovascular risk factors or clinical outcomes.

The review included 11 RCTs comprising 5,942 participants. Several trials reported significant reductions in the formation of procoagulant and prothrombotic microvesicles with MD compared with LFD. MD was also associated with larger reductions in several cardiometabolic parameters compared with LFD.

Reported benefits included larger reductions in total cholesterol, cholesterol-high-density lipoprotein (HDL) ratios, insulin levels, blood glucose levels, leukocyte count, and body mass index. These findings were consistently reported across the included randomized comparisons evaluating dietary effects on cardiovascular risk profiles.

The findings suggest that MD may provide greater improvements in several cardiovascular risk factors compared with LFD.