Box 1.

Target dietary strategies and their cardiovascular effects

Dietary strategy	Description of dietary strategy	Cardiovascular effects
Energy deficit	Diets specifically formulated to reduce calorie intake (for example, very-low energy diets [<800 kcal/day]) or lifestyle change to induce an energy deficit (including diet with or without exercise)	Decreased body weight lowers blood pressure10
Mediterranean diet	A naturalistic dietary pattern that promotes high intakes of wholegrains, vegetables, and fruits, moderate intakes of seafood, unsaturated fats, and red wine, and limited intake of red meats. Regular exercise is promoted as part of the lifestyle	Combination of lifestyle factors thought to be cardioprotective via reduced blood pressure, and reduced blood lipids, among other mechanisms11
Sodium reduction
Salt reduction	Table salt (NaCl) intake is decreased through reduction of added table salt to foods, or manipulation of table salt intake to allow for comparison between higher and lower salt intake groups	Decreased sodium lowers blood pressure12
Salt substitution	Sodium in regular table salt or other high sodium products is replaced with potassium (KCl)	Decreased sodium lowers blood pressure;12 increased potassium may have cardioprotective effects13
DASH diet	Dietary pattern designed specifically to reduce hypertension that promotes high intakes of fruits and vegetables, moderate intake of wholegrains and low-fat dairy, moderate-to-limited intakes of meats, and limited intake of fats and salt	Combination of lifestyle factors thought to reduce blood pressure14
Alcohol reduction	Reduction in usual alcohol intake or elimination of alcohol from diet	Decreased alcohol is thought to lower blood pressure. Alcohol consumption has a complex relationship with cardiovascular health and excess consumption is associated with many CV diseases, so reduction may reduce CV disease risk15,16
Fish/fish oil consumption	Diets high in fish, or supplemental fish oils	Omega chain fatty acids, commonly found in fish, are thought to be cardioprotective17

CV = cardiovascular. DASH = Dietary Approaches to Stop Hypertension.