Background/Objectives: Lifestyle interventions such as dietary changes have been proposed to control the cardiometabolic risk factors and thus prevent cardiovascular (CV) disease (CVD). We performed an umbrella review to investigate whether different dietary patterns affect CV risk in individuals with at least one cardiometabolic risk factor (hypertension, dyslipidemia, obesity, diabetes, metabolic syndrome) but not established CVD. Methods: We systematically searched the PubMed and Scopus databases (up to August 2024) for the systematic reviews and meta-analyses of randomized controlled trials (RCTs). Articles should be written in English and refer to a specific dietary pattern (such as Mediterranean diet, etc.). The population studied referred to adults with at least one cardiovascular (CV) risk factor. Results: From 4512 records identified, we finally included 25 meta-analyses with a total of 329 associations. Strong evidence for a benefit was found for LCD with reductions in BW [MD: −4.79 (95% CI −5.85, −3.72) kg, p ≤ 0.001], SBP [MD: −6.38 (95% CI −7.84, −4.93) mmHg, p ≤ 0.001], TG [WMD: −5.81 (95% CI −7.96, −3.66) mg/dL, p ≤ 0.001], and fasting plasma insulin [MD: −15.35 (95% CI −19.58, −11.12) pmol/L, p ≤ 0.001], as well as for low-GI diet for the reduction of BW [SMD: −0.66 (95% CI −0.90, −0.43) kg, p ≤ 0.001]. Conclusions: Across many dietary patterns, LCD showed strong or highly suggestive evidence for a benefit on SBP, BW reduction, and lipid profile improvement. Secondarily, low-GI, DASH, and Portfolio and Nordic diets suggested beneficial effects on controlling CV risk.

Physical activity (PA) is important for the prevention and management of cardiovascular (CV) disease (CVD). We aim to investigate the effect of different types of exercise on cardiometabolic risk factors in these subjects with CV risk factors but no history of CVD is lacking. PubMed and Scopus databases were searched up to November 2025 for systematic reviews and meta-analyses of randomized controlled trials (RCTs). The population studied referred to adults with at least one CV risk factor. 16 meta-analysis publications were included. Strong evidence for a benefit was found for i) aerobic exercise and waist circumference (WC) reduction compared to control group in males and females with metabolic syndrome [Mean Difference (MD) -3.44 (95% CI -4.81, -2.07) cm, ii) Tai Chi and SBP reduction after ≥6 months [MD -8.80 (95% CI -11.28, -6.32) mmHg], DBP reduction after 3 months [MD -7.58 (95% CI -8.56, -6.60) mmHg] and after ≥6 months of Tai Chi training [MD -4.62 (95% CI -6.09, -3.16) mmHg], and total cholesterol reduction following Tai Chi training in adult males and females with essential hypertension [MD -8.46 (-11.7, -5.4) mg/dL] compared to control group. HIIT, resistance, Yoga and Qigong training did not show any convincing evidence for a benefit in cardiometabolic parameters. The most convincing evidence relates to a benefit from Aerobic or Tai Chi training mainly in SBP and DBP reduction and secondarily to WC and total cholesterol reduction. The role of HIIT, Resistance, Yoga and Qigong training in cardiometabolic health is uncertain.