Systematic Review and Meta‐Analysis Reveal the Strength of Mediterranean, DASH, and Plant‐Based Diets in Diabesity

OBJECTIVES: Obesity and type 2 diabetes mellitus (T2DM) frequently coexist as diabesity, a condition marked by chronic low-grade inflammation. This systematic review and meta-analysis compared the Mediterranean diet (MedDiet), Dietary Approaches to Stop Hypertension (DASH), and plant-based diets (PBD) on anthropometric, metabolic, and inflammatory outcomes in adults with obesity and/or T2DM. MATERIALS AND METHODS: PubMed/MEDLINE, ScienceDirect, and SciELO were searched to June 2025 for randomized controlled trials. The minimum intervention duration of 8 weeks applied exclusively to the meta-analysis, whereas shorter trials could be included in the qualitative synthesis. Study quality was assessed with the Downs & Black scale and certainty of evidence with GRADE. Random-effects meta-analyses estimated mean differences (MDs) with 95% confidence intervals. RESULTS: and total cholesterol were not significant. Within-group analyses, reported descriptively, showed reductions from baseline in both arms, and inflammatory markers declined in some studies. Most studies were of fair-to-poor quality; comparisons among diets are indirect, and certainty of evidence was low to very low. CONCLUSION: The MedDiet and PBD may support the management of obesity and/or T2DM, although current evidence does not establish the superiority of any single pattern. Future trials should address long-term adherence, mechanisms, and head-to-head comparisons.