Dietary patterns, nutrition, and food–drug interactions during statin therapy: a narrative review

Abstract Objectives The aim of this literature review was to summarize the current state of knowledge regarding dietary patterns and drug–food interactions in the context of statin therapy, with particular emphasis on their impact on the efficacy and safety of treatment. Background Statins are the first-line pharmacological therapy for lipid lowering in the prevention of cardiovascular disease, as recommended by current European Society of Cardiology/European Atherosclerosis Society guidelines. Despite their well-established efficacy, residual cardiovascular risk often persists, highlighting the importance of adjunctive lifestyle interventions. Dietary factors not only independently influence lipid metabolism but may also modify statin efficacy and safety through metabolic and pharmacokinetic interactions. Methods A literature search was conducted in PubMed (MEDLINE), Scopus, Web of Science, and Google Scholar for English-language publications published between January 2000 and December 2024. Eligible studies included randomized controlled trials, observational studies, meta-analyses, systematic reviews, and international clinical guidelines evaluating dietary factors in statin-treated adults. Due to the heterogeneity of the included studies, a qualitative narrative synthesis was performed. Results The evidence indicates that selected dietary interventions, particularly soluble fiber and long-chain omega-3 fatty acids, may provide additive lipid-lowering and cardiovascular benefits when combined with statin therapy. Conclusions Dietary interventions, particularly the Mediterranean dietary pattern, may complement statin therapy by providing additive cardiovascular and lipid-lowering benefits. Evidence supporting direct interactions with statins is strongest for the Mediterranean diet, whereas data regarding dietary approaches to stop hypertension and other dietary patterns remain limited despite their established cardiovascular benefits. Personalized dietary counseling should also account for clinically relevant food–drug interactions, particularly grapefruit juice and alcohol.