Peripheral artery disease (PAD) happens when blood vessels in your legs and arms get clogged, similar to heart disease. This review looked at how food choices affect PAD prevention and treatment. Researchers found that eating healthy diets—especially Mediterranean-style eating with lots of vegetables, fish, and olive oil—may work almost as well as some medicines at reducing PAD risk and improving outcomes. The problem is that most people with PAD don’t eat healthy diets, and doctors rarely give them nutrition advice. Since healthy eating is safe, affordable, and powerful, it could be a game-changer for preventing and managing this serious condition.

The Quick Take

  • What they studied: How different foods and eating patterns affect the development and progression of peripheral artery disease (clogged blood vessels in the legs and arms)
  • Who participated: This was a review article that examined existing research rather than conducting a new study with participants. It looked at evidence from many different studies on nutrition and PAD
  • Key finding: Eating healthy dietary patterns, particularly Mediterranean-style diets rich in vegetables, fish, whole grains, and olive oil, appears to reduce PAD risk and improve outcomes with effects comparable to some medications
  • What it means for you: If you’re concerned about blood vessel health or have been diagnosed with PAD, improving your diet through healthy eating patterns may be as beneficial as some medical treatments—and it’s something you can start doing today with your doctor’s guidance

The Research Details

This is a narrative review, which means researchers examined and summarized existing scientific studies on nutrition and peripheral artery disease rather than conducting their own experiment. They looked at evidence about different eating patterns (like Mediterranean diets), specific food groups, nutrients, fiber, and plant compounds called flavonoids that are found in foods like berries and dark chocolate.

The researchers searched through published studies to understand what we currently know about how food affects PAD—from early stages when people have no symptoms, to advanced cases where blood flow is severely restricted. They compared findings across different types of research to identify patterns and draw conclusions about what dietary approaches seem most helpful.

This type of review is valuable because it brings together information from many different studies, allowing researchers to see the bigger picture of how nutrition affects this disease.

Understanding nutrition’s role in PAD is important because current treatments focus mainly on medications and surgery. However, most people with PAD don’t follow healthy eating patterns, and doctors rarely provide nutrition counseling. Since diet is something people can control themselves, affordable, and safe, it could be a powerful tool that’s currently being underused. This review helps identify what dietary changes might work best and highlights the need for more research specifically testing nutrition interventions in PAD patients.

This review was published in a respected medical journal focused on heart disease prevention. As a narrative review, it synthesizes existing evidence rather than presenting new experimental data. The strength of conclusions depends on the quality of studies reviewed. The authors acknowledge that while evidence supports healthy diets for PAD, there haven’t been many large clinical trials specifically testing nutrition interventions in PAD patients, so some recommendations are based on research from related heart conditions. The review provides a comprehensive overview of current knowledge but also identifies important gaps in research.

What the Results Show

The review found strong evidence that healthy eating patterns, particularly Mediterranean-style diets, may reduce the risk of developing PAD and improve outcomes in people who already have it. The beneficial effects appear to be comparable to some pharmaceutical treatments—meaning diet can be as powerful as medicine in some cases.

Specific foods and nutrients that appear protective include vegetables, fish, whole grains, olive oil, fiber, and plant compounds called flavonoids found in berries, nuts, and dark chocolate. These foods help reduce inflammation and improve blood vessel function.

A concerning finding is that most people with PAD—both those without symptoms and those with symptoms—do not follow healthy dietary patterns. Additionally, malnutrition (not getting enough nutrients) is common in people with advanced PAD and is linked to worse outcomes and complications after surgery.

The review found that dietary counseling is rarely offered to PAD patients despite its potential benefits. Many people with advanced PAD show signs of poor nutrition status, which independently predicts worse surgical outcomes and more complications. The research suggests that nutrition should be integrated into standard PAD care alongside medications and procedures, but currently it’s largely overlooked. The review also notes that while we have good evidence from studies on heart disease, we need more research specifically designed to test nutrition interventions in PAD populations.

The findings align with well-established research on nutrition and heart disease prevention. Mediterranean diets and similar healthy eating patterns have strong evidence for preventing coronary artery disease (heart attacks). This review extends that knowledge to PAD, suggesting similar dietary principles apply to blood vessel disease throughout the body. However, PAD has received less research attention than heart disease, so there are fewer studies specifically examining nutrition’s role in PAD compared to coronary disease.

This review has several important limitations. First, it’s a summary of existing research rather than a new study, so conclusions depend on the quality of studies reviewed. Second, there are relatively few large clinical trials that directly test nutrition interventions in PAD patients—most evidence comes from studies on related heart conditions. Third, the review doesn’t provide specific dietary recommendations tailored to PAD (like exact amounts of foods to eat). Finally, individual responses to dietary changes vary, so what works for one person may not work the same way for another.

The Bottom Line

Based on available evidence with moderate confidence: Adopt a Mediterranean-style eating pattern emphasizing vegetables, fruits, whole grains, fish, legumes, nuts, and olive oil. Include foods rich in fiber and plant compounds (flavonoids). Limit processed foods, added sugars, and unhealthy fats. If you have PAD or are at risk, ask your doctor for a referral to a registered dietitian who can create a personalized nutrition plan. These dietary changes appear to reduce PAD risk and improve outcomes, with effects potentially comparable to some medications.

Everyone concerned about blood vessel health should care about these findings, but they’re especially important for: people with a family history of PAD or heart disease; those with risk factors like smoking, diabetes, or high blood pressure; people already diagnosed with PAD; and older adults. If you have advanced PAD or are planning surgery, nutrition becomes even more critical. However, anyone can benefit from the healthy eating patterns described. Consult your doctor before making major dietary changes, especially if you take blood-thinning medications or have other health conditions.

Realistic expectations vary. Some benefits like improved blood vessel function may begin within weeks of dietary changes. However, significant reductions in PAD progression or symptom improvement typically take several months to a year of consistent healthy eating. For prevention in people without PAD, benefits accumulate over years. Think of dietary changes as a long-term investment in your health rather than a quick fix.

Want to Apply This Research?

  • Track daily servings of key foods: vegetables (aim for 5+ servings), fish (2-3 times weekly), whole grains, nuts/legumes, and olive oil use. Monitor weekly adherence to Mediterranean diet principles using a simple checklist (0-7 days per week following the pattern).
  • Start by adding one Mediterranean diet element weekly: Week 1 add more vegetables, Week 2 switch to whole grains, Week 3 add fish twice, Week 4 use olive oil instead of other oils. Use the app to log these additions and celebrate small wins to build momentum.
  • Create a weekly Mediterranean diet adherence score (0-100%) based on servings of key food groups consumed. Set a goal of 70%+ adherence. Track any symptom changes (like leg pain or walking distance if you have PAD) alongside dietary adherence to see personal correlations. Review monthly trends to identify which dietary changes feel most sustainable for you.

This review summarizes scientific evidence about nutrition and peripheral artery disease but is not a substitute for medical advice. Peripheral artery disease is a serious condition requiring professional medical care. Before making significant dietary changes, especially if you have PAD, take medications, or have other health conditions, consult with your doctor or a registered dietitian. Dietary modifications should complement, not replace, prescribed medications and medical treatments. Individual responses to dietary changes vary, and what works for one person may differ for another. If you experience symptoms like leg pain, numbness, or difficulty walking, seek immediate medical attention.