Despite continued advances in health care, the cardiovascular disease CVD mortality rate has plateaued in recent years and appears to be trending upward. Poor diet is a leading cause of obesity and type 2 diabetes mellitus, which are leading contributors to CVD morbidity and mortality. Although dietary modification is a cornerstone of CVD prevention, implementation in clinical practice is limited by inadequate formal training in nutrition science. In this report, we review the individual components of a heart-healthy diet, evidence-based dietary recommendations, and the impact of diet on CVD risk factor prevention and management. Furthermore, we examine the unique difficulties of dietary counseling in low-socioeconomic-status environments and provide an evidence-based approach to better serve these populations. Clinicians should understand the barriers that patients may face in terms of access to healthy dietary choices. Further research is needed to determine the dietary changes that are most economically, socioculturally, and logistically feasible to reduce these barriers. Improvement in diet is a public health priority that can lead to a significant population-level reduction in CVD morbidity and mortality. It is imperative that clinicians understand current dietary practice guidelines and implement evidence-based dietary counseling in those at high risk for CVD. The rate of cardiovascular disease CVD mortality reduction in the United States has plateaued in recent years despite the development of new medical therapies, increased access to health care, and increased health care spending, in large part due to the increasing prevalence of obesity and type 2 diabetes mellitus in younger individuals. Nutrition counseling is a core aspect of primary and secondary prevention of hyperlipidemia, hypertension, type 2 diabetes mellitus, and CVD.
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