NUTRITIONAL COUNSELING FOR CORONARY HEART DISEASE
The WHO has stated that over three-quarters of all CVD mortality may be prevented with lifestyle changes (Perk et al. 2012). The U.S. Preventive Task Force has found that medium- to high-intensity dietary counseling for patients with hyperlipidemia and other risk factors for CVD can result in the patients adopting the core components of a healthy diet (Moyer and Force 2012). At the same time, the data regarding the effect of medium- to high-intensity behavioral counseling interventions on the rates of CVD events are inadequate (Moyer and Force 2012). Although the correlations between a healthy diet, physical activity, and the incidence of CVD are strong, it seems that the initiation of behavioral counseling in the primary care setting to promote a healthy diet and physical activity has a small beneficial effect in the prevention of cardiovascular disease (Moyer and Force 2012). It seems that combining the knowledge and skills of clinicians and nutrition experts into multimodal behavioral interventions could help in the optimization of preventive efforts (Anderson et al. 2013). Dietary habits influence the risk of cardiovascular disease either through their effect on risk factors such as cholesterol, blood pressure, body weight, and diabetes or through an effect independent of these risk factors (Perk et al. 2012). The risk factors of cardiovascular disease could be potential targets for intervention and nutritional counseling (Anderson et al. 2013). Nutrition therapy is a very significant component of health behavior interventions and one of its main goals is the improvement of the lipid profile, which could potentially result in the reduction of cardiovascular events. The characteristics of the dietary patterns that could be suggested for patients with CVD or who are at risk of CVD are that energy intake should be limited to the amount needed to maintain (or obtain) a healthy weight, saturated fatty acids should account for <10% of total energy intake, trans fatty acids should be consumed as little as possible (preferably <1% of total energy intake), and patients should consume <5 g of salt per day, 30-45 g of fiber per day, 2-3 servings of fruit per day, and 2-3 servings of vegetables per day (Perk et al. 2012).