Effecting Dietary Modifications in Patients: 5 Things to Know

Amit Khera, MD, MSc, FACC; Susan G. Rodder, MS, RDN, LD


January 28, 2020

Editorial Collaboration

Medscape &

Physicians are well aware of the difficulties in effecting dietary changes in patients, especially in light of the ubiquity of unhealthy and convenient food options, along with the multitude of conflicting information on the Internet and in the scientific literature regarding what constitutes a healthy diet. Moreover, most physicians, who typically receive only basic instruction on dietary counseling during their training, report feeling ill-equipped when it comes to providing guidance in this area.[1] By forming a strong partnership with registered dietitians and incorporating a few simple tips into practice, however, physicians can successfully guide patients on the correct path toward healthier eating habits.

Here are five things to know about effecting successful dietary modifications in patients.

1. Physicians should make clear to patients the goals and intended end results of dietary interventions.

The primary focus of the preventive cardiology program at our institution is to reduce patients' risk factors for, and prevent first and future, atherosclerotic cardiovascular disease (ASCVD) events. One of the key elements of this program is a healthy diet. With all of the conflicting information and hype on "fad" diets that abound in the media, particularly on the Internet, patients may be confused about what truly constitutes a healthy diet; many have the misconception that weight-loss diets are synonymous with heart-healthy diets. For example, while the currently popular low-carbohydrate and ketogenic diets may be effective for weight loss,[2] replacement of carbohydrates with the high amounts of animal protein that are recommended in these diets can increase serum cholesterol levels and may be associated with a higher risk for death.[3] In contrast, diets that replace carbohydrates with plant-based proteins have cardioprotective benefits.[3,4]

When discussing dietary modifications, an effective way to initiate the conversation is to ask patients about their personal goals. This will help clinicians better align patients' desired outcomes with clinical goals, especially in patients at increased risk for ASCVD.