The PREDIMED (Prevenci n con Dieta Mediterr nea) trial randomized participants to a Mediterranean diet supplemented with either extra-virgin olive oil or nuts and demonstrated 30% and 28% reductions, respectively, in the combined endpoint (MI, stroke, or cardiovascular mortality), but the improved outcome was driven largely by the reduction in stroke, with no signifi- cant improvement over the control diet for mor- tality or MI.S3.1-1 When the PREDIMED cohort was reanalyzed post hoc for the provegetarian food pattern (more vegetable consumption versus ani- mal, egg, fish, dairy, or meat product consump- tion), a significant mortality rate reduction (41%) was noted in the 2 quintiles with the highest A comparison of plant and animal protein from the Adventist Health Study-2 similarly indicated that using meat for protein was associated with a 61% increase in mortality rate, whereas replacing meat with nuts and seeds was associated with a 40% reduction in mortality rate. Similarly, the graded risk published by Song et al. indicated that lower mortality rate was associated with replacing animal protein of different origins with plant protein.S3.1-9 The evi- dence is mixed with regard to the effectiveness of dairy intake to reduce ASCVD risk factors, which is why it is not included in the listed foods for this recommendation. Although the DASH (Dietary Approaches to Stop Hypertension) diet, which includes low-fat dairy products, was shown to and the PURE (Prospective Urban Rural Epidemiology) study indicated that dairy intake was associated with a 23% lower mortality Song et al. indicated an 11% increase in cardiovascular mortality rate with dairy consump- tion as compared with vegetable protein S3.1-9). 2. 