Nutrition and Diet Recommendations for Nutrition and Diet Referenced studies that support recommendations are summarized in Online Data Supplements 4 and 5. COR LOE Recommendations I B-R A diet emphasizing intake of vegetables, fruits, legumes, nuts, whole grains, and fish is recommended to decrease ASCVD risk IIa B-NR Replacement of saturated fat with dietary monounsaturated and polyunsaturated fats can be beneficial to reduce ASCVD IIa B-NR A diet containing reduced amounts of cholesterol and sodium can be beneficial to decrease ASCVD risk.S3.1-9,S3.1-14 S3.1-16 IIa B-NR As a part of a healthy diet, it is reasonable to minimize the intake of processed meats, refined carbohydrates, and sweetened beverages to reduce ASCVD risk.S3.1-17 S3.1-24 III: Harm B-NR As a part of a healthy diet, the intake of trans fats should be avoided to reduce Synopsis Approximately 630000 Americans died from heart dis- ease in 2015, of whom 366000 died from coronary ar- tery disease. After 4 decades of decline, heart disease deaths rose in 2015 by 1%.S3.1-28 This trend has been attributed to the obesity epidemic. Healthy nutrition has an important impact on ASCVD and its risk factors (see recommendations in the individual sections), po- tentially reversing or reducing obesity, high cholesterol, diabetes, and hypertension. The cardiovascular nutri- tion literature is limited by the paucity of large-scale prospective randomized trials with ASCVD outcomes. Although RCTs focused on hard endpoints are limited, multiple observational studies have focused on the association of CVD mortality with dietary patterns specifically, sugar, low-calorie sweeteners, high-carbo- hydrate diets, low-carbohydrate diets, refined grains, trans fat, saturated fat, sodium, red meat, and pro- cessed red meat (eg, bacon, salami, ham, hot dogs, Processed meats are any meat pre- served by smoking, curing, or salting, or additional Recommendation-Specific Supportive Text 1. 