For this reason, a more reliable indicator of statin efficacy is percentage reduction. In the present document, the percentage reduction is used in follow- up monitoring of patients to estimate the efficacy of statin therapy. As a rough guide, a lowering of LDL-C levels of 1% gives an approximate 1% reduction in the risk of ASCVD somewhat more at higher base- line LDL-C levels and somewhat less at lower baseline 3. THERAPEUTIC MODALITIES 3.1. Lifestyle Therapies 3.1.1. Diet Composition, Weight Control, and Physical Activity For many years, the AHA and ACC have recommend- ed essentials of a healthy diet for the general public and for patients at risk for ASCVD. The current docu- ment supports evidence-based recommendations pro- vided in the 2013 AHA/ACC guidelines on lifestyle Patients should consume a dietary pattern that emphasizes intake of vegetables, fruits, whole grains, legumes, healthy protein sources (low-fat dairy products, low-fat poultry (without the skin), fish/seafood, and nuts), and nontropical vegetable oils; and limits intake of sweets, sugar-sweetened bev- erages, and red meats. This dietary pattern should be adjusted to appropriate calorie requirements, personal and cultural food preferences, and nutritional therapy for other medical conditions including diabetes. Caloric intake should be adjusted to avoid weight gain, or in overweight/obese patients, to promote weight loss. In general, adults should be advised to engage in aerobic physical activity 3-4 sessions per week, lasting on aver- age 40 minutes per session and involving moderate-to vigorous-intensity physical activity. 3.1.2. Lifestyle Therapies and Metabolic Syndrome Lifestyle therapies are particularly indicated for the metabolic syndrome, which is a cluster of risk factors associated with an increased risk of ASCVD, diabetes mellitus, and all-cause death.S3.1.2-1,S3.1.2-2 Metabolic syndrome is a risk-enhancing factor for ASCVD. 