9
erapeutic dosages of EPA + DHA for TG reduction are
2.0–4.0 g/day. Use of these dosages of long-chain omega-3
fatty acids for TG-lowering should be done only under
the supervision of a qualified clinician. Clinicians are
encouraged to educate patients on the importance of
the amount of EPA + DHA in each capsule of dietary
supplement or prescription products, and to take the
appropriate number of capsules daily to achieve therapeutic
levels. At present, prescription forms of EPA and EPA +
DHA concentrates are indicated only for treatment of very
high TG (≥500 mg/dL) to reduce the risk of pancreatitis.
B Moderate
For primary and secondary prevention of ASCVD,
consuming ≥2 servings/week of fish/seafood (preferably
oily) is recommended. One serving is equal to 3.5–4 oz. and
should ideally not be prepared using deep-frying.
A Moderate
For patients with known ASCVD, suggestive, but not
conclusive, evidence from RCTs is available for a benefit of
long-chain omega-3 fatty acid supplementation at ~1 g/day
EPA + DHA on cardiac mortality, but not non-fatal ASCVD
events. EPA + DHA supplements may be considered for
such patients, especially those who do not consume the
recommended intakes of EPA + DHA from dietary sources.
C Low
For patients with heart failure, 1 g/day of EPA + DHA is
recommended as an adjunct to heart failure therapy.
A Moderate
An alpha linonelic acid intake of 0.6–1.2% of energ y is
recommended.
A Moderate
Consumption of at least three 1-oz. equivalent servings per
day of fiber-rich whole grains is recommended.
A Moderate
Consumption of ≥ 4 servings/week (1 oz. per serving ) of
nuts (including the legume, peanuts) is recommended,
because nut consumption has been consistently associated
with reduced ASCVD risk. Nuts may be included in
the diet as a protein food and as a source of healthy fat
(predominantly unsaturated fatty acids).
A Moderate
Soy protein foods are one source of plant protein, among
others (e.g., nuts, legumes), that may be used as a substitute
for protein foods high in saturated fat as part of a
cardioprotective eating pattern.
B Moderate
Nutrition education/MNT by a registered dietitian
nutritionist with follow-up and monitoring are
recommended to promote long-term dietary adherence.
Clinicians should, when feasible, refer patients to a
registered dietitian nutritionist for MNT to individualize
a cardioprotective dietary pattern and promote successful
lifestyle modifications.
A Moderate
Chart 1. Nutritional Recommendations (cont'd)
Recommendations
Strength Quality
