Table 7.

Level of evidence and classes of recommendations for food items.

Food item	Recommendations	Strength	Level of evidence
Whole grains and dietary fiber	The recommended dietary fiber intake is 14 g per 1000 kcal, or 25 g for adult women and 38 g for adult men.	II a	B
	It is recommended to increase dietary fiber intake in order to reduce blood LDL-C and glucose.	I	A
Vegetables and fruits	It is recommended to consume at least 8 portions of vegetables and fruits a day. Preferably root vegetables and deep-colored fruits such as spinach, carrot, peach, and blueberries (since they usually contain more micronutrients compared to other vegetables and fruits).	II a	B
	It is recommended to eat the whole fruit rather than fruit juice because of the fiber content and the satiation.	II a	A
	It is recommended to use cooking techniques such as sautéing or simmering that preserve the micronutrients in the vegetables and fruits without additional calories, SFA, TFA, salt or sugar.	II a	A
	In cases of disease influenced by dietary carbohydrates, sodium, or potassium (diabetes, kidney, coagulation), vegetables and fruits quantity should be personally adjusted.	II a	A
Nuts and almonds	It is recommended to consume 20–30 g/day of unsalted nuts and almonds, or 150 g/week, as a substitute for other food (with equal caloric content to prevent weight gain) in order to
	improve blood lipids.	II a	A
	Reduce CVD risk.	II a	B
Milk and dairy products	It is recommended to include dairy products (preferably low-fat and without added sugar) as part of a balanced diet.	II a	B
	Low-fat milk and dairy products lower blood pressure.	I	A
	There is epidemiologic data to suggest an association between dairy product consumption and reduced CVD.	II a	B
	At this stage, there is no evidence that calcium and/or vitamin D supplements prevent CVD (supplements may be taken for other indications such as osteoporosis).	III	C
Alcohol	Due to the absence of interventional controlled studies of moderate alcohol consumption with clinical endpoints, there is no recommendation to start drinking alcohol for health benefits.	III	C
	In individuals who regularly drink a moderate amount of alcohol (1 drink a day in women and 2 drinks per day in men) with meals, there is an associated reduced CVD incidence. Larger amounts should be discouraged.	I	B
	Individuals with liver disease and/or fatty liver, HTN, or hypertriglyceridemia, and pregnant women should avoid alcohol consumption.	III	B
	Alcohol drinking should be avoided before driving and/or coordinated activity.	III	A
Coffee	In order not to increase CVD morbidity and mortality, and/or side effects, it is recommended to consume the following amounts of caffeine: Healthy adults without caffeine sensitivity: up to 400 mg/day; Pregnant women: up to 200–300 mg/day; Children 4–6 years old: up to 45 mg/day.	II a	B
Green tea	Green tea consumption is associated with a lower risk for stroke and CVD. However, the causal effect and the dose needed for this effect is unknown.	II a	B
	Green tea consumption may reduce LDL-C; however, the effect-size and the dose needed are still unknown.	II b	A
Chocolate	It is not recommended to consume chocolate for CVD prevention.	III	C
	Dark chocolate, with a high cocoa percent, has abundant antioxidants and therefore preferable over milk chocolate.	II a	B
Garlic	Eating 2 garlic cloves a day may marginally reduce blood cholesterol levels.	II b	C
Eggs	Consumption of 5 eggs per week does not significantly increase CVD risk in healthy people.	II a	B
	In people with diabetes, CHD, and/or hypercholesterolemia that is not medically balanced there may be an increased risk from egg consumption. It is recommended to limit egg consumption to 3–4 per week, including eggs contained in other foods.	II a	B