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Avoiding excess calories is an integral part of halting the development of cardiovascular disease risk factors (i.e. primordial prevention). Unfavorable eating patterns are driven by a variety of biological, social, economic, and psychological factors , and a robust intervention from all levels of society may steer populations toward a healthier diet and prevent disease progression. Diet and other lifestyle changes remain crucial steps in primary and secondary prevention of cardiovascular disease, although the relative importance of medication and clinical procedures increases over time with disease progression. Abbreviations: AHEI, Alternative Healthy Food Index; CHD, coronary heart disease; CI, confidence interval; CVD, cardiovascular disease; DASH, Dietary Approaches to Stop Hypertension; MedDiet, Mediterranean Diet; RR, risk ratio; SSB, sugar sweetened beverage.