Beyond ‘low salt, low fat’: Reimagining nutrition advice in the cardiac discharge summary

Abstract

Despite strong evidence on the role of nutrition in secondary prevention of cardiovascular diseases, most cardiac discharge advises are generic and vague. This commentary advocates for a paradigm shift in post-discharge dietary counseling, positioning it as a critical, evidence-based tool for secondary prevention. Gathering evidence from global and interventional studies, we discuss the need for specific, prescriptive nutritional advice during discharge when patients are in the most receptive period. This commentary also briefs about the challenges that prevent clinicians from delivering meaningful dietary advice. We propose a multi-level strategy: integrating nutrition and behavior change counseling into medical education and licensing standards; building physician competence through experiential methods like culinary medicine; embedding structured dietary prescriptions into electronic health records; and ensuring consistent discharge summary quality through institutional policies and training. Furthermore, aligning policy reforms—including insurance coverage for nutrition counseling and food-is-medicine initiatives—will be essential to scale these interventions equitably. By redefining the role of nutrition in discharge planning, health systems can improve patient engagement, reduce readmissions, and contribute meaningfully to cardiovascular disease prevention and health system sustainability.