A 55-Year-Old Man With Exertional Chest Pain

Editor's Note: Based on the 2013 Blood Cholesterol, Lifestyle Management, Obesity, and Risk Assessment Guidelines.

This 55-year-old man developed exertional chest pain. He had a positive stress exercise test and a coronary angiogram that revealed 2-vessel nonobstructive coronary disease. His risk profile indicates he is a nonsmoker with treated hypertension, and a low HDL–C. His father had an MI at age 67. His mother had type 2 diabetes diagnosed at age 60. He is on a low dose aspirin, long-acting beta blocker, a high-intensity statin, and an ACE inhibitor. His BP 135/86, pulse 58, weight 183 lbs and BMI 26.3. His LDL–C is 95 mg/dL, his HDL–C 39 mg/d and triglycerides are 145 mg/dL. His fasting glucose is 109 mg/dL. He wants to know what dietary change recommendations you would make. His cardiologist has given him physical activity recommendations.

Which of the following statements is the most correct answer?

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