Diet Change to Reduce Residual Risk After Myocardial Infarction

A 56-year-old man presents for outpatient follow-up 6 weeks after a non-ST-elevation myocardial infarction (NSTEMI) treated with a percutaneous coronary intervention. He reports good adherence to dual antiplatelet therapy, a beta-blocker, an angiotensin-converting enzyme inhibitor, and atorvastatin 80 milligrams daily. His physical exam is notable only for a body mass index of 32 and visceral adiposity. Lab data from 2 days ago are shown below:

Fasting blood glucose: 114 mg/dl
Total cholesterol: 230 mg/dl
High-density lipoprotein cholesterol (HDL-C): 45 mg/dl
Non-HDL-C: 185 mg/dl
Low-density lipoprotein cholesterol (LDL-C): 130 mg/dl
Triglycerides: 275 mg/dl

When you inquire about his diet, the patient admits to routine consumption of eggs, bacon, sausage, sweetened cereals, donuts, lunch meats, hamburgers, hot dogs, French fries, and chips, and reports a low intake of fruits, vegetables, fish, whole grains, nuts, beans and legumes. He is single, typically eats out or purchases ready-made foods, and rarely cooks. You discuss diet interventions with the patient.

All of the following statements about diet intervention in post-MI patients are true, EXCEPT:

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