Cardiometabolic risk factors, such as hypercholesterolemia, hypertriglyceridemia, metabolic syndrome, diabetes, and arterial hypertension, are major predictors of the premature development of cardiovascular diseases (CVD). Since CVD prevention needs a life-course approach, beyond dietary and pharmacological treatment, non-pharmacological treatment should be considered an important alternative for patients in primary prevention with mild-moderate cardiometabolic risk factors at low-moderate global risk of CVD. Several functional foods and nutraceuticals are efficacious, safe and well tolerated. However, only some (monacolins of red yeast rice and omega-3 fatty acids) have showed, in long-term randomized clinical trials, a reduction of cardiovascular events.