The importance of proper diet in primary and secondary cardiovascular prevention is now quite clear: several recent studies, e.g. on fat and saturated fat intake, on sodium, and on dietary cholesterol, are being discussed by the lay press and by professionals. This paper reviews the most solid published evidence on diet and cardiovascular risk, to provide clinicians (namely, cardiologists) with a useful tool to be discussed with patients. Where evidence was strong enough, we discussed the cardiovascular actions of specific nutrients and of dietary patterns. Particular attention was paid to dietary fat, carbohydrates (in terms of glycemic index), and functional, polyphenol-rich foods. Of note, we critically review the available evidence in light of the Italian dietary patterns, to draw practical conclusions applicable to this country.