Beside pharmacological therapy, therapeutic lifestyle changes (TLC) including diet therapy is essential for prevention of atherosclerosis. Dietary guidelines to reduce risk for atherosclerosis should be individualized considering the risk factors of atherosclerosis, i.e., obesity, hyperlipidemia, diabetes, and hypertension. In obese patients, the primary goal should be weight reduction to improve overall health by reducing the calorie intake allowed for balanced essential nutrients, especially, adequate protein and micronutrients. Especially, alcohol has been the critical factor in calorie intake in Koreans. Nutritional recommendations of the TLC diet for hyperlipidemia are reduced intake of saturated fat, trans fat, and cholesterol, and increased intake of polyunsaturated fat, monounsaturated fat, soluble fiber, and phytosterols. Excessive intake of carbohydrate and simple sugar might be the risk factors for elevating VLDL in Korean women. For the management of diabetes, mealtime regularity, regular meal size, and balanced nutrients should be emphasized. Low GI diet can be beneficial to control blood glucose. Dietary Approaches to Stop Hypertension (DASH) diet is known to improve the health of hypertensive patients. Nutrient targets for the DASH diet are low fat, saturated fat, and cholesterol, and high fiber. Low sodium diet (2,300 mg/day) and foods rich in potassium, calcium, and magnesium are recommended. The Korean traditional diet considering the individual dietary pattern of patients could be the practical healthy diet to prevent atherosclerosis.