Low-fat, vegetarian diets have demonstrated potency in improving cardiovascular status, but little information is available regarding their acceptability or the levels of adherence that can be achieved. The current report was part of a larger study of a group of 27 patients with cardiac disease who were treated with a vegetarian diet containing less than 10% fat and other life style changes compared with a control group of 20 patients who received medical care from their regular physicians. Quantitative measures included a 3-day dietary history, serum lipid levels, and scales for dietary acceptability. The experimental group reduced fat intake dramatically, from 31.1% to 7% of kcal. There was no reduction in fat intake from baseline levels for the control subjects. Despite the differences in dietary content, there were no differences between the two groups in the measures of dietary acceptability. The authors concluded that a low-fat, vegetarian diet as part of a comprehensive program can achieve high levels of adherence and acceptability among patients with cardiac disease.