The document, entitled 'Toward Healthful Diets' that was developed by the Food and Nutrition Board of the National Academy of Sciences last year, has again stirred major controversy among the general public and in the medical community regarding the diet-heart hypothesis as a basis for efforts to favorably modify the natural history of atherosclerotic vascular disease in the American population. In this rebuttal to the conclusion drawn in 'Toward Healthful Diets', we review recent evidence in support of the diet-heart hypothesis. We conclude that continued efforts to reduce dietary cholesterol and saturated fat, in the context of efforts to eliminate other reversible risk factors as well, should remain an important goal for individuals and physicians seeking to limit premature death or disability fom atherosclerotic vascular disease.