Suitability of the Pakistan dietary guidelines for better nutrition for patients with coronary artery disease and high-risk populations

Coronary artery disease (CAD) is the leading cause of death in Pakistan, with rising prevalence in the young population. Diet plays a crucial role in the development of coronary artery disease, making dietary guidelines essential for the prevention and management of CAD. This review is based on the Pakistan Dietary Guidelines for Better Nutrition (PDGN) and their comparison with international cardiovascular dietary guidelines, including those of the American Heart Association (AHA), the European Society of Cardiology (ESC), and the World Health Organization (WHO). The narrative review critically analyzes the current Pakistan Dietary Guidelines for Better Nutrition (PDGN) and compares them with international and well-established guidelines, such as those of the American Heart Association (AHA), the European Society of Cardiology (ESC), and the World Health Organization (WHO). This review found that PDGN offers culturally relevant and affordable recommendations and includes general quantitative dietary guidance; however, compared with selected international cardiovascular guidelines, it provides less detailed CAD-specific targets and limited emphasis on structured cardioprotective dietary patterns. International guidelines emphasize numeric thresholds and structured diets shown to reduce the CAD risk. Updating PDGN to include more detailed CAD-specific quantitative guidance, culturally adapted cardioprotective dietary patterns, and integration into clinical and public health strategies is critical to curb Pakistan’s rising CAD burden. Strengthening the guidelines is an opportunity to align national policy with global evidence and with cultural feasibility, thereby supporting improved cardiovascular outcomes.