Eh, I&#x27;m not sure I totally agree with what you are saying:<p>a) As you mentioned, smoking is a huge confounder in your example<p>b) A lot of congenital heart disease is not preventable via dietary intervention.  For people who do require dietary intervention it&#x27;s going to depend on the disease.  For a small portion of people, for instance, eating low cholesterol is important, but the vast majority it makes no difference.  For these people eating low cholesterol is the biggest difference, not a generally balanced diet.<p>c) There is a ton of science showing massive improvements in heart disease outcomes from losing weight.<p>I&#x27;m not saying eating a balanced diet doesn&#x27;t matter, but for most people actually being a healthy weight is the most important thing, and for many others the dietary intervention is pretty specific, ie: not low cholesterol not &quot;eat a balanced diet.&quot;