Changing dietary behavior is inherently difficult and even more so given the current obesity-promoting environment. Health professionals may facilitate this process for patients by assessing readiness to change, identifying personal priorities and barriers, and providing personalized knowledge, while increasing healthy-eating skills, motivation, and self-efficacy. It is also important to address the obesity-promoting environment through pubic policy as well as individual dietary change. Implementation of the American Heart Association diet and lifestyle recommendations is discussed along with barriers and recent assessment data. Patients may require assistance with interpretation of recommendations to their specific situations and practical application strategies considering their barriers and needs. One concept that may be helpful is a discussion that dietary change is not an end point but a process. Introducing patients to the 90-10 rule applied to food choices may help them conceptualize this process more easily. This idea revolves around the principle that what an individual does 90% of the time is most critical, and allowing some flexibility can make changing any lifestyle behavior more palatable and achievable.