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Therapeutic Area: Nutrition/Exercise Background: The Standard American Diet (SAD), typically poor in nutritional value, is a known contributor to cardiometabolic syndromes and cardiovascular disease. Suboptimal nutrition composed of processed and red meat, refined carbohydrates, high salt and added sugars contributes to cardiovascular death and premature mortality. Dietary patterns that focus on plant-based foods are associated with reductions and slowing progression of cardiovascular disease . Specifically, the Mediterranean Diet (MD) has a strong association with lower rates of heart disease, cancer, and obesity while increasing longevity. In recent years, a plant based diet (PBD) has also emerged as a nutritional alternative to the MD with health benefits.The growing knowledge of the importance of well-balanced diet to cardiovascular health has become more well-known as it is a component of the AHA's Life Essential 8, which illustrates the factors that are important to cardiovascular health. Dietary changes are traditionally focused in the outpatient setting, though little has been done in the acute care setting when patients are most vulnerable and amenable to change, especially after a life altering event. Methods: We will recruit adults >18 years of age who are admitted to Temple University Hospital with a standard cardiac diet order with one of the following diagnoses: acute coronary syndrome, heart failure, atrial fibrillation/flutter or hypertensive crisis. Patients will be given a baseline questionnaire to assess dietary behaviors prior to hospital admission.Patients will then be randomized to either a cardiac, PBD or MD. The PBD and MD were created for this study in collaboration with registered dietitians to assure all nutritional requirements were met during the admission.One month following hospital discharge, patients will be contacted with a follow up questionnaire to assess if dietary behaviors have changed compared to baseline. Results: The study is in the enrollment phase. We plan to have preliminary data to present at the conference. Conclusions: A prior inpatient study illustrated that inpatient diet could impact dietary behaviors. We hypothesize that an intervention with either a PBD or MD in patients hospitalized for cardiovascular disease will have a positive impact on dietary behaviors one month post discharge.