Guidelines for nutrition therapy of cardiometabolic-based chronic disease (CMBCD) have moved away from nutrient-based recommendations to food/dietary pattern-based recommendations. Dietary patterns that combine the advantages of different foods can result in meaningful improvements in glycemic control, blood lipids, blood pressure, and inflammation. By allowing for flexibility in the proportion of macronutrients in the diet, these dietary patterns provide an opportunity to individualize therapy based on values, preferences, and treatment goals. To assist in the implementation of these dietary patterns into clinical practice, patient and physician engagement tools have been developed including food pyramids, infographics, and apps. Several research gaps remain related to the reliance on small RCTs of intermediate outcomes and observational prospective cohort studies, the lack of large RCTs of clinical outcomes, pragmatic trial designs leveraging primary care networks, and administrative and multi-omics approaches.