The complexity of nutrient-gene interactions has led to the development of a new branch in the nutrition sciences, the nutrigenomics. The individual susceptibility to nutrients based on environment ? genotype ? phenotype interplay makes this new research field extremely promising although complex. In this review, we highlight and examine recent findings and the most relevant hypotheses on the role of the diet in the onset and progression of cardiovascular diseases. The effect of unbalanced diets on the cardiovascular system is considered one of the most important risk factors both for ischemic and degenerative myocardial pathologies. The concept that nutrigenomics could help in improving public and personal health is becoming tangible indicating future directions for basic and applied research in the pathophysiology of cardiovascular disease.Keywords Nutrigenomics Á Diet Á Cardiovascular disease Á Polyunsaturated fatty acids During the last two centuries, much progress have been achieved in understanding how food is metabolized. Carbohydrates, proteins and fats are oxidized by the body, and related energy values can be calculated. Since the early twentieth century, considerable research on energy exchange, nature of food components [36] and how nutrients influence the right balance between health and disease [27] has been carried out. Once the understanding of macronutrients was clarified, nutrition scientists turned their attention to the elucidation of the role of micronutrients in particular minerals and vitamins [23,32,33]. During the last half of the twentieth century, most work focused on the clarification of the functions of essential nutrients and the definition of the role of micronutrients as enzyme and hormone cofactors, and their subsequent roles in metabolic pathways [2]. Also, the relevance of carbohydrates and fats in different diseases, such as diabetes and atherosclerosis, was discovered, and their actual and potential mechanisms detailed [24,51,64]. However, the mechanism by which nutrients influence health and disease status remained unclear. For example, how can some individuals consume high fat diets and yet show no evidence of atherosclerotic disease? Genetic differences certainly were suspected, but the elucidation of cellular, molecular and ultimately genetic mechanisms in both healthy and unhealthy individuals proved to be a challenge.Development of new tools enabling exploration of the cause-effect phenomena at the molecular level stimulated scientists to develop hypotheses and conduct experiments to lay the foundation for a deeper level of understanding of gene-diet interactions. Today, an emerging field of nutritional research focuses on identifying the molecular interactions between nutritional bioactive components and processes through which genome-encoded proteins are expressed. Discoveries in genomics offered unpredictable possibilities for more dynamic scientific investigations based on understanding the effects of nutrients in processes at molecular-level as well as the...