LEARNING OUTCOME: To demonstrate how a Diet Habit Survey comparison can be used to measure outcome of nutritional counseling. Dietary changes can decrease the risk of developing coronary heart disease in individuals with lipid abnormalities. Current emphasis is on gradual dietary change. A diet assessment tool that identifies current eating behaviors and provides a means for tracking behavioral changes made over time can be useful to improve compliance and predict outcomes. The Oregon Health Sciences University Diet Habit Survey is an inexpensive, reliable and valid instrument for rapid assessment of eating habits and diet composition. Thirty (30) outpatients who participated in a Lipid Clinic at VAMC Bay Pines, Florida during a 4 year period were given the Oregon Health Sciences University Diet Habit Survey following their initial consultation with the clinic dietitian. Completed surveys were returned and scored prior to the patient's second visit to the clinic. Patients received feedback from the dietitian about their eating behaviors. Areas of concern were discussed in subsequent visits to the clinic and advice was provided to improve diet behaviors and patient compliance. Patients were followed up every three (3) months for a 12-24 month period. Upon completion of the counseling sessions, a second Diet Habit Survey was administered. Eleven (11) of the 30 outpatients seen in the clinic completed and returned the second Diet Habit Survey. Scores of the first survey were then compared to the second survey to assess what changes patients had made in their eating behaviors. Results showed that 64% of the counseled patients had made improvements in diet behaviors. The comparison was recognized as a quantifiable measure of the outcome of patient education and follow-up. The Oregon Health Sciences University Diet Habit Survey is a useful tool to assess impact of nutritional counseling in an outpatient clinic setting. This dietary assessment tool is helpful in the dietary management of patients with hyperlipidemia and coronary heart disease.