The aim of this study was to evaluate the feasibility of dietary counselling and the predictability of success in reducing fat intake to less than 20% of total energy in patients with symptomatic coronary heart disease. Forty-seven patients with coronary heart disease attended a 2-week in-house cardiac rehabilitation course with the main emphasis on individual dietary counselling by a nutritionist. Patients were followed up at 3 and 6 months. The dietary data were collected by means of 3-7days food diaries. Mean fat intake decreased from 33.6 6.2% to 24.7 5.5% of total energy intake at 3 months and to 27.0 6.9% ( p < 0.001) at 6 months. Only 13% of the patients were able to reduce their dietary fat intake as recommended. Thus, reduction of 20% was considered a good response, while reduction of < 20% was classified as poor. Forty-seven percent ( n = 22) of the patients were good and 53% ( n = 25) poor responders. It was not possible to predict the success rate from the baseline data. After a 2-week intensive counselling period at the rehabilitation centre, half of the coronary patients were able to comply with a low-fat diet at home for 6 months. Long-term compliance requires further investigation.