Cardiovascular disease is the leading cause of death and a major cause of disability. The aging population, obesity epidemic, underuse of prevention strategies, and suboptimal control of risk factors will exacerbate the future cardiovascular disease burden. Despite compelling evidence regarding the positive effect of diet and physical activity on cardiovascular mortality, the clinical practice has been largely unable to incorporate diet and physical activity counseling into patient care. Our goal is to close the gap between clinical research and practice in this area. The objective of this translational research pilot study is to develop and test a new dietary and physical activity counseling intervention for cardiovascular risk reduction that will be sustainable in the current health care environment. Our central hypothesis is that a physician-directed, Internet-delivered dietary and physical activity counseling intervention is feasible in today’s primary care office settings and will be able to reduce cardiovascular risk factors. The e-healthcare is a consumer focused health care delivery paradigm physicians and the healthcare system can no longer ignore. Lifestyle counseling and preventive medicine are potentially ideal areas of patient care that could be provided efficiently through this emerging avenue of healthcare delivery.