Presently, there are no European dietary guidelines on the appropriate food consumption for the prevention of cardiometabolic diseases. This hampers the implementation of concerted actions to make the food system more suitable for the people and environment health. The aims of our study are: 1) to identify the food groups for which more relevant discrepancies exist between the national dietary guidelines and 2) to propose an evidence based unifying model for the most appropriate food choices for cardiometabolic health and ecological sustainability at the European level. Present dietary guidelines for cardiometabolic prevention in five European Countries (France, Germany, Italy, Spain, and Sweden) participating in the EU funded SWITCH Project have been evaluated. The available dietary guidelines are rather consistent in relation to the recommended intake of fruit, vegetables, nuts, fish, eggs, and dietary fat, but discordant for legumes, starchy foods, meat, and dairy foods. Consumption of wholegrain is often not recommended. Recommendations of red meat consumption vary from 100 to 350 g/week, processed meat from zero to 150 g/week, cheese from 100 to 400 g/week, while there is no specific recommendation for yogurt; the frequency of legume consumption can vary from twice/week to daily. Taking into account the national guidelines and the available scientific evidence, an healthy and sustainable dietary pattern is proposed consisting of 400 g/day vegetables, 400 g/day fruits, 90 g/day whole grains, 30 g/day nuts, 350-500 g/day low-fat milk and dairy products, one egg/day, 25-30 g/day non-tropical vegetable oils; the proposal includes 150g/week legumes, 300 g/week fatty fish, 150 g/week lean fish, 300 g/week poultry, 150 g/week red and processed meat. This pattern allows for a flexible implementation of food choices tailored to preferences and cultures of the different European populations but firmly based on the available scientific evidence on the appropriate dietary patterns for cardiometabolic prevention and ecological sustainability.