Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Cardiovascular Risk Factors: US Preventive Services Task Force Recommendation Statement | Cardiology | JAMA | JAMA Network
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1.
Centers for Disease Control and Prevention, National Center for Health Statistics. Leading causes of death, 2015. https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm. Accessed May 1, 2017.
2.
Ford  ES, Bergmann  MM, Boeing  H, Li  C, Capewell  S.  Healthy lifestyle behaviors and all-cause mortality among adults in the United States.  Prev Med. 2012;55(1):23-27.PubMedGoogle ScholarCrossref
3.
Patnode  CD, Evans  CV, Senger  CA, Redmond  N, Lin  JS.  Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors: An Updated Systematic Review for the US Preventive Services Task Force. Evidence Synthesis No. 152. Rockville, MD: Agency for Healthcare Research and Quality; 2017. AHRQ publication 15-05222-EF-1.
4.
Patnode  CD, Evans  CV, Senger  CA, Redmond  N, Lin  JS.  Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults without known cardiovascular disease risk factors: updated evidence report and systematic review for the US Preventive Services Task Force.  JAMA. doi:10.1001/jama.2017.3303Google Scholar
5.
US Department of Health and Human Services and US Department of Agriculture. 2015–2020 dietary guidelines for Americans, eighth edition. https://health.gov/dietaryguidelines/2015/guidelines/. 2015. Accessed May 1, 2017.
6.
US Department of Health and Human Services.  2008 Physical Activity Guidelines for Americans. Washington, DC: US Department of Health and Human Services; 2008. ODPHP publication U0036.
7.
Community Preventive Services Task Force. Diabetes: combined diet and physical activity promotion programs to prevent type 2 diabetes among people at increased risk. https://www.thecommunityguide.org/findings/diabetes-combined-diet-and-physical-activity-promotion-programs-prevent-type-2-diabetes. 2014. Accessed May 1, 2017.
8.
LeFevre  ML; U.S. Preventive Services Task Force.  Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: U.S. Preventive Services Task Force Recommendation Statement.  Ann Intern Med. 2014;161(8):587-593.PubMedGoogle ScholarCrossref
9.
Moyer  VA; U.S. Preventive Services Task Force.  Screening for and management of obesity in adults: U.S. Preventive Services Task Force recommendation statement.  Ann Intern Med. 2012;157(5):373-378.PubMedGoogle Scholar
10.
Siu  AL; U.S. Preventive Services Task Force.  Screening for abnormal blood glucose and type 2 diabetes mellitus: U.S. Preventive Services Task Force recommendation statement.  Ann Intern Med. 2015;163(11):861-868.PubMedGoogle ScholarCrossref
11.
Siu  AL; U.S. Preventive Services Task Force.  Screening for high blood pressure in adults: U.S. Preventive Services Task Force recommendation statement.  Ann Intern Med. 2015;163(10):778-786.PubMedGoogle ScholarCrossref
12.
Bibbins-Domingo  K, Grossman  DC, Curry  SJ,  et al; US Preventive Services Task Force.  Statin use for the primary prevention of cardiovascular disease in adults: US Preventive Services Task Force recommendation statement.  JAMA. 2016;316(19):1997-2007.PubMedGoogle ScholarCrossref
13.
Siu  AL; U.S. Preventive Services Task Force.  Behavioral and pharmacotherapy interventions for tobacco smoking cessation in adults, including pregnant women: U.S. Preventive Services Task Force recommendation statement.  Ann Intern Med. 2015;163(8):622-634.PubMedGoogle ScholarCrossref
14.
Bibbins-Domingo  K; U.S. Preventive Services Task Force.  Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer: U.S. Preventive Services Task Force recommendation statement.  Ann Intern Med. 2016;164(12):836-845.PubMedGoogle ScholarCrossref
15.
LeBlanc  E, O’Connor  E, Whitlock  EP, Patnode  C, Kapka  T.  Screening for and Management of Obesity and Overweight in Adults. Evidence Synthesis No. 89. Rockville, MD: Agency for Healthcare Research and Quality; 2011. AHRQ publication 11-05159-EF-1.
16.
Mozaffarian  D, Benjamin  EJ, Go  AS,  et al; Writing Group Members; American Heart Association Statistics Committee; Stroke Statistics Subcommittee.  Heart disease and stroke statistics—2016 update: a report from the American Heart Association.  Circulation. 2016;133(4):e38-e360.PubMedGoogle ScholarCrossref
17.
Hypertension Prevention Trial Research Group.  The Hypertension Prevention Trial: three-year effects of dietary changes on blood pressure.  Arch Intern Med. 1990;150(1):153-162.PubMedGoogle ScholarCrossref
18.
Whelton  PK, Appel  L, Charleston  J,  et al.  The effects of nonpharmacologic interventions on blood pressure of persons with high normal levels: results of the Trials of Hypertension Prevention, phase I.  JAMA. 1992;267(9):1213-1220.PubMedGoogle ScholarCrossref
19.
Trials of Hypertension Prevention Collaborative Research Group.  Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with high-normal blood pressure: the Trials of Hypertension Prevention, phase II.  Arch Intern Med. 1997;157(6):657-667.PubMedGoogle ScholarCrossref
20.
Tinker  LF, Bonds  DE, Margolis  KL,  et al; Women’s Health Initiative.  Low-fat dietary pattern and risk of treated diabetes mellitus in postmenopausal women: the Women’s Health Initiative randomized controlled dietary modification trial.  Arch Intern Med. 2008;168(14):1500-1511.PubMedGoogle ScholarCrossref
21.
Lawton  BA, Rose  SB, Elley  CR, Dowell  AC, Fenton  A, Moyes  SA.  Exercise on prescription for women aged 40-74 recruited through primary care: two year randomised controlled trial.  BMJ. 2008;337:a2509.PubMedGoogle ScholarCrossref
22.
Moyer  VA; U.S. Preventive Services Task Force.  Behavioral counseling interventions to promote a healthful diet and physical activity for cardiovascular disease prevention in adults: U.S. Preventive Services Task Force recommendation statement.  Ann Intern Med. 2012;157(5):367-371.PubMedGoogle Scholar
23.
Artinian  NT, Fletcher  GF, Mozaffarian  D,  et al; American Heart Association Prevention Committee of the Council on Cardiovascular Nursing.  Interventions to promote physical activity and dietary lifestyle changes for cardiovascular risk factor reduction in adults: a scientific statement from the American Heart Association.  Circulation. 2010;122(4):406-441.PubMedGoogle ScholarCrossref
24.
American Academy of Family Physicians. Clinical preventive service recommendation: healthful diet and physical activity to prevent cardiovascular disease (CVD). http://www.aafp.org/patient-care/clinical-recommendations/all/diet-cvd.html. 2012. Accessed May 1, 2017.
US Preventive Services Task Force
Recommendation Statement
July 11, 2017

Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Cardiovascular Risk Factors: US Preventive Services Task Force Recommendation Statement

US Preventive Services Task Force
JAMA. 2017;318(2):167-174. doi:10.1001/jama.2017.7171
Abstract

Importance  Adults who adhere to national guidelines for a healthful diet and physical activity have lower rates of cardiovascular morbidity and mortality than those who do not. All persons, regardless of their risk status for cardiovascular disease (CVD), can gain health benefits from healthy eating behaviors and appropriate physical activity.

Objective  To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention among adults without obesity who do not have cardiovascular risk factors (hypertension, dyslipidemia, abnormal blood glucose levels, or diabetes).

Evidence Review  The USPSTF reviewed the evidence on whether primary care–relevant counseling interventions to promote a healthful diet, physical activity, or both improve health outcomes, intermediate outcomes associated with CVD, or dietary or physical activity behaviors in adults; interventions to reduce sedentary behaviors; and the harms of behavioral counseling interventions.

Findings  Counseling interventions result in improvements in healthful behaviors and small but potentially important improvements in intermediate outcomes, including reductions in blood pressure and low-density lipoprotein cholesterol levels and improvements in measures of adiposity. The overall magnitude of benefit related to these interventions is positive but small. The potential harms are at most small, leading the USPSTF to conclude that these interventions have a small net benefit for adults without obesity who do not have CVD risk factors.

Conclusions and Recommendation  The USPSTF recommends that primary care professionals individualize the decision to offer or refer adults without obesity who do not have hypertension, dyslipidemia, abnormal blood glucose levels, or diabetes to behavioral counseling to promote a healthful diet and physical activity. Existing evidence indicates a positive but small benefit of behavioral counseling for the prevention of CVD in this population. Persons who are interested and ready to make behavioral changes may be most likely to benefit from behavioral counseling. (C recommendation)

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