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Editorial
September 2017

Healthful Physical Activity and Diet Promotion—For the Many or the Few?

Author Affiliations
  • 1Northwestern University Feinberg School of Medicine, Preventive Medicine, Chicago, Illinois
JAMA Cardiol. 2017;2(9):941-943. doi:10.1001/jamacardio.2017.2568

A new guideline from the US Preventive Services Task Force (USPSTF) published in JAMA1 advises primary care clinicians about whether they should offer behavioral counseling to promote healthful diet and physical activity to adults without traditional risk factors for cardiovascular disease (CVD) (hypertension, dyslipidemia, abnormal blood glucose levels, or diabetes). The practice of offering behavioral counseling to these low-risk patients received a C recommendation. This means that the USPSTF recommends selectively offering or providing this service to individual patients based on professional judgment and patient preferences; there is at least moderate certainty that the net benefit is small.1 Because the reviewers did not find grade B evidence of benefit, the provision of diet and activity counseling will not be routinely covered by private insurers. Instead, the new guideline advises clinicians to judge whether to provide behavioral counseling or whether to refer individual patients to receive it by making a shared decision that integrates the patient’s preferences, values, and circumstances.

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