In 2014, the US Preventive Services Task Force (USPSTF) issued advice focused on individuals with elevated cardiovascular risk factors.1 They have now focused on “healthy” adults who do not have hypertension, dyslipidemia, obesity, abnormal blood glucose, or diabetes. The current issue of JAMA contains the latest USPSTF recommendation, which states as follows: “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, 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 cardiovascular disease (CVD) in this population. Individuals who are interested and ready to make behavioral changes may be most likely to benefit from behavioral counseling. (C recommendation)”2 (The generalized language for a C recommendation is as follows: 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.)2
Capewell S, Dowrick C. Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Risk Factors: Is Behavioral Counselling Necessary? JAMA Intern Med. 2017;177(9):1254–1255. doi:10.1001/jamainternmed.2017.1979
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