Virginia A. Moyer, MD, MPH; on behalf of the U.S. Preventive Services Task Force
Disclaimer: Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
Financial Support: The USPSTF is an independent, voluntary body. The U.S. Congress mandates that the Agency for Healthcare Research and Quality support the operations of the USPSTF.
Potential Conflicts of Interest: Dr. Moyer: Consulting fee or honorarium: USPSTF. Support for travel to meetings for the study or other purposes: USPSTF. Disclosure forms from USPSTF members can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-1261.
Requests for Single Reprints: Reprints are available from the USPSTF Web site (www.uspreventiveservicestaskforce.org).
Update of the 2003 and 2002 U.S. Preventive Services Task Force (USPSTF) recommendation statements on behavioral counseling to promote a healthful diet and physical activity in adults without preexisting cardiovascular disease (CVD) or its risk factors.
The USPSTF reviewed new evidence on whether counseling interventions relevant to primary care for physical activity or a healthful diet modify self-reported behaviors; intermediate physiologic outcomes (for example, reduced lipid levels, blood pressure, weight, and body mass index and increased glucose tolerance); and cardiovascular morbidity and mortality in adults without known CVD, hypertension, hyperlipidemia, or diabetes.
General adult population without a known diagnosis of hypertension, diabetes, hyperlipidemia, or CVD.
Although the correlation among healthful diet, physical activity, and the incidence of CVD is strong, existing evidence indicates that the health benefit of initiating behavioral counseling in the primary care setting to promote a healthful diet and physical activity is small. Clinicians may choose to selectively counsel patients rather than incorporate counseling into the care of all adults in the general population.
Considerations: Issues to consider include other risk factors for CVD, a patient's readiness for change, social support and community resources that support behavioral change, and other health care and preventive service priorities.
Potential Harms: Harms may include the lost opportunity to provide other services that have a greater health effect.
This is a grade C recommendation.
Behavioral counseling interventions to promote a healthful diet and physical activity for cardiovascular disease prevention in adults: clinical summary of U.S. Preventive Services Task Force recommendation.
What the USPSTF Grades Mean and Suggestions for Practice
USPSTF Levels of Certainty Regarding Net Benefit
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Moyer VA, on behalf of the 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;157:367–372. doi: 10.7326/0003-4819-157-5-201209040-00486
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Published: Ann Intern Med. 2012;157(5):367-372.
Cardiology, Guidelines, Prevention/Screening.
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