The draft recommendation by Task Force is directed towards behavioral counseling to promote a healthy diet and physical activity for cardiovascular disease prevention in adults without risk factors. The statement induces clinicians decide with their patients who do not have risk factors for cardiovascular disease whether counseling interventions on healthy diet and physical activity might help to prevent heart attack and stroke.
This is a C grade recommendation by the USPSTF suggesting that clinicians individualize the decision to offer or refer adults without cardiovascular disease risk factors to behavioral counseling interventions to promote a healthy diet and physical activity. See the "Practice Considerations" section for information on determining which patients may benefit most from this service.
Cardiovascular disease, which includes heart attack and stroke, is the number one killer of adults in the United States, accounting for about one in three deaths. This recommendation applies to adults who do not have any known risk factors for cardiovascular disease, including high blood pressure, unhealthy cholesterol levels, and high blood sugar. This recommendation does not apply to people who have obesity; the USPSTF has a separate related recommendation for people who have obesity.
"Healthy diet and physical activity are essential to cardiovascular disease prevention, and behavioral counseling to promote healthy lifestyles can help even some people without cardiovascular disease risk factors," says Task Force member Lori Pbert, Ph.D. "We found that people who are interested in making changes to their diet and physical activity are most likely to benefit from counseling, so clinicians are encouraged to talk with their patients anddecide together if behavioral counseling is right for them."
Counseling interventions involve a trained professional delivering dietary or physical activity advice in the clinical setting, either in-person, virtually, or using other methods of communication. Dietary counseling focuses on increasing consumption of fruits, vegetables, whole grains, fat-free or low-fat dairy, lean proteins, and healthy oils.
Physical activity counseling focuses on activities that enhance or maintain overall health and physical fitness, such as walking. When determining which patients might benefit from counseling interventions, clinicians should consider the patient's goals and motivations, activity and ability, circumstances, and personal preferences.
"The Task Force recognizes that many people face barriers to healthy eating and physical activity," says Task Force member Michael Cabana M.D., M.A., M.P.H. "We encourage clinicians to engage patients in a conversation on how best to support them to maintain a healthy lifestyle based on patients' individual circumstances."
The Task Force has a separate B grade recommendation on behavioral counseling interventions for adults who have risk factors for cardiovascular disease, which can be found on the Task Force website. Everyone, regardless of risk factors, can improve their health by eating a healthy diet and participating in physical activity.