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U.S. Preventive Services Task Force


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

Population General adult population without a known diagnosis of hypertension, diabetes, hyperlipidemia, or cardiovascular disease
Recommendation Although the correlation among healthful diet, physical activity, and the incidence of cardiovascular disease 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 cardiovascular disease, patient 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 with a greater health effect.

Grade: C
Risk Assessment If an individual's risk for cardiovascular disease is uncertain, there are several calculators and models available to quantify a person's 10-year risk for cardiac events, such as the Framingham-based Adult Treatment Panel III calculator (available at http://hp2010.nhlbihin.net/atpiii/calculator.asp). Generally, persons with a 10-year risk greater than 20% are considered to be high-risk, those with a 10-year risk less than 10% are considered to be low-risk, and those in the 10% to 20% range are considered to be intermediate-risk.
Interventions Medium- or high-intensity behavioral interventions to promote a healthful diet and physical activity may be provided to individual patients in primary care settings or in other sectors of the health care system after referral from a primary care clinician. In addition, clinicians may offer healthful diet and physical activity interventions by referring the patient to community-based organizations. Strong linkages between the primary care setting and community-based resources may improve the delivery of these services.
Balance of Harms and Benefits The USPSTF concludes with moderate certainty that medium- or high-intensity primary care behavioral counseling interventions to promote a healthful diet and physical activity have a small net benefit in adult patients without cardiovascular disease, hypertension, hyperlipidemia, or diabetes.
Other Relevant USPSTF Recommendations The USPSTF has made recommendations on screening for carotid artery stenosis, coronary heart disease, high blood pressure, lipid disorders, peripheral arterial disease, and obesity. These recommendations are available at http://www.uspreventiveservicestaskforce.org.

For a summary of the evidence systematically reviewed in making these recommendations, the full recommendation statement, and supporting documents, please go to http://www.uspreventiveservicestaskforce.org.

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.

AHRQ Publication No. 11-05149-EF-3
Current as of June 2012


Internet Citation:

U.S. Preventive Services Task Force. 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. AHRQ Publication No. 11-05149-EF-3. June 2012. http://www.uspreventiveservicestaskforce.org/uspstf11/physactivity/physsum.htm


 


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