The U.S. Preventive Services Task Force (USPSTF) on Nov. 29 posted a draft recommendation statement and draft evidence review on behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults without cardiovascular risk factors.

Among the proposals, the USPSTF includes a Class C recommendation that primary care professionals consider offering or referring people at low or average risk for heart disease to counseling to encourage healthy lifestyle choices to prevent cardiovascular disease, especially if the patient is interested in and motivated to make lifestyle changes. 

“The Task Force found that for people who are not at increased risk for heart disease, counseling on healthy eating and physical activity may help prevent heart disease for some people,” says USPSTF Vice Chair Susan Curry, PhD. “In this draft recommendation, the Task Force encourages primary care professionals to individualize this counseling and consider offering it to adults who are interested in and motivated to make lifestyle changes.”

The Task Force’s recommendation applies to adults age 18 and older without obesity and who have not been diagnosed with high blood pressure or cholesterol, diabetes, or abnormal blood glucose. Behavioral counseling interventions usually include educational sessions, as well as individualized care plans, problem solving skills, and feedback. These interventions often involve face-to-face and/or telephone contacts for multiple sessions over several months and can also include print and electronic resources. As part of a separate recommendation, the USPSTF also recommends intensive behavioral counseling for people who are obese or overweight and have other known risk factors for heart disease.

“The USPTF has now expanded its recommendation to help motivated patients live more healthfully to those not necessarily with manifested risk (i.e., hypertension, dyslipidemia, obesity, etc.),” said Andrew Freeman, MD, FACC, a member of ACC’s Prevention Section. “In this light, the USPTF has shown great wisdom and forethought to help prevent heart (and other) disease in patients before they develop it. As there are still some patients who show up with their index cardiac event without prior known risk factors and with normal body weight (particularly those who may not eat healthfully or exercise regularly), making changes earlier in life may prevent coronary events. This recommendation behooves the medical community to improve training and education in counseling, nutrition, and healthy lifestyles to ensure the entire care team has the tools they need to implement these preventative measures.”

The USPSTF draft recommendation statement and draft evidence review have been posted for public comment at www.uspreventiveservicestaskforce.org. Comments will be accepted through Jan. 2, 2017.

Keywords: Adult, Blood Glucose, Cardiovascular Diseases, Cholesterol, Counseling, Diabetes Mellitus, Diet, Dyslipidemias, Exercise, Heart Diseases, Hypertension, Ideal Body Weight, Life Style, Obesity, Overweight, Primary Health Care, Risk Factors

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