USPSTF releases draft recommendation on behavioral counseling for healthy diet, CVD prevention

The U.S. Preventive Services Task Force (USPSTF) released a draft recommendation statement Nov. 29 regarding behavioral counseling to promote a healthful diet and cardiovascular disease prevention among adults with no known risk factors.

The USPSTF is accepting comments on the recommendation through Jan. 2, 2017. The recommendation applies to adults who are not obese and do not have hypertension, dyslipidemia, abnormal blood glucose or diabetes.

The statement mentioned that primary care professionals should make a case-by-case recommendation with regards to deciding to offer or refer adults to behavioral counseling.

The USPSTF gave the recommendation a “C” rating, which it defines as “selectively offering or providing this service to individual patients based on professional judgment and patient preferences.”

More than 2,000 people in the U.S. die from cardiovascular disease each day, according to the USPSTF researchers. They added that fewer than 40 percent of adults who were 50 years old or older in 2012 had the recommended amount of physical activity and fewer than 2 percent had an ideal diet.

After reviewing 88 trials with 121 distinct intervention groups, the USPSTF found that behavioral counseling provides at least a small benefit for cardiovascular risk reduction, including improvements in systolic and diastolic blood pressure levels, low-density lipoprotein cholesterol levels, body mass index and waist circumference. However, it found inadequate evidence that behavioral counseling leads to a reduction in mortality or cardiovascular disease rates.

The behavioral counseling included low-intensity interventions such as print- or Web-based materials and medium- and high-intensity interventions such as face-to-face individual or group counseling.

The USPSTF said this draft recommendation statement was an update to one published in 2012.

“The current recommendation is based on a new systematic evidence review that included 50 trials from the previous review and an additional 38 new trials,” the researchers wrote. “The current recommendation is similar to the previous recommendation. Given the recent publication of recommendations focused on behavioral counseling in adults at higher risk for [cardiovascular disease], adults with obesity, and adults with abnormal blood glucose or diabetes, the current recommendation focuses on persons without these risk factors.”