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New Guidelines for Overweight Adults With Heart Risks

Health professionals urged to promote healthy diet and physical activity

The U.S. Preventive Services Task Force has published its final recommendation statement and final evidence summary on behavioral counseling to prevent cardiovascular disease in at-risk adults.

The task force recommends that adults who are overweight or obese and who also have at least one risk factor for cardiovascular disease be offered or referred to behavioral counseling interventions to promote a healthy diet and physical activity to help prevent the disease.

Cardiovascular disease, which includes heart disease and stroke, is one of the leading causes of death in the U.S. Nearly half of all adults have at least one risk factor for cardiovascular disease, such as hypertension, high cholesterol, being obese or overweight, or being a current smoker. Approximately 70% of all adults in the U.S. are overweight or obese, which increases their risk for hypertension, high cholesterol, and diabetes.

For adults who are overweight or obese and have hypertension, high cholesterol, or high blood sugar, the evidence shows that intensive behavioral counseling interventions to improve diet and to increase physical activity can help reduce their risk for cardiovascular disease.

“By following the recommended interventions, patients can experience health benefits, such as lower blood pressure and cholesterol, thus decreasing their risk for heart disease and stroke,” said task force member Sue Curry, PhD. “The most effective interventions vary but typically involve a trained counselor who provides education, helps patients set goals, shares tools to help promote healthy behaviors, and regularly monitors and follows up with patients.” Counselors can include dieticians or nutritionists, health educators, psychologists, physiotherapists, exercise professionals, or other trained professionals.

This recommendation applies specifically to adults who are obese or overweight and who already have a known risk factor for cardiovascular disease. The task force issued a separate recommendation in 2012 for people at average risk for cardiovascular disease, recommending that health care professionals selectively counsel these people to encourage healthy lifestyle choices that can help prevent cardiovascular disease. The new recommendation is intended to complement, not replace, the 2012 recommendation. The task force also has issued a recommendation on screening for and managing obesity, which focuses on weight loss.

“Cardiovascular disease prevention is most effective when diet and physical activity are improved together,” said task force member Mark Ebell, MD, MS. “Regardless of their risk for cardiovascular disease, everyone can experience the health benefits of improved nutrition, healthy eating behaviors, and increased physical activity.”

The task force’s final recommendation statement was published online in the Annals of Internal Medicine as well as on the group’s Web site.

Sources: USPSTF; August 26, 2014; and Recommendation Statement; August 2014.

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