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Annals of Internal Medicine tip sheet for Aug. 26, 2014

American College of Physicians

1. Task Force recommends intensive behavioral counseling for overweight and obese patients with cardio risk factors

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The United States Preventive Services Task Force (USPSTF) recommends that overweight or obese adults with at least one additional risk factor for cardiovascular disease (CVD) be offered or referred to intensive behavioral counseling interventions to promote a healthful diet and physical activity for CVD prevention. The recommendation is being published in Annals of Internal Medicine. Cardiovascular disease is the leading cause of death in the United States and obesity is associated with increased CVD mortality. Individuals that follow guidelines for a healthful diet and physical activity can decrease their risk for cardiovascular morbidity and mortality. Researchers for the USPSTF reviewed 74 published studies to determine if primary care-relevant counseling interventions about diet and/or exercise could change behaviors and improve cardiovascular health among adults with known risk factors for cardiovascular disease. They concluded that intensive behavioral counseling interventions that promoted healthy diets and physical activity helped persons lose weight and reduce their lipid levels, blood pressure, and glucose levels.

This systematic review was designed to complement the existing reviews that supported a 2012 recommendation by the USPSTF that clinicians should consider selectively providing or referring adults without preexisting CVD or risk factors for intensive behavioral interventions.

This recommendation is an update to the USPSTF's 2003 recommendations on healthy diet and physical activity counseling in persons with known CVD risk factors. This new recommendation differs from 2003 in that it targets overweight or obese adults who have additional CVD risk factors. Interventions assess for this recommendation focused on improved healthy eating, increasing physical activity, or combined approaches to developing a healthier lifestyle.


Note: The URL will go live at 5:00 p.m. on Monday, August 25 and can be included in news stories. For an embargoed PDF, please contact Megan Hanks. To interview the author of the evidence review, please contact Mary Sawyers at or 503-335-6602. To interview a member of the USPSTF, please contact Nicole Raisch at or 202-572-2044.

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