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    'Intensive' Counseling Could Help Lessen CVD Risk in Individuals Who are Overweight or Obese

    Behavioral counseling that promotes physical activity and a healthy diet has been found to be beneficial for adults who are overweight or obese with a risk of cardiovascular disease (CVD), according to a recent report from the US Preventive Services Task Force (USPSTF).

    In an article published August 26, the USPSTF cited "adequate evidence" that behavioral interventions "have a moderate net benefit" for this group, and that potential harm is "small to none." The conclusions were reached after the task force reviewed 74 clinical trials, most of which studied combined counseling on diet and activity through multiple contacts over 9 to 12 months. The interventions were not focused specifically on weight loss, and trials conducted exclusively with persons who have diabetes were excluded.

    The USPSTF review of intermediate and longer-term health outcomes found that behavioral counseling resulted in "small but important changes in health behavior outcomes and selected clinical outcomes after 12 to 24 months." These clinical outcomes included decreases in total and LDL cholesterol, blood pressure, fasting glucose levels, and weight. Additionally, authors write, "the reduction in glucose levels was large enough to decrease the incidence of a diabetes diagnosis."

    The interventions studied by USPSTF for the most part included educational and supportive components, with a focus on behavior change through individualized plans. The counseling was performed by "specially trained professionals" that included "dietitians or nutritionists, physiotherapists or exercise professionals, health educators, and psychologists," according to the report. The interventions could be applied to a large portion of the US population—according to the USPSTF report, nearly half of all Americans have at least 1 CVD risk factor, and 70% are overweight or obese.

    The task force writes that more research is needed on the effectiveness of less intensive counseling, as well as the ways the interventions affect outcomes and behavior after 2 to 3 years. Other needed areas of study include the effectiveness of interventions for physical activity alone, and "trials examining the interaction or potentiation of clinical counseling and community-based lifestyle interventions," authors write.

    Check out APTA resources that emphasize the importance of collaborative approaches to behavior change in patients and clients at the behavior change webpage, including podcasts, measures, and guidance on how to facilitate the change process.


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