New Guidelines Recommended for Overweight Americans with Heart Problems

This study finds that “intensive behavioral counseling” works better than do-it-yourself. In fact – do it yourself may not work at all. The United States Preventive Services Task Force has recently issued new guidelines for overweight adults with an increased risk of developing heart conditions. Health officials recommend that they receive preventive care as well as counseling on diet and exercise.

According to the United States Preventive Services Task Force (USPSTF), doctors should offer intensive lifestyle counseling, or referrals for counseling, to all adults aged 18 years or older in primary care settings who are overweight or obese and have known CVD risk factors (hypertension, dyslipidemia, impaired fasting glucose, or the metabolic syndrome). In the studies reviewed by the USPSTF, the vast majority of participants had a BMI greater than 25 kg/. Nearly half of all U.S. adults have at least one risk factor for cardiovascular disease while roughly 70 percent are overweight or obese, according to the task force. And what does “intensive” mean? In studies, it has typically meant five to 15 sessions with a dietitian, exercise specialist or other health professional — usually in-person, though sometimes over the phone.

The USPSTF recommends offering or referring adults who are overweight or obese and have additional cardiovascular disease (CVD) risk factors to intensive behavioral counseling interventions to promote a healthful diet and physical activity for CVD prevention. Cardiovascular disease, primarily in the forms of heart disease and stroke, is a leading cause of death in the United States . Obesity is associated with increased CVD mortality . Adults who adhere to national guidelines for a healthful diet  and physical activity  have lower cardiovascular morbidity and mortality than those who do not. All persons, regardless of CVD risk status, can accrue the health benefits of improved nutrition, healthy eating behaviors, and increased physical activity. The USPSTF found adequate evidence that the harms of behavioral counseling interventions are small to none. None of the dietary intervention studies explicitly reported adverse events. Studies of physical activity interventions reported mostly minor adverse events, and intense physical activity was rarely associated with cardiovascular events. The USPSTF concludes with moderate certainty that intensive behavioral counseling interventions to promote a healthful diet and physical activity have a moderate net benefit in overweight or obese adults who are at increased risk for CVD.

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The Fat Switch by Richard J. Johnson M.D. (Author)

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