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Behavioral Counseling To Promote A Healthful Diet And Physical Activity For Cardiovascular Disease Prevention In Adults Without Known Cardiovascular Disease Risk Factors
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Book Synopsis Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors by : Carrie D. Patnode
Download or read book Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors written by Carrie D. Patnode and published by . This book was released on 2017 with total page 305 pages. Available in PDF, EPUB and Kindle. Book excerpt: OBJECTIVE: We conducted this systematic review to support the U.S. Preventive Services Task Force (USPSTF) in updating its 2012 recommendation on behavioral counseling to promote a healthful diet and physical activity for the primary prevention of cardiovascular disease (CVD) in adults without known CVD risk factors. Our review addressed four key questions: 1. Do primary care behavioral counseling interventions to improve diet, increase physical activity, and/or reduce sedentary behavior improve health outcomes in adults? 2. Do primary care behavioral counseling interventions to improve diet, increase physical activity, and/or reduce sedentary behavior improve intermediate outcomes associated with CVD in adults? 3. Do primary care behavioral counseling interventions to improve diet, increase physical activity, and/or reduce sedentary behavior improve associated health behaviors in adults? 4. What adverse events are associated with primary care behavioral counseling interventions to improve diet, increase physical activity, and/or reduce sedentary behavior in adults? CONCLUSIONS: The results of our updated systematic review are generally consistent in magnitude with our 2010 review on this topic. In general, diet and physical activity behavioral interventions for generally unselected adults who were not targeted for counseling based on their CVD risk resulted in consistent modest benefits across a variety of important intermediate health outcomes, including blood pressure, low-density lipoprotein, and total cholesterol levels as well as adiposity, with evidence of a dose-response effect with higher intensity interventions resulting in greater improvements. Small-to-moderate improvements were also seen in dietary and physical activity behaviors. Very limited evidence exists on health outcomes or harmful effects of these interventions. The improvements we saw, however, in intermediate and behavioral health outcomes could translate into long-term reduction in CVD-related events, with minimal to no harms, if such changes were maintained over time.
Book Synopsis Behavioral Counseling Interventions to Promote a Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors by : Carrie D. Patnode
Download or read book Behavioral Counseling Interventions to Promote a Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors written by Carrie D. Patnode and published by . This book was released on 2017 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: OBJECTIVE: We conducted this systematic review to support the U.S. Preventive Services Task Force (USPSTF) in updating its 2012 recommendation on behavioral counseling to promote a healthful diet and physical activity for the primary prevention of cardiovascular disease (CVD) in adults without known CVD risk factors. Our review addressed four key questions: 1. Do primary care behavioral counseling interventions to improve diet, increase physical activity, and/or reduce sedentary behavior improve health outcomes in adults? 2. Do primary care behavioral counseling interventions to improve diet, increase physical activity, and/or reduce sedentary behavior improve intermediate outcomes associated with CVD in adults? 3. Do primary care behavioral counseling interventions to improve diet, increase physical activity, and/or reduce sedentary behavior improve associated health behaviors in adults? 4. What adverse events are associated with primary care behavioral counseling interventions to improve diet, increase physical activity, and/or reduce sedentary behavior in adults? CONCLUSIONS: The results of our updated systematic review are generally consistent in magnitude with our 2010 review on this topic. In general, diet and physical activity behavioral interventions for generally unselected adults who were not targeted for counseling based on their CVD risk resulted in consistent modest benefits across a variety of important intermediate health outcomes, including blood pressure, low-density lipoprotein, and total cholesterol levels as well as adiposity, with evidence of a dose-response effect with higher intensity interventions resulting in greater improvements. Small-to-moderate improvements were also seen in dietary and physical activity behaviors. Very limited evidence exists on health outcomes or harmful effects of these interventions. The improvements we saw, however, in intermediate and behavioral health outcomes could translate into long-term reduction in CVD-related events, with minimal to no harms, if such changes were maintained over time.
Book Synopsis Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors: Updated Systematic Review for by :
Download or read book Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors: Updated Systematic Review for written by and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :U. S. Department of Health and Human Services Publisher :Createspace Independent Pub ISBN 13 :9781484827857 Total Pages :608 pages Book Rating :4.8/5 (278 download)
Book Synopsis Behavioral Counseling to Promote Physical Activity and a Healthful Diet to Prevent Cardiovascular Disease in Adults: Update of the Evidence for the U. S. Preventive Services Task Force by : U. S. Department of Health and Human Services
Download or read book Behavioral Counseling to Promote Physical Activity and a Healthful Diet to Prevent Cardiovascular Disease in Adults: Update of the Evidence for the U. S. Preventive Services Task Force written by U. S. Department of Health and Human Services and published by Createspace Independent Pub. This book was released on 2013-04-27 with total page 608 pages. Available in PDF, EPUB and Kindle. Book excerpt: Physical activity has been defined as “bodily movement produced by the contraction of skeletal muscle that increases energy expenditure above the basal level.” This review operationalized this definition to include interventions promoting aerobic- or strength-related physical activity. We did not review interventions focusing primarily on flexibility or balance. A healthful diet promotes health and reduces risk of chronic disease through nutritious eating patterns. For this review, we considered dietary counseling that promoted a balanced diet (e.g., appropriate energy content); balance of fats (e.g., consumption of mono- and polyunsaturated fats, omega-3 fats, avoidance of excess saturated fat, avoidance of trans fats); increased consumption of fruits and vegetables; increased consumption of legumes; increased consumption of lean proteins; increased consumption of non- or low-fat dairy; diet balanced in carbohydrates (e.g., consumption of whole grain and fiber, avoidance of excess refined carbohydrates, including excess sweetened beverages); and avoidance of excess sodium. We did not review dietary counseling that focused only on micronutrient intake, vitamin and/or antioxidant supplementation, or alcohol moderation. Diseases associated with physical inactivity and poor diet rank among the leading causes of illness and death in the United States, and are well established determinants in many chronic diseases, including cardiovascular and cerebrovascular disease, hypertension, dyslipidemia, and type 2 diabetes. Convincing evidence suggests that regular physical activity decreases CVD risk and numerous studies have shown an inverse relationship between exercise and heart disease mortality. Similarly, regular exercise increases high-density lipoprotein (HDL) cholesterol and decreases triglycerides, blood pressure, and risk of CVD events. Studies have also shown that diet clearly affects cardiovascular health. Diets high in fruits and vegetables can decrease CVD. Evidence also suggests that saturated and trans fatty acids increase CVD while linoleic acid, fish oils, plant sterols and stanols, alpha-linolenic acid, oleic acid, and nuts decrease CVD. Likewise, there is convincing evidence that high sodium intake increases high blood pressure, while potassium can decrease blood pressure. Available evidence strongly suggests that regular physical activity decreases an individual's risk for type 2 diabetes, likely through improving insulin sensitivity and reduced total and abdominal adiposity. Similarly, excess energy intake increases obesity, which may increase the risk for type 2 diabetes. While there is little evidence that total carbohydrate intake is associated with diabetes, high glycemic index of a diet may be a risk factor. Evidence also suggests that saturated fatty acids can increase the risk for type 2 diabetes, while a high intake of fruits, vegetables, and dietary fiber can decrease type 2 diabetes risk. In 2002 and 2003, the U.S. Preventive Services Task Force (USPSTF) made recommendations on counseling to improve physical activity and healthful diet based on two separate systematic reviews of the literature. We undertook the current review to assist the USPSTF in updating these recommendations. This review combined both topics and evaluates the effectiveness and adverse effects of physical activity and dietary counseling interventions to prevent cardiovascular disease (CVD) in adults. In addition, this review focuses on the effectiveness of behavioral counseling as primary prevention for CVD and therefore does not include counseling interventions targeted to persons with known CVD, diabetes, hypertension, or dyslipidemia. Trials focusing on weight loss or weight management in adults are addressed in a separate USPSTF review on adult obesity, which is currently being updated.
Book Synopsis Behavioral Counseling to Promote a Healthy Lifestyle for Cardiovascular Disease Prevention in Persons with Cardiovascular Risk Factors by : Jennifer Lin
Download or read book Behavioral Counseling to Promote a Healthy Lifestyle for Cardiovascular Disease Prevention in Persons with Cardiovascular Risk Factors written by Jennifer Lin and published by . This book was released on 2014 with total page 253 pages. Available in PDF, EPUB and Kindle. Book excerpt: PURPOSE: We conducted a systematic evidence review of the benefits and harms of behavioral counseling interventions to prevent cardiovascular disease (CVD) in persons with established risk factors to assist the U.S. Preventive Services Task Force (USPSTF) in updating its previous recommendation statements. DATA SOURCES: We searched MEDLINE, PsycInfo, the Database of Abstracts of Reviews of Effects, and the Cochrane Central Register of Controlled Trials from 2001 through October 2013 to locate relevant trials for all key questions published since the previous reviews in support of prior recommendations. We supplemented our searches with reference lists from relevant existing systematic reviews, suggestions from experts, and information from Clinicaltrials.gov to identify ongoing trials. STUDY SELECTION: Two investigators independently reviewed 7,218 abstracts and 553 articles against a set of a priori inclusion criteria. Investigators also independently critically appraised each study using design-specific quality criteria based on USPSTF methods. We included fair- or good-quality trials evaluating behavioral counseling interventions to promote a healthy diet, physical activity, or both in persons with CVD risk factors, including hypertension, dyslipidemia, metabolic syndrome, and impaired fasting glucose or glucose tolerance. We resolved discrepancies by consensus. DATA EXTRACTION AND ANALYSIS: One investigator abstracted data from 74 included studies into evidence tables and a second reviewer checked these data. We conducted meta-analyses on 57 of the 71 trials that provided necessary data to estimate the effect size of counseling on intermediate health outcomes (lipids, blood pressure, weight measures, and glucose measures). We qualitatively summarized the evidence for effects on health outcomes, behavioral outcomes, and harms. DATA SYNTHESIS: Key Question 1. Do healthy lifestyle counseling interventions improve CVD health outcomes in adults with known CVD risk factors? Only a subset of trials (k=16) reported measures of patient health outcomes, including CVD events (k=5) and self-reported measures of quality of life (QOL) or depression symptoms (k=11). In general, intensive interventions that combined lifestyle interventions did not reduce CVD events or mortality at up to 10 years of followup, although event rates were generally low. In one early good-quality trial, a high-intensity behavioral counseling intervention in conjunction with a protocol to start medication reduced CVD events at 6.6 years compared with usual care (relative risk [RR], 0.71 [95% CI, 0.51 to 0.99]). This study was conducted in Swedish men at high risk for CVD (which included persons with diabetes and known CVD). Overall, combined lifestyle interventions did not appear to improve self-reported depression symptoms (k=4) in persons with impaired fasting glucose or glucose tolerance at 6 to 12 months. Findings that showed a benefit on self-reported QOL measures were mixed. While three combined lifestyle counseling trials showed improvement on selected QOL measures, two combined lifestyle counseling trials and two physical activity-only counseling trials showed no benefit on self-reported QOL at 6 to 12 months. Key Question 2. Do healthy lifestyle counseling interventions improve intermediate CVD outcomes in adults with known CVD risk factors? Medium- (31 to 360 minutes) to high-intensity (>360 minutes) combined lifestyle counseling in persons selected for CVD risk factors reduces total cholesterol, low-density lipoprotein (LDL) cholesterol, blood pressure, fasting glucose, diabetes incidence, and weight outcomes. Overall, at 12 to 24 months, behavioral counseling appears to reduce total cholesterol (k=34) by an average of 4.48 mg/dL (95% CI, 6.36 to 2.59), LDL cholesterol (k=25) by 3.43 mg/dL (95% CI, 5.37 to 1.49), systolic blood pressure (k=31) by 2.03 mm Hg (95% CI, 2.91 to 1.15), diastolic blood pressure (k=24) by 1.38 mm Hg (95% CI, 1.92 to 0.84), fasting glucose (k=22) by 2.08 mg/dL (95% CI, 3.29 to 0.88), diabetes incidence (k=8) by an RR of 0.58 (95% CI, 0.37 to 0.89), and weight outcomes (k=34) by a pooled mean difference of 0.26, using standardized units (95% CI, 0.35 to 0.16). There was substantial statistical heterogeneity for weight outcomes. High-intensity combined lifestyle counseling in persons with impaired fasting glucose or glucose tolerance (k=5) can reduce diabetes incidence in the long term (RR, 0.55 [95% CI, 0.45 to 0.67]). Intensive diet-only counseling interventions primarily in persons with dyslipidemia who are not yet taking medications can also modestly lower total (k=8) and LDL (k=7) cholesterol at 12 to 24 months. In contrast, medium-intensity (k=8) physical activity-only counseling interventions (k=10) did not appear to improve intermediate CVD outcomes at 12 to 24 months. Findings from trials that could not be included in quantitative analyses were generally consistent with pooled findings. Key Question 3. Do healthy lifestyle counseling interventions improve diet and physical activity behavioral outcomes in adults with known CVD risk factors? Overall, objectively measured and self-reported changes in dietary intake and physical activity were concordant with intermediate outcome findings. Only three of the 61 trials that reported behavioral outcomes did not also report intermediate health outcomes. In selected trials conducted in persons who were already taking medications to lower cholesterol or blood pressure, counseling interventions appeared to improve dietary intake and physical activity despite a lack of benefit on lipid or blood pressure outcomes. Many physical activity-only counseling trials (k=9) had less than 12 months of followup. Four of five trials reporting behavioral outcomes at 12 to 24 months found statistically significant improvements in self-reported physical activity (i.e., number of persons meeting the recommended 150 minutes of moderate activity per week, minutes per week of total or moderate physical activity). Key Question 4. What are the adverse effects of healthy lifestyle counseling in adults with known CVD risk factors? We examined all included counseling trials for harms, including any paradoxical change in outcomes. While we searched for additional studies examining harms of healthy lifestyle counseling interventions, we did not find any. Overall, harms (or lack thereof) were not commonly reported (k=10). In general, included interventions did not have significant adverse effects, except for two persons who had serious events resulting from physical activity in one trial targeting older adults. Reported increases in carbohydrate intake (k=8) were accompanied by dietary improvements in fat, saturated fat, fiber, or fruits and vegetables, without an overall increase in sugar or total calories consumed. LIMITATIONS: Only a small subset of trials reported patient health outcomes, longer-term followup of intermediate and behavioral outcomes, and harms. We were unable to identify important contributors to statistical heterogeneity other than gross categorizations of type of population or intervention. CONCLUSIONS: Medium- and high-intensity diet and physical activity behavioral counseling in overweight or obese persons with CVD risk factors resulted in consistent improvements across a variety of important cardiovascular intermediate health outcomes up to 2 years. High-intensity combined lifestyle counseling reduced diabetes incidence in the longer term. The applicability of these findings depends largely on the availability of intensive counseling in practice and real-world fidelity and adherence to these interventions.
Book Synopsis Behavioral Counseling Interventions to Promote a Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults with Cardiovascular Risk Factors by : Elizabeth A. O'Connor
Download or read book Behavioral Counseling Interventions to Promote a Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults with Cardiovascular Risk Factors written by Elizabeth A. O'Connor and published by . This book was released on 2020 with total page 460 pages. Available in PDF, EPUB and Kindle. Book excerpt: OBJECTIVE: To review the benefits and harms of behavioral counseling interventions to improve diet and increase physical activity in adults with cardiovascular risk factors. DATA SOURCES: We performed a search of MEDLINE, PubMed (publisher-supplied records only), PsycINFO, and the Cochrane Central Register of Controlled Trials for relevant English-language studies published between January 2013 and September 2019. Additionally, we re-evaluated all studies included in the 2014 USPSTF review and related USPSTF systematic reviews. We conducted ongoing surveillance for relevant literature through July 24, 2020. STUDY SELECTION: Two investigators independently reviewed 14,409 unique citations and 466 full-text articles against a priori inclusion criteria. We included English-language randomized clinical trials of behavioral counseling interventions to help people with elevated blood pressure or lipids improve their diet and increase physical activity. Critical appraisal was completed independently by two investigators. Data were extracted from studies by one reviewer and checked by a second. DATA ANALYSIS: Random effects meta-analysis was used to examine outcomes with sufficient evidence to warrant pooled analyses, including all-cause mortality, cardiovascular events, blood pressure, lipids, adiposity-related outcomes, glucose-related outcomes, dietary measures, and physical activity. Subgroup analyses and meta-regression were used to explore effect modification for systolic blood pressure, total cholesterol, and weight. RESULTS: Ninety-four randomized trials were included (N=52,174). Behavioral counseling interventions were associated with a lower risk of cardiovascular events (pooled relative risk [RR]=0.80 [95% confidence interval (CI), 0.73 to 0.87]; 9 randomized controlled trials [RCTs] [n=12,551]; I2=0%), myocardial infarction (MI) (pooled RR=0.85 [95% CI, 0.70 to 1.02]; 6 RCTs [n=10,375]; I2=0%) and stroke (RR=0.52 [95% CI, 0.25 to 1.10]; 4 RCTs [n=9,800]; I2=0%), although the pooled effect was not statistically significant for stroke or MI. Event rates were variable; in the largest trial (Prevención con Dieta Mediterránea [PREDIMED]) 3.6 percent in the intervention groups experienced a cardiovascular event, compared with 4.4 percent in the control group. In addition, behavioral counseling interventions were associated with small, statistically significant reductions in continuous measures of blood pressure, total cholesterol, fasting glucose, and adiposity-related outcomes at 12 to 24 months' followup. Blood pressure in intervention groups was reduced by a greater amount than in control groups--by a mean 1.8/1.2 mm Hg--after 12 to 24 months (pooled systolic blood pressure [SBP]=−1.8 [95% CI, −2.5 to −1.1]; 44 RCTs [n=14,580]; I2=37%; pooled diastolic blood pressure [DBP]=−1.2 [95% CI, −1.6 to −0.8]; 40 RCTs [n=13,098]; I2=32%). Total cholesterol was reduced by 3.5 mg/dL (95% CI, −5.6 to −1.4; 38 RCTs [n=11,414]; I2=66%) and low-density lipoprotein cholesterol was reduced by 2.1 mg/dL (95% CI, −4.1 to −0.2; 32 RCTs [n=8,894]; I2=56%). Intervention groups also showed slightly greater reductions in three adiposity-related measures: pooled body mass index=−0.5 kg/m2 (95% CI, −0.7 to −0.3); 30 RCTs (n=9,909); I2=83%; pooled weight=−1.6 kg (95% CI, −2.1 to −1.1); 37 RCTs (n=16,345); I2=88%; and pooled waist circumference=−1.8 cm (95% CI, −2.4 to −1.1); 23 RCTs (n=11,708); I2=87%. Reporting of diet and physical activity was very heterogeneous, and evidence suggested small mean improvements in dietary intake consistent with the intervention targets but small to no impact on physical activity. Results for blood pressure, lipid, and adiposity-related measures were generally consistent with the previous review despite some modifications to the review scope. LIMITATIONS: Health outcomes were reported in a small proportion of the included trials, and many had very few events. Measurement of behavioral outcomes was extremely heterogeneous, and the clinical importance of measures of a single aspect of participants' diet is limited. CONCLUSIONS: Medium- and high-contact multi-session behavioral counseling interventions to improve diet and increase physical activity provided to people with hypertension, dyslipidemia, or elevated blood pressure and lipid levels are effective in reducing CVD events, blood pressure, total cholesterol, and adiposity-related outcomes, with little to no risk of serious harm.
Book Synopsis WHO guidelines on physical activity and sedentary behaviour by :
Download or read book WHO guidelines on physical activity and sedentary behaviour written by and published by World Health Organization. This book was released on 2020-11-20 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Behavioral Counseling to Promote a Healthy Lifestyle for Cardiovascular Disease Prevention in Persons with Cardiovascular Risk Factors by : Agency for and Qualtiy
Download or read book Behavioral Counseling to Promote a Healthy Lifestyle for Cardiovascular Disease Prevention in Persons with Cardiovascular Risk Factors written by Agency for and Qualtiy and published by CreateSpace. This book was released on 2014-12-28 with total page 264 pages. Available in PDF, EPUB and Kindle. Book excerpt: A healthy diet promotes health and reduces an individual's risk for chronic disease through nutritious eating patterns. For the purposes of this review, we will include any dietary counseling interventions that promote a balanced diet (e.g., appropriate energy content); balance of fats (e.g., consumption of mono and poly unsaturated fats, omega-3 fats, avoidance of excess saturated fat, avoidance of trans fat); increased consumption of fruits and vegetables; increased consumption of legumes; increased consumption of lean proteins; increased consumption of nonfat or low-fat dairy; balance of carbohydrates (e.g., consumption of whole grain and fiber; avoidance of excess refined carbohydrates, including excess sweetened beverages); and avoidance of excess sodium. This guidance is generally consistent with dietary recommendations of a number of groups, including the Institute of Medicine, the World Health Organization, the U.S. Department of Health and Human Services (DHHS), the U.S. Department of Agriculture, the Academy of Nutrition and Dietetics (previously the American Dietetic Association), the Centers for Disease Control and Prevention (CDC), the American Heart Association (AHA) and American College of Cardiology (ACC), the American Cancer Society, and the American Diabetes Association. We did not review dietary counseling interventions that only focused on micronutrient intake, vitamin and/or antioxidant supplementation, or alcohol moderation. Although no internationally accepted definition of physical activity exists, American researchers have defined physical activity as "bodily movement produced by the contraction of skeletal muscle that increases energy expenditure above the basal level." DHHS and other organizations recommend that adults age 18 years and older should engage in at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic physical activity per week, in addition to engaging in strengthening activities at least twice per week. Based on these definitions, this review focused on counseling interventions promoting aerobic- or strength-related physical activity. Risk factors for CVD are well established and include both modifiable and nonmodifiable components. Modifiable risk factors include: dyslipidemia or hyperlipidemia (referred to as dyslipidemia in this report), hypertension, diabetes, overweight and obesity, smoking, lack of physical activity, and unhealthy diet. Nonmodifiable risk factors include: age, sex, and family history. This review focuses on patients who are at high risk for CVD, which we defined as having one or more of the following risk factors: dyslipidemia, hypertension, impaired fasting glucose/impaired glucose tolerance, and/or metabolic syndrome. Metabolic syndrome is a clustering of metabolic risk factors that include abdominal obesity, dyslipidemia, increased blood pressure, insulin resistance, or glucose intolerance. While diabetes is a strong risk factor for CVD, we considered existing diabetes to be a CVD risk equivalent. As such, we did not review studies primarily aimed at patients with diabetes or pre-existing coronary heart disease, cerebrovascular disease, peripheral artery disease, or severe chronic kidney disease.
Book Synopsis Behavioral Counseling to Promote Physical Activity and a Healthful Diet to Prevent Cardiovascular Disease in Adults by :
Download or read book Behavioral Counseling to Promote Physical Activity and a Healthful Diet to Prevent Cardiovascular Disease in Adults written by and published by . This book was released on 2010 with total page 600 pages. Available in PDF, EPUB and Kindle. Book excerpt: PURPOSE: We conducted this systematic evidence review of trials of physical activity and/or dietary counseling to prevent cardiovascular disease (CVD) to assist the U.S. Preventive Services Task Force (USPSTF) in updating its 2002 and 2003 recommendations on counseling to improve physical activity and diet, respectively. DATA SOURCES: We searched MEDLINE, PsycInfo, and the Cochrane Central Register of Controlled Trials 2001-2009 to locate relevant trials for all key questions published since the previous reviews were conducted. We supplemented our searches with suggestions from experts and reference lists from other publications, including the prior USPSTF reviews and other relevant systematic reviews. STUDY SELECTION: Two investigators independently reviewed 13,562 abstracts and 474 articles against a set of a priori inclusion criteria, and also independently critically appraised each study using design-specific quality criteria based on USPSTF methods. Discrepancies were resolved by consensus. In total, 109 articles representing 73 unique studies were included. DATA EXTRACTION AND ANALYSIS: One investigator abstracted data from included studies into evidence tables and a second reviewer checked these data. We conducted meta-analyses on 58 trials that provided necessary data to estimate the effect size of counseling on both intermediate health outcomes (adiposity, systolic and diastolic blood pressure, total cholesterol, high-density lipoproteins [HDLs], low-density lipoproteins [LDLs], triglycerides, and glucose) and behavioral outcomes (self-reported physical activity; fitness; intake of total energy, fat, saturated fat, fiber, fruits and vegetables; and urinary sodium as a measure of sodium intake). DATA SYNTHESIS: Key Question 1: Do healthful diet and/or physical activity interventions improve CVD health outcomes in adults? One large, good-quality trial evaluating an intensive healthful diet counseling intervention showed no difference in the incidence of coronary heart disease or stroke over a mean of 8 years followup. Observational followup of two hypertension prevention trials evaluating intensive sodium reduction counseling showed a decrease in the incidence of CVD outcomes over 10 to 15 years of followup. Key Question 2: Do healthful diet and/or physical activity interventions improve intermediate outcomes associated with CVD in adults? Medium- (31 to 360 minutes) to high-intensity (>360 minutes) dietary interventions (with or without concomitant physical activity counseling) decreased body mass index (BMI) approximately 0.3 to 0.7 kg/m2 at 12 months. The largest reduction in blood pressures occurred in three intensive salt-restriction counseling interventions in persons with mildly elevated diastolic blood pressure, resulting in approximately 1.8 mmHg lower systolic blood pressure and 1.1 mmHg lower diastolic blood pressure at 12 months. Medium- and high-intensity diet and lifestyle interventions decreased systolic blood pressure by 0.9 to 1.4 mmHg and diastolic blood pressure by 0.7 mmHg. Medium- and high-intensity diet and combined lifestyle counseling decreased total cholesterol and LDL. When stratified by intervention intensity, however, this decrease was only significant among the six high-intensity counseling interventions with a reduction in total cholesterol of 0.17 mmol/L (6.56 mg/dL) and LDL by 0.13 mmol/L (5.02 mg/dL). Overall, few trials provided followup longer than 12 months. Key Question 3: Do healthful diet and/or physical activity interventions change associated health behaviors in adults? Medium- to high-intensity counseling interventions improved self-reported dietary intake of salt, energy, fats, and fruits and vegetables and self-reported physical activity. The medium-intensity physical activity counseling interventions in this review resulted in an approximately 38-minute increase in physical activity per week. Diet and combined lifestyle counseling interventions decreased total fat and saturated fat intake and increased fruit and vegetable consumption. Although there was significant statistical heterogeneity across interventions, there appeared to be an increasing effect size with intervention intensity. Among low-intensity interventions, there was an approximate 1.5 percent decrease in energy intake from fats; for medium-intensity counseling there was an approximate 3.0 to 4.9 percent decrease in energy intake from fats; and for high-intensity interventions there was an approximate 5.9 to 11 percent decrease in energy intake from total fat. Saturated fat intake was reported less frequently, but effects were generally consistent with the magnitude of effect seen with total fat intake. Counseling interventions increased fruit and vegetable intake by approximately 0.4 to 2 servings per day. Key Question 4: What are the adverse effects of healthful diet and/or physical activity interventions? We found no studies designed to assess the adverse effects of dietary counseling and none of the included healthful diet counseling trials reported specific adverse events. Two physical activity counseling trials reported common findings of mild muscular fatigue, strain, or soreness. Seven comparative observational studies showed that the risk of a cardiac event is increased during vigorous exertion, with a range of 2- to 17-fold increases in risk. LIMITATIONS: In addition to the large statistical heterogeneity limiting confidence in the pooled estimates of effect sizes for some outcomes, other limitations included: there were only 10 trials with followup beyond 12 months, the fact that most trials relied on self-reported behavioral outcomes subject to bias, potential bias due to including only published data, and possible selective reporting of outcomes. CONCLUSIONS: Medium- to high-intensity dietary behavioral counseling resulted in small but statistically significant changes in adiposity, blood pressure, and cholesterol, as well as medium to large changes in self-reported dietary and physical activity behaviors. Evidence for changes in physiologic outcomes was strongest for high-intensity counseling interventions. Medium- to high-intensity physical activity counseling resulted in increases in self-reported physical activity. However, there was limited evidence for maintenance of behavioral or physiologic effects beyond 12 months. Most trials of high-intensity interventions that had followup beyond 12 months showed persistent beneficial changes in adiposity and lipids, as well as improvements in self-reported behavioral outcomes.
Book Synopsis Health Promotion and Disease Prevention in Clinical Practice by : Jessica S. Coviello
Download or read book Health Promotion and Disease Prevention in Clinical Practice written by Jessica S. Coviello and published by Lippincott Williams & Wilkins. This book was released on 2019-03-19 with total page 628 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Third Edition of Health Promotion and Disease Prevention in Clinical Practice reflects a clinically-focused, team-based approach to health promotion conversations. This practical reference incorporates the latest guidelines from major organizations, including the U.S. Preventive Services Task Force, and offers a complete overview of how to help patients adopt healthy behaviors and deliver recommended screening tests and immunizations. Packed with realistic strategies throughout, it offers expert guidance on counseling patients about exercise, nutrition, tobacco use, substance use, sexually transmitted infections, depression, and more.
Book Synopsis Preventive Cardiovascular Nursing by : Sandra B. Dunbar
Download or read book Preventive Cardiovascular Nursing written by Sandra B. Dunbar and published by Springer Nature. This book was released on with total page 738 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Lifestyle Medicine, Third Edition by : James M. Rippe
Download or read book Lifestyle Medicine, Third Edition written by James M. Rippe and published by CRC Press. This book was released on 2019-04-17 with total page 2152 pages. Available in PDF, EPUB and Kindle. Book excerpt: The field of lifestyle medicine, which is the study of how daily habits and actions impact on both short- and long-term health and quality of life, continues to expand globally. The scientific and medical literature that supports the success of these lifestyle habits and actions is now overwhelming. Thousands of studies provide evidence that regular physical activity, maintenance of a health body weight, following sound nutritional practices, stress reduction, and other good practices all profoundly impact both health and quality of life. Following its predecessors, Lifestyle Medicine, Third Edition, is edited by lifestyle medicine pioneer, cardiologist Dr. James Rippe. This edition has been thoroughly updated and represents the expert opinions of 20 section editors as well as more than 150 expert chapter authors whose knowledge span all aspects of this emerging discipline. Topics cover lifestyle medicine practices including regular physical activity, proper nutrition, and weight management. These principles are applied to the prevention and or treatment of a wide variety of chronic conditions ranging from heart disease and diabetes to cancer, mental health, addiction, and injury prevention. This book serves as evidence base for individuals who wish to practice lifestyle medicine or incorporate some of its principles into either general medicine or subspecialty practice. It provides valuable information to healthcare workers in the fields of nutrition, exercise physiology, psychology, behavioral medicine, health promotion, and public policy where lifestyle medicine principles play an ever-increasing role.
Book Synopsis Nutrition, Fitness, and Mindfulness by : Jaime Uribarri
Download or read book Nutrition, Fitness, and Mindfulness written by Jaime Uribarri and published by Springer Nature. This book was released on 2020-01-31 with total page 290 pages. Available in PDF, EPUB and Kindle. Book excerpt: This comprehensive volume presents an approach based on cutting edge clinical science to the integration of healthy behaviors in clinical practice, using three major categories; healthy eating, active living, and mindfulness. Chapters are authored and edited by a select group of national and international experts in their respective fields who have developed these concepts for application in routine practice. All chapters are formatted to provide key learning points and summarized conclusions for easy reference. Topics include the DASH diet, plant based nutrition, the Mediterranean diet, beneficial herbs and spices, fitness, spirituality, meditation, healthy sleep, and disease prevention. Nutrition, Fitness, and Mindfulness will be a useful guide for all clinicians and healthcare professionals encouraging patients to make more thoughtful and healthy lifestyle choices.
Book Synopsis Clinical Preventive Services for Women by : Institute of Medicine
Download or read book Clinical Preventive Services for Women written by Institute of Medicine and published by National Academies Press. This book was released on 2011-10-27 with total page 249 pages. Available in PDF, EPUB and Kindle. Book excerpt: Women suffer disproportionate rates of chronic disease and disability from some conditions, and often have high out-of-pocket health care costs. The passage of the Patient Protection and Affordable Care Act of 2010 (ACA) provides the United States with an opportunity to reduce existing health disparities by providing an unprecedented level of population health care coverage. The expansion of coverage to millions of uninsured Americans and the new standards for coverage of preventive services that are included in the ACA can potentially improve the health and well-being of individuals across the United States. Women in particular stand to benefit from these additional preventive health services. Clinical Preventive Services for Women reviews the preventive services that are important to women's health and well-being. It recommends that eight preventive health services for women be added to the services that health plans will cover at no cost. The recommendations are based on a review of existing guidelines and an assessment of the evidence on the effectiveness of different preventive services. The services include improved screening for cervical cancer, sexually transmitted infections, and gestational diabetes; a fuller range of contraceptive education, counseling, methods, and services; services for pregnant women; at least one well-woman preventive care visit annually; and screening and counseling for interpersonal and domestic violence, among others. Clinical Preventive Services for Women identifies critical gaps in preventive services for women as well as measures that will further ensure optimal health and well-being. It can serve as a comprehensive guide for federal government agencies, including the Department of Health and Human Services and the Center for Disease Control and Prevention; state and local government agencies; policy makers; health care professionals; caregivers, and researchers.
Book Synopsis Interprofessional Perspectives for Community Practice by : Michael Pizzi
Download or read book Interprofessional Perspectives for Community Practice written by Michael Pizzi and published by Taylor & Francis. This book was released on 2024-06-01 with total page 544 pages. Available in PDF, EPUB and Kindle. Book excerpt: Now more than ever health care professionals play an increased role in the promotion of health to populations. Unique and innovative, Interprofessional Perspectives for Community Practice: Promoting Health, Well-being and Quality of Life weaves everyday care into prevention, community, and population health, creating a new and more expansive vision of health for all without compromising traditional practices. Authors and editors Drs. Pizzi and Amir discuss and illustrate a client-centered preventive and health, well-being and quality of life approach rooted in best practice principles from interprofessional literature and firsthand experience. The text illustrates how allied health professionals implement those principles in their everyday and traditional practices with an emphasis on exploring health and well-being issues. Interprofessional Perspectives for Community Practice provides detailed guidance in program development and implementation. What’s included in Interprofessional Perspectives for Community: Clinical anecdotes on successful community practices A focus on primary and secondary prevention Assessments, interventions, and community practice examples Descriptions of community-based practice settings such as adult day care, independent living programs, hospice, and home health care Health and wellness across the lifespan Bonus chapters available online as PDFs for readers The first text of its kind to weave interprofessionalism, community practice, and health, well-being, and quality of life, Interprofessional Perspectives for Community Practice: Promoting Health, Well-being and Quality of Life is for all health care workers and students who wish to transfer practice skills from the clinical setting to a population-based program development model.
Book Synopsis Motivation and Self-regulation in Sport and Exercise by : Chris Englert
Download or read book Motivation and Self-regulation in Sport and Exercise written by Chris Englert and published by Routledge. This book was released on 2021-06-06 with total page 287 pages. Available in PDF, EPUB and Kindle. Book excerpt: The ability to effectively use one’s thoughts, emotions and motivation to enhance performance and well-being is one of the most important skills in sport and exercise contexts. Motivation and Self-Regulation in Sport and Exercise explores the theories, research and processes that underpin these self-regulatory and motivational processes. A deeper understanding of motivation and self-regulation has far-reaching implications, from helping individuals to begin an active lifestyle, to seasoned athletes looking for a competitive edge. For the first time, the globally leading researchers in this research field come together to provide their unique, cutting-edge insight into how to exercise or perform more effectively. In doing so, the book provides new insight into established theories of motivation and self-regulation, but also breaks new ground by inspecting lesser-known or emerging paradigms. This book is intended for all scholars interested in self-regulation and motivation, from undergraduate students to experienced researchers, as well as practicing sport and exercise psychologists, coaches and athletes.
Book Synopsis A Population-Based Policy and Systems Change Approach to Prevent and Control Hypertension by : Institute of Medicine
Download or read book A Population-Based Policy and Systems Change Approach to Prevent and Control Hypertension written by Institute of Medicine and published by National Academies Press. This book was released on 2010-08-13 with total page 236 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hypertension is one of the leading causes of death in the United States, affecting nearly one in three Americans. It is prevalent in adults and endemic in the older adult population. Hypertension is a major contributor to cardiovascular morbidity and disability. Although there is a simple test to diagnose hypertension and relatively inexpensive drugs to treat it, the disease is often undiagnosed and uncontrolled. A Population-Based Policy and Systems Change Approach to the Prevention and Control Hypertension identifies a small set of high-priority areas in which public health officials can focus their efforts to accelerate progress in hypertension reduction and control. It offers several recommendations that embody a population-based approach grounded in the principles of measurement, system change, and accountability. The recommendations are designed to shift current hypertension reduction strategies from an individual-based approach to a population-based approach. They are also designed to improve the quality of care provided to individuals with hypertension and to strengthen the Center for Disease Control and Prevention's leadership in seeking a reduction in the sodium intake in the American diet to meet dietary guidelines. The book is an important resource for federal public health officials and organizations, especially the Center for Disease Control and Prevention, as well as medical professionals and community health workers.
