Behavioral Counseling Interventions to Promote a Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors: Updated Systematic Review for the U.S. Preventive Services Task Force. Evidence Synthesis No. 217.

Patnode CD, Redmond N, Iacocca MO, Henninger M. (2022)

U.S. Preventive Services Task Force - N/A

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Evidence Categories

• Care setting: Community setting
• Care setting: Primary care
• Care setting: Virtual and digital
• Population group: General Population
• Population group: Adults living with overweight and obesity
• Population group: Adults with poor diet
• Intervention: Intra-/Inter-personal: Multicomponent programme in-person
• Intervention: Intra-/Inter-personal: Multicomponent programme remote
• Outcome: Healthy Eating: Fruit and veg intake
• Outcome: Healthy Eating: Fibre intake
• Outcome: Healthy Eating: Fat intake
• Outcome: Healthy Eating: Salt intake
• Outcome: Healthy Eating: Whole diet quality

Type of Evidence

Systematic Review

Aims

The authors state:

"We conducted this systematic review to support the U.S. Preventive Services Task Force (USPSTF) in updating its 2017 recommendation on behavioral counseling to promote a healthy diet and physical activity in adults without known CVD risk factors."

Findings

The authors state:

• "One-hundred and thirteen randomized clinical trials were included (N=129,993)."
• "There was also consistent evidence that behavioral interventions improved participants’ dietary intake and physical activity levels."
• "Meta-analysis indicated statistically significant associations between healthy diet counseling interventions (with or without physical activity messages) and measures of saturated fat (standardized mean difference [SMD], -0.5 [95% CI, -0.8 to -0.3]; 16 RCTs [n=48,661]; I2=97%), fiber (SMD, 0.2 [95% CI, 0.1 to 0.4]; 13 RCTs [n=47,571]; I2=94%), and daily servings of fruits and vegetables (1.1 [95% CI, 0.4 to 1.8]; 17 RCTs [n=53,711]; I2=99%)."
• "Measurement of behavioral outcomes was extremely heterogeneous."

Conclusions

The authors state:

"The results of this systematic review update are consistent with the 2017 review on this topic. Healthy diet and physical activity behavioral interventions for persons without a known risk of CVD were associated with very small but statistically significant benefits across a variety of important intermediate health outcomes and small-to-moderate effects on dietary and physical activity behaviors. Very limited evidence exists regarding the health outcomes or harmful effects of these interventions."