July 11, 2017 / 8:14 PM / 2 months ago

Panel backs heart counseling for some healthy people

(Reuters Health) - Healthy individuals might still benefit from behavioral counseling to promote a better diet and more physical activity, according to advice for doctors and patients from a panel of U.S. government-backed experts.

The U.S. Preventive Services Task Force (USPSTF) says that for certain people without high blood pressure, high cholesterol, high blood sugar, diabetes or obesity, diet and exercise counseling might help prevent heart disease, although the benefit would likely be small.

“Patients who express interest in these types of changes are most likely to benefit from those counseling opportunities,” said panel vice-chair Susan Curry, who is interim executive vice president and provost of the University of Iowa in Iowa City.

The new recommendation from the USPSTF is a grade C, which means doctors should selectively offer the service based on an individual’s circumstances. The finding is nearly unchanged since the panel last reviewed the evidence in 2012.

“We were able to look at additional studies that have been published since the last recommendation,” Curry told Reuters Health. “The good news is that there were more studies to look at than in 2012, and that evidence confirms the recommendation we made last time.”

The behavioral counseling can take many forms from mailings to face-to-face meetings, the panel writes in JAMA.

The reviewed studies examined the potential benefits of counseling about a healthy diet, physical activity or both.

Heart-healthy diets generally focus on increasing the amount of fruits, vegetables, fiber and whole grains while decreasing the amount salt, fat and processed meats.

Adults are also encouraged to get 150 minutes of moderate-intensity exercise, 75 minutes of vigorous-intensity exercise or a combination of the two each week. They should also take part in strength training exercises twice per week.

Programs that focus on those behaviors were found to lead to better levels of heart risk factors like cholesterol and blood pressure, according to a review of the evidence published with the recommendation.

Curry said the recommendation regarding counseling for healthy people is for those who feel they could do better managing their diet and getting the right amount of exercise.

“Those are the folks I’d be likely to refer to a behavioral counseling program,” she said.

An editorial accompanying the new recommendation points out that all people should be concerned about poor heart health.

“Indeed, the guideline also states that adults who adhere to national guidelines for a healthful diet and physical activity have lower rates of cardiovascular morbidity and mortality than those who do not,” write Drs. Philip Greenland, of the Northwestern University Feinberg School of Medicine in Chicago, and Valentin Fuster, of the Icahn School of Medicine at Mount Sinai in New York City.

SOURCE: bit.ly/2uforBf and bit.ly/2t1bURz JAMA, online July 11, 2017.

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