Behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention in adults with cardiovascular risk factors: U.S. Preventive Services Task Force Recommendation Statement

IBC has been widely accepted as an effective approach for compliant individuals to reduce body weight, improve clinical measures, and lower risk of obesity-related comorbidities.

“Intensive Behavioral Counseling (IBC) has been widely accepted as an effective approach for compliant individuals to reduce body weight, improve clinical measures, and lower risk of obesity-related comorbidities [1–6].”

The USPSTF recommends that all overweight and obese adults between age 40 and 70 be screened for abnormal blood glucose, and those with CVD risk factors be referred for IBC.

“The US Preventive Services Task Force (USPSTF) recommends that, as part of cardiovascular diseases (CVD) risk assessment, all overweight and obese adults between age 40 and 70 be screened for abnormal blood glucose, and those with CVD risk factors (e.g., hypertension, dyslipidemia, prediabetes) be referred for IBC, such as programs modeled on the National Diabetes Prevention Program (NDPP) [3,5].”

At 3 years of follow-up, lifestyle intervention in the DPPOS reduced diabetes incidence by 58% and reduced CVD risk with significantly less use of hypertension and hyperlipidemia medication.

“Outcomes from the Diabetes Prevention Program and Outcomes Study (DPPOS) have shown that at 3 years of follow up, lifestyle intervention successfully reduced diabetes incidence by 58% and reduced CVD risk with significantly less use of hypertension and hyperlipidemia medication [3].”

Intensive Behavioral Counseling (IBC) interventions like the National Diabetes Prevention Program (NDPP) have demonstrated effectiveness in reducing excess body weight and lowering or delaying morbidity onset.

“Intensive Behavioral Counseling (IBC) interventions like the National Diabetes Prevention Program (NDPP), have demonstrated effectiveness in reducing excess body weight and lowering or delaying morbidity onset.”

Previous work has found that IBC intervention, including NDPP, among overweight and obese adults with prediabetes and CVD risk factors can improve clinical measures, prevent or delay disease onset, reduce medical expenditures, and increase productivity.

“Previous work has found that IBC intervention, including NDPP, among overweight and obese adults with prediabetes and CVD risk factors can improve clinical measures, prevent or delay disease onset, reduce medical expenditures, and increase productivity (in the form of higher labor force participation and lower work absenteeism) [1–6,13–15,19].”

All individuals in the study sample met USPSTF criteria for receiving IBC because they had CVD risk factors independent of excess body weight; 997 (89%) also met CDC and NDPP recommendations for intervention due to prediabetes.

“All individuals met the USPSTF criteria for receiving IBC because they had CVD risk factors independent of excess body weight; with 997 (89%) also meeting the CDC and NDPP recommendations for intervention due to prediabetes [3,5,17].”

For the population with an average BMI ≥27 and at least one additional risk factor (hypertension, type 2 diabetes, and/or dyslipidemia), Thorpe et al. projected that 10% sustained weight loss could generate $8,648 (inflated to 2015 USD) in direct medical savings over 10 years.

“For the population with an average BMI ≥27 and at least one additional risk factor (hypertension, type 2 diabetes, and/or dyslipidemia), Thorpe et al. projected that 10% sustained weight loss could generate $8,648 (inflated to 2015 USD) in direct medical savings over 10 years.”

These findings affirm recommendations for coverage of IBC by the U.S. Preventive Services Task Force.

“These findings affirm recommendations for coverage of IBC by the U.S. Preventive Services Task Force [3].”