Episode 011: Behavioral Counseling Regarding Diet and Physical Activity In Healthy Adults: Do You Think You Would Benefit?
Mixing things up this week, I have provided a short commentary on a recent recommendation from the United States Preventative Services Task Force (USPSTF) regarding the efficacy of routine behavioral health counseling for the prevention of cardiovascular disease in healthy adults.
“The USPSTF recommends that primary care professionals individualize the decision to offer or refer adults without obesity who do not have hypertension, dyslipidemia, abnormal blood glucose levels, or diabetes to behavioral counseling to promote a healthful diet and physical activity. Existing evidence indicates a positive but small benefit of behavioral counseling for the prevention of CVD in this population. Persons who are interested and ready to make behavioral changes may be most likely to benefit from behavioral counseling. (C recommendation).”
You may be wondering:
Who/What is the USPSTF and what are their recommendations in the first place?
Who are they directed towards and to whom do they apply?
And most importantly why should I care?
In my commentary I examine some of the details behind this recommendation and the studies that informed it. I dig a little deeper to explore some rather curious questions:
Why don’t they recommend counseling for everyone? It seems like it would help?
In what ways did the USPSTF determined “benefit” from such counseling?
What types of health counseling were involved? What modalities were used?
Who was delivering the interventions?
Could we have even expected to see a benefit from such interventions in the first place?
How would you decide if nutrition counseling was helpful to you?
Is preventing cardiovascular enough or relevant?
And pushing still I begin to open some doors and push some buttons examining
What does a Grade C recommendation mean when it comes to insurance? payment? Will this type of service be covered?
Were the interventions studied “unsuccessful” because of the participants or was it the content and delivery?
Are we actually telling patients the right things when it comes to nutrition and exercise?
What if we studied counseling for sleep, stress management and social connection? Would we see a benefit with these types of interventions? Is this where we should look to next?
And lastly I leave the discussion with a note on motivation, purpose and the willingness to change- is motivation and willingness to change a prerequisite for making meaningful lifestyle changes? Should we only educate those that seem interested to change?
I really hope you enjoy this commentary and want to hear from you!
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May you be happy, healthy, and forever at peace.