| Behavioral counseling to promote physical activity and a healthful diet to prevent cardiovascular disease in adults: a systematic review for the U.S. Preventive Services Task Force. | |
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MedLine Citation:
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PMID: 21135297 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Poor diet and lack of physical activity can worsen cardiovascular health, yet most Americans do not meet diet and physical activity recommendations. PURPOSE: To assist the U.S. Preventive Services Task Force in updating its previous recommendations by systematically reviewing trials of physical activity or dietary counseling to prevent cardiovascular disease. DATA SOURCES: MEDLINE, PsycINFO, Cochrane Central Register of Controlled Trials (2001 to January 2010), experts, and existing systematic reviews. STUDY SELECTION: Two investigators independently reviewed 13 562 abstracts and 481 articles against a set of a priori inclusion criteria and critically appraised each study by using design-specific quality criteria. DATA EXTRACTION AND ANALYSIS: Data from 73 studies (109 articles) were abstracted by one reviewer and checked by a second reviewer. Random-effects meta-analyses were conducted for multiple intermediate health and behavioral outcomes. DATA SYNTHESIS: Long-term observational follow-up of intensive sodium reduction counseling showed a decrease in the incidence of cardiovascular disease; however, other direct evidence for reduction in disease morbidity is lacking. High-intensity dietary counseling, with or without physical activity counseling, resulted in changes of -0.3 to -0.7 kg/m(2) in body mass index (adiposity), -1.5 mm Hg (95% CI, -0.9 to -2.1 mm Hg) in systolic blood pressure, -0.7 mm Hg (CI, -0.6 to -0.9 mm Hg) in diastolic pressure, -0.17 mmol/L (CI, -0.09 to -0.25 mmol/L) (-6.56 mg/dL [CI, -3.47 to -9.65 mg/dL]) in total cholesterol level, and -0.13 mmol/L (CI, -0.06 to -0.21 mmol/L) (-5.02 mg/dL [CI, -2.32 to -8.11 mg/dL]) in low-density lipoprotein cholesterol level. Medium- and high-intensity counseling resulted in moderate to large changes in self-reported dietary and physical activity behaviors. LIMITATIONS: Meta-analyses for some outcomes had large statistical heterogeneity or evidence for publication bias. Only 11 trials followed outcomes beyond 12 months. CONCLUSION: Counseling to improve diet or increase physical activity changed health behaviors and was associated with small improvements in adiposity, blood pressure, and lipid levels. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality. |
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Authors:
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Jennifer S Lin; Elizabeth O'Connor; Evelyn P Whitlock; Tracy L Beil |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, P.H.S.; Review |
Journal Detail:
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Title: Annals of internal medicine Volume: 153 ISSN: 1539-3704 ISO Abbreviation: Ann. Intern. Med. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-07 Completed Date: 2011-01-05 Revised Date: 2011-08-25 |
Medline Journal Info:
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Nlm Unique ID: 0372351 Medline TA: Ann Intern Med Country: United States |
Other Details:
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Languages: eng Pagination: 736-50 Citation Subset: AIM; IM |
Affiliation:
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Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon 97227, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adiposity Adult Behavior Therapy* Blood Pressure Cardiovascular Diseases / prevention & control* Counseling / methods* Diet, Sodium-Restricted* Exercise* Health Behavior* Humans Lipids / blood |
| Grant Support | |
ID/Acronym/Agency:
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HHS-290-2007-10057-I, TASK ORDER 3//PHS HHS |
| Chemical | |
Reg. No./Substance:
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0/Lipids |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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