Behavioral counseling to promote a healthful 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

Scope

Primary care–feasible counseling to improve diet, physical activity, and/or sedentary time in adults without diagnosed hypertension, dyslipidemia, diabetes, or known CVD—not the same evidence base as DASH controlled-feeding efficacy trials.

Pooled intermediate outcomes (6–12 months; random-effects)

• Systolic BP: mean difference −1.26 mmHg (95% CI −1.77 to −0.75; k = 22)
• Diastolic BP: −0.49 mmHg (−0.82 to −0.16; k = 23)
• LDL cholesterol: −2.58 mg/dL (−4.30 to −0.85; k = 13)
• Total cholesterol: −2.85 mg/dL (−4.95 to −0.75; k = 19)
• Adiposity: BMI −0.41 kg/m², weight −1.04 kg, waist −1.19 cm (very high I² in adiposity models—interpret cautiously)

Behavioural endpoints (abstract)

Counseling improved self-reported diet metrics and produced ~+35 minutes/week of physical activity and 32% higher odds of meeting activity recommendations versus controls in pooled activity analyses.

Evidence hygiene

Sparse / heterogeneous reporting of hard CVD events; this row is an intermediate-outcome / behaviour anchor, not a mortality substitute.

Publication

Patnode CD, Evans CV, Senger CA, et al. AHRQ Evidence Syntheses. July 2017. PubMed record PMID 29364620.