DALLAS—Self-monitoring of an individual’s diet, combined with exercise, counseling, extended follow-up with a healthcare provider, is one of the best ways to reduce the risk of cardiovascular disease (CVD), which is the leading cause of death in the United States, according to a recent American Heart Association statement published in the journal Circluation. The AHA calls for a modification of current healthcare policies to encourage these changes.
“We need to do a better job finding ways to help people not only change their behaviors, but maintain them over a lifetime,” said Nancy T. Artinian, Ph.D., R.N., professor, associate dean for research and director of the Center for Health Research at Wayne State University College of Nursing in Detroit, Mich. “As healthcare providers, we’re pretty good at saying that you are at risk for a disease, you need to lose weight, be more physically active, and eat more fruits and vegetables. While that’s easy to say, it’s not easy for the person to actually translate it into their everyday life.”
Researchers analyzed 74 studies conducted among U.S. adults between January 1997 and May 2007. The studies measured the effects of behavioral change on blood pressure and cholesterol levels; physical activity and aerobic fitness; and diet, including reduced calorie, fat, cholesterol and salt intake, and increased fruit, vegetable and fiber consumption.
The authors identified several critical parts of effective behavioral change programs, including healthcare providers using a motivational interviewing technique to encourage patients to make healthier lifestyle choices, counseling patients that occasional setbacks are normal, and scheduling recurring follow-up sessions with patients. The most effective patient-controlled behaviors include setting specific goals for physical activity and dietary improvements, and keeping track of progress toward their goals.
“Lifestyle change is never easy and often under-emphasized in clinical encounters with our patients. This statement shows what types of programs work and supports the increased need for counseling and goal setting to improve healthy cardiovascular habits,” said Ralph Sacco, M.D, president of the American Heart Association. “We need to find more effective ways to make lifestyle change programs available, especially to the groups at highest risk for cardiovascular diseases—older Americans, African-Americans and people of Hispanic origin.”