We know what we’re supposed to do: follow a healthy, balanced diet and get regular physical exercise. It sounds simple enough, but for most of us it’s easier said than done. We try to practice good habits – at least most of the time – and limit our indulgences. But far too many people consistently make poor choices, putting themselves at risk for serious health problems, including heart disease (1).
That’s worrisome enough, but what’s even more alarming is that many people are already at increased risk for cardiovascular disease due to high blood pressure, high cholesterol, high risk of diabetes or because they smoke or are significantly overweight (2;3). While these risk factors can be improved with changes to diet and exercise, some people are unable to make or maintain these changes on their own.
For them, the intensive guidance and support offered by behavioural lifestyle counselling programs could be the solution. Research has shown that lifestyle interventions in people at risk for type 2 diabetes may decrease or postpone their risk of progressing to diabetes (4), but what about those at risk for heart disease?
To better determine if such programs benefit people with cardiovascular risk factors, a systematic review analyzed the results of 74 relevant studies conducted between 1990 and 2013. Most involved a combination of diet and exercise counselling, with some focusing on diet or exercise only. Participants (more than 34,000 across the 74 studies) were men and women aged 40 to 71 who had at least one risk factor for heart disease. The programs lasted an average of 12 months, included individualized care plans, and were delivered by dietitians, nutritionists, physiotherapists and exercise professionals (5).
What the research tells us
So do lifestyle counselling programs help? In a word, yes. The studies showed improvements in dietary and physical activity behaviours and reductions in cholesterol levels, blood pressure, weight, glucose levels (5;6) and incidence of diabetes (5). While the reductions were small to moderate, they may still translate into fewer strokes or reduced stroke risk (5;6), and fewer heart attacks (5).
The review points out that although intensive lifestyle counselling programs can be beneficial, they involve resources that may not be available or funded through healthcare systems. Future research might address alternate ways of offering lifestyle counselling support at a lower cost (5).