Interventions to promote physical activity and dietary lifestyle changes for cardiovascular risk factor reduction in adults: a scientific statement from the American Heart Association.

N. Artinian, Gerald F Fletcher Dariush, Mozaffarian Penny, Kris-Etherton Linda, Van Horn, Artinian Nt, Fletcher Gf, Mozaffarian D Kris-Etherton, Lichtenstein Ah, Kumanyika S, Kraus We, Fleg Jl, Redeker Ns, Jc Meininger, J. Banks, Stuart-Shor Em, Fletcher Bj, Miller Td, Hughes S, Braun Lt, Kopin La, Berra K, Hayman Ll, Ewing Lj, Ades Pa, Durstine L, Houston-Miller N, Burke Le • 7/27/2010

Abstract

Approximately 79 400 000 American adults, or 1 in 3, have cardiovascular disease (CVD).1 CVD accounts for 36.3% or 1 of every 2.8 deaths in the United States and is the leading cause of death among both men and women in the United States, killing an average of 1 American every 37 seconds.1 Older adults, some ethnic minority populations, and socioeconomically disadvantaged individuals have an increased prevalence of CVD and vascular/metabolic risk factors such as hypertension, dyslipidemia, and diabetes; are more likely to have ≥2 risk factors; and are at increased risk of being sedentary, overweight or obese, and having unhealthy dietary habits.2–10 Black and Hispanic immigrants are initially at lower risk for vascular/metabolic risk factors and CVD than US-born black and Hispanic individuals,2 but as they adapt to the diet and activity habits of this country, the prevalence of vascular/metabolic risk factors increases.3 Each of these issues emphasizes the importance of interventions to promote physical activity (PA) and healthy diets in all American adults. Even modest sustained lifestyle changes can substantially reduce CVD morbidity and mortality. Because many of the beneficial effects of lifestyle changes accrue over time, long-term adherence maximizes individual and population benefits. Interventions targeting dietary patterns, weight reduction, and new PA habits often result in impressive rates of initial behavior changes, but frequently are not translated into long-term behavioral maintenance.4 Both adoption and maintenance of new cardiovascular risk-reducing behaviors pose challenges for many individuals. According to the National Center for Health Statistics, life expectancy could increase by almost 7 years if all forms of major CVD were eliminated.5 Improvements in morbidity and quality of life would also be substantial. In order to achieve these goals, healthcare providers must focus on reducing CVD risk factors such as overweight and obesity, …

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