Healthy eating and activity counseling
For adults with heart risk factors, the USPSTF recommends offering or referring them to counseling on healthy eating and physical activity (grade B, 2020). For adults without known risk factors, it is a case-by-case decision (grade C, 2022). (USPSTF, 2020) (USPSTF, 2022)
This is about structured counseling, usually several sessions over months, not a one-off tip. If you have high blood pressure or high cholesterol, ask your doctor about a program near you.
- USPSTF grade
- B (risk factors), C (none)
- Who
- Adults
- Ages
- 18 and older
- What
- Counseling on diet and activity
Who it is for
| Adults 18 and older | USPSTF grade | What it means |
|---|---|---|
| With high or elevated blood pressure, abnormal cholesterol, or several risk factors such as metabolic syndrome or a 10-year heart risk of 7.5% or more | B (2020) | Offer or refer to counseling |
| Without known heart risk factors | C (2022) | Offer selectively, by clinician judgment and your preferences |
The 2020 recommendation does not cover high blood sugar, obesity or smoking; the USPSTF handles those in other recommendations. (USPSTF, 2020)
For people without risk factors, those interested and ready to change their habits are most likely to benefit. (USPSTF, 2022)
What the counseling looks like
In the studies for adults with risk factors, counseling was intensive: a median of 12 contacts, about 6 hours over 12 months, one to one or in groups. Diet advice cut saturated fat, sodium and sweets and added fruit, vegetables and whole grains; activity goals were 90 to 180 minutes a week of moderate to vigorous activity. (USPSTF, 2020)
For adults without risk factors, activity counseling often encourages building up to at least 150 minutes a week of moderate activity, with walking often emphasized. (USPSTF, 2022)
What other groups say
As summarized by the USPSTF, the American Heart Association and American College of Cardiology recommend counseling on healthy diet and activity for all adults, and their prevention guidelines advise 150 minutes a week of moderate or 75 minutes of vigorous activity. That is broader than the USPSTF, which grades counseling for adults without risk factors as case by case. (USPSTF, 2020) (USPSTF, 2022)
Questions people ask
Who should get diet and exercise counseling for heart health?
Adults with heart risk factors such as high blood pressure, abnormal cholesterol or a 10-year heart risk of 7.5% or more: the USPSTF recommends offering or referring them to counseling (grade B). (USPSTF, 2020)
What if I have no heart risk factors?
The USPSTF says the decision to offer counseling should be individual (grade C), and that people ready to change their habits are most likely to benefit. (USPSTF, 2022)
How much exercise is the goal?
In the counseling studies for people with risk factors, the goal was 90 to 180 minutes a week of moderate to vigorous activity. For people without risk factors, programs often aim for at least 150 minutes a week of moderate activity. (USPSTF, 2020) (USPSTF, 2022)
Is the recommendation being updated?
An update is in progress. On our review the USPSTF update page was last updated October 27, 2023 and showed no draft recommendation yet, so the 2020 and 2022 statements still apply. (USPSTF, 2020)
This page explains what the guidelines say. It cannot tell you what is right for you: talk to your doctor.