Nutrition Counseling

NC: Cardiovascular Disease Risk Factors (2007-2008)

Read more about behavior change theory. 

Cognitive-Behavioral Therapy

  • Cardiovascular disease risk factors
  • Intervention
    What is the evidence that cognitive-behavioral therapy, of short duration (< 6 months) targeted to reduce cardiovascular disease risk factors, results in health/food behavior change in adults counseled in an outpatient/clinic setting?
    • Conclusion

      In two small research studies, one RCT and one non-randomized trial of neutral quality, cognitive-behavioral therapy (CBT) of short duration (eight-weeks) targeted to reduce cardiovascular disease risk factors was shown to produce modest, but significant reductions in a variety of cardiovascular risk factors. In one study, researchers found cognitive-behavioral therapy significantly reduced weight, body fat, and changed regional body composition in both men and women, and reduced leptin level in women, and serum cholesterol in men. In the other study, researchers found CBT reduced serum cholesterol levels in both men and women.

       

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What is the evidence that cognitive-behavioral therapy of intermediate duration (six to 12 months), targeted to reduce cardiovascular disease risk factors, results in health or food behavior change in adults counseled in an outpatient or clinic setting?
    • Conclusion

      Two positive-quality and one neutral-quality RCT evaluated the effect of weight-reduction programs with a behavioral component on reducing cardiovascular risk factors in middle-aged subjects. These researchers found behavioral therapy was significantly more effective in facilitating weight loss, beneficial change in diet and exercise habits, decreasing triglyceride levels, increasing HDL-cholesterol in men and women and decreasing systolic blood pressure in women. Additional studies with more intense, validated behavioral components should be conducted to assess optimal outcomes achievable.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What is the evidence that cognitive-behavioral therapy conducted over a 12-month or longer time frame, targeted to reduce cardiovascular disease risk factors, results in health or food behavior change in adults counseled in an outpatient or clinic setting?
    • Conclusion

      Four large positive-quality RCTs provide evidence that cognitive-behavioral therapy of greater than 18-months' duration is beneficial in facilitating modification of dietary habits, weight and cardiovascular risk factors.

    • Grade: I
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.