NPA-GP: Guideline Scope (2023)
Guideline Scope Characteristics
Scope, Population, and Health Questions Addressed
This EBNPG aims to inform practice decisions for nutrition and exercise practitioners by providing nutrition and physical activity interventions for adults (≥18 years of age) who are healthy or have cardiometabolic risk factors, such as overweight (body mass index ≥25 kg/m2 or as defined for the specific population), pre-diabetes and pre-hypertension.This EBNPG does not focus on adults with diagnosed disease, though adults with obesity were not excluded; thus, the expert panel uses the term ‘clients’ instead of ‘patients’ to refer to individuals receiving interventions in this EBNPG. This EBNPG is supported by research conducted both in the U.S. and across the globe. While authors primarily use examples of resources available for adults in the U.S., such as the Dietary Guidelines for Americans (2020-2025) and Physical Activity Guidelines for Americans 2nd edition, recommendations are not limited to a specific country or setting. Instead, nutrition and exercise practitioners should adapt recommendations and implementation to the context and individual client.
Specifically, this EBNPG addresses three major questions:
- In adults who are healthy or have cardiometabolic risk factors (CMDs), what is the effect of nutrition and physical activity interventions provided by nutrition and exercise practitioners on health behaviors and CMD risk factors?
- What intervention components contribute to efficacy?
- What is the scope of practice for nutrition and exercise practitioners providing interventions to these populations?
This EBNPG does not provide specific dietary or physical activity recommendations but rather informs nutrition and exercise practitioners about how they may utilize existing guidelines for the general population to individualize programming for a range of clients to prevent CMDs. This EBNPG does not address nutrition and physical activity interventions provided by nurses, primary care physicians or other non- nutrition or exercise practitioners. This EBNPG does not apply to pediatric individuals, elite athletes, or adults with diagnosed diseases, including but not limited to type 2 diabetes mellitus, cardiovascular disease, or chronic kidney disease.
Counseling, Treatment, Intervention
Cardiology, Family Practice, Geriatrics, Nutrition, Physical Medicine and Rehabilitation, Sports Medicine
This guideline targets registered dietitian nutritionists or international equivalents (referred to as ‘dietitians’ in this EBNPG) and certified exercise practitioners and health coaches recognized by organizations such as the United States (U.S.) Registry of Exercise Professionals and American Council on Exercise (2018, US Registry of Exercise Professionals 2021, American Council on Exercise 2022)
In this EBNPG, dietitians, exercise practitioners and health coaches are collectively referred to as ‘nutrition and exercise practitioners’. While this EBNPG targets nutrition and exercise practitioners, the content is also valuable to primary care and sports medicine providers, including medical doctors, and other allied healthcare practitioners. As a secondary and long-term goal, these recommendations and their supporting evidence could influence policy makers in developing CMD prevention-targeted legislation.
The objective of this evidence-based practice guideline (EBPG) is to inform practice decisions for nutrition and exercise practitioners by providing nutrition and physical activity interventions for adults (≥18 years of age) who are healthy or have cardiometabolic risk factors to guide improvement of nutrition and physical activity behaviors and cardiometabolic disease (CMD) risk reduction.
Adult (19 to 44 years), Middle Age (45 to 64 years), Aged (65 to 79 years), Male, Female
Target Population Description
Adults (≥18 years of age) who are healthy or have cardiometabolic risk factors, such as overweight (body mass index ≥25 kg/m2 or as defined for the specific population), pre-diabetes and pre-hypertension. It does not focus on adults with a diagnosed disease.
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