Research ArticleExercise and Diet Counseling Trends From 2002 to 2015: A Serial Cross-Sectional Study of U.S. Adults With Cardiovascular Disease Risk
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INTRODUCTION
Cardiovascular disease (CVD) poses substantial health and economic burdens in the U.S.1 The cost of treating CVD was $213 billion in 2015.2 Treating obesity and diabetes, both prominent CVD risk factors, have been estimated to cost $149 billion and $237 billion annually, respectively.3,4 Thus, it is imperative to implement and evaluate large-scale policies and interventions addressing CVD risk factors such as high blood pressure, high cholesterol, obesity, and diabetes.2
Behavioral counseling
METHODS
The Medical Expenditure Panel Survey (MEPS) is run by the Agency for Healthcare Research and Quality. MEPS collects data from a nationally representative sample of individuals and families, medical providers, and employers to provide concrete estimates regarding the use of medical services in the country. The MEPS-Household Component (MEPS-HC) collects nationally representative data on demographic characteristics, health conditions, health status, the use of medical care services, charges and
RESULTS
From 2002 to 2015, there were 346,177 MEPS respondents, and 119,138 (34.4%) were eligible for this analysis. A total of 116,327 (33.6%) eligible respondents had complete data on sociodemographic variables. After excluding respondents missing both exercise and dietary counseling data, the final study sample consisted of 116,048 (33.5%) respondents. The demographic characteristics of the eligible sample with complete sociodemographic variables are shown in Table 1.
In 2002, exercise counseling had
DISCUSSION
When comparing serial cross-sectional data from 2002 to 2015, modest increases in the prevalence of self-reported receipt of diet and exercise counseling among individuals were observed. However, 37% of potentially eligible individuals, on the basis of the current USPSTF clinical recommendations, were still not receiving exercise counseling, and 43% were not receiving dietary counseling in 2015.13 In stratified analyses, individuals who were male, White, uninsured, and with fewer CVD risk
CONCLUSIONS
Despite modest improvements in the last decade, 37% of the U.S. population with overweight or obesity with an additional CVD risk factor were still not receiving exercise counseling, and 43% were not receiving dietary counseling, as per USPSTF recommendations, in 2015. The differences in PRs were associated with important health and sociodemographic factors such as insurance status, number of CVD risk factors, race, and sex. Continued implementation and scale up of effective programs to
ACKNOWLEDGMENTS
No financial disclosures were reported by the authors of this paper.
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