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Health Care Providers' Advice on Lifestyle Modification in the US Population: Results from the NHANES 2011-2016

Grabovac, I; Smith, L; Stefanac, S; Haider, S; Cao, C; Waldhoer, T; Jackson, SE; (2019) Health Care Providers' Advice on Lifestyle Modification in the US Population: Results from the NHANES 2011-2016. The American Journal of Medicine , 132 (4) 489-497.e1. 10.1016/j.amjmed.2018.11.021. Green open access

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Abstract

OBJECTIVE: Healthcare providers are encouraged to prescribe lifestyle modifications for preventing and managing obesity and associated chronic conditions. However, the pattern of lifestyle advice provision is unknown. We investigate the prevalence of advised lifestyle modification according to weight status and chronic conditions in a US nationally representative sample. METHODS: Adults 20-64 years (n=11,467) from National Health and Nutrition Examination Study between 2011 and 2016 were analyzed, with weight status, and chronic conditions (high blood pressure, high blood cholesterol, osteoarthritis, coronary heart disease and type 2 diabetes mellitus). Lifestyle modification advice by healthcare providers included increase physical activity/exercise, reduce dietary fat/calories, control/lose weight, and all of above. RESULTS: High blood pressure (32.7%) and cholesterol (29.3%) were highly prevalent compared to osteoarthritis (7.4%), type 2 diabetes (5.7%) and coronary heart disease (3.7%). Those with type 2 diabetes received considerably frequent advice (56.5%; 95%CI: 52.4%-60.6%) than those with high blood pressure (31.4%; 95%CI:29.3%-33.6%) and cholesterol (27.0%; 95%CI:24.9%-29.3%). Prevalence of lifestyle advice exhibited substantial increases with graded BMI and comorbidity (all P<0.001). After adjusting for comorbid conditions, advice were more commonly reported among women, those overweight/obese, non-white, or insured. Remarkably low proportion of overweight (21.4: 95%CI: 18.7-24.3%) and obese (44.2%;95%CI:41.0%-47.4%) adults free of chronic conditions reported receiving any lifestyle advice. CONCLUSION: Prevalence of lifestyle modification advised by healthcare providers is generally low among US adults with chronic conditions, and worryingly low among those without chronic conditions however overweight or obese. Prescribed lifestyle modification is a missing opportunity in implementing sustainably strategies reducing chronic condition burden.

Type: Article
Title: Health Care Providers' Advice on Lifestyle Modification in the US Population: Results from the NHANES 2011-2016
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.amjmed.2018.11.021
Publisher version: https://doi.org/10.1016/j.amjmed.2018.11.021
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Healthcare provider advice, Chronic condition, Obesity, Lifestyle modification, NHANES
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
URI: https://discovery.ucl.ac.uk/id/eprint/10063430
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