The United States Preventive Services Task Force (USPSTF) recently posted a draft research plan for public comment under the banner: behavioral counseling to promote a healthy diet and physical activity for cardiovascular disease (CVD) prevention in persons with known risk factors for CVD. The USPSTF describes itself as “an independent panel of non-Federal experts in prevention and evidence-based medicine and is composed of primary care providers (such as internists, pediatricians, family physicians, gynecologists/obstetricians, nurses, and health behavior specialists).”
The USPSTF conducts scientific evidence reviews of a broad range of clinical preventive health care services (such as screenings, counseling, and preventive medications) and develops recommendations for primary care clinicians and health systems. These recommendations are published in the form of "Recommendation Statements."
This can sometimes be a complicated undertaking because of underlying medical conditions. For example, a patient taking Coumadin, a blood anticoagulant, cannot simply add more green vegetables to the diet as such vegetables can reverse the effect of the drug. A plan is needed to reintroduce green vegetables while adjusting drug dosages. A patient with fecal incontinence, a condition where bowel movements are not well controlled, must be very careful with how much fiber is added to the diet, as one of my patients recently learned as he barely made it to the toilet in time. It requires much reassurance to overcome the fears of patients with diverticulosis, an abnormality of the colon that results in growth of out-pockets of tissue that can become clogged, that they can in fact consume nuts and seeds after years of being told otherwise. But with patience and perseverance, I have seen the amazing happen.