Secular Trend Analysis of NHANES Data Suggests Only Modest Increases in Health-Related Lifestyle Advice Delivered by...

Chronic non-communicable diseases are widespread in the US and exert a high burden on its society. Poor lifestyle habits contribute to this contemporary public health crisis. To address the prevalence of non-communicable diseases and related risk factors in Americans, we studied trends in US health professionals' delivery of health-related lifestyle advice. The major aim was to identify trends and long-term directions in the predicted probability of lifestyle advice delivery. We conducted a secular trend analysis of 18 426 participant reports over 4 consecutive National Health and Nutrition Examination Survey cycles (2011-2018) to estimate the predict probability of their receiving specific lifestyle recommendations by a health professional. Lifestyle-related advice included: (1) sodium or salt intake monitoring; (2) physical activity or exercise encouragement; (3) fat or calorie intake monitoring; and (4) weight control within the last 12 months. In all 4 analyzed NHANES cycles combined, 24.79% (CI: 23.52-26.11) of participants received advice to reduce salt intake, 39.91% (CI: 38.67-41.16) were told to exercise and 30.01% (28.73-31.32) were advised to reduce fat/calories. Compared with 2011-2012, modest increases were observed in 2017-2018 across all lifestyle recommendations; about one-third of participants reported receiving advice to reduce sodium/salt/calories or control/lose weight. The predicted number of lifestyle recommendations received increased over the examined time frame (contrast for 2017-2018 vs 2011-2012: +0.23 (0.13-0.35), P < .001). Health professionals' competency in delivering health-related lifestyle advice appears deficient warranting its prioritization given health promotion is an established accredited health professional competency comparable to drug prescription.