Primary prevention
Reputable organisations, including the American Heart Association, the US Department of Health and Human Services, the World Health Organization (WHO), and numerous national health councils and non-profit organisations, have published dietary and lifestyle recommendations. These recommendations advocate moderation of caloric intake, while encouraging consumption of complex carbohydrates, fibre, high-quality protein, and vegetable oils, and avoiding saturated and trans fat, simple carbohydrates, and processed food in general.[87][88][89] They also emphasise the importance of daily physical activity. Environmental preventative measures are being investigated.[90][91]
The WHO’s physical activity and sedentary behaviour guidelines, published by a multidisciplinary panel of experts, are outlined below.[92]
Adults of all ages should take part in regular, safe physical activity regardless of age or other medical comorbidities.
Sedentary tasks should be limited and replaced with activities of even light intensity when possible, as any activity at all is of benefit compared with no activity.
For adults aged 18 to 64, it is strongly recommended that they partake in 150 to 300 minutes of moderate intensity aerobic activity or 75 to 150 minutes of vigorous aerobic activity throughout each week in order to obtain significant health benefits and improvement in comorbid conditions.
In addition to aerobic activity, muscle strengthening exercises should be completed at least 2 days per week.
As physical conditioning improves, additional health benefits have been seen in adults who are able to increase their physical activity above minimal recommended amounts, when not contraindicated by a chronic medical condition.
In adults aged 65 years or older, addition of a multicomponent routine is strongly recommended, with emphasis on strength training and balance to enhance functional capacity and prevent falls.
Secondary prevention
Risk factors for cardiovascular disease should be assessed in patients with overweight or obesity to guide the use of preventative medical therapy.[98][262] Any comorbidities (e.g., type 2 diabetes, hypertension, cardiovascular disease, dyslipidaemia, and sleep apnoea) should be managed when they are identified, without waiting until the person has lost weight.[100] The patient should adopt a sound lifestyle of sensible eating and physical activity and be supported to maintain weight loss.[88][263][264]
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