The role of dietary and physical activity assessment in the predictive ability of cardiovascular disease risk scores: A narrative review

Due to the increased burden of cardiovascular disease (CVD) around the world, country specific risk prediction models (or scores) of future CVD events have been developed and recommended as screening tools for primary prevention, as well as treatment management. Most of these risk scores include basic demographic characteristics, like age and sex, smoking habits, as well as some clinical and biochemical factors, like blood pressure, cholesterol, and glucose levels. Dietary habits and physical activity status of individuals have consistently shown in many studies during the past years a strong, and independent association with CVD risk. However, their integration in CVD risk scores is rare, even though when used for the assessment of overall CVD risk, the models showed improved classification ability. In this review paper, and in the light of the recent SCORE 2 (2021) tool presented by the European Society of Cardiology, we discuss the benefits from the incorporation of dietary and physical activity assessment in the predictive ability of CVD risk prediction tools.