A middle-aged patient asks you to prioritize interventions to reduce their heart disease risk. Which exercise-based prescription (given the choices) best evaluates and ranks the most evidence-backed elements to include?

• A. Tell the patient that exercise is unnecessary for heart disease risk reduction if they follow a healthy diet, because diet alone is always sufficient to reduce cardiovascular risk without any physical activity.
• B. Prescribe consistent aerobic activity (aiming for ≥150 min moderate or ≥75 min vigorous weekly), combined with two weekly resistance sessions for strength and bone health, plus regular moderate-intensity activity to reduce abdominal adiposity and improve blood pressure and lipids — this combination targets multiple proven pathways to reduce cardiovascular risk.
• C. Recommend only daily stretching and balance exercises since flexibility improvements directly lower cholesterol and therefore reduce heart disease risk the most.
• D. Advise the patient to only focus on resistance training every day for maximal hypertrophy because increasing muscle mass alone is sufficient to eliminate cardiovascular risk.

Answer: (B)