Abstract: Objective: This study aims to evaluate the three-year effect of lifestyle counseling by a nurse practitioner (NP) on physical activity (PA) and dietary intake compared with usual care by a general practitioner (GP).Methods: At baseline, subjects were randomly allocated to the NP group (n=225) or to the GP group (n=232). The NP group received a low-intensive lifestyle intervention for three years by the NP and the GP group received one consultation by the GP and thereafter usual care. PA and dietary intake were assessed with questionnaires at baseline, 1 year follow-up and 3 year follow-up.Results: After three years, leisure-time activity increased and favorable improvements towards a healthy diet were made for both groups. These three-year changes in PA and diet did not differ significantly between groups. Changes in PA and dietary habits after one year were practically maintained after 3 years, because only small relapses were found.Conclusion: After three years, subjects were more physically active and had a healthier diet compared to baseline. Lifestyle counseling by NP resulted in similar lifestyle changes compared to GP consultation.Practice implications: NPs could also advice patients at cardiovascular risk by lifestyle counseling, to possibly reduce GP barriers.