Background: Lifestyle-related diseases account for 82% of deaths in Austria. Austria's preventive medical check-up (PMCU) was last updated in 2005, while lifestyle-related health indicators have worsened. This umbrella review evaluated evidence-based brief interventions for physical activity, healthy diet and alcohol consumption, and explored implementation feasibility in lifestyle counselling of PMCU.

Methods: Following PRISMA guidelines, three databases (Medline, Embase, The Cochrane Library) were searched for systematic reviews (2015-2025). Studies were selected using PICO criteria; their quality assessed using ROBIS. Fourteen Austrian physicians were surveyed regarding implementation feasibility.

Results: Six systematic reviews were included (one on physical activity, one on healthy diet, four on alcohol consumption). Physical activity interventions (2-13 minutes) increased self-reported activity over 4-12 weeks, with follow-up sessions apperaring to be more important than duration; however, evidence had a high risk of bias. Single-session healthy diet interventions showed mixed results; education combined with feedback/tailored advice demonstrated some improvements, though clinical relevance remains uncertain. Alcohol interventions reduced consumption at 12 months. Physicians identified critical counselling barriers: inadequate time allocation, low health literacy and motivation to change, language barriers, and failure to reach target populations. Key requirements included extended consultation time, multilingual materials, appropriate remuneration and interdisciplinary collaboration, especially for dietary counselling.

Discussion: Evidence quality varies, long-term effectiveness is uncertain, and transferability to Austria faces substantial limitations due to contextual differences and methodological constraints. Clinical relevance remains unclear. Accompanying research is essential and a broader public health perspective required.

Conclusion: While the evidence suggests potential effectiveness, substantial implementation barriers exist. Follow-up sessions might be feasible for physical activity and structured referral systems for nutrition counselling. A multimodal approach with structural adaptations, appropriate remuneration and interdisciplinary collaborations is necessary to further develop the Austrian PMCU. Gaps between current practice and PMCU standards should be closed.