Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the Look AHEAD trial Look AHEAD Research Group Diabetes Care 2007 30 6 1374 83 10.2337/dc07-0048

St. Luke's Roosevelt Hospital Center, USA.
Diabetes care (Impact Factor: 8.57). 07/2007; 30(6):1374-83. DOI: 10.2337/dc07-0048
Source: PubMed

ABSTRACT The effectiveness of intentional weight loss in reducing cardiovascular disease (CVD) events in type 2 diabetes is unknown. This report describes 1-year changes in CVD risk factors in a trial designed to examine the long-term effects of an intensive lifestyle intervention on the incidence of major CVD events.
This study consisted of a multicentered, randomized, controlled trial of 5,145 individuals with type 2 diabetes, aged 45-74 years, with BMI >25 kg/m2 (>27 kg/m2 if taking insulin). An intensive lifestyle intervention (ILI) involving group and individual meetings to achieve and maintain weight loss through decreased caloric intake and increased physical activity was compared with a diabetes support and education (DSE) condition.
Participants assigned to ILI lost an average 8.6% of their initial weight vs. 0.7% in DSE group (P < 0.001). Mean fitness increased in ILI by 20.9 vs. 5.8% in DSE (P < 0.001). A greater proportion of ILI participants had reductions in diabetes, hypertension, and lipid-lowering medicines. Mean A1C dropped from 7.3 to 6.6% in ILI (P < 0.001) vs. from 7.3 to 7.2% in DSE. Systolic and diastolic pressure, triglycerides, HDL cholesterol, and urine albumin-to-creatinine ratio improved significantly more in ILI than DSE participants (all P < 0.01).
At 1 year, ILI resulted in clinically significant weight loss in people with type 2 diabetes. This was associated with improved diabetes control and CVD risk factors and reduced medicine use in ILI versus DSE. Continued intervention and follow-up will determine whether these changes are maintained and will reduce CVD risk.

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Available from: Karen C Johnson, Aug 16, 2015
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    • "At baseline, none of the demographic variables were significantly different when comparing ILI with DSE and these demographics have been published previously [10] on a larger sample (n = 5145); however, the data for this paper are only on those for whom we could calculate HRR at Year 1 (n = 4503). The reasons for missing data have been explained in an earlier report by Jakicic et al. [14]. "
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    ABSTRACT: The primary aims of this paper were (1) to evaluate the influence of intensive lifestyle weight loss and exercise intervention (ILI) compared with diabetes support and education (DSE) upon Heart Rate Recovery (HRR) from graded exercise testing (GXT) and (2) to determine the independent and combined effects of weight loss and fitness changes upon HRR. In 4503 participants (45-76 years) who completed 1 year of intervention, HRR was measured after a submaximal GXT to compare the influence of (ILI) with (DSE) upon HRR. Participants assigned to ILI lost an average 8.6% of their initial weight versus 0.7% in DSE group (P < 0.001) while mean fitness increased in ILI by 20.9% versus 5.8% in DSE (P < 0.001). At Year 1, all exercise and HRR variables in ILI improved (P < 0.0001) versus DSE: heart rate (HR) at rest was lower (72.8 ± 11.4 versus 77.7 ± 11.7 b/min), HR range was greater (57.7 ± 12.1 versus 53.1 ± 12.4 b/min), HR at 2 minutes was lower (89.3 ± 21.8 versus 93.0 ± 12.1 b/min), and HRR was greater (41.25 ± 22.0 versus 37.8 ± 12.5 b/min). Weight loss and fitness gain produced significant separate and independent improvements in HRR.
    Journal of obesity 11/2012; 2012:309196. DOI:10.1155/2012/309196
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    • "The fundamental therapy goals for diabetes mellitus [19] addressed to maintain low or as closer to normal as possible the values of glycemia, blood pressure, and serum lipoprotein levels, able to reduce the cardiovascular disease risk were accomplished by the results of this study. Nutritional interventions in diabetes have evidenced the capacity of diet to reduce the cardiovascular risk improving the metabolic control but only with discrete impact on drug consumption [20] [21] [22] [23]. A recent assay in New Zealand diabetic adults [24], which reduced saturated fat and increased protein intake Table 2: Changes of anthropometric variables and arterial blood pressure during 3-month intervention with Ma-Pi 2 macrobiotic diet in type 2 diabetic adults. "
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    ABSTRACT: Background. In Cuba, the Ma-Pi 2 macrobiotic diet has shown positive results in 6-month assays with type 2 diabetic patients. The objective of this study was to assess the influence of this diet at short and medium terms. Methods. Sixty-five type 2 diabetic volunteers were included for dietary intervention, institutionally based for 21 days and followed later at home, until completing 3 months. 54 of them stayed until assay end. Before intervention, and after both assay periods, they were submitted to anthropometric records, body composition analyses and measurements of serum biochemical indicators, glycemic profile in capillary blood, blood pressure, and medication consumption; food intake was evaluated by the 3-day dietary recall. Results. During the intervention, the energy intake was 200 kcal higher at instance of more complex carbohydrates and dietary fiber and despite less fat and protein. Blood pressure and serum biochemical indicators decreased significantly in both periods; the safety nutritional indicators (hemoglobin, serum total proteins, and albumin) showed no variations. The global cardiovascular risk decreased and insulin consumption dropped by 46% and 64%, in both periods, respectively. Conclusions. The Ma-Pi 2 macrobiotic diet was a successful therapy at short term and after 3-month home-based intervention, for type 2 diabetics.
    Journal of nutrition and metabolism 10/2012; 2012:856342. DOI:10.1155/2012/856342
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    • "Only a few large RCTs have examined the effects of a long-term exercise-only intervention on these metabolic factors in older women. Of five previous noteworthy RCTs with similar study populations and/or outcomes of interest (Houmard et al. 2004, Frank et al. 2005, Giannopoulou et al. 2005, Pi-Sunyer et al. 2007, Arsenault et al. 2009), only one trial lead by McTiernan (Frank et al. 2005, McTiernan et al. 2005) was of comparable size, duration and scope to the ALPHA Trial. In contrast to the other trials, the ALPHA Trial included healthy, postmenopausal women with a BMI ranging from 22–40 kg/m 2 rather than women with a BMI O25 kg/m 2 . "
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    Endocrine Related Cancer 04/2011; 18(3):357-69. DOI:10.1530/ERC-10-0303 · 4.91 Impact Factor
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