Article

Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial.

St. Luke's Roosevelt Hospital Center, USA.
Diabetes care (Impact Factor: 7.74). 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.

0 Bookmarks
 · 
106 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Oxidative damage to lipoproteins, in particular low density lipoprotein (LDL), is known to play a role in a number of diseases associated with aging such as cardiovascular disease (CVD) and dementia. Exercise can alter the balance of oxidative and anti-oxidative species within the human body and may cause oxidative damage to lipoproteins. The purpose of this study was to assess the effect of a moderate intensity exercise program on markers of oxidative stress in older age adults. Parameters of lipoprotein protein and lipid oxidation, and lipoprotein nitration were assessed in aged individuals who undertook a program of moderate physical activity for a period of 8 weeks. There were no significant changes in LDL protein oxidation or nitration which could be attributed to 8 weeks of walking exercise, however, LDL nitration was increased following acute steady state exercise (pre-: 0.34±0.1 vs. post-: 0.44±0.07 μm/mg LDL; p=0.04). Walking at moderate intensity caused a significant weight decrease in the exercise group, but did not have any significant effect on VO2max. Exercise at this intensity was not harmful and did not increase risk factors for diseases associated with oxidative stress in the participants of the study.
    Archives of gerontology and geriatrics 01/2011; 53(3):350-3. · 1.36 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The prevalence of obesity and diabetes is increasing dramatically throughout the world. Studies have shown that excess adiposity is a critical predictor of new onset T2DM. This meta-analysis is aimed to assess the metabolic effects of fluoxetine in T2DM. Electronic search was conducted in the database Medline, PubMed, EMBASE, and the Cochrane library, from inception through to March 2011. A systematic review of the studies on the metabolic effects of fluoxetine in T2DM was performed. The weighted mean difference (WMD) and its 95% CI were calculated from the raw data extracted from the original literature. The software Review Manager (version 4.3.1) and Stata (version 11.0) were applied for meta-analysis. Five randomized, placebo-controlled trials were included in the meta-analysis. According to WMD calculation, fluoxetine therapy led to 4.27 Kg of weight loss (95%CI 2.58-5.97, P<0.000 01), 1.41 mmol/L of fasting plasma glucose (FPG) decrement (95%CI 0.19-2.64, P = 0.02) and 0.54 mmol/L of triglyceride (TG) reduction (95%CI 0.35-0.73, P<0.000 01) compared with placebo. Moreover, fluoxetine therapy produced 0.78% of HbA1c decrement (95%CI -0.23-1.78). However, this effect was not statistically significant (P = 0.13). Short period of fluoxetine therapy can lead to weight loss as well as reduction of FPG, HbA1c and TG in T2DM.
    PLoS ONE 01/2011; 6(7):e21551. · 3.53 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The US government released its first formal recommendations on physical activity, the Physical Activity Guidelines for Americans, in 2008. By issuing the guidelines, the government has established increased physical activity as a major societal health target for the 21st century. The guidelines include recommendations of the types and amounts of physical activity that people should perform to gain important health benefits. Physicians and other health care providers can help people attain and maintain regular physical activity by providing advice on how to be active, appropriate types of activities, and ways to reduce the risk of injuries. Although training for providers on how to counsel patients about physical activity is limited, training of future providers offers an opportunity to improve this area of medical education. Public health practitioners have shifted their efforts to promote physical activity toward an environmental focus, usually incorporating organizational and community-level interventions. As federal health policy moves toward a greater emphasis on prevention of chronic diseases, it is expected that new resources will become available to support physical activity promotion in health care and public health settings. Familiarity with the guidelines should aid professionals in medicine and public health in responding effectively to these new expectations and opportunities.
    American Journal of Lifestyle Medicine 01/2010; 4(3):209-217.

Full-text (2 Sources)

View
26 Downloads
Available from
Jun 6, 2014