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Association of the Magnitude of Weight Loss and Physical Fitness Change on Long-term CVD outcomes: The Look AHEAD Study
  • Published Date:
    Aug 30 2016
  • Source:
    Lancet Diabetes Endocrinol. 4(11):913-921.


Public Access Version Available on: November 01, 2017 information icon
Please check back on the date listed above.
Details:
  • Personal Authors:
  • Corporate Authors:
    The Look AHEAD Study Group
  • Pubmed ID:
    27595918
  • Pubmed Central ID:
    PMC5094846
  • Description:
    Background

    The Look AHEAD Study found no significant reduction in cardiovascular disease (CVD) incidence among adults with diabetes enrolled in an intensive weight loss intervention (ILI) compared to those randomized to diabetes support and education (DSE). We examined whether CVD incidence in Look AHEAD varied by weight or fitness change.

    Methods

    Among overweight or obese adults people aged 45–76 with type 2 diabetes in the Look AHEAD study, this observational analysis examined the association of magnitude of weight loss (N=4834) and fitness change (N=4406) over the first year with CVD incidence over a median 10.2 years of follow-up. The primary outcome was a composite of CVD death, myocardial infarction, stroke, or angina hospitalization; the secondary outcome included the same indices plus coronary–artery bypass grafting, carotid endartectomy, percutaneous coronary intervention, hospitalization for congestive heart failure, peripheral vascular disease, or total mortality. Analyses adjusted for baseline differences in weight or fitness, demographics and CVD risk factors.

    Findings

    In analyses of the full cohort combining ILI and DSE, persons who lost > 10% body weight in the first year had 21% lower risk of the primary outcome (HR=0.79, 95% CI, 0.64 to 0.98) and a 24% reduced risk of the secondary outcome (HR=0.76, 95% CI, 0.63 to 0.91) relative to those with stable weight/weight gain. Achieving a > 2 MET fitness change was associated with a significant reduction in the secondary outcome (HR=0.77, 95% CI, 0.61 – 0.96) but not the primary outcome (HR=0.78, 0.60 – 1.03). In analyses treating the DSE as the referent group, ILI participants with > 10% weight losses had a 20% lower risk of the primary outcome (HR=0.80 (95% CI, 0.65 – 0.99) and a 21% reduced risk of the secondary outcome (0.79 (95% CI, 0.66 – 0.95); fitness change was not significantly associated with either outcome.

    Interpretation

    This secondary analysis of Look AHEAD suggests an association between the magnitude of intentional weight loss and CVD incidence.

  • Document Type:
  • Collection(s):
  • Funding:
    U01 DK057151/DK/NIDDK NIH HHS/United States
    P30 DK048520/DK/NIDDK NIH HHS/United States
    U01 DK057135/DK/NIDDK NIH HHS/United States
    UL1 RR024153/RR/NCRR NIH HHS/United States
    P30 DK046204/DK/NIDDK NIH HHS/United States
    M01 RR002719/RR/NCRR NIH HHS/United States
    M01 RR000056/RR/NCRR NIH HHS/United States
    U01 DK057219/DK/NIDDK NIH HHS/United States
    U01 DK057154/DK/NIDDK NIH HHS/United States
    U01 DK056992/DK/NIDDK NIH HHS/United States
    U01 DK057171/DK/NIDDK NIH HHS/United States
    U01 DK057182/DK/NIDDK NIH HHS/United States
    U01 DK057136/DK/NIDDK NIH HHS/United States
    U01 DK057002/DK/NIDDK NIH HHS/United States
    U01 DK057177/DK/NIDDK NIH HHS/United States
    M01 RR001066/RR/NCRR NIH HHS/United States
    U01 DK057078/DK/NIDDK NIH HHS/United States
    CC999999/Intramural CDC HHS/United States
    U01 DK057131/DK/NIDDK NIH HHS/United States
    M01 RR000051/RR/NCRR NIH HHS/United States
    UL1 TR001120/TR/NCATS NIH HHS/United States
    U01 DK056990/DK/NIDDK NIH HHS/United States
    U01 DK057178/DK/NIDDK NIH HHS/United States
    U01 DK057008/DK/NIDDK NIH HHS/United States
    U01 DK057149/DK/NIDDK NIH HHS/United States
    M01 RR001346/RR/NCRR NIH HHS/United States
  • Supporting Files:
    No Additional Files
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