Journal
DIABETES CARE
Volume 39, Issue 8, Pages 1345-1355Publisher
AMER DIABETES ASSOC
DOI: 10.2337/dc16-0509
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Funding
- Department of Health and Human Services through the following cooperative agreements with the National Institutes of Health [DK-57136, DK-57149, DK-56990, DK-57177, DK-57171, DK-57151, DK-57182, DK-57131, DK-57002, DK-57078, DK-57154, DK-57178, DK-57219, DK-57008, DK-57135, DK-56992]
- National Institute of Diabetes and Digestive and Kidney Diseases
- National Heart, Lung, and Blood Institute
- National Institute of Nursing Research
- National Center on Minority Health and Health Disparities
- Office of Research on Women's Health
- Centers for Disease Control and Prevention
- Department of Veterans Affairs
- Intramural Research Program of the National Institute of Diabetes and Digestive and Kidney Diseases
- Johns Hopkins Medical Institutions Bayview General Clinical Research Center [M01-RR-02719]
- Massachusetts General Hospital Mallinckrodt General Clinical Research Center and the Massachusetts Institute of Technology General Clinical Research Center [M01-RR-01066]
- University of Colorado Health Sciences Center General Clinical Research Center [M01-RR-00051]
- Clinical Nutrition Research Unit [P30-DK-48520]
- University of Tennessee at Memphis General Clinical Research Center [M01-RR-0021140]
- University of Pittsburgh General Clinical Research Center [M01-RR-000056]
- Clinical and Translational Science Award [UL1 RR 024153]
- National Institutes of Health [DK-046204]
- Frederic C. Bartter General Clinical Research Center [M01-RR-01346]
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OBJECTIVEShort-term weight loss improves cardiovascular disease (CVD) risk factors. We sought to determine the longer-term effects of maintaining weight loss or, conversely, regaining weight.RESEARCH DESIGN AND METHODSWe used data from Action for Health in Diabetes (Look AHEAD), a randomized trial of intensive lifestyle intervention (ILI) compared to a control condition in overweight/obese individuals with type 2 diabetes. ILI participants were grouped according to weight change patterns, as follows: 1) no weight loss (3% at years 1 and 4); 2) moderate weight loss (3-8% at years 1 and 4); 3) large weight loss (8-20% at years 1 and 4); 4) moderate loss/full regain (3-8% at year 1/3% at year 4); 5) large loss/full regain (8-20% at year 1/+/- 3% year 4); and 6) large loss/partial regain (8-20% at year 1/3-8% at year 4) and changes in CVD risk factors were compared.RESULTSAdjusting for baseline differences and medication use, larger weight losses produced greater improvements in HbA(1c), systolic blood pressure, HDL cholesterol, and triglycerides at years 1 and 4 (all P 0.02). Despite maintenance of weight loss, HbA(1c) levels worsened between years 1 and 4, and remained below baseline only in those with large weight losses. We found no negative associations of losing and regaining weight relative to not having lost weight. Moreover, those who had large initial weight loss but full regain of weight had greater improvements in HbA(1c) levels at year 4 than those with smaller or no initial weight loss.CONCLUSIONSLarger initial weight loss should be encouraged in individuals with type 2 diabetes, despite the possibility of regain.
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