TY - JOUR
T1 - Effect of improved fitness beyond weight loss on cardiovascular risk factors in individuals with type 2 diabetes in the Look AHEAD study
AU - Gibbs, Bethany Barone
AU - Brancati, Frederick L.
AU - Chen, Haiying
AU - Coday, MacE
AU - Jakicic, John M.
AU - Lewis, Cora E.
AU - Stewart, Kerry J.
AU - Clark, Jeanne M.
N1 - Funding Information:
This study was supported by the Department of Health and Human Services through the following cooperative agreements from the National Institutes of Health: DK57136, DK57149, DK56990, DK57177, DK57171, DK57151, DK57182, DK57131, DK57002, DK57078, DK57154, DK57178, DK57219, DK57008, DK57135, and DK56992. The following federal agencies have contributed support: 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; the Centers for Disease Control and Prevention; and the Department of Veterans Affairs. This research was supported in part by the Intramural Research Program of the National Institute of Diabetes and Digestive and Kidney Diseases. The Indian Health Service (IHS) provided personnel, medical oversight, and use of facilities. Additional support was received from The Johns Hopkins Bayview General Clinical Research Center (M01RR02719); the Diabetes Prevention & Control Core of the Baltimore Diabetes Research and Training Center (P60 DK079637); the Massachusetts General Hospital Mallinckrodt General Clinical Research Center and the Massachusetts Institute of Technology General Clinical Research Center (M01RR01066); the University of Colorado Health Sciences Center General Clinical Research Center (M01RR00051) and Clinical Nutrition Research Unit (P30 DK48520); the University of Tennessee at Memphis General Clinical Research Center (M01RR0021140); the University of Pittsburgh General Clinical Research Center (GCRC) (M01RR000056), the Clinical Translational Research Center (CTRC) funded by the Clinical & Translational Science Award (UL1 RR 024153) and NIH grant (DK 046204); and the Frederic C. Bartter General Clinical Research Center (M01RR01346).
PY - 2014/5
Y1 - 2014/5
N2 - Background: Because lifestyle-induced improvements in cardiovascular risk factors vary substantially across individuals with type 2 diabetes, we investigated the extent to which increases in fitness explain cardiovascular risk factor improvements independent of weight loss in a lifestyle intervention. Methods: We studied 1-year changes in Look AHEAD, a randomized trial comparing an intensive lifestyle intervention (ILI) to a diabetes support and education (DSE) control group in adults with type 2 diabetes. Assessments included weight, fitness, blood pressure (BP), glucose, HbA1c, and lipids.We evaluated the effects of changes in weight and fitness on changes in cardiovascular risk factors by study arm, using R2 from multiple linear regression. Results: Analyses included participants with fitness data at baseline and 1-year (n=4408; 41% male, 36% non-white; mean age 58.7 6.8 years). Weight change alone improved R2 for explaining changes in risk factors up to 8.2% in ILI and 1.7% in DSE. Fitness change alone improved R2 up to 3.9% in ILI and 0.8% in DSE. After adjusting for weight change, fitness was independently associated (p<0.05) with improvements in R2 for glucose (+0.7%), HbA1c (+1.1%), highdensity lipoprotein (HDL) cholesterol (+0.4%), and triglycerides (+0.2%) in ILI and diastolic BP (+0.3%), glucose (+0.3%), HbA1c (+0.4%), and triglycerides (+0.1%) in DSE. Taken together, weight and fitness changes explained from 0.1-9.3% of the variability in cardiovascular risk factor changes. Conclusion: Increased fitness explained statistically significant but small improvements in several cardiovascular risk factors beyond weight loss. Further research identifying other factors that explain cardiovascular risk factor change is needed.
AB - Background: Because lifestyle-induced improvements in cardiovascular risk factors vary substantially across individuals with type 2 diabetes, we investigated the extent to which increases in fitness explain cardiovascular risk factor improvements independent of weight loss in a lifestyle intervention. Methods: We studied 1-year changes in Look AHEAD, a randomized trial comparing an intensive lifestyle intervention (ILI) to a diabetes support and education (DSE) control group in adults with type 2 diabetes. Assessments included weight, fitness, blood pressure (BP), glucose, HbA1c, and lipids.We evaluated the effects of changes in weight and fitness on changes in cardiovascular risk factors by study arm, using R2 from multiple linear regression. Results: Analyses included participants with fitness data at baseline and 1-year (n=4408; 41% male, 36% non-white; mean age 58.7 6.8 years). Weight change alone improved R2 for explaining changes in risk factors up to 8.2% in ILI and 1.7% in DSE. Fitness change alone improved R2 up to 3.9% in ILI and 0.8% in DSE. After adjusting for weight change, fitness was independently associated (p<0.05) with improvements in R2 for glucose (+0.7%), HbA1c (+1.1%), highdensity lipoprotein (HDL) cholesterol (+0.4%), and triglycerides (+0.2%) in ILI and diastolic BP (+0.3%), glucose (+0.3%), HbA1c (+0.4%), and triglycerides (+0.1%) in DSE. Taken together, weight and fitness changes explained from 0.1-9.3% of the variability in cardiovascular risk factor changes. Conclusion: Increased fitness explained statistically significant but small improvements in several cardiovascular risk factors beyond weight loss. Further research identifying other factors that explain cardiovascular risk factor change is needed.
KW - Cardiovascular risk factor
KW - fitness
KW - lifestyle intervention
KW - obesity
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U2 - 10.1177/2047487312462823
DO - 10.1177/2047487312462823
M3 - Article
C2 - 23012688
AN - SCOPUS:84900436076
SN - 2047-4873
VL - 21
SP - 608
EP - 617
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
IS - 5
ER -