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Effect of improved fitness beyond weight loss on cardiovascular risk factors in individuals with type 2 diabetes in the Look AHEAD study.
Eur J Prev Cardiol 2014; 21(5):608-17EJ

Abstract

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 R (2) 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 R (2) for explaining changes in risk factors up to 8.2% in ILI and 1.7% in DSE. Fitness change alone improved R (2) 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 R (2) for glucose (+0.7%), HbA1c (+1.1%), high-density 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.

Authors+Show Affiliations

The Johns Hopkins Bloomberg School of Public Health and School of Medicine, Baltimore, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23012688

Citation

Gibbs, Bethany Barone, et al. "Effect of Improved Fitness Beyond Weight Loss On Cardiovascular Risk Factors in Individuals With Type 2 Diabetes in the Look AHEAD Study." European Journal of Preventive Cardiology, vol. 21, no. 5, 2014, pp. 608-17.
Gibbs BB, Brancati FL, Chen H, et al. Effect of improved fitness beyond weight loss on cardiovascular risk factors in individuals with type 2 diabetes in the Look AHEAD study. Eur J Prev Cardiol. 2014;21(5):608-17.
Gibbs, B. B., Brancati, F. L., Chen, H., Coday, M., Jakicic, J. M., Lewis, C. E., ... Clark, J. M. (2014). Effect of improved fitness beyond weight loss on cardiovascular risk factors in individuals with type 2 diabetes in the Look AHEAD study. European Journal of Preventive Cardiology, 21(5), pp. 608-17. doi:10.1177/2047487312462823.
Gibbs BB, et al. Effect of Improved Fitness Beyond Weight Loss On Cardiovascular Risk Factors in Individuals With Type 2 Diabetes in the Look AHEAD Study. Eur J Prev Cardiol. 2014;21(5):608-17. PubMed PMID: 23012688.
* Article titles in AMA citation format should be in sentence-case
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, AU - ,, Y1 - 2012/09/25/ PY - 2012/9/27/entrez PY - 2012/9/27/pubmed PY - 2014/12/15/medline KW - Cardiovascular risk factor KW - fitness KW - lifestyle intervention KW - obesity SP - 608 EP - 17 JF - European journal of preventive cardiology JO - Eur J Prev Cardiol VL - 21 IS - 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 R (2) 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 R (2) for explaining changes in risk factors up to 8.2% in ILI and 1.7% in DSE. Fitness change alone improved R (2) 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 R (2) for glucose (+0.7%), HbA1c (+1.1%), high-density 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. SN - 2047-4881 UR - https://www.unboundmedicine.com/medline/citation/23012688/Effect_of_improved_fitness_beyond_weight_loss_on_cardiovascular_risk_factors_in_individuals_with_type_2_diabetes_in_the_Look_AHEAD_study_ L2 - http://journals.sagepub.com/doi/full/10.1177/2047487312462823?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -