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Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes.

Wing RR, Lang W, Wadden TA, Safford M, Knowler WC, Bertoni AG, Hill JO, Brancati FL, Peters A, Wagenknecht L, Look AHEAD Research Gro - Diabetes Care (2011)

Bottom Line: Compared with weight-stable participants, those who lost 5 to <10% ([means±SD] 7.25±2.1 kg) of their body weight had increased odds of achieving a 0.5% point reduction in HbA1c (odds ratio 3.52 [95% CI 2.81-4.40]), a 5-mmHg decrease in diastolic blood pressure (1.48 [1.20-1.82]), a 5-mmHg decrease in systolic blood pressure (1.56 [1.27-1.91]), a 5 mg/dL increase in HDL cholesterol (1.69 [1.37-2.07]), and a 40 mg/dL decrease in triglycerides (2.20 [1.71-2.83]).The odds of clinically significant improvements in most risk factors were even greater in those who lost 10-15% of their body weight.Modest weight losses of 5 to <10% were associated with significant improvements in CVD risk factors at 1 year, but larger weight losses had greater benefits.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry and Human Behavior, Brown Medical School, The Miriam Hospital, Providence, Rhode Island, USA. rwing@lifespan.org

ABSTRACT

Objective: Overweight and obese individuals are encouraged to lose 5-10% of their body weight to improve cardiovascular disease (CVD) risk, but data supporting this recommendation are limited, particularly for individuals with type 2 diabetes.

Research design and methods: We conducted an observational analysis of participants in the Look AHEAD (Action For Health in Diabetes) study (n=5,145, 40.5% male, 37% from ethnic/racial minorities) and examined the association between the magnitude of weight loss and changes in CVD risk factors at 1 year and the odds of meeting predefined criteria for clinically significant improvements in risk factors in individuals with type 2 diabetes.

Results: The magnitude of weight loss at 1 year was strongly (P<0.0001) associated with improvements in glycemia, blood pressure, triglycerides, and HDL cholesterol but not with LDL cholesterol (P=0.79). Compared with weight-stable participants, those who lost 5 to <10% ([means±SD] 7.25±2.1 kg) of their body weight had increased odds of achieving a 0.5% point reduction in HbA1c (odds ratio 3.52 [95% CI 2.81-4.40]), a 5-mmHg decrease in diastolic blood pressure (1.48 [1.20-1.82]), a 5-mmHg decrease in systolic blood pressure (1.56 [1.27-1.91]), a 5 mg/dL increase in HDL cholesterol (1.69 [1.37-2.07]), and a 40 mg/dL decrease in triglycerides (2.20 [1.71-2.83]). The odds of clinically significant improvements in most risk factors were even greater in those who lost 10-15% of their body weight.

Conclusions: Modest weight losses of 5 to <10% were associated with significant improvements in CVD risk factors at 1 year, but larger weight losses had greater benefits.

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Related in: MedlinePlus

Change in risk factors by weight loss categories for the Look AHEAD cohort. Data in all figures are presented as least square means and 95% CIs adjusted for clinical sites, age, sex, race/ethnicity, baseline weight, baseline measurement of the outcome variable, and treatment group assignment.
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Figure 1: Change in risk factors by weight loss categories for the Look AHEAD cohort. Data in all figures are presented as least square means and 95% CIs adjusted for clinical sites, age, sex, race/ethnicity, baseline weight, baseline measurement of the outcome variable, and treatment group assignment.

Mentions: Figure 1 shows the least square mean changes for each of the risk factors across the six weight change categories, adjusted for age, sex, race, treatment group assignment, baseline weight, and baseline level of the risk factor. A strong graded association was seen for changes in glucose, HbA1c, SBP, DBP, triglycerides, and HDL cholesterol (all P values <0.0001). Each higher category of weight loss was associated with greater improvements in the risk factor. In contrast, the magnitude of improvement in LDL cholesterol did not differ across the weight categories, even in those not using lipid-lowering medications at baseline and 1 year. There were no significant interactions between baseline weight and weight change categories, except for HDL categories (P < 0.0002), for which the slope of the association between weight change category and change in HDL cholesterol was steepest in those who weighed least at baseline.


Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes.

Wing RR, Lang W, Wadden TA, Safford M, Knowler WC, Bertoni AG, Hill JO, Brancati FL, Peters A, Wagenknecht L, Look AHEAD Research Gro - Diabetes Care (2011)

Change in risk factors by weight loss categories for the Look AHEAD cohort. Data in all figures are presented as least square means and 95% CIs adjusted for clinical sites, age, sex, race/ethnicity, baseline weight, baseline measurement of the outcome variable, and treatment group assignment.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3120182&req=5

Figure 1: Change in risk factors by weight loss categories for the Look AHEAD cohort. Data in all figures are presented as least square means and 95% CIs adjusted for clinical sites, age, sex, race/ethnicity, baseline weight, baseline measurement of the outcome variable, and treatment group assignment.
Mentions: Figure 1 shows the least square mean changes for each of the risk factors across the six weight change categories, adjusted for age, sex, race, treatment group assignment, baseline weight, and baseline level of the risk factor. A strong graded association was seen for changes in glucose, HbA1c, SBP, DBP, triglycerides, and HDL cholesterol (all P values <0.0001). Each higher category of weight loss was associated with greater improvements in the risk factor. In contrast, the magnitude of improvement in LDL cholesterol did not differ across the weight categories, even in those not using lipid-lowering medications at baseline and 1 year. There were no significant interactions between baseline weight and weight change categories, except for HDL categories (P < 0.0002), for which the slope of the association between weight change category and change in HDL cholesterol was steepest in those who weighed least at baseline.

Bottom Line: Compared with weight-stable participants, those who lost 5 to <10% ([means±SD] 7.25±2.1 kg) of their body weight had increased odds of achieving a 0.5% point reduction in HbA1c (odds ratio 3.52 [95% CI 2.81-4.40]), a 5-mmHg decrease in diastolic blood pressure (1.48 [1.20-1.82]), a 5-mmHg decrease in systolic blood pressure (1.56 [1.27-1.91]), a 5 mg/dL increase in HDL cholesterol (1.69 [1.37-2.07]), and a 40 mg/dL decrease in triglycerides (2.20 [1.71-2.83]).The odds of clinically significant improvements in most risk factors were even greater in those who lost 10-15% of their body weight.Modest weight losses of 5 to <10% were associated with significant improvements in CVD risk factors at 1 year, but larger weight losses had greater benefits.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry and Human Behavior, Brown Medical School, The Miriam Hospital, Providence, Rhode Island, USA. rwing@lifespan.org

ABSTRACT

Objective: Overweight and obese individuals are encouraged to lose 5-10% of their body weight to improve cardiovascular disease (CVD) risk, but data supporting this recommendation are limited, particularly for individuals with type 2 diabetes.

Research design and methods: We conducted an observational analysis of participants in the Look AHEAD (Action For Health in Diabetes) study (n=5,145, 40.5% male, 37% from ethnic/racial minorities) and examined the association between the magnitude of weight loss and changes in CVD risk factors at 1 year and the odds of meeting predefined criteria for clinically significant improvements in risk factors in individuals with type 2 diabetes.

Results: The magnitude of weight loss at 1 year was strongly (P<0.0001) associated with improvements in glycemia, blood pressure, triglycerides, and HDL cholesterol but not with LDL cholesterol (P=0.79). Compared with weight-stable participants, those who lost 5 to <10% ([means±SD] 7.25±2.1 kg) of their body weight had increased odds of achieving a 0.5% point reduction in HbA1c (odds ratio 3.52 [95% CI 2.81-4.40]), a 5-mmHg decrease in diastolic blood pressure (1.48 [1.20-1.82]), a 5-mmHg decrease in systolic blood pressure (1.56 [1.27-1.91]), a 5 mg/dL increase in HDL cholesterol (1.69 [1.37-2.07]), and a 40 mg/dL decrease in triglycerides (2.20 [1.71-2.83]). The odds of clinically significant improvements in most risk factors were even greater in those who lost 10-15% of their body weight.

Conclusions: Modest weight losses of 5 to <10% were associated with significant improvements in CVD risk factors at 1 year, but larger weight losses had greater benefits.

Show MeSH
Related in: MedlinePlus