Exercise Capacity and Cardiovascular/Metabolic Characteristics of Overweight and Obese Individuals With Type 2 Diabetes
The Look AHEAD clinical trial
- Paul M. Ribisl, PHD1,
- Wei Lang, PHD2,
- Sarah A. Jaramillo, MS2,
- John M. Jakicic, PHD3,
- Kerry J. Stewart, EDD4,
- Judy Bahnson, MS2,
- Renee Bright, MS5,
- Jeff F. Curtis, MD6,
- Richard S. Crow, MD7,
- Judith E. Soberman, MD8 and
- on behalf of the Look AHEAD Research Group
- 1Health and Exercise Sciences, Department of Biostatistical Sciences, Wake Forest University, Winston-Salem, North Carolina
- 2Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
- 3Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, Pennsylvania
- 4Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland
- 5Department of Behavioral and Preventive Medicine, Brown Medical School/Miriam Hospital, Brown University, Providence, Rhode Island
- 6Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona
- 7Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
- 8Division of Cardiology, Department of Medicine, University of Tennessee, Memphis, Tennessee
- Address correspondence and reprint requests to Paul M. Ribisl, PhD, Health and Exercise Sciences, Wake Forest University, Wake Forest Road, Winston-Salem, NC 27109. E-mail: ribisl{at}wfu.edu
Abstract
OBJECTIVE— We examined associations of cardiovascular, metabolic, and body composition measures with exercise capacity using baseline data from 5,145 overweight and/or obese (BMI ≥25.0 kg/m2) men and women with type 2 diabetes who were randomized participants for the Look AHEAD (Action for Health in Diabetes) clinical trial.
RESEARCH DESIGN AND METHODS— Peak exercise capacity expressed as METs and estimated from treadmill speed and grade was measured during a graded exercise test designed to elicit a maximal effort. Other measures included waist circumference, BMI, type 2 diabetes duration, types of medication used, A1C, history of cardiovascular disease, metabolic syndrome, β-blocker use, and race/ethnicity.
RESULTS— Peak exercise capacity was higher for men (8.0 ± 2.1 METs) than for women (6.7 ± 1.7 METs) (P < 0.001). Exercise capacity also decreased across each decade of age (P < 0.001) and with increasing BMI and waist circumference levels in both sexes. Older age, increased waist circumference and BMI, a longer duration of diabetes, increased A1C, a history of cardiovascular disease, having metabolic syndrome, β-blocker use, and being African American compared with being Caucasian were associated with a lower peak exercise capacity for both sexes. Hypertension and use of diabetes medications were associated with lower peak exercise capacity in women.
CONCLUSIONS— Individuals with diabetes who are overweight or obese have impaired exercise capacity, which is primarily related to age, female sex, and race, as well as poor metabolic control, BMI, and central obesity.
Footnotes
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Published ahead of print at http://care.diabetesjournals.org on 20 July 2007. DOI: 10.2337/dc06-2487. Clinical trial reg. no. NCT00017953, clinicaltrials.gov.
Additional information for this article can be found in an online appendix at http://dx.doi.org/10.2337/dc06-2487.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.
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- Accepted July 12, 2007.
- Received December 7, 2006.
- DIABETES CARE
