Benefits of Modest Weight Loss in Improving Cardiovascular Risk Factors in Overweight and Obese Individuals With Type 2 Diabetes

  1. the Look AHEAD Research Group*
  1. 1Department of Psychiatry & Human Behavior, Brown Medical School, The Miriam Hospital, Providence, Rhode Island
  2. 2Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
  3. 3Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
  4. 4Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama
  5. 5Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona
  6. 6Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina
  7. 7Centers for Human Nutrition, University of Colorado Health Sciences Center, Denver, Colorado
  8. 8Department of Medicine, Johns Hopkins University, Baltimore, Maryland
  9. 9Roybal Comprehensive Health Center, Los Angeles, California
  1. Corresponding author: Rena R. Wing, rwing{at}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, tryiglycerides, 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.

Footnotes

  • Received December 22, 2010.
  • Accepted April 8, 2011.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

| Table of Contents

This Article

  1. Diabetes Care vol. 34 no. 7 1481-1486
  1. Supplementary Data
  2. All Versions of this Article:
    1. dc10-2415v1
    2. 34/7/1481 most recent