Benefits of Modest Weight Loss in Improving Cardiovascular Risk Factors in Overweight and Obese Individuals With Type 2 Diabetes
- Rena R. Wing, PHD1⇓,
- Wei Lang, PHD2,
- Thomas A. Wadden, PHD3,
- Monika Safford, MD4,
- William C. Knowler, MD, DRPH5,
- Alain G. Bertoni, MD6,
- James O. Hill, PHD7,
- Frederick L. Brancati, MD8,
- Anne Peters, MD9,
- Lynne Wagenknecht, DRPH6 and
- the Look AHEAD Research Group*
- 1Department of Psychiatry & Human Behavior, Brown Medical School, The Miriam Hospital, Providence, Rhode Island
- 2Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
- 3Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
- 4Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- 5Diabetes Epidemiology and Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona
- 6Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina
- 7Centers for Human Nutrition, University of Colorado Health Sciences Center, Denver, Colorado
- 8Department of Medicine, Johns Hopkins University, Baltimore, Maryland
- 9Roybal Comprehensive Health Center, Los Angeles, California
- Corresponding author: Rena R. Wing, .
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.
This article contains Supplementary Data online at http://care.diabetesjournals.org/lookup/suppl/doi:10.2337/dc10-2415/-/DC1.
- Received December 22, 2010.
- Accepted April 8, 2011.
- © 2011 by the American Diabetes Association.
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