Effect of Weight Loss With Lifestyle Intervention on Risk of Diabetes
Article Figures & Tables
Figures
- Figure 1—
Diabetes incidence (per 100 person-years) by change in weight after baseline among DPP ILS participants based on the multivariate model in Table 2. •, overall risk in the group at the mean weight loss over an average of 3.2 years of follow-up.
- Figure 2—
HRs for diabetes onset over 3.2 years of follow-up in DPP ILS subgroups defined by meeting intervention goals at 1 year compared with those meeting none of the goals (group 1). The solid line is adjusted for baseline covariates used in Table 2 (other than IGR and insulin); the dashed line is also adjusted for weight change over time. ♦, adjusted HRs; •, adjusted HRs plus weight change.
Tables
- Table 1—
Weight, physical activity, and diet at baseline and annual changes from baseline among participants in the ILS group: DPP, 1996–2001
Baseline Year 1 Year 2 Year 3 Mean (25th–75th percentile)* Mean change (25th–75th percentile)* Mean change (25th–75th percentile)* Mean change (25th–75th percentile)* Weight n 1,079 1,023 999 638 Weight (kg) 94.1 (79.2–105.1) −6.8 (−10.0 to −2.6)† −5.4 (−8.5 to −1.10)† −4.1 (−7.3 to 0.0)† BMI (kg/m2) 33.9 (28.9–37.2) −2.4 (−3.5 to −1.0)† −1.9 (−3.0 to −0.4)† −1.5 (−2.7 to 0.0)† Percent weight loss — 7.2 (3.0–10.5)† 5.8 (1.2–9.8)† 4.5 (0–8.5)† Energy expenditure n 1,077 1,013 995 635 Modifiable Activity Questionnaire (MET hours/week)‡ 15.5 (3.8–19.3) +6.6 (−0.1 to +14.4)† +5.7 (−0.7 to +13.9)† +4.3 (−2.3 to +13.1)† Low Level Physical Activity Recall (MET hours/week)§ 67.1 (36.3–91.1) +8.3 (−15.1 to +30.9)† +8.0 (−17.0 to +33.9)† +8.1 (−19.3 to +35.2)† Energy intake‖ n 1,054 987 — — Total kcal/day 2,137 (1,452–2,550) −452.3 (−803.3 to +29.0)† — — Total fat/day (g) 83.0 (49.3–102.5) −30.3 (−47.6 to −6.3)† — — Percent of calories from fat 34.1 (29.6–38.5) −6.6 (−10.9 to −1.9)† — — - *
↵* Twenty-fifth to 75th percentile of change in variable.
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↵† P < 0.0001 compared with baseline value by paired t test.
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↵‡ One-year recall using Modifiable Activity Questionnaire (see research design and methods).
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↵§ Seven-day recall using Low Level Physical Activity Recall (see research design and methods).
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↵‖ Diet information was not collected after year 1 (see research design and methods).
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- Table 2—
Univariate and multivariate association of weight loss, behavioral, and metabolic variables on lower diabetes incidence in participants in the ILS group: DPP, 1996–2001
Variables (unit change) Model Models assessing one characteristic at a time* R2 (%)§ Multivariate model† HR (95% CI)‡ P HR (95% CI)‡ P R2 (%)§ Baseline variables Lower weight (10 kg) 1 0.81 (0.75–0.86) <0.0001 3.46 0.88 (0.81–0.96) 0.003 0.82 Higher leisure physical activity (MAQ)(5 MET hours/week) 2 1.00 (0.96–1.05) 0.89 0.00 1.00 (0.96–1.04) 0.98 0.00 Higher recreational activity (LoPAR)(20 MET hours/week) 3 1.12 (1.01–1.23) 0.03 0.42 1.08 (0.97–1.20) 0.16 0.19 Lower percent of calories from fat (5%) 4 0.96 (0.84–1.10) 0.57 0.03 0.91 (0.79–1.05) 0.19 0.16 Follow-up variables Weight loss (5 kg) 1 0.49 (0.43–0.57) <0.0001 7.55 0.42 (0.35–0.50) <0.0001 8.09 Higher leisure physical activity (MAQ)(5 MET hours/week) 2 0.95 (0.88–1.02) 0.17 0.17 0.97 (0.90–1.05) 0.50 0.04 Higher recreational activity (LoPAR)(5 MET hours/week) 3 0.99 (0.97–1.02) 0.66 0.01 0.99 (0.96–1.02) 0.45 0.05 Lower percent of calories from fat (5%) 4 0.75 (0.63–0.88) 0.0007 1.06 0.93 (0.77–1.12) 0.42 0.06 - *
↵* Baseline proportional hazards models (1–4) include baseline and follow-up (time-dependent) variables for each characteristic and are also adjusted for baseline demographic factors (age, sex, race/ethnic group, and weight). Separate models are shown with numbers.
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† Multivariate proportional hazards model includes all baseline and follow-up (time-dependent) variables shown, as well as age, sex, ethnic group, HbA1c, and baseline fasting measures of insulin, glucose, and IGR.
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↵‡ HRs for specified unit differences: <1 indicates less diabetes at follow-up; >1 indicates more diabetes.
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↵§ Partial R2 indicates the proportion of explained variance in predicting the development of diabetes at a specified time point. LoPAR, Low Level Physical Activity Recall questionnaire; MAQ, Modifiable Activity Questionnaire.
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