Correlates of cardiorespiratory fitness among overweight or obese individuals with type 2 diabetes

IntroductionMechanistic studies suggest that type 2 diabetes is independently associated with low cardiorespiratory fitness (CRF). Little is known about the CRF profile in type 2 diabetes; we assessed the correlates of low CRF among overweight/obese adults with type 2 diabetes.Research design and methodsA total of 4215 participants with type 2 diabetes and without cardiovascular disease underwent maximal exercise testing in the Look AHEAD (Action for Health in Diabetes) study. Low CRF was defined based on the Aerobics Center Longitudinal Study reference standards. Calorie intake and physical activity were assessed using questionnaires. Body fat composition was assessed using dual-energy X-ray absorptiometry.ResultsWaist circumference, systolic blood pressure, glycemic measures, whole body fat, caloric intake, and fat-free mass were inversely associated with fitness across sex (all p<0.001). Comparing with moderate or high CRF groups, the low CRF group was associated with higher adjusted odds of obesity (OR 3.19 (95% CI 1.95 to 5.20) in men, 3.86 (95% CI 2.55 to 5.84)) in women), abdominal obesity (OR 3.99 (95% CI 2.00 to 7.96) in men, 2.28 (95% CI 1.08 to 4.79) in women), hypertension (OR 1.74 (95% CI 1.09 to 2.77) in men, 1.44 (95% CI 1.02 to 2.05) in women), metabolic syndrome (OR 5.52 (95% CI 2.51 to 12.14) in men, 2.25 (95% CI 1.35 to 3.76) in women), use of beta-blocker (1.22 (95% CI 0.86 to 1.73) in men, 1.33 (95% CI 1.03 to 1.73) in women), and ACE inhibitor/angiotensin-receptor blocker (1.86 (95% CI 1.39 to 2.50) in men, 1.07 (95% CI 0.86 to 1.32) in women). Women with low CRF had higher odds of current smoking (2.02 (95% CI 1.25 to 3.28)).ConclusionsLow CRF was associated with increased odds of cardiometabolic correlates in a large cohort of adults with type 2 diabetes.

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170-OR: Association of Timing of Physical Activity Bouts with Cardiorespiratory Fitness in Adults with Type 2 Diabetes in the Look AHEAD Study

Diabetes ◽

10.2337/db20-170-or ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 170-OR

Author(s):

JINGYI QIAN ◽

MICHAEL P. WALKUP ◽

SHYH-HUEI CHEN ◽

PETER H. BRUBAKER ◽

DALE BOND ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Cardiorespiratory Fitness ◽

Look Ahead ◽

The Look

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Four-Year Change in Cardiorespiratory Fitness and Influence on Glycemic Control in Adults With Type 2 Diabetes in a Randomized Trial: The Look AHEAD Trial

Diabetes Care ◽

10.2337/dc12-0712 ◽

2012 ◽

Vol 36 (5) ◽

pp. 1297-1303 ◽

Cited By ~ 41

Author(s):

J. M. Jakicic ◽

C. M. Egan ◽

A. N. Fabricatore ◽

S. A. Gaussoin ◽

S. P. Glasser ◽

...

Keyword(s):

Type 2 Diabetes ◽

Glycemic Control ◽

Randomized Trial ◽

Cardiorespiratory Fitness ◽

Look Ahead ◽

The Look

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Effect of a lifestyle intervention on change in cardiorespiratory fitness in adults with type 2 diabetes: results from the Look AHEAD Study

International Journal of Obesity ◽

10.1038/ijo.2008.280 ◽

2009 ◽

Vol 33 (3) ◽

pp. 305-316 ◽

Cited By ~ 83

Author(s):

J M Jakicic ◽

◽

S A Jaramillo ◽

A Balasubramanyam ◽

B Bancroft ◽

...

Keyword(s):

Type 2 Diabetes ◽

Lifestyle Intervention ◽

Cardiorespiratory Fitness ◽

Look Ahead ◽

The Look

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1526-P: Time-Dependent Effect of Kidney Disease on All-Cause and CVD Mortality in Adults with Type 2 Diabetes: A Secondary Analysis of the Look AHEAD Clinical Trial

Diabetes ◽

10.2337/db20-1526-p ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 1526-P

Author(s):

ANDREW C. WILLS ◽

WILLIAM C. KNOWLER

Keyword(s):

Type 2 Diabetes ◽

Clinical Trial ◽

Secondary Analysis ◽

Time Dependent ◽

Dependent Effect ◽

Look Ahead ◽

Time Dependent Effect ◽

The Look ◽

Cvd Mortality

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Does Lifestyle Intervention Improve Health of Adults with Overweight/Obesity and Type 2 Diabetes: Findings from the Look AHEAD Randomized Trial

Obesity ◽

10.1002/oby.23158 ◽

2021 ◽

Author(s):

Rena R. Wing ◽

Keyword(s):

Type 2 Diabetes ◽

Randomized Trial ◽

Lifestyle Intervention ◽

Look Ahead ◽

The Look ◽

Improve Health

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Association Between Change in Accelerometer-Measured and Self-Reported Physical Activity and Cardiovascular Disease in the Look AHEAD Trial

10.2337/figshare.17157926 ◽

2022 ◽

Author(s):

John M. Jakicic ◽

Robert I. Berkowitz ◽

Paula Bolin ◽

George A. Bray ◽

Jeanne M. Clark ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Proportional Hazards ◽

Secondary Analysis ◽

Cox Proportional Hazards ◽

Self Report ◽

Look Ahead ◽

The Look

OBJECTIVE: To conduct post-hoc secondary analysis examining the association between change in physical activity (PA), measured with self-report and accelerometry, from baseline to 1 and 4 years and cardiovascular disease (CVD) outcomes in the Look AHEAD Trial. RESEARCH DESIGN AND METHODS: Participants were adults with overweight/obesity and type 2 diabetes with PA data at baseline and year 1 or 4 (n = 1,978). Participants were randomized to diabetes support and education or intensive lifestyle intervention. Measures included accelerometry-measured moderate-to-vigorous PA (MVPA), self-reported PA, and composite (morbidity and mortality) CVD outcomes. RESULTS: In pooled analyses of all participants, using Cox proportional hazards models, each 100 MET-min/wk increase in accelerometry-measured MVPA from baseline to 4 years was associated with decreased risk of the subsequent primary composite outcome of CVD. Results were consistent for changes in total MVPA [HR=0.97 (95% CI: 0.95, 0.99)] and MVPA accumulated in >10-minute bouts [HR=0.95 (95% CI: 0.91, 0.98)], with a similar pattern for secondary CVD outcomes. Change in accelerometry-measured MVPA at 1 year and self-reported change in PA at 1 and 4 years were not associated with CVD outcomes. CONCLUSIONS: Increased accelerometry-measured MVPA from baseline to year 4 is associated with decreased risk of CVD outcomes. This suggests the need for long-term engagement in MVPA to reduce the risk of CVD in adults with overweight/obesity and type 2 diabetes.

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