scholarly journals Effect of a long-term intensive lifestyle intervention on prevalence of cognitive impairment

Neurology ◽  
2017 ◽  
Vol 88 (21) ◽  
pp. 2026-2035 ◽  
Author(s):  
Mark A. Espeland ◽  
José A. Luchsinger ◽  
Laura D. Baker ◽  
Rebecca Neiberg ◽  
Steven E. Kahn ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Lifestyle Intervention ◽  
Cognitive Test ◽  
Intervention Effect ◽  
Intensive Lifestyle Intervention

Objective:To assess whether an average of 10 years of lifestyle intervention designed to reduce weight and increase physical activity lowers the prevalence of cognitive impairment among adults at increased risk due to type 2 diabetes and obesity or overweight.Methods:Central adjudication of mild cognitive impairment and probable dementia was based on standardized cognitive test battery scores administered to 3,802 individuals who had been randomly assigned, with equal probability, to either the lifestyle intervention or the diabetes support and education control. When scores fell below a prespecified threshold, functional information was obtained through proxy interview.Results:Compared with control, the intensive lifestyle intervention induced and maintained marked differences in weight loss and self-reported physical activity throughout follow-up. At an average (range) of 11.4 (9.5–13.5) years after enrollment, when participants' mean age was 69.6 (54.9–87.2) years, the prevalence of mild cognitive impairment and probable dementia was 6.4% and 1.8%, respectively, in the intervention group, compared with 6.6% and 1.8%, respectively, in the control group (p = 0.93). The lack of an intervention effect on the prevalence of cognitive impairment was consistent among individuals grouped by cardiovascular disease history, diabetes duration, sex, and APOE ε4 allele status (all p ≥ 0.50). However, there was evidence (p = 0.03) that the intervention effect ranged from benefit to harm across participants ordered from lowest to highest baseline BMI.Conclusions:Ten years of behavioral weight loss intervention did not result in an overall difference in the prevalence of cognitive impairment among overweight or obese adults with type 2 diabetes.Clinicaltrials.gov identifier:NCT00017953 (Action for Health in Diabetes).Level of evidence:This study provides Class II evidence that for overweight adults with type 2 diabetes, a lifestyle intervention designed to reduce weight and increase physical activity does not lower the risk of cognitive impairment.

Abstract 14192: Breakfast Consumption is Associated With Weight Loss During an Intensive Lifestyle Intervention for Adults With Overweight/Obesity and Type 2 Diabetes: Results From the Look AHEAD Trial

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Daisy Duan ◽  
Scott J Pilla ◽  
Jeanne M Clark ◽  
Nisa M Maruthur
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Lifestyle Intervention ◽  
Caloric Intake ◽  
Activity Level ◽  
Breakfast Consumption ◽  
Intensive Lifestyle Intervention ◽  
Look Ahead

Background: Breakfast skipping is linked to obesity and related cardiometabolic outcomes in observational studies, but the association between breakfast eating and weight loss is not well-established. We examined if weight loss outcomes in Look AHEAD were related to breakfast consumption frequency (BCF). Methods: We included a subset of participants (n=3862) from the public access dataset of Look AHEAD, an RCT that compared intensive lifestyle intervention (ILI) to diabetes support and education (DSE) control in adults with overweight/obesity and type 2 diabetes. A self-reported questionnaire collected BCF over a 7-day week annually. This value (0-7) was averaged across 4 years of the intervention to calculate an average BCF. We used robust multivariable linear regression analysis to estimate the association between % weight change and 4-year average BCF controlling for baseline sociodemographics, BMI, and diabetes-related variables. In separate models, we adjusted for self-reported caloric intake (n=880) and self-reported physical activity level (n=735) among those with data. Results: 4-year average BCF was similar in DSE (n=1914) and ILI (n=1948) arms, with a median of 7 days (IQR 6-7) for both arms (p=0.11). Each 1 day increase in average BCF was associated with an additional 0.43% weight loss in the ILI arm (p=0.002) but not in the DSE arm (β-coefficient 0.04% weight loss; p=0.73; p-interaction for arm x BCF=0.01). This association in the ILI arm remained significant after adjustment for daily caloric intake (p=0.04) but not after adjustment for physical activity (p=0.16). Conclusions: Breakfast consumption was associated with greater weight loss in subjects who received ILI, which was attenuated after adjustment for caloric intake and physical activity. To optimize weight loss interventions, the relationship between breakfast consumption and other weight loss behaviors should be further explored.

scholarly journals Does the effect of lifestyle intervention for individuals with diabetes vary by food insecurity status? A preplanned subgroup analysis of the REAL HEALTH randomized clinical trial

2020 ◽  
Vol 8 (1) ◽  
pp. e001514
Author(s):  
Seth A Berkowitz ◽  
Yuchiao Chang ◽  
Bianca Porneala ◽  
Sara J Cromer ◽  
Deborah J Wexler ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trial ◽  
Weight Loss ◽  
Food Security ◽  
Food Insecurity ◽  
Lifestyle Intervention ◽  
Subgroup Analysis ◽  
Intervention Effect ◽  
Food Security Status

IntroductionWe aimed to test the effectiveness of a lifestyle intervention (LI) for individuals with food insecurity and type 2 diabetes.Research design and methodsAdults with type 2 diabetes, body mass index ≥25 kg/m2 (or ≥23 kg/m2 if Asian), hemoglobin A1c of 6.5%–11.5% (48–97 mmol/mol) and who were willing to lose 5%–7% bodyweight were enrolled in REAL HEALTH-Diabetes. This practice-based randomized clinical trial compared LI (delivered inperson or by telephone) with medical nutrition therapy (MNT) on weight loss at 6 and 12 months. Two or more affirmative responses on the six-item US Department of Agriculture Food Security Survey Module indicated food insecurity. In this prespecified subgroup analysis, we tested using linear mixed effects models whether the intervention effect varied by food security status.ResultsOf 208 participants, 13% were food insecure. Those with food insecurity were more likely to be racial/ethnic minorities (p<0.001) and have lower education (p<0.001). LI, versus MNT, led to greater weight loss at 6 months (5.1% lost vs 1.1% lost; p<0.0001) and 12 months (4.7% lost vs 2.0% lost; p=0.0005). The intervention effect was similar regardless of food security status (5.1% bodyweight lost vs 1.1% in food secure participants and 5.1% bodyweight lost vs 1.3% in food insecure participants at 6 months; 4.7% bodyweight lost vs 2.1% in food secure participants and 4.5% bodyweight lost vs 0.9% in food insecure participants at 12 months; p for interaction=0.99).ConclusionsThe REAL HEALTH-Diabetes lifestyle intervention led to meaningful weight loss for individuals with food insecurity and type 2 diabetes.Trial registration numberNCT02320253.

How to Maintain a Healthy Body Weight

2006 ◽  
Vol 76 (4) ◽  
pp. 208-215 ◽  
Author(s):  
Astrup
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Body Weight ◽  
Glycemic Index ◽  
Dairy Products ◽  
Weight Control ◽  
Healthy Body Weight ◽  
Healthy Body

The epidemic of both obesity and type 2 diabetes is due to environmental factors, but the individuals developing the conditions possess a strong genetic predisposition. Observational surveys and intervention studies have shown that excess body fatness is the major environmental cause of type 2 diabetes, and that even a minor weight loss can prevent its development in high-risk subjects. Maintenance of a healthy body weight in susceptible individuals requires 45–60 minutes physical activity daily, a fat-reduced diet with plenty of fruit, vegetables, whole grain, and lean meat and dairy products, and moderate consumption of calorie containing beverages. The use of table values to predict the glycemic index of meals is of little – if any – value, and the role of a low-glycemic index diet for body weight control is controversial. The replacement of starchy carbohydrates with protein from lean meat and lean dairy products enhances satiety, and facilitate weight control. It is possible that dairy calcium also promotes weight loss, although the mechanism of action remains unclear. A weight loss of 5–10% can be induced in almost all obese patients providing treatment is offered by a professional team consisting of a physician and dieticians or nurses trained to focus on weight loss and maintenance. Whereas increasing daily physical activity and regular exercise does not significantly effect the rate of weight loss in the induction phase, it plays an important role in the weight maintenance phase due to an impact on daily energy expenditure and also to a direct enhancement of insulin sensitivity.

scholarly journals Risk factors for developing dementia in type 2 diabetes mellitus patients with mild cognitive impairment

2019 ◽  
Vol Volume 15 ◽  
pp. 167-175 ◽  
Author(s):  
Oana Albai ◽  
Mirela Frandes ◽  
Romulus Timar ◽  
Deiana Roman ◽  
Bogdan Timar
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment

The Role of Disordered Eating in Type 2 Diabetes: A Pilot Study

2021 ◽  
pp. 155982762110024
Author(s):  
Alyssa M. Vela ◽  
Brooke Palmer ◽  
Virginia Gil-Rivas ◽  
Fary Cachelin
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Disordered Eating ◽  
Lifestyle Intervention ◽  
Eating Behaviors ◽  
Diabetes Management ◽  
Behavioral Therapy ◽  
Exercise Stress ◽  
Increased Risk

Rates of type 2 diabetes mellitus continue to rise around the world, largely due to lifestyle factors such as poor diet, overeating, and lack of physical activity. Diet and eating is often the most challenging aspect of management and, when disordered, has been associated with increased risk for diabetes-related complications. Thus, there is a clear need for accessible and evidence-based interventions that address the complex lifestyle behaviors that influence diabetes management. The current study sought to assess the efficacy and acceptability of a pilot lifestyle intervention for women with type 2 diabetes and disordered eating. The intervention followed a cognitive behavioral therapy guided-self-help (CBTgsh) model and included several pillars of lifestyle medicine, including: diet, exercise, stress, and relationships. Ten women completed the 12-week intervention that provided social support, encouraged physical activity, and addressed eating behaviors and cognitions. Results indicate the lifestyle intervention was a feasible treatment for disordered eating behaviors among women with type 2 diabetes and was also associated with improved diabetes-related quality of life. The intervention was also acceptable to participants who reported satisfaction with the program. The current CBTgsh lifestyle intervention is a promising treatment option to reduce disordered eating and improve diabetes management.

Intensive Lifestyle Intervention for Type 2 Diabetes—Reply

JAMA ◽  
2017 ◽  
Vol 318 (24) ◽  
pp. 2494
Author(s):  
Mathias Ried-Larsen ◽  
Mette Yun Johansen ◽  
Bente Klarlund Pedersen
Keyword(s):  
Type 2 Diabetes ◽  
Lifestyle Intervention ◽  
Intensive Lifestyle Intervention
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