In This ArticleView AllIn This ArticleHow Was the Study Conducted?What Did the Study Show?How Does This Apply to Real Life?The Bottom Line
In This ArticleView All
View All
In This Article
How Was the Study Conducted?
What Did the Study Show?
How Does This Apply to Real Life?
The Bottom Line
Close
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Getty Images
We know how important lifestyle factors, includingphysical activityand maintaining a healthy weight, are for diabetes management. The same applies to helping prevent heart disease.
But what about physical activity and weight loss for preventing cardiovascular events in people with diabetes? Do physical activity and weight loss have the same effect when factors are combined? A new study, published on February 22, 2024, inJAMA Network Open,sheds some light on this.
This study was a secondary examination of the data from the Look AHEAD study, a randomized clinical trial that took place at 16 clinical sites. According to a 2016 article inThe Lancet, the Look AHEAD study recruited 5,145 patients, ages 45 to 76, who have type 2 diabetes plus overweight or obesity. Recruitment took place between August 2001 and April 2004, and researchers followed up with participants for about 10 years.
The original Look AHEAD study investigated the cardiovascular benefits of an intensive lifestyle intervention—aiming for at least 7% weight loss from each participant’s baseline body weight—compared to those who received just diabetes support and education.
For this newest round, what is referred to as the sub-study, 1,229 participants met the criteria the researchers were looking for. Participants included men (43.4%) and women of various races and ethnicities.
Researchers first looked at accelerometer data from the first four years of the study. An accelerometer is a wearable device that tracks all movements to determine physical activity levels—as opposed to a pedometer, which just tracks steps taken.
Researchers also looked at average weight loss during the first four years of the study. They chose the first four years because participants received more frequent physical activity measurements, individual supervision and group sessions during this period of the Look AHEAD study.
They then examined participants’ records, looking for nonfatal cardiovascular events, as well as causes of death in participants, which included death from cardiovascular events, like heart attack and stroke, and death from all other causes.
After data was adjusted for several confounders and variables, including age, sex, race and other medical conditions, several statistical analyses were run.
Compared to participants with low physical activity and no weight loss, those with high physical activity levels plus weight loss had a significantly lower risk of cardiovascular events.
Researchers also found:
Keeping in mind that these individuals fell into being categorized as having overweight or obesity at the time, perhaps the most interesting finding was that weight loss alone was not associated with a statistically significant reduction in cardiovascular events risk—nor was physical activity alone. It was the combination of physical activity with weight loss that significantly reduced the risk of cardiovascular events.
Specifically, higher physical activity combined with weight loss of at least 7% of baseline body weight resulted in a 61% reduction in what researchers called the “composite cardiovascular outcome,” which included death from cardiovascular causes, nonfatal myocardial infarction (heart attack), nonfatal stroke or hospitalization for angina.
“This study highlights the association between combined weight loss and increased physical activity with a reduced risk of cardiovascular events in individuals with type 2 diabetes and overweight or obesity,” concluded the study authors. “First, maintaining a high physical activity volume and losing weight are important, but the combination may be more beneficial in this population.”
According to theCenters for Disease Control and Prevention, people who have diabetes are twice as likely to have heart disease or a stroke compared to people who don’t have diabetes. And the longer you have diabetes, the more likely you are to have heart disease.
We also know that exercise, including strength training, can reduce the risk of heart disease and diabetes. And research supports the importance maintaining ahealthy weight to reduce the risk of diabetesand heart disease, too.
As the study authors said, being physically active and losing weight (if you need to) each on their own will have some benefits.
It’s important to note that “losing weight” isn’t something that just happens. It’s the lifestyle behaviors you engage in that influence your weight (along with other things, like genetics and hormones).
And while the combination of physical activity and weight loss had more benefits than each one on their own in this study, there is evidence from other studies that focusing on weight loss alone may not work for lasting change, is stressful and ultimately can result in weight regain. Rather, shifting the focus from weight loss to increasing physical activity and improving cardiorespiratory fitness lowers the risk of death.
This study focused on physical activity and weight loss in people with diabetes who were also categorized as having overweight or obesity. The participants who had higher levels of physical activity and lost at least 7% of their body weight had a 61% lower risk of cardiovascular events compared to those with low physical activity and no weight loss. If you’re not already physically active and aren’t sure where to begin, this12-week walking planmay be a good place to start.
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