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Oct 26, 2012

Exercise and Diet Remain Important for Diabetes Prevention and Control

Study shows that lifestyle intervention improves weight, fitness, blood pressure, and cholesterol in adults with diabetes, but doesn’t reduce cardiovascular risk.

Many of us were surprised to hear that one of the largest studies testing lifestyle interventions to reduce cardiovascular risk in diabetics was recently cut short. This study, coined the Look AHEAD (Action for Health in Diabetes) study, had been in the works for 11 years and involved nearly 5,150 overweight adults with diabetes.

For participants receiving the intensive lifestyle intervention, which included frequent counseling and support for diet modification and physical activity, the intervention meant significant improvements in numerous markers of health. One year into the study, participants receiving the intervention lost as much as 10% of their body weight and were able to keep most of it off in the following three years. They also saw significant improvements in blood pressure, cholesterol, and fitness compared to those who received standard education and counseling. 

So why was the study stopped? Although the intervention helped participants control their cardiovascular risk factors, this did not translate into reduced risk for heart disease. In other words, diabetic patients in both the intervention and “standard care” group had the same risk for heart disease, stroke, death and hospitalization down the road, despite differences in certain markers of health.

While the results of Look AHEAD are disappointing, there is still much we can learn from study findings. First, the lifestyle intervention program helped improve many markers of health in overweight adults with diabetes when compared with education alone. In the end, while this didn’t translate into reduced heart disease events, it could have important impact on other health outcomes or quality of life for diabetic patients. So for those with diabetes, it’s important to not stop exercising or to begin eating whatever you want. Many studies show that weight loss and exercise can help control and even reverse diabetes in some, so it’s still important to stay active and maintain a healthy weight. And for those without diabetes, we know for sure that exercise and diet have the power to prevent diabetes altogether. For anyone who is pre-diabetic or simply interested in improving their heart health, diet and exercise are always the best ways to help prevent diabetes and heart disease and promote better health. 

Questions for You to Consider

  • How did the intensive lifestyle intervention differ from the "standard care" group?

  • Patients in the lifestyle intervention group received individualized counseling and support designed to help patients change their diet (limit calorie and fat consumption, increase protein intake) and increase physical activity. Patients in the “standard care” group were only invited to a few group sessions a year, which were not individualized and focused on education around diet, physical activity and social support.
  • If the intervention was effective in reducing weight, why was the study stopped early?

  • Although the intervention helped promote weight loss, the ultimate goal of the study was to see if the intervention reduced cardiovascular risk. Once they found that the intervention did not have a significant impact on cardiovascular risk, the study was ended.

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