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Wing reports serving on a scientific advisory board for Noom. Please see the study for all other authors’ relevant financial disclosures.
Intensive lifestyle intervention participants in the Look AHEAD randomized controlled trial who lost at least 10% of their body weight had a lower mortality risk compared with those in the control group, according to study data.
In a secondary exploratory analysis of follow-up data from Look AHEAD — in which adults aged 45 to 76 years with type 2 diabetes and a BMI of at least 25 kg/m2 were randomly assigned to an intensive lifestyle intervention or a control group receiving diabetes support and education — no difference in mortality risk was observed between intervention and control participants. However, researchers found a significantly lower risk for death in a subgroup of intervention participants who lost more weight.
Wing is a professor of psychiatry and human behavior at Brown Medical School.
“Lifestyle intervention had many other benefits, but larger weight losses may be needed for it to influence mortality in individuals with type 2 diabetes and overweight or obesity,” Rena R. Wing, PhD, professor of psychiatry and human behavior at Brown Medical School, told Healio.
Wing and colleagues followed 5,145 participants in the Look AHEAD trial for a median of 16.7 years. Participants were randomly assigned to an intensive lifestyle intervention group attending weekly group and individual sessions emphasizing behavioral strategies for weight loss for 6 months (n = 2,570) or to a diabetes support and education group attending three to four group meetings per year focused on education about diet, exercise and social support without individualized plans or feedback. Mortality data were adjudicated by a physician committee masked to the intervention assignments. Deaths reported from randomization through June 30, 2020, were included and categorized as cancer, cardiovascular or other.
The findings were published in Diabetes Care.
During the follow-up period, 21% of participants in the intensive lifestyle intervention group and 23% of the diabetes support and education group died. There was no significant difference in mortality risk between the two groups, nor was there a significant interaction between the intervention and time period. Specific causes of death also did not differ between the two groups. No significant associations were observed in sex, age, race and ethnicity and history of cardiovascular disease subgroups.
Researchers conducted a secondary post hoc analysis in which participants in the intensive lifestyle intervention group were divided into subgroups based on the percentage of weight lost in the first year of the intervention. Adults in the intervention group who lost 10% or more body weight at 1 year had a lower risk for mortality compared with all participants in the diabetes support and education group (HR = 0.8; 95% CI, 0.67-0.94; P = .007).
“It may be important to aim for weight losses of 10% or more to reduce mortality risk,” Wing said.
Wing added that it is important to continue following the Look AHEAD participants over a longer period to determine longer-term effects and risk of intensive lifestyle intervention.
For more information:
Rena R. Wing, PhD, can be reached at rwing@lifespan.org.
