Weight loss, increased fitness improve mobility in adults; Findings from NIH Study could lead to lower diabetes health care costs
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Pennington Biomedical Research Center's Look AHEAD Research Included in the Analysis
BATON ROUGE, LA - Weight loss and increased physical fitness nearly halved the risk of losing mobility in overweight or obese adults with type 2 diabetes, according to four-year results of the Look AHEAD trial funded by the National Institutes of Health (NIH). The results are published in the March 29 issue of the New England Journal of Medicine (NEJM).
According to Pennington Biomedical Research Center Boyd Professor George Bray, M.D., principal investigator for the Look AHEAD study at Pennington Biomedical and a member of the editorial writing group for the NEJM article, "This study shows clearly that weight loss is beneficial by slowing the loss of mobility in elderly people. Loss of mobility is one of the strongest predictors of future 'ill-health' and thus anything we can do to keep older people more mobile has great advantages." Dr. Bray is one of 20 principal investigators who conducted NIH-sponsored Look AHEAD research. In Baton Rouge, nearly 350 volunteers were enrolled in the trial.
"Being able to perform routine activities is an important contributor to quality of life," said Griffin P. Rodgers, M.D., director of the NIH's National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), which led the study. "These findings add support to making lifestyle changes that improve health and reduce disability in people with type 2 diabetes, changes that already have been shown to prevent the disease and provide a good return on investment."
Look AHEAD is a multi-center, randomized clinical trial designed to determine the long-term effects of intentional weight loss on the risk of cardiovascular disease in overweight and obese individuals with type 2 diabetes. Beginning in 2001, a total of 5145 Look AHEAD participants were randomly assigned to a either an intensive lifestyle intervention (ILI) involving group and individual meetings to achieve and maintain weight loss through decreased caloric intake and increased physical activity or to a diabetes support and education (DSE) condition.
To assess mobility and disability, Look AHEAD participants reported on their ability to conduct six vigorous and moderate activities such as running and lifting heavy objects; pushing a vacuum cleaner or playing golf; climbing a flight of stairs; bending, kneeling or stooping; walking over a mile; and walking one block. Both groups were weighed annually and completed a treadmill fitness test at baseline, after year 1, and at the end of 4 years.
After 4 years of the study, Look AHEAD participants in the intensive lifestyle group experienced a 48 percent reduction in the risk of loss of mobility compared with the diabetes support and education group. Furthermore, after 4 years, 20.6 percent of ILI participants reported severe disability compared to 26.2 percent of participants in the DSE group. Likewise, 38.5 percent of those in the ILI reported good mobility, whereas the rate was 31.9 percent in the DSE group. Weight loss was a slightly stronger predictor of better mobility than improved fitness, but both contributed significantly to the observed reduction in risk.
"With nearly 80 percent of participants reporting mild, moderate, or severe restrictions in mobility when Look AHEAD began, it is critical to address to this problem," said Mary Evans, Ph.D., project scientist for Look AHEAD. "This study of mobility highlights the value of finding ways to help adults with type 2 diabetes keep moving as they age. We know that when adults lose mobility, it becomes difficult for them to live on their own, and they are likely to develop more serious health problems, increasing their health care costs."
Overweight and obesity affects more than two-thirds of U.S. adults age 20 and older. More than one-third of adults are obese. Many factors contribute to the problem, including genetics and lifestyle habits. Excess weight can lead to type 2 diabetes, heart disease, high blood pressure, stroke, and certain cancers. Nearly 26 million Americans have diabetes, and more than 7 million of them do not know it.
"The weight loss and physical activity goals promoted in the study are well within the reach of most Americans," said Jack Rejeski, Ph.D., lead author and Thurman D. Kitchin professor of health and exercise science at Wake Forest University in North Carolina. "Future research is needed to determine if this sort of intervention can be translated into public health interventions, particularly in light of possible effects on health care costs."
Find more information about the Look AHEAD trial (NCT00017953) at www.lookaheadtrial.org. Learn more about diabetes and weight at http://diabetes.niddk.nih.gov, from the National Diabetes Education Program at http://Yourdiabetesinfo.org and from the Weight-control Information Network at www.win.niddk.nih.gov.
Information on the Pennington Biomedical Research Center's Look AHEAD clinical trial is available at http://www.pbrc.edu/the-research/collaborative-research/.
The Pennington Biomedical Research Center is at the forefront of medical discovery as it relates to understanding the triggers of obesity, diabetes, cardiovascular disease, cancer and dementia. It is a campus of Louisiana State University and conducts basic, clinical and population research. The research enterprise at Pennington Biomedical includes approximately 80 faculty and more than 25 post-doctoral fellows who comprise a network of 44 laboratories supported by lab technicians, nurses, dietitians, and support personnel, and 13 highly specialized core service facilities. Pennington Biomedical's more than 500 employees perform research activities in state-of-the-art facilities on the 222-acre campus located in Baton Rouge, Louisiana.