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ARS Home » Plains Area » Grand Forks, North Dakota » Grand Forks Human Nutrition Research Center » Healthy Body Weight Research » Research » Publications at this Location » Publication #270808
Title: Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with Type 2 diabetes

Author
item Raatz, Susan

Submitted to: Diabetes Care
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/8/2011
Publication Date: 7/25/2011
Citation: Raatz, S.K. 2011. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with Type 2 diabetes. Diabetes Care. 34:1481-1486.

Interpretive Summary: Data supporting the recommendation for overweight and obese individuals with type 2 diabetes to lose 5–10% of their body weight to reduce cardiovascular disease (CVD) risk are limited. We conducted an analysis of participants in the Look AHEAD (Action for Health in Diabetes) study and examined the association between weight loss and changes in CVD risk factors at 1 year in individuals with type 2 diabetes. The magnitude of weight loss at 1 year was strongly (P = 0.0001) associated with Improvements in glycemia, blood pressure, triglycerides, and HDL cholesterol but not with LDL cholesterol (P = 0.79). Compared with weight-stable participants, those who lost 5 to 10% of their body weight had increased odds of achieving a 0.5% reduction in HbA1c, a 5-mmHg decrease in diastolic blood pressure, a 5-mmHg decrease in systolic blood pressure, a 5mg/dL increase in HDL cholesterol, and a 40mg/dL decrease in triglycerides. The odds of clinically significant improvements in most risk factors were even greater in those who lost 10–15% of their body weight. We conclude that modest weight losses of 5 to 10% were associated with significant improvements in CVD risk factors at 1 year, but larger weight losses had greater benefits.

Technical Abstract: Overweight and obese individuals are encouraged to lose 5–10% of their body weight to improve cardiovascular disease (CVD) risk, but data supporting this recommendation are limited, particularly for individuals with type 2 diabetes. We conducted an observational analysis of participants in the Look AHEAD (Action For Health in Diabetes) study (n = 5,145, 40.5% male, 37% from ethnic/racial minorities) and examined the association between the magnitude of weight loss and changes in CVD risk factors at 1 year and the odds of meeting predefined criteria for clinically significant improvements in risk factors in individuals with type 2 diabetes. The magnitude of weight loss at 1 year was strongly (P , 0.0001) associated with improvements in glycemia, blood pressure, tryiglycerides, andHDL cholesterol but not with LDL cholesterol (P = 0.79). Compared with weight-stable participants, those who lost 5 to ,10%([means6SD] 7.2562.1 kg) of their body weight had increased odds of achieving a 0.5%point reduction in HbA1c (odds ratio 3.52 [95%CI 2.81–4.40]), a 5-mmHg decrease in diastolic blood pressure (1.48 [1.20–1.82]), a 5-mmHg decrease in systolic blood pressure (1.56 [1.27–1.91]), a 5mg/dL increase inHDL cholesterol (1.69 [1.37–2.07]), and a 40mg/dL decrease in triglycerides (2.20 [1.71–2.83]). The odds of clinically significant improvements in most risk factors were even greater in those who lost 10–15% of their body weight. Modest weight losses of 5 to ,10% were associated with significant improvements in CVD risk factors at 1 year, but larger weight losses had greater benefits.