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ARS Home » Plains Area » Grand Forks, North Dakota » Grand Forks Human Nutrition Research Center » Dietary Prevention of Obesity-related Disease Research » Research » Publications at this Location » Publication #313775
Title: The look AHEAD trial: bone loss at four-year follow-up in type 2 diabetes

Author
item Raatz, Susan

Submitted to: Diabetes Care
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/22/2014
Publication Date: 10/1/2014
Publication URL: http://handle.nal.usda.gov/10113/60280
Citation: Raatz, S.K. 2014. The look AHEAD trial: bone loss at four-year follow-up in type 2 diabetes. Diabetes Care. 37(10):2822-2829.

Interpretive Summary: OBJECTIVE: To determine whether an intensive lifestyle intervention for weight loss and physical fitness in overweight or obese persons with type 2 diabetes was associated with bone loss after 4 years of follow-up. RESEARCH DESIGN AND METHODS: In a randomized controlled trial oif intensive lifestyle intervention (ILI) compared to diabetes support and education (DSE) group among 1,309 subjects, bone mineral density was assessed at baseline and after 1 year and 4 years. RESULTS: ILI was effective in producing significant weight and increased fitness at year 4. In men, ILI participants had a greater rate of bone loss during the first year. Differences between groups were reduced by one-half after 4 years but remained significant. The difference in rate of hip bone loss between groups over 4 years was related to increased weight loss in ILI. Among women, the rate of bone loss did not differ between ILI and DSE after 4 years. CONCLUSIONS: A 4-year weight loss intervention was significantly associated with a modest increase in bone loss at the hip in men but not in women.

Technical Abstract: OBJECTIVE: To determine whether an intensive lifestyle intervention (ILI) designed to sustain weight loss and improve physical fitness in overweight or obese persons with type 2 diabetes was associated with bone loss after 4 years of follow-up. RESEARCH DESIGN AND METHODS: This randomized controlled trial of intensive weight loss compared an ILI with a diabetes support and education (DSE) group among 1,309 overweight or obese subjects. Bone mineral density was assessed at baseline and after 1 year and 4 years of intervention. RESULTS: ILI was effective in producing significant weight loss (5.3% vs. 1.8% in ILI and DSE, respectively; P < 0.01) and increased fitness (6.4% vs.20.8%) at year 4. Inmen, ILI participants had a greater rate of bone loss during the first year (21.66% vs. 20.09% per year in ILI and DSE, respectively). Differences between groups were diminished by one-half after 4 years (20.88% vs 20.05% per year in ILI and DSE, respectively) but remained significant (P < 0.01). The difference in rate of hip bone loss between groups over 4 years was related to increased weight loss in ILI. Among women, the rate of bone loss did not differ between ILI and DSE after 4 years. CONCLUSIONS: A 4-year weight loss intervention was significantly associated with a modest increase in bone loss at the hip in men but not in women.