| Autor: |
the Look AHEAD Research Group, Holly Wyatt, Thomas A. Wadden, Xavier Pi-Sunyer, Helmut Steinburg, KayLoni Olson, William C. Knowler, Karen C. Johnson, James O. Hill, Mark A. Espeland, Jeanne M. Clark, Judy L. Bahnson, Rebecca H. Neiberg, Rena R. Wing |
| Rok vydání: |
2022 |
| Popis: |
Objective. Patients with type 2 diabetes are encouraged to lose weight, but excessive weight loss in older adults may be a marker of poor health and subsequent mortality. We examined weight changes during the post-intervention period of Look AHEAD, a randomized trial comparing intensive lifestyle intervention (ILI) and diabetes support and education (DSE; control) in individuals with overweight/obesity and type 2 diabetes and sought to identify predictors of excessive post-intervention weight loss and its association with mortality. Research Design and Methods. These secondary analyses compared post-intervention weight change (year-8 to final visit [median 16 years]) in ILI and DSE in 3999 Look AHEAD participants. Using empirically derived trajectory categories, we compared four subgroups: Weight Gainers (N= 307), Weight Stable (N=1561), Steady Losers (N=1731) and Steep Losers (N=380) on post-intervention mortality, demographic variables and health status at randomization and year-8. Results. Post-intervention weight change averaged -3.7 ±9.5%, with greater weight loss in DSE than ILI. The steep weight loss trajectory subgroup lost on average 17.7 + 6.6%.; 30% of Steep Losers died during post-intervention follow-up vs 10-18% in other trajectories (pBaseline - older; longer diabetes duration; higher BMI; greater multimorbidity; Intervention – randomization to control group; less weight loss in years 1-8; Year 8 - higher prevalence of frailty, multimorbidity and depressive symptoms; lower use of weight control strategies. Conclusion. Steep weight losses post-intervention were associated with increased risk of mortality. Older individuals with longer duration diabetes and multi-morbidity should be monitored for excessive, unintentional weight loss. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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