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Randomized Controlled Trial
. 2015 Mar;23(3):565-72.
doi: 10.1002/oby.21005.

Changes in body composition over 8 years in a randomized trial of a lifestyle intervention: the look AHEAD study

Henry J Pownall  1 , George A Bray, Lynne E Wagenknecht, Michael P Walkup, Stanley Heshka, Van S Hubbard, James Hill, Steven E Kahn, David M Nathan, Anne V Schwartz, Karen C Johnson; Look AHEAD Research Group
Collaborators, Affiliations
Randomized Controlled Trial

Changes in body composition over 8 years in a randomized trial of a lifestyle intervention: the look AHEAD study

Henry J Pownall et al. Obesity (Silver Spring). 2015 Mar.

Abstract

Objective: To determine the effects of an intensive lifestyle intervention versus a comparison group on body composition in obese or overweight persons with type 2 diabetes at baseline and at 1, 4, and 8 years.

Methods: Body composition was measured by dual-energy X-ray absorptiometry in a subset of 1019 Look AHEAD study volunteers randomized to intervention or comparison groups. The intervention was designed to achieve and maintain ≥7% weight loss through increased physical activity and reduced caloric intake. The comparison group received social support and diabetes education.

Results: At 1 year, the intervention group lost fat (5.6 ± 0.2 kg) and lean mass (2.3 ± 0.1 kg) but regained fat (∼100%) and lost lean mass between years 1 and 8. Between baseline and year 8, weight loss was greater in intervention versus comparison groups (4.0 ± 0.4 vs. 2.3 ± 0.4 kg); comparison group weight loss was mostly lean mass (2.1 ± 0.17 kg). Fat mass in the intervention group was lower than that of the comparison group at all post-baseline time points.

Conclusions: Reduced fat mass may place the intervention group at a lower risk of obesity-linked sequelae, a hypothesis that can be tested by future studies of this cohort.

Trial registration: ClinicalTrials.gov NCT00017953.

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Figures

Figure 1
Figure 1
Flow chart for the DXA Body Composition Sub study. All participants received DXA scans at baseline and at least one follow-up scan. Numbers in rectangles indicate number of DXA scans at each visit. The number of patients who were scanned at a given pair of visits are connected by the brackets as shown.
Figure 2
Figure 2
Anthropometric changes as labeled, baseline to year eight. *P < 0.05, comparison and intervention groups are different. A – I, P <0.0001 for overall treatment effects.
Figure 3
Figure 3
Percent change in LM and FM from baseline to year eight, as labeled. *P < 0.05, comparison and intervention groups are different. A – F, P <0.0001 for overall treatment effects.
See this image and copyright information in PMC

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