Changes in Body Composition over Eight Years in a Randomized Trial of a Lifestyle Intervention: The Look AHEAD Study

Abstract

Objective: To determine the effects of an intensive lifestyle intervention vs. a comparison group on body composition in obese or overweight persons with type 2 diabetes at baseline and at 1, 4, and 8 years. Design and 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 vs. 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 FM 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 Identifier: NCT00017953