The DOI matches its Crossref record; 60 of the 61 references it cites were found in a registry or an index.
Long-term Effects of a Lifestyle Intervention on Weight and Cardiovascular Risk Factors in Individuals With Type 2 Diabetes Mellitus: Four-Year Results of the Look AHEAD Trial
Open accessAbstract
BACKGROUND: Lifestyle interventions produce short-term improvements in glycemia and cardiovascular disease (CVD) risk factors in individuals with type 2 diabetes mellitus, but no long-term data are available. We examined the effects of lifestyle intervention on changes in weight, fitness, and CVD risk factors during a 4-year study. METHODS: The Look AHEAD (Action for Health in Diabetes) trial is a multicenter randomized clinical trial comparing the effects of an intensive lifestyle intervention (ILI) and diabetes support and education (DSE; the control group) on the incidence of major CVD events in 5145 overweight or obese individuals (59.5% female; mean age, 58.7 years) with type 2 diabetes mellitus. More than 93% of participants provided outcomes data at each annual assessment. RESULTS: Averaged across 4 years, ILI participants had a greater percentage of weight loss than DSE participants (-6.15% vs -0.88%; P < .001) and greater improvements in treadmill fitness (12.74% vs 1.96%; P < .001), hemoglobin A(1c) level (-0.36% vs -0.09%; P < .001), systolic (-5.33 vs -2.97 mm Hg; P < .001) and diastolic (-2.92 vs -2.48 mm Hg; P = .01) blood pressure, and levels of high-density lipoprotein cholesterol (3.67 vs 1.97 mg/dL; P < .001) and triglycerides (-25.56 vs -19.75 mg/dL; P < .001). Reductions in low-density lipoprotein cholesterol levels were greater in DSE than ILI participants (-11.27 vs -12.84 mg/dL; P = .009) owing to greater use of medications to lower lipid levels in the DSE group. At 4 years, ILI participants maintained greater improvements than DSE participants in weight, fitness, hemoglobin A(1c) levels, systolic blood pressure, and high-density lipoprotein cholesterol levels. CONCLUSIONS: Intensive lifestyle intervention can produce sustained weight loss and improvements in fitness, glycemic control, and CVD risk factors in individuals with type 2 diabetes. Whether these differences in risk factors translate to reduction in CVD events will ultimately be addressed by the Look AHEAD trial. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00017953.
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“Evidence of T2D remission beyond two years is sparse, with examples in bariatric surgery and following the three lifestyle interventions: 1) meal replacements for caloric restriction and physical activity [5,7,8]; 2) short-term total diet replacement with rescue therapy for weight maintenance [9]; and 3) a calorie-restricted Mediterranean diet [10].”
From 5-Year effects of a novel continuous remote care model with carbohydrate-restricted nutrition therapy including nutritional ketosis in type 2 diabetes: An extension study (2024) · cites this paper as [8]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“We previously reported improvements in glycemia, body weight, markers of liver disease and cardiovascular risk over two years among participants with T2D receiving a continuous care intervention (CCI) delivered via telemedicine by a care team who counseled participants on a very low carbohydrate diet including nutritional ketosis [8,19].”
From 5-Year effects of a novel continuous remote care model with carbohydrate-restricted nutrition therapy including nutritional ketosis in type 2 diabetes: An extension study (2024) · cites this paper as [8]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“the trajectory of outcomes in the usual care group followed for two years (showing no change in HbA1c and body weight concurrent with greater medication use [8])”
From 5-Year effects of a novel continuous remote care model with carbohydrate-restricted nutrition therapy including nutritional ketosis in type 2 diabetes: An extension study (2024) · cites this paper as [8]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“As comprehensive lifestyle treatment of overweight and obese adults with type 2 diabetes continues over 4 years, some weight regain will occur on average; partial weight regain is associated with an increase in hemoglobin A1c, but hemoglobin A1c remains below preintervention levels, and the reduction remains clinically meaningful.23”
From 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society (2014) · cites this paper as [23]
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“Structured weight loss programs with regular visits and use of meal replacements have been shown to enhance weight loss in people with diabetes (138 -140).”
From Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report (2019) · cites this paper as [140]
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In the citing paper
“It is well recognized among professional society guidelines that carbohydrate restricted nutrition therapy results in improved glycemia, most cardiovascular risk markers and reduced need for medication [11][12][13][14], yet current evidence is limited to two-years of follow-up [8,15,16,17,18].”
From 5-Year effects of a novel continuous remote care model with carbohydrate-restricted nutrition therapy including nutritional ketosis in type 2 diabetes: An extension study (2024) · cites this paper as [8]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“The slight increase in LDL-C encountered at one [19] and two years [8] (Fig. 2C) of the intervention regressed back to the baseline level at five years despite no significant changes in statin use, potentially reflecting the transient hypercholesterolemia associated with significant weight loss [31].”
From 5-Year effects of a novel continuous remote care model with carbohydrate-restricted nutrition therapy including nutritional ketosis in type 2 diabetes: An extension study (2024) · cites this paper as [8]
Experimental — accuracy not yet measuredIn the citing paper
“Structured weight loss programs with regular visits have been shown to enhance weight loss in T2DM [121,122,123].”
From Effects of diet, lifestyle, Chrononutrition and alternative dietary interventions on postprandial Glycemia and insulin resistance (2022) · cites this paper as [123]
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Citations
Cites
Friedewald, W. T., Levy, R. I., & Fredrickson, D. S. (1972) · Clinical Chemistry · doi:10.1093/clinchem/18.6.499 · Cited by 32,423
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin
(2002) · New England Journal of Medicine · doi:10.1056/nejmoa012512 · Cited by 19,011
Tuomilehto, J., Lindström, J., Eriksson, J. G., Valle, T. T., Hämäläinen, H., Ilanne-Parikka, P., Keinänen-Kiukaanniemi, S., Laakso, M., Louheranta, A., Rastas, M., et al. (2001) · New England Journal of Medicine · doi:10.1056/nejm200105033441801 · Cited by 10,873
(1998) · PsycEXTRA Dataset · doi:10.1037/e565682010-001 · Cited by 9,453
Effects of Bariatric Surgery on Mortality in Swedish Obese Subjects
Sjöström, L., Narbro, K., Sjöström, C. D., Karason, K., Larsson, B., Wedel, H., Lystig, T., Sullivan, M., Bouchard, C., Carlsson, B., et al. (2007) · New England Journal of Medicine · doi:10.1056/nejmoa066254 · Cited by 4,668
Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery
Sjöström, L., Lindroos, A.-K., Peltonen, M., Torgerson, J., Bouchard, C., Carlsson, B., Dahlgren, S., Larsson, B., Narbro, K., Sjöström, C. D., et al. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa035622 · Cited by 4,457
Pan, X.-R., Li, G.-W., Hu, Y.-H., Wang, J.-X., Yang, W.-Y., An, Z.-X., Hu, Z.-X., Juan-Lin, Xiao, J.-Z., Cao, H.-B., et al. (1997) · Diabetes Care · doi:10.2337/diacare.20.4.537 · Cited by 4,320
Helsinki Heart Study: Primary-Prevention Trial with Gemfibrozil in Middle-Aged Men with Dyslipidemia
Frick, M. H., Elo, O., Haapa, K., Heinonen, O. P., Heinsalmi, P., Helo, P., Huttunen, J. K., Kaitaniemi, P., Koskinen, P., Manninen, V., et al. (1987) · New England Journal of Medicine · doi:10.1056/nejm198711123172001 · Cited by 3,881
Rubins, H. B., Robins, S. J., Collins, D., Fye, C. L., Anderson, J. W., Elam, M. B., Faas, F. H., Linares, E., Schaefer, E. J., Schectman, G., et al. (1999) · New England Journal of Medicine · doi:10.1056/nejm199908053410604 · Cited by 3,439
(1998) · PubMed · Cited by 2,737
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1 of the 61 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- [13]Trials of Hypertension Prevention Collaborative Research Group Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with high-normal blood pressure: The Trials of Hypertension Prevention, Phase II Arch Intern Med 1997 157 657 667 1997 9080920
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Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association
Benjamin, E. J., Blaha, M. J., Chiuve, S. E., Cushman, M., Das, S. R., Deo, R., de Ferranti, S. D., Floyd, J., Fornage, M., Gillespie, C., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000485 · Cited by 12,591
Standards of medical care in diabetes—2013
American Diabetes Association (2013) · Diabetes Care · doi:10.2337/dc13-s011 · Cited by 4,369
2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults
Jensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., Hu, F. B., Hubbard, V. S., Jakicic, J. M., Kushner, R. F., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.11.004 · Cited by 4,058
Standards of medical care in diabetes—2011
American Diabetes Association (2011) · Diabetes Care · doi:10.2337/dc11-s011 · Cited by 2,880
Jensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., Hu, F. B., Hubbard, V. S., Jakicic, J. M., Kushner, R. F., et al. (2014) · Circulation · doi:10.1161/01.cir.0000437739.71477.ee · Cited by 2,735
“The remain ing 28 publications were rated good or fair quality and included in the evidence base that was used to form ulate the ESs and recommendations (12-39).”
BackgroundMethod
Metadata
- Authors
- The Look AHEAD Research Group
- Affiliations
- Miriam Hospital (US)
- Corresponding author
- The Look AHEAD Research Group
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2010-09-27
- Volume
- 170
- Issue
- 17
- Pages
- 1566-75
- ISSN
- 0003-9926 (ISSN-L)
- PMC
- PMC3084497
- OpenAlex
- W1580839177
- Cited by
- 1,162
- References
- 61
- Citations by year
- 2026: 19 · 2025: 33 · 2024: 31 · 2023: 38 · 2022: 37 · 2021: 54 · 2020: 75 · 2019: 66 · 2018: 84 · 2017: 96 · 2016: 90 · 2015: 83 · 2014: 102 · 2013: 146 · 2012: 113
- FWCI
- 84.72
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5p30dk046204-15)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK-57171, DK 57136, DK57149, DK 57002, DK57182, DK56990, (DK 046204, DK57008, DK57177, DK 57078, DK57219, U01DK057149, DK-57178, U01DK057151, U01DK057135, U01DK057131, U01DK056990, DK-57135, U01DK057136, DK-56992, DK57154, U01DK057178, U01DK057182, U01DK057078, U01DK057154, P30DK079637, U01DK057008, U01DK057171, DK57131, U01DK057219, U01DK056992, U01DK057177, P30DK017047, P30DK048520, DK 57151, P30-DK 48520)
- National Center for Research Resources (M01-RR-0021140, M01RR-00051, M01RR002719, M01RR000056, M01RR01346, M01RR000051, M01RR001066, M01RR001346, UL1RR024153, M0-1-RR-02719, M01-RR01066)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Keywords
- type 2 diabetes, intensive lifestyle intervention, weight loss, cardiovascular risk factors, glycemic control, HbA1c, blood pressure, HDL cholesterol, triglycerides, LDL cholesterol, diabetes support and education, Look AHEAD trial, long-term outcomes, overweight and obesity, cardiovascular disease prevention
- MeSH terms
- Aged, Blood Glucose, Blood Pressure, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Female, Humans, Life Style, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Obesity, Patient Education as Topic, Physical Fitness, Risk Factors, Severity of Illness Index, Time Factors, Triglycerides, United States, Biomarkers, Weight Loss, Body Mass Index, Treatment Outcome, Diabetes Complications, Overweight
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