Physical Function Following a Long-Term Lifestyle Intervention Among Middle Aged and Older Adults With Type 2 Diabetes: The Look AHEAD Study
Background: Lifestyle interventions have been shown to improve physical function over the short term; however, whether these benefits are sustainable is unknown. The long-term effects of an intensive lifestyle intervention (ILI) on physical function were assessed using a randomized post-test design in the Look AHEAD trial. Methods: Overweight and obese (body mass index ≥ 25 kg/m2) middle-aged and older adults (aged 45-76 years at enrollment) with type 2 diabetes enrolled in Look AHEAD, a trial evaluating an ILI designed to achieve weight loss through caloric restriction and increased physical activity compared to diabetes support and education (DSE), underwent standardized assessments of performance-based physical function including a 4- and 400-m walk, lower extremity physical performance (expanded Short Physical Performance Battery, SPPBexp), and grip strength approximately 11 years postrandomization and 1.5 years after the intervention was stopped (n = 3,783). Results: Individuals randomized to ILI had lower odds of slow gait speed (<0.8 m/s) compared to those randomized to DSE (adjusted OR [95% CI]: 0.84 [0.71 to 0.99]). Individuals randomized to ILI also had faster gait speed over 4- and 400-m (adjusted mean difference [95% CI]: 0.019 [0.007 to 0.031] m/s, p = .002, and 0.023 [0.012 to 0.034] m/sec, p < .0001, respectively) and higher SPPBexp scores (0.037 [0.011 to 0.063], p = .005) compared to those randomized to DSE. The intervention effect was slightly larger for SPPBexp scores among older versus younger participants (0.081 [0.038 to 0.124] vs 0.013 [-0.021 to 0.047], p = .01). Conclusions: An intensive lifestyle intervention has modest but significant long-term benefits on physical function in overweight and obese middle-aged and older adults with type 2 diabetes. ClinicalTrials.gov Identifier: NCT00017953.
The journals of gerontology. Series A, Biological sciences and medical sciences
Houston, Denise K.; Neiberg, Rebecca H.; Miller, Michael E.; Hill, James O.; Jakicic, John M.; Johnson, Karen C.; Gregg, Edward W.; Hubbard, Van S.; Pi-Sunyer, Xavier; Rejeski, W Jack; Wing, Rena R.; Bantle, John P.; Beale, Elizabeth; Berkowitz, Robert I.; Cassidy-Begay, Maria; Clark, Jeanne M.; Coday, Mace; Delahanty, Linda M.; Dutton, Gareth; Egan, Caitlin; Foreyt, John P.; Greenway, Frank L.; Hazuda, Helen P.; Hergenroeder, Andrea; Horton, Edward S.; Jeffery, Robert W.; Kahn, Steven E.; Kure, Anne; Knowler, William C.; Lewis, Cora E.; Martin, Corby K.; Michaels, Sara; and Montez, Maria G., "Physical Function Following a Long-Term Lifestyle Intervention Among Middle Aged and Older Adults With Type 2 Diabetes: The Look AHEAD Study" (2018). Loewenberg College of Nursing Faculty Publications. 125.