Can weight loss decrease heart disease
in type 2 diabetes?
Boston-area adults with type 2 diabetes
begin 12-year weight loss, exercise study at three Boston medical
BOSTON January 22, 2002 More than 40 men and
women from the Boston area ranging from nurses to accountants
to retirees have already put their New Years resolutions
to lose weight and exercise more to the ultimate test by enrolling
in the first long-term study to look at the effects of weight loss
in people with type 2 diabetes in a nationwide study conducted locally
at Massachusetts General Hospital, Joslin Diabetes Center and Beth
Israel-Deaconess Medical Center. The three institutions, which jointly
make up one of the studys 16 research sites in the United
States, are seeking to enroll a total of 313 volunteers for the
study over the next two years.
Funded by the National Institute of Diabetes and Digestive and
Kidney Diseases (NIDDK) of the National Institutes of Health (NIH),
it is the largest study on the effects of weight-loss interventions
ever funded by the NIH. The study began screening participants for
eligibility in July.
Named Look AHEAD: Action for Health in Diabetes, the multicenter,
randomized clinical trial will examine the effects of a lifestyle
intervention program designed to promote weight loss through reduced
calorie intake and regular exercise in approximately 5,000 volunteers.
Look AHEAD will examine how the lifestyle interventions affect heart
attack, stroke and cardiovascular-related death in people with type
2 diabetesthe disease most affected by excess weight. An intensive
lifestyle intervention program will be compared to a program involving
general diabetes support and education.
People who are between 45 and 75 years of age, have type 2 diabetes
and are classified as overweight or obese (body mass index equal
to or greater than 25 kg/m2) are eligible for the study. The study
seeks equal numbers of men and women and expects that 33 percent
of the participants will come from ethnic minority groups.
People who qualify for Look AHEAD will be assigned at random to
either its Lifestyle Program or its Diabetes Support and Education
Program. The Lifestyle Program is an intensive diet and exercise
program designed to help participants lose at least 10 percent of
their initial weight in the first year of the study. Participants
are expected to adopt a program of regular exercise, primarily walking,
with a goal of 25 minutes per day. The comparison group enrolled
in the Diabetes Support and Education Program will attend sessions
on nutrition and physical activity and may attend support groups
with other people who have diabetes.
Individuals will be followed for up to 11.5 years. Researchers
will track cardiovascular risk factors, diabetes control and development
of complications, general health and quality of life.
"We have an enormous opportunity to learn more about the role
long-term weight loss can play in improving the health of overweight
individuals with type 2 diabetes," said David M. Nathan, M.D.,
local principal investigator of Look AHEAD and director of the Diabetes
Center at Massachusetts General Hospital. "We know that short-term
weight loss can benefit overweight people with diabetes; and we
now know, thanks to the Diabetes Prevention Program, that weight
loss can prevent type 2 diabetes. In Look AHEAD, we hope to learn
whether it can also improve the long-term health especially
cardiovascular health of overweight people who have diabetes."
Nathan is professor of Medicine at Harvard Medical School. The Diabetes
Prevention Program, a major national study, announced last year
that lifestyle changes can reduce the chance that at-risk adults
will develop type 2 diabetes.
More than 50 percent of adults in America are considered overweight.
The percent of obese Americans has risen from 16 to 22 percent in
the past 15 years. Although the reasons are not well understood,
obesity affects minorities disproportionately.
Type 2 diabetes has reached epidemic proportions in the United
States, largely due to the number of Americans who are overweight.
According to the American Diabetes Association, the incidence of
diabetes among people 40 to 74 years of age increased 38 percent
between 1976 and 1994. Today, 80 percent of people with type 2 diabetes
"This study will provide vital information on how losing weight
and exercising regularly impacts the cardiovascular health of those
with type 2 diabetes. We know that type 2 diabetes is associated
with a two-to-fourfold increased risk of coronary artery disease.
Heart attacks and strokes are the leading causes of death in people
with type 2 diabetes," said Edward S. Horton, MD, Look AHEAD
co-investigator, and director of Clinical Research at Joslin Diabetes
Center, who is directing the Joslin-BIDMC part of the study. Horton
is professor of Medicine at Harvard Medical School.
"Obesity in America is a serious risk factor for a number
of diseases and conditions, diabetes especially," said George
Blackburn, M.D., Ph.D., an obesity expert at Beth Israel Deaconess
Medical Center and the S. Daniel Abraham Associate Professor of
Nutrition at Harvard Medical School.
Short-term weight loss has been shown to have beneficial effects
on diabetes and cardiovascular disease. To date there have been
no randomized trials on the long-term benefits of weight loss because
of the difficulty of achieving and maintaining weight loss. The
study has a budget of more than $180 million.
Other sponsors of Look AHEAD include the National Heart, Lung and
Blood Institute; the National Institute of Nursing Research; The
National Center for Minority Health and Health Disparities; the
Office of Research on Womens Health; all of the NIH, and the
Centers for Disease Control and Prevention.
information about the study is available at www.LookAHEADstudy.org.
information about diabetes care, treatment and research at Mass
General, please visit:
the Boston area who meet the study criteria and
wish to participate in the study should call toll-free at (866)
call the national toll-free number (866) 552-4323.
Media Contact: Nicole
Gustin, MGH Public Affairs
Physician Referral Service: 1-800-388-4644
about Clinical Trials