WEDNESDAY, March 28 (HealthDay News) -- Weight loss and regular
exercise help prevent disability in obese people with type 2
diabetes, according to new research.
After four years, 21 percent of people enrolled in a
lifestyle-intervention program focusing on diet and physical
activity had severe disability compared with 26 percent of those
enrolled in a diabetes support group. What's more, the
lifestyle-intervention group had about half the risk of losing
their mobility compared to the support group.
"The lifestyle intervention combined caloric restriction and increased activity," said study author, W. Jack Rejeski, a professor of health and exercise science at the Wake Forest University School of Medicine, in Winston-Salem, N.C. "More of the lifestyle intervention group remained in the good-mobility category. And, that was with modest changes. Just a 6 percent change in body weight helped to ward off an important outcome."
Results of the study are published in the March 29 issue of the
New England Journal of Medicine.
The study included slightly more than 5,000 overweight or obese
adults who had type 2 diabetes. All were between the ages of 45 and
74, with an average age of 59. The researchers excluded anyone with
a hemoglobin A1C (HbA1C) above 11 percent. HbA1C is a long-term
measure of blood-sugar control, and the American Diabetes
Association generally recommends that people with diabetes should
aim for an HbA1C of less than 7 percent. They also excluded people
with very high blood pressure or high triglycerides (a type of
At the start of the study, just one-third of the study
volunteers reported good mobility. That means around two-thirds had
at least some type of mobility disability, according to the
The volunteers were randomly assigned to one of two treatment
groups. The first included lifestyle interventions to lose weight
and get more physical activity. The goal in this group was to lose
more than 7 percent of body weight and exercise more than 175
minutes a week, according to the study. The second group was a
diabetes support and education program.
To evaluate mobility, the researchers asked the study volunteers
how well they could perform certain activities, such as running,
lifting heavy objects, pushing a vacuum cleaner, playing golf,
climbing a flight of stairs, bending, kneeling, stooping, walking
more than a mile or walking one block.
At the end of four years, those in the lifestyle intervention
group had a 48 percent reduction in mobility-related disability
compared to the support group.
Almost 39 percent of the lifestyle intervention group reported
good mobility at the end of the study compared to 32 percent of
those in the support group, according to the study.
For every reduction of 1 percent of body weight, there was a 7.3
percent reduction in the risk of mobility disability. For every 1
percent improvement in fitness, there was a 1.4 percent drop in the
risk of mobility disability. But, Rejeski pointed out that doing
both interventions is best for your overall health.
"If all you do is lose weight, the danger of losing muscle mass is greater. The message is that you need to lose weight and be active to enhance your function and not lose muscle mass," he said.
Dr. Joel Zonszein, director of the clinical diabetes center at
Montefiore Medical Center, in New York City, said lifestyle changes
are as important as medications. "Papers like this continue to show
how important lifestyle changes are," Zonszein said. "But, the
issue always is in the implementation. We can tell patients to
exercise and lose weight, but we don't have the resources to follow
up as they do in clinical trials."
For people who want to make changes on their own, Rejeski
recommended trying to cut calorie consumption to about 1,800
calories a day. Then, he said, find a place to walk -- the mall, a
walking path, a school track -- and get a walking buddy so that you
can each keep the other one accountable. If you haven't exercised
in a while, start by walking just a little bit, and then the next
day add a few more steps. "Eventually, you'll make progress. And,
the lower your function was to start with, the more you'll notice
the change," he said.
Current U.S. government recommendations are to exercise at a
moderate pace for at least 30 minutes most days of the week.
Learn more about how exercise can benefit you from the
U.S. National Institute on Aging.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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