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The message of the powerful role of minimal weight loss attained with healthy lifestyle changes (physical activity, intensive support and use of meal replacements) in type 2 was reiterated recently.
The study was initiated through the National Institutes of Health nearly 10 years ago and is currently scheduled to conclude in 2014 (it's already been extended once). For support ILI participants were seen weekly for the first 6 months and 3 times per month for the next 6 months with group and one on one contact. The lifestyle counselors were registered dietitians, behavioral counselors or exercise specialists. Glucose, blood pressure and lipids (blood fats): ILI participants continued to have greater improvements in systolic blood pressure (BP) (the lower number), A1c and HDL-C (the good cholesterol) than DSE at 4 years.
Use of drugs to improve glucose , blood pressure and lipids: By years 3 and 4 DSE people had a greater decrease in LDL-C (bad cholesterol) than ILI participants, but they were using more medications to improve this number (such as statins).
So, ILI positively impacted glucose, blood pressure and lipids - The ABCs of diabetes care. But do you need to wait to apply these results in your life or tell a loved one or friend about them? There’s now an overwhelming amount of research reinforcing the importance of getting to and maintaining a healthy weight, eating healthfully and staying physically active.
As a reliable, reputable voice in the food and nutrition world, I strive to blog and engage in social media with integrity.


One of the most frustrating things we experience is to be looking for something that we cannot find. Yet the impressive role of lifestyle changes (along with a hefty among of expert-led support) in preventing or delaying type 2 or slowing the progression of type 2 has and continues to be reinforced by research studies over and over again. This happened when the interim results (the 4 year mark) of the lengthy NIH multicenter study known as Look AHEAD – Action for Health in Diabetes, were published (Archives of Internal Medicine, Sept 27, 2010). Look AHEAD enrolled over five thousand people 55 to 74 years old with type 2 diabetes who were risk for heart and blood vessel diseases (as are most people with type 2). During years 2 through 4 people were seen at least once a month individually, received follow-up at least monthly and were invited to group classes and activities to support their efforts.
At 4 years ILI fitness level was about 5% from the study’s start and over baseline, and interestingly about 1% below the study start for DSE participants.
These differences were most apparent at year one and not all of these initial improvements were maintained at 4 years. A greater proportion of ILI than DSE participants discontinued use of BP or glucose-lowering drugs.
Eventually we’ll see if maintaining even a small amount of weight loss, healthy changes in food choices and eating habits, a good bit of regular physical activity and SUPPORT can decrease heart and blood vessel problems in people with type 2 diabetes.
Yes, at this point you’d think these 4 year Look AHEAD conclusions are a ‘dah’ – but apparently not. And that can be tiring work, because for so many of us, it feels like we’re not quite up for that kind of journey.


The rate of weight regain (also commonly seen in weight loss studies) in the ILI group appears to be slowing overtime. A greater proportion of ILI participants hit the A1c target of <7% advised by the American Diabetes Association. And among ILI participants not using any of these drugs at the start of the study, fewer people started them.
Any blogs or social media posts that are sponsored or for which I am compensated for my time will be disclosed appropriately. One half of the participants received what’s called intensive lifestyle intervention (ILI) and the other half, the control group, received what’s called Diabetes Support and Education (DSE).
Translated these results show that people in ILI group spent more time (over years) at lower risk of heart and blood vessel problems.
DSE is intended to be minimal care (however, let's admit it, for many people this is more care than many people in actuality receive).



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