The Look AHEAD study: a description of the lifestyle intervention and the evidence supporting it.
The Look AHEAD (Action for Health in Diabetes) study is a multicenter, randomized controlled trial designed to determine whether intentional weight loss reduces cardiovascular morbidity and mortality in overweight individuals with type 2 diabetes. The study began in 2001 and is scheduled to conclude in 2012. A total of 5145 participants have been randomly assigned to a lifestyle intervention or to an enhanced usual care condition (i.e., diabetes support and education). This article describes the lifestyle intervention and the empirical evidence to support it. The two principal intervention goals are to induce a mean loss >or = 7% of initial weight and to increase participants' moderately intense physical activity to > or =175 min/wk. For the first 6 months, participants attend one individual and three group sessions per month and are encouraged to replace two meals and one snack a day with liquid shakes and meal bars. From months 7 to 12, they attend one individual and two group meetings per month and continue to replace one meal per day (which is recommended for the study's duration). Starting at month 7, more intensive behavioral interventions and weight loss medication are available from a toolbox, designed to help participants with limited weight loss. In Years 2 to 4, treatment is provided mainly on an individual basis and includes at least one on-site visit per month and a second contact by telephone, mail, or e-mail. After Year 4, participants are offered monthly individual visits. The intervention is delivered by a multidisciplinary team that includes medical staff who monitor participants at risk of hypoglycemic episodes.
University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA [corrected]
Wadden
Thomas A
TA
West
Delia Smith
DS
Delahanty
Linda
L
Jakicic
John
J
Rejeski
Jack
J
Williamson
Don
D
Berkowitz
Robert I
RI
Kelley
David E
DE
Tomchee
Christine
C
Hill
James O
JO
Kumanyika
Shiriki
S
D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D015444:Exercise / Q000502:physiology; D005544:Forecasting; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods / Q000639:trends; D006801:Humans; D008019:Life Style; D015337:Multicenter Studies as Topic; D009765:Obesity / Q000150:complications*; D016032:Randomized Controlled Trials as Topic; D015431:Weight Loss / Q000502:physiology