title: A long-term intensive lifestyle intervention and physical function: the look AHEAD Movement and Memory Study.
abstract: OBJECTIVE
  To assess the long-term effects of an intensive lifestyle intervention on physical function using a randomized post-test design in the Look AHEAD trial.
  
  
  METHODS
  Overweight and obese (BMI ≥ 25 kg m(-2)) middle-aged and older adults (aged 45-76 years at enrollment) with type 2 diabetes (n = 964) at four clinics in Look AHEAD, a trial evaluating an intensive lifestyle intervention (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 an expanded short physical performance battery (SPPBexp ), 20-m and 400-m walk, and grip and knee extensor strength 8 years post-randomization, during the trial's weight maintenance phase.
  
  
  RESULTS
  Eight years post-randomization, individuals randomized to ILI had better SPPBexp scores [adjusted mean (SE) difference: 0.055 (0.022), P = 0.01] and faster 20-m and 400-m walk speeds [0.032 (0.012) m s(-1) , P = 0.01, and 0.025 (0.011) m s(-1) , P = 0.02, respectively] compared to those randomized to DSE. Achieved weight loss greatly attenuated the group differences in physical function, and the intervention effect was no longer significant.
  
  
  CONCLUSIONS
  An intensive lifestyle intervention has long-term benefits for mobility function in overweight and obese middle-aged and older individuals with type 2 diabetes.
authors.affiliation: Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
authors.forename: Denise K
authors.initials: DK
authors.lastname: Houston
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Leng
authors.forename: George A
authors.initials: GA
authors.lastname: Bray
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Hergenroeder
authors.forename: James O
authors.initials: JO
authors.lastname: Hill
authors.forename: John M
authors.initials: JM
authors.lastname: Jakicic
authors.forename: Karen C
authors.initials: KC
authors.lastname: Johnson
authors.forename: Rebecca H
authors.initials: RH
authors.lastname: Neiberg
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Marsh
authors.forename: W Jack
authors.initials: WJ
authors.lastname: Rejeski
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Kritchevsky
mesh_terms: D000368:Aged; D001521:Behavior Therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000628:therapy*; D005081:Exercise Therapy; D005260:Female; D006266:Health Education / Q000379:methods; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000150:complications / Q000628:therapy*; D050177:Overweight / Q000150:complications / Q000628:therapy*; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods*