title: Changes in body composition over 8 years in a randomized trial of a lifestyle intervention: the look AHEAD study.
abstract: OBJECTIVE
  To determine the effects of an intensive lifestyle intervention versus a comparison group on body composition in obese or overweight persons with type 2 diabetes at baseline and at 1, 4, and 8 years.
  
  
  METHODS
  Body composition was measured by dual-energy X-ray absorptiometry in a subset of 1019 Look AHEAD study volunteers randomized to intervention or comparison groups. The intervention was designed to achieve and maintain ≥7% weight loss through increased physical activity and reduced caloric intake. The comparison group received social support and diabetes education.
  
  
  RESULTS
  At 1 year, the intervention group lost fat (5.6 ± 0.2 kg) and lean mass (2.3 ± 0.1 kg) but regained fat (∼100%) and lost lean mass between years 1 and 8. Between baseline and year 8, weight loss was greater in intervention versus comparison groups (4.0 ± 0.4 vs. 2.3 ± 0.4 kg); comparison group weight loss was mostly lean mass (2.1 ± 0.17 kg). Fat mass in the intervention group was lower than that of the comparison group at all post-baseline time points.
  
  
  CONCLUSIONS
  Reduced fat mass may place the intervention group at a lower risk of obesity-linked sequelae, a hypothesis that can be tested by future studies of this cohort.
authors.affiliation: Department of Cardiology, Division of Atherosclerosis, Houston Methodist Research Institute and Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Henry J
authors.initials: HJ
authors.lastname: Pownall
authors.forename: George A
authors.initials: GA
authors.lastname: Bray
authors.forename: Lynne E
authors.initials: LE
authors.lastname: Wagenknecht
authors.forename: Michael P
authors.initials: MP
authors.lastname: Walkup
authors.forename: Stanley
authors.initials: S
authors.lastname: Heshka
authors.forename: Van S
authors.initials: VS
authors.lastname: Hubbard
authors.forename: James
authors.initials: J
authors.lastname: Hill
authors.forename: Steven E
authors.initials: SE
authors.lastname: Kahn
authors.forename: David M
authors.initials: DM
authors.lastname: Nathan
authors.forename: Anne V
authors.initials: AV
authors.lastname: Schwartz
authors.forename: Karen C
authors.initials: KC
authors.lastname: Johnson
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D001521:Behavior Therapy; D001823:Body Composition; D031204:Caloric Restriction; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D050177:Overweight / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D010353:Patient Education as Topic; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods*