title: Changes in regional body composition over 8 years in a randomized lifestyle trial: The look AHEAD study.
abstract: To test the hypothesis that an 8-year intensive lifestyle intervention (ILI) suppresses aging-dependent changes in regional lean mass (LM) and fat mass (FM) among people with overweight/obesity and type 2 diabetes.
  
  
  
  Regional body composition was measured by dual-energy X-ray absorptiometry within a subset of 1,019 volunteers (45-75 years old) in the Look AHEAD study randomized to ILI or diabetes support and education (DSE). The ILI goal was to achieve and maintain ≥7% weight loss through increased physical activity and reduced caloric intake.
  
  
  
  Over 8 years, the DSE group exhibited a linear loss of LM and FM. During year 1, the ILI group lost LM and FM. Between years 1 and 8, the ILI group regained most FM in all regions; regional LM converged with that of the DSE group; the percent of LM loss was greater for the leg than for the trunk. Among both groups, regional LM and FM change was proportional to the size of the region, trunk > leg > arm.
  
  
  
  Aging-dependent LM losses, particularly in the leg region, were not suppressed by ILI. The long-term consequences of rapid LM and FM loss and subsequent regain mostly as fat are unknown.
authors.affiliation: Department of Cardiology, Houston Methodist Research Institute and Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Henry J
authors.initials: HJ
authors.lastname: Pownall
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA.
authors.forename: Anne V
authors.initials: AV
authors.lastname: Schwartz
authors.affiliation: Department of Clinical Obesity and Metabolism, Pennington Biomedical Research Center/LSU, Baton Rouge, Louisiana, USA.
authors.forename: George A
authors.initials: GA
authors.lastname: Bray
authors.affiliation: Department of Child and Adolescent Psychiatry and Behavioral Science, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
authors.forename: Robert I
authors.initials: RI
authors.lastname: Berkowitz
authors.affiliation: Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Cora E
authors.initials: CE
authors.lastname: Lewis
authors.affiliation: Department of Internal Medicine, VA Puget Sound Health Care System and University of Washington, Seattle, Washington, USA.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Boyko
authors.affiliation: Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Jakicic
authors.affiliation: Department of Biostatistics, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
authors.forename: Haiying
authors.initials: H
authors.lastname: Chen
authors.affiliation: Institute of Human Nutrition, St. Luke's/Roosevelt Hospital, New York, New York, USA.
authors.forename: Stanley
authors.initials: S
authors.lastname: Heshka
authors.affiliation: Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Edward W
authors.initials: EW
authors.lastname: Gregg
authors.affiliation: Department of Preventive Medicine, University of Tennessee, Memphis, Tennessee, USA.
authors.forename: Karen C
authors.initials: KC
authors.lastname: Johnson
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000375:Aging / Q000502:physiology; D001823:Body Composition; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D002149:Energy Intake; D005260:Female; D006266:Health Education; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology*; D050177:Overweight / Q000503:physiopathology*; D015431:Weight Loss