OBJECTIVE: To conduct
post-hoc
secondary analysis examining the association between change in physical
activity (PA), measured with self-report and accelerometry, from baseline to 1
and 4 years and cardiovascular disease (CVD) outcomes in the Look AHEAD Trial.
RESEARCH DESIGN AND METHODS: Participants were adults with overweight/obesity
and type 2 diabetes with PA data at baseline and year 1 or 4 (n = 1,978). Participants
were randomized to diabetes support and education or intensive lifestyle
intervention. Measures included accelerometry-measured moderate-to-vigorous PA
(MVPA), self-reported PA, and composite (morbidity and mortality) CVD outcomes.
RESULTS: In pooled analyses of all participants, using Cox
proportional hazards models, each 100 MET-min/wk increase in accelerometry-measured
MVPA from baseline to 4 years was associated with decreased risk of the subsequent
primary composite outcome of CVD. Results were consistent for changes in total MVPA
[HR=0.97 (95% CI: 0.95, 0.99)] and MVPA accumulated in >10-minute
bouts [HR=0.95 (95% CI: 0.91, 0.98)], with a similar pattern for secondary CVD
outcomes. Change in accelerometry-measured MVPA at 1 year and self-reported
change in PA at 1 and 4 years were not associated with CVD outcomes.
CONCLUSIONS: Increased accelerometry-measured MVPA from
baseline to year 4 is associated with decreased risk of CVD outcomes. This
suggests the need for long-term engagement in MVPA to reduce the risk of CVD in
adults with overweight/obesity and type 2 diabetes.
Funding
Funded by the National Institutes of Health through cooperative agreements with the National Institute of Diabetes and Digestive and Kidney Diseases: DK57136, DK57149, DK56990, DK57177, DK57171, DK57151, DK57182, DK57131, DK57002, DK57078, DK57154, DK57178, DK57219, DK57008, DK57135, and DK56992. Additional funding was provided by the National Heart, Lung, and Blood Institute; National Institute of Nursing Research; National Center on Minority Health and Health Disparities; NIH Office of Research on Women’s Health; and the Centers for Disease Control and Prevention. This research was supported in part by the Intramural Research Program of the National Institute of Diabetes and Digestive and Kidney Diseases. The Indian Health Service (I.H.S.) provided personnel, medical oversight, and use of facilities. Additional support was received from The Johns Hopkins Medical Institutions Bayview General Clinical Research Center (M01RR02719); the Massachusetts General Hospital Mallinckrodt General Clinical Research Center and the Massachusetts Institute of Technology General Clinical Research Center (M01RR01066); the Harvard Clinical and Translational Science Center (RR025758-04); the University of Colorado Health Sciences Center General Clinical Research Center (M01RR00051) and Clinical Nutrition Research Unit (P30 DK48520); the University of Tennessee at Memphis General Clinical Research Center (M01RR0021140); the University of Pittsburgh General Clinical Research Center (GCRC) (M01RR000056), the Clinical Translational Research Center (CTRC) funded by the Clinical & Translational Science Award (UL1 RR 024153) and NIH grant (DK046204); the VA Puget Sound Health Care System Medical Research Service, Department of Veterans Affairs; and the Frederic C. Bartter General Clinical Research Center (M01RR01346). The following organizations have committed to make major contributions to Look AHEAD: FedEx Corporation; Health Management Resources; LifeScan, Inc., a Johnson &
