Changes in Body Composition Over 8 Years in a Randomized Trial of a Lifestyle Intervention: The Look AHEAD Study

ObjectiveTo 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. MethodsBody 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. ResultsAt 1 year, the intervention group lost fat (5.60.2 kg) and lean mass (2.3 +/- 0.1 kg) but regained fat (approximate to 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. ConclusionsReduced 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.