Shedding ‘just a few pounds’ cuts risk of diabetes and stroke

From scotsman.com

Shedding just a few pounds can dramatically reduce the risk of diabetes patients suffering a heart attack or stroke, according to new research. A study found a weight loss programme boosted cardiovascular health among obese individuals - including those who slimmed down only a little. It followed 129 participants with an average BMI (body mass index) of 38 who managed an average loss of body weight of 9.7 per cent (24 lbs) at the completion of the initial 12 week intervention. This evened out to 6.4 per cent (16 lbs) after five years. They had been enrolled in the Why WAIT (Weight Achievement and Intensive Management) programme.
Even those who maintained relatively little loss of weight after demonstrated reduced risks of cardiovascular disease. A BMI higher than 30 is considered obese. Professor Osama Hamdy, of the Joslin Diabetes Centre, Boston, said: “This weight loss was very impressive, since we know from previous research if this population can maintain a seven per cent weight loss, they show a marked improvement in insulin sensitivity and many other cardiovascular risk factors. “To the best of our knowledge, this is the longest follow up in the real world of clinical practice to show encouraging results that weight loss can be achieved and maintained.”
The study published in BMJ Open Diabetes Research & Care found reaching the target seven per cent weight loss after a year was a good predictor of maintaining weight loss over longer periods. The researchers divided the participants into two groups, depending on whether they reached that level. The group that didn’t achieve this goal saw an average weight loss of 3.5 per cent after five years, while the second group (with 53 per cent of participants) maintained an average loss of nine per cent at that time. These varied results were reflected in measurements of hemoglobin A1C levels. a standard assessment of blood glucose levels over two to three months, and people with type 2 diabetes seek to keep these below seven per cent.
Those who lost the most weight saw average A1C levels drop from 7.4 per cent to 6.4 per cent at 12 weeks and then slowly climb to 7.3 per cent over the five year period. In the lower-weight-loss group, results were not so positive, with average A1C decreasing from 7.5 per cent to 6.7 per cent at 12 weeks and then rising to eight per cent at five years. These trends were reflected in patient use of insulin and drugs that help maintain control of blood glucose levels, blood pressure and cholesterol level. Prescriptions of these medications increased significantly among lower-weight-loss participants, but either did not change or dropped in the higher-weight-loss group. But the lower-weight-loss group maintained better LDL (bad cholesterol) and HDL (good cholesterol) levels over five years, and their average blood pressure remained unchanged during that time.
The higher-weight-loss group also maintained improvements in their LDL and HDL levels over the length of the study. Additionally, they showed lower blood pressure at 18 months, although blood pressure returned to baseline levels after five years.
Obese people with type 2 diabetes generally continue to gain weight over time, increasing their risks of cardiovascular damage, Prof Hamdy explained. Launched in 2005, the Why WAIT programme aims to deliver an innovative and achievable combination of nutritional, exercise, medication, learning and monitoring offerings. Among its benefits, for example, “the plan is designed to maintain muscle mass during weight loss so most of the weight loss is from the fat mass, and people will retain high energy expenditure for long-term,” Prof Hamdy says. “This study demonstrated that they were able to do this.” He added: “This programme is giving hope to many people with diabetes there is something that works for weight loss and can work for a long time. People can maintain their weight loss, and their big benefits in cardiovascular risk factors and diabetes control.”

http://www.scotsman.com/news/shedding-just-a-few-pounds-cuts-risk-of-diabetes-and-stroke-1-4334552