Mixed
Intensive lifestyle intervention (caloric restriction, meal replacements, and physical activity) fails to reduce the incidence of major cardiovascular events in overweight or obese individuals with type 2 diabetes, despite achieving significant long-term weight loss and improvements in cardiovascular risk factors.
For individuals with type 2 diabetes, intensive lifestyle changes (diet, exercise, behavioral support) are still recommended because they improve weight, fitness, and other risk factors (like blood pressure and blood sugar), even if they do not directly reduce the risk of heart attacks or strokes. Focus on the overall health benefits rather than just cardiovascular event reduction.
The primary result was that the incidence of cardiovascular events over a median follow-up of 9.6 years was not reduced in the Intensive Lifestyle Group relative to the control group.
Why this rating
Large-scale, randomized, long-term clinical trial (N=5145, median 9.6 years follow-up).
Source
Implications of Look <scp>AHEAD</scp> for clinical trials and clinical practice
Rena R. Wing · Diabetes Obesity and Metabolism · 2014
DOI 10.1111/dom.12318
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