Mixed
An intensive lifestyle intervention (ILI) comprising caloric restriction and increased physical activity significantly reduces the progression of kidney disease (decline in eGFR and need for kidney replacement therapy) in adults aged 60 years or older with type 2 diabetes, with benefits persisting after the active intervention ends.
If you are over 60 and have type 2 diabetes, a structured lifestyle program focusing on modest calorie reduction (1200-1800 kcal/day) and building up to 175 minutes of moderate exercise per week can significantly slow kidney damage. This benefit is specific to older adults and persists even after the formal program ends, making it a crucial strategy for renal protection in this demographic.
The 2205 participants aged >60 years at baseline had benefit in both kidney outcomes during intervention and overall (HR=0.75, 0.62 to 0.90 for eGFR <45 mL/min/1.73 m2; HR=0.62, 0.43 to 0.91 for KRT).
Why this rating
Randomized clinical trial with long-term follow-up (median 15.6 years) and large sample size (n=5145), though it is a secondary analysis.
Source
Within and post-trial effects of an intensive lifestyle intervention on kidney disease in adults with overweight or obesity and type 2 diabetes mellitus: a secondary analysis of the Look AHEAD clinical trial
William C. Knowler et al. · BMJ Open Diabetes Research & Care · 2024
DOI 10.1136/bmjdrc-2024-004079
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