Hormonal
The effect of lifestyle intervention on cognitive impairment varies by baseline BMI, with potential benefit for overweight individuals (BMI 25-29) and potential harm for obese individuals (BMI ≥40).
For overweight individuals (BMI 25-29) with type 2 diabetes, lifestyle intervention may offer some cognitive protection. However, for those with severe obesity (BMI ≥40), the same intervention might be associated with a higher risk of cognitive impairment compared to controls. This suggests that the cognitive impact of weight loss may depend on starting weight, with potential benefits for the overweight and potential risks for the severely obese, possibly due to the loss of neuroprotective factors associated with higher body fat.
there was evidence (p = 0.03) that the intervention effect ranged from benefit to harm across participants ordered from lowest to highest baseline BMI.
Why this rating
Statistically significant interaction (p=0.03) but exploratory subgroup analysis; confidence intervals for specific BMI subgroups crossed 1.
Source
Effect of a long-term intensive lifestyle intervention on prevalence of cognitive impairment
Mark A. Espeland et al. · Neurology · 2017
DOI 10.1212/wnl.0000000000003955
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