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An intense lifestyle intervention for patients with type 2 diabetes that was focused on diet and exercise failed to protect patients against heart problems according to AHEAD Trial.
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See also in New England Journal of Medicine
In terms of retention, early numbers suggest success. The 1-year exam was attended by 96.4% of participants, which was only slightly, but statistically significant between the two study arms (Intensive Lifestyle Intervention 97.1% versus DSEI 95.7%; p = 0.004) [17]. The 4-year exam was attended by 93.6% of participants. There was no significant difference between the two study arms (Intensive Lifestyle Intervention 94.1% versus DSEI 93.0%; p = 0.11) [18]. Such high 1-year and 4-year retention rates in a weight loss trial are remarkable. Furthermore, there was a significant stepwise trend between attending a greater number of DSEI sessions and higher retention at the 1-year visit, with only 85% of those participants who attended no DSEI sessions the first year completing data collection, compared to 99% of those attending all three DSEI classes (p < 0.001). While this does not prove causality, it provides face validity that the DSEI sessions were valuable in enhancing retention in the comparison group. The years 1 and 4 retention data in Look AHEAD equal or exceed those of other large multi-center lifestyle intervention trials (Table 4). The Weight Loss Maintenance trial retained 94.7% of its Self-Directed control group after 30 months; however, this study randomized only patients who had lost 4 kg during a 6-month intervention period [15]. The Diabetes Prevention Program retained 92.4% of its participants at the end of the study (2.8 years); however, the control group in that study was a placebo control group designed in comparison to the metformin and troglitazone arms of the study [19]. Perhaps most similarly, the Finnish Diabetes Prevention Study had an overall retention rate of 97.1% at 1 year, but only 90.1% at 2 years [20]; furthermore, the retention rates by study arm were not reported clearly. Prior to Look AHEAD, the longest lifestyle intervention trial was the Women’s Health Initiative which reported an overall retention rate of 90.8% (90.4% for lifestyle and 91.1% for the comparison group) at 8 years of follow-up [21]. Look AHEAD is currently in year 8 of data collection, so comparison at that time point will be available in the future.
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