{"doi":"10.2337/dc21-1805","title":"Effects of Intensive Lifestyle Intervention on All-Cause Mortality in Older Adults With Type 2 Diabetes and Overweight/Obesity: Results From the Look AHEAD Study","abstract":"OBJECTIVE: Look AHEAD, a randomized trial comparing intensive lifestyle intervention (ILI) and diabetes support and education (DSE) (control) in 5,145 individuals with overweight/obesity and type 2 diabetes, found no significant differences in all-cause or cardiovascular mortality or morbidity during 9.6 (median) years of intervention. Participants in ILI who lost ≥10% at 1 year had lower risk of composite cardiovascular outcomes relative to DSE. Since effects of ILI may take many years to emerge, we conducted intent-to-treat analyses comparing mortality in ILI over 16.7 years (9.6 years of intervention and then observation) to DSE. In a secondary exploratory analysis, we compared mortality by magnitude of weight loss in ILI relative to DSE. RESEARCH DESIGN AND METHODS: Primary outcome was all-cause mortality from randomization to 16.7 years. Other outcomes included cause-specific mortality, interactions by subgroups (age, sex, race/ethnicity, and cardiovascular disease history), and an exploratory analysis by magnitude of weight loss in ILI versus DSE as reference. Analyses used proportional hazards regression and likelihood ratio. RESULTS: The incidence of all-cause mortality did not differ significantly in ILI and DSE (549 and 589 participants, respectively) (hazard ratio [HR] 0.91 [95% CI 0.81, 1.02]; P = 0.11). There were no significant differences between treatments in cause-specific mortality or within prespecified subgroups. ILI participants who lost ≥10% at 1 year had a 21% reduced risk of mortality (HR 0.79 [95% CI 0.67, 0.94]; P = 0.007) relative to DSE. CONCLUSIONS: ILI focused on weight loss did not significantly affect mortality risk. However, ILI participants who lost ≥10% had reduced mortality relative to DSE.","journal":"Diabetes Care","year":2022,"id":237759,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":58,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7843,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":74149,"name":"George A. 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Ryan","orcid":"0000-0001-8374-2277","position":27,"is_corresponding":false},{"id":691350,"name":"Valerie Ruelas","orcid":"0000-0003-0243-2192","position":28,"is_corresponding":false},{"id":368263,"name":"Helmut Steinburg","orcid":null,"position":29,"is_corresponding":false},{"id":861254,"name":"Katie Toledo","orcid":null,"position":30,"is_corresponding":false},{"id":110110,"name":"Thomas A. Wadden","orcid":"0000-0002-0438-4609","position":31,"is_corresponding":false},{"id":305437,"name":"Lynne E. Wagenknecht","orcid":"0000-0002-9980-0889","position":32,"is_corresponding":false},{"id":861255,"name":"Jacqueline Wesche-Thobaben","orcid":null,"position":33,"is_corresponding":false},{"id":367545,"name":"Holly R. Wyatt","orcid":"0000-0003-1651-4092","position":34,"is_corresponding":false},{"id":367546,"name":"Susan Z. 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