Physical function following a long-term lifestyle intervention among middle aged and older adults with type 2 diabetes: The Look AHEAD study

Denise K. Houston, Rebecca H. Neiberg, Michael E. Miller, James O. Hill, John M. Jakicic, Karen C. Johnson, Edward W. Gregg, Van S. Hubbard, Xavier Pi-Sunyer, W. Jack Rejeski, Rena R. Wing, John P. Bantle, Elizabeth Beale, Robert I. Berkowitz, Maria Cassidy-Begay, Jeanne M. Clark, Mace Coday, Linda M. Delahanty, Gareth Dutton, Caitlin EganJohn P. Foreyt, Frank L. Greenway, Helen P. Hazuda, Andrea Hergenroeder, Edward S. Horton, Robert W. Jeffery, Steven E. Kahn, Anne Kure, William C. Knowler, Cora E. Lewis, Corby K. Martin, Sara Michaels, Maria G. Montez, David M. Nathan, Jennifer Patricio, Anne Peters, Henry Pownall, Judith Regensteiner, Helmut Steinburg, Thomas A. Wadden, Karen White, Susan Z. Yanovski, Ping Zhang, Stephen B. Kritchevsky

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Background: Lifestyle interventions have been shown to improve physical function over the short term; however, whether these benefits are sustainable is unknown. The long-term effects of an intensive lifestyle intervention (ILI) on physical function were assessed using a randomized post-test design in the Look AHEAD trial.

Methods: Overweight and obese (body mass index ≥ 25 kg/m2) middle-aged and older adults (aged 45-76 years at enrollment) with type 2 diabetes enrolled in Look AHEAD, a trial evaluating an ILI designed to achieve weight loss through caloric restriction and increased physical activity compared to diabetes support and education (DSE), underwent standardized assessments of performance-based physical function including a 4- and 400-m walk, lower extremity physical performance (expanded Short Physical Performance Battery, SPPBexp), and grip strength approximately 11 years postrandomization and 1.5 years after the intervention was stopped (n = 3,783).

Results: Individuals randomized to ILI had lower odds of slow gait speed (<0.8 m/s) compared to those randomized to DSE (adjusted OR [95% CI]: 0.84 [0.71 to 0.99]). Individuals randomized to ILI also had faster gait speed over 4- and 400-m (adjusted mean difference [95% CI]: 0.019 [0.007 to 0.031] m/s, p = .002, and 0.023 [0.012 to 0.034] m/sec, p < .0001, respectively) and higher SPPBexp scores (0.037 [0.011 to 0.063], p = .005) compared to those randomized to DSE. The intervention effect was slightly larger for SPPBexp scores among older versus younger participants (0.081 [0.038 to 0.124] vs 0.013 [-0.021 to 0.047], p = .01).

Conclusions: An intensive lifestyle intervention has modest but significant long-term benefits on physical function in overweight and obese middle-aged and older adults with type 2 diabetes. Identifier: NCT00017953.

Original languageEnglish (US)
Pages (from-to)1552-1559
Number of pages8
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Issue number11
Early online dateOct 19 2017
StatePublished - Oct 8 2018


  • Diabetes
  • Mobility
  • Physical function
  • Weight loss

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology


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