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Long-term weight-loss intervention may reduce adverse effects of diabetes on brain structure
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Study participants with diabetes who were assigned to an intensive lifestyle intervention for 10 years exhibited a lower volume of white matter hyperintensities compared with participants assigned to a diabetes support and education intervention, according to study findings published in Diabetes Care.
Mark A. Espeland, PhD, professor of public health sciences at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina, and colleagues evaluated data from the Action for Health in Diabetes clinical trial, in which adults with type 2 diabetes and overweight or obesity underwent standardized structural brain MRI imaging and tests of cognitive function 10 to 12 years after randomization to 10 years of a lifestyle intervention (n = 164) or a control group (n = 155). Researchers sought to determine whether successful participation in the lifestyle intervention is linked to better profiles of brain structure.
Mark A. Espeland
For the intervention, participants were randomly assigned to group and individual counseling plus diet modifications and physical activity designed to effect a 7% weight loss (intensive lifestyle intervention group) or to a control group that received diabetes support and education through group sessions on diet, physical activity and social support.
Both groups had similar total brain and hippocampus volumes. Compared with the control group, the intensive lifestyle intervention group had 28% smaller mean white matter hyperintensity volume (P = .02) and 9% smaller mean ventricle volume (P = .04). Compared with participants with less than 5 years of diabetes duration at enrollment, those with at least 5 years of duration tended to have larger estimates of intervention effects for white matter hyperintensity volumes (P = .03 for interaction) and ventricle volume (P = .08 for interaction).
There were no consistent differences in cognitive function between the two groups.
“Long-term intensive weight-loss intervention may delay increases in subclinical cerebrovascular disease and brain atrophy associated with type 2 diabetes,” the researchers wrote. “If so, this furthers the importance of implementing behavioral interventions in adults with this disease and may hold great public health significance as the number of older adults with diabetes continues to increase rapidly. However, it is unknown whether the beneficial effects on brain anatomy that we describe may ultimately lead to better cognitive functioning and lower risk for cognitive impairment.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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