All Posts tagged cardiovascular

High fibre diet helps you live longer

Eating a diet rich in fibre has long been known to help keep your digestive tract working properly. It’s also thought to lower the risk of heart disease, some cancers and diabetes. Now, a new study suggests it could reduce the risk of death from cardiovascular, infectious and respiratory diseases. People who ate a high-fibre diet decreased their risk of dying over a nine year period compared to those who ate less fibre, according to a new study in the Archives of Internal Medicine.

The findings are based on a diet study from the National Institutes of Health and AARP, which included 219,123 men and 168,999 women ages 50 to 71 when the study began. Researchers from the National Cancer Institute examined food surveys completed by the participants in 1995 or 1996. After nine years about 11,000 people died and researchers used national records to determine the cause.

People who ate at least 26 grams per day were 22 percent less likely to die than those who consumed the least amount of fibre — about 13 grams per day or less. Men and women who consumed diets higher in fibre also had a reduced risk of cardiovascular, infectious and respiratory diseases, the study found. Getting fibre from grains seemed to have the biggest impact, the authors write.

The study has some limitations — mainly, people who ate high-fibre diets might also have been more likely to eat healthier diets overall, attributing to their longevity. Still, the study offers more evidence that fibre is certainly good for you. Federal dietary guidelines recommend people consume at least 14 grams of fibre per 1,000 calories, so about 28 grams for an average 2,000 calorie-per-day diet. But many experts say many people don’t get enough.

 

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Olive oil and veggies help the heart

It's no secret that eating well is good for both body and mind, so it may not come as a surprise that a new study finds women who eat more olive oil and leafy vegetables such as salads and cooked spinach are significantly less likely to develop heart disease.A group of Italian researchers found that women who ate at least 1 serving of leafy vegetables per day were more than 40 percent less likely to develop heart disease over an average of eight years, relative to women who ate two or fewer portions of those vegetables each week. Women who downed at least 3 tablespoons of olive oil daily – such as in salad dressing – were also 40 percent less likely to be diagnosed with heart disease, compared to women who ate the least olive oil.

It's not exactly clear why specifically leafy vegetables and olive oil may protect the heart, said study author Dr. Domenico Palli of the Cancer Research and Prevention Institute in Florence. “Probably the mechanisms responsible for the protective effect of plant-origin foods on cardiovascular diseases involve micronutrients such as folate, antioxidant vitamins and potassium, all present in green leafy vegetables.” Folate reduces blood levels of homocysteine, Palli explained, which is thought to increase the risk of cardiovascular disease by damaging the inner lining of arteries. Other studies have shown people who eat more potassium have lower blood pressure, which can protect the cardiovascular system. Virgin olive oil may be particularly effective at lowering heart disease risk because of its high level of antioxidant plant compounds, he added.

This is not the first study to link olive oil or vegetables to good heart health. Most famously, the traditional Mediterranean diet — rich in vegetables and monounsaturated fats from olive oil and nuts, but low in saturated fat from meat and dairy — has been tied to a decreased risk of heart disease. Mediterranean-style eating has also been credited with lowering risk for some cancers, diabetes, and, more recently, with slowing brain aging. Cardiovascular disease is a major killer, responsible for 30 percent of all deaths worldwide and the leading cause of death for both men and women in the U.S.

To look more closely at the role of foods in protecting against heart disease, Palli and colleagues reviewed dietary information collected from nearly 30,000 Italian women participating in a large national health study. Researchers followed the women, whose mean age was 50 at the beginning of the study, for an average of 8 years, noting who developed heart disease. In that time, the women experienced 144 major heart disease-related events, such as heart attack or bypass surgery, the authors report in the American Journal of Clinical Nutrition. Women who ate at least one daily serving (about two ounces) of leafy vegetables – such as raw lettuce or endives, or cooked vegetables like spinach or chard — had a 46 percent lower risk of developing heart disease than women who ate at most two portions per week. Consuming at least an ounce of olive oil per day lowered their risk by 44 percent relative to women who consumed a half-ounce or less daily, the authors found.

The women's intake of other types of vegetables, such as roots and cabbages, and their consumption of tomatoes or fruit did not seem to be linked to their risk for major heart events. Both fruits and vegetables have been associated with heart benefits in past studies conducted elsewhere in Europe and in North America. The authors caution that the apparent lack of positive effect from high fruit consumption in their results may have something to do with a different attitude toward fruit in Italy. It is cheap, varied and easily available, so eating a lot of fruit is a widespread habit but it does not necessarily signal that the rest of someone's diet is as healthy, the authors wrote. Another issue with the study, Palli noted, is that women had to report how much they ate of various items, and some may not have remembered their diets accurately, or may have changed their eating habits during the study period. In addition, people sometimes over-estimate their healthy behaviors, believing they eat healthier than they really do.

SOURCE: American Journal of Clinical Nutrition, published online December 22, 2010.

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Red meat increases women stroke risk

Women consuming too much red meat may have a higher risk of stroke than women eating less, says a new study. Red meat is high in saturated fat and cholesterol; both are risk factors for cardiovascular disease, heart attack, and stroke. The United States Centers for Disease Control and Prevention suggests lowering saturated fat intake and eating more fresh fruits and vegetables to help reduce your risk of stroke. Writing in the journal Stroke, researchers examined nearly 35,000 Swedish women, ages 39 to 73. None of the women had heart disease prior to the start of the study in 1997.

After ten years, results showed 4% of the study participants, 1,680 women, had a stroke. Those consuming the most red meat had the highest risk of stroke. Women in the top tenth of red meat intake, consuming at least 3.6 ounces each day, were 42% more likely to have a stroke, compared to women who ate just under one ounce of red meat daily.

Eating processed meat also increased stroke risk. Women eating 1.5 ounces of processed meat each day were 24% more likely to suffer a cerebral infarction, compared to woman consuming less than half an ounce of processed meat each day. Processed meat was not linked to any other form of stroke. Cerebral infarction is a type of stroke caused by a disturbance in the blood vessels supplying blood to the brain. Other types of stroke involve a rupturing of a blood vessel, called hemorrhagic strokes.

The scientists blame red meat and processed meat’s effect on raising blood pressure for the increased stroke risk. According to the World Health Organization (WHO), every year an estimated 17 million people die due to cardiovascular diseases, most notably stroke and heart attack. The WHO lists physical inactivity and unhealthy diet as the main risk factors for heart disease and major cardiac events.

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Fish diet lowers risk of stroke

Fish diet lowers risk of stroke

Women who eat more than three servings of fish per week are less likely to experience a stroke, a new study suggests. Specifically, fish-lovers in Sweden were 16 percent less likely to experience a stroke over a 10-year-period, relative to women who ate fish less than once a week. “Fish consumption in many countries, including the U.S., is far too low, and increased fish consumption would likely result in substantial benefits in the population,” said Dr. Dariush Mozaffarian of the Harvard School of Public Health. When choosing fish to eat, it’s best to opt for fish that are rich in omega-3 fatty acids, found most abundantly in fatty fish like salmon, mackerel and albacore tuna. “But any fish is better than none,” Mozaffarian noted.

 

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“Indeed, these fatty acids likely underlie the benefits of fish on stroke risk”, said study author Dr. Susanna Larsson of the Karolinska Institute in Stockholm. “These fatty acids may reduce the risk of stroke by reducing blood pressure and blood (fat) concentrations.”

This is not the first study to suggest that people who eat more fish have a lower risk of stroke, and experts already recommend a fishy diet to reduce the risk of cardiovascular problems, Mozaffarian added. “This study supports current recommendations.” Earlier this year, for instance, a study showed that middle-aged and older men who eat fish every day are less likely than infrequent fish eaters to develop a suite of risk factors for heart disease, diabetes and stroke.

In the current study, published in the American Journal of Clinical Nutrition, Larsson and her colleagues looked at 34,670 women 49 to 83 years old. All were free of cardiovascular disease and cancer at the beginning of the study, in 1997. During 10 years of follow-up, 1,680 of the women (4 percent) had a stroke. Stroke caused by blockage of an artery that supplies blood to the brain — also known as a “cerebral infarction” or “ischemic stroke” — was the most common event, representing 78 percent of all strokes in the study. Other types of strokes were due to bleeding in the brain, or unspecified causes.

Women who ate more than three servings of fish per week had a 16 percent lower risk of stroke than women who ate less than one serving a week. “Not a small effect,” Mozaffarian said, noting that it was roughly equivalent to the effect of statin drugs on stroke risk. Furthermore, the researchers asked women about their diets only once, using a questionnaire, which might have caused errors that would underestimate the link between a fishy diet and stroke risk, he explained. “So, the true risk reduction may be larger.”

Interestingly, women appeared to benefit most from eating lean fish, when other research shows fatty fish is better for health. This finding may stem from the fact that most fatty fish, such as herring and salmon, is eaten salted in Sweden, Larsson explained. “A high intake of salt increases blood pressure and thus may increase the risk of stroke,” she said. “So the protective effects of fatty acids in fatty fish may be attenuated because of the salt.”

Indeed, when it comes to fish, not all have equal benefits, Mozaffarian noted – for instance, he said, research has not shown any cardiovascular benefits from eating fast food fish burgers or fish sticks. In addition, women of childbearing age should avoid certain types of fish known to carry relatively high levels of pollutants, such as shark and swordfish, Mozaffarian cautioned. “This is a very, very short list of fish to avoid or minimize — there are many, many other types of fish to consume,” he said. “Women at risk of stroke are generally beyond their child-bearing years, and so for these women, all types of fish can be consumed.”

Larsson and her team speculate that certain nutrients in fish, such as fatty acids and vitamin D, might explain its apparent benefits. The Swedish study cannot prove cause and effect for high fish consumption and lowered stroke risk, however. For instance, fish consumption could be a sign of a generally healthier lifestyle or some other mechanism at work. Last December, Larsson and colleagues published data from the same group of women in the journal Stroke showing that those who eat a lot of red meat may also be putting themselves at increased risk of stroke.

SOURCE: bit.ly/dKunk8 American Journal of Clinical Nutrition, online December 29, 2010.

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Almonds ward off diabetes, says study

Eating almonds could help prevent diabetes and heart disease, according to a study.

The research found incorporating the nuts into our diets may help treat type 2 diabetes, which accounts for 90 to 95 per cent of all cases.

As well as combating the condition, linked to obesity and physical inactivity, it could tackle cardiovascular disease, the report published in the Journal of the American College of Nutrition said.

Diabetes is one of the fastest growing diseases in the world, and sufferers have a shortage of insulin or a decreased ability to use the hormone that allows glucose (sugar) to enter cells and be converted to energy.

When diabetes is not controlled, glucose and fats remain in the blood and over time, damage vital organs.

The study found consuming a diet rich in almonds may help improve insulin sensitivity and decrease LDL-cholesterol levels in those with pre-diabetes, a condition in which people have blood glucose levels higher than normal but not high enough to be classified as diabetes.

Researchers looked at the effects of consuming an almond-enriched diet on 65 adults with pre-diabetes (48 women and 17 men) with an average age in the mid-50s.

The participants were split up, and the group on the almond-enriched diet showed greater improvements in insulin sensitivity and clinically significant reductions in LDL-cholesterol compared with the nut-free group.

Dr Michelle Wien, assistant research professor in nutrition at Loma Linda University's School of Public Health, said, “We have made great strides in chronic disease research from evidence of effective treatment to evidence of effective prevention.”

The principal researcher for the study, conducted at the University of Medicine and Dentistry of New Jersey, added, “It is promising for those with risk factors for chronic diseases, such as type 2 diabetes and cardiovascular disease, that dietary changes may help to improve factors that play a potential role in the disease development.”

An estimated 55 million people in Europe have been diagnosed with diabetes, and the figure is expected to rise to 66 million by 2030.

There is no known way to prevent type 1 diabetes, which may be autoimmune, genetic, or environmental. It accounts for five per cent of all cases. Type 2 diabetes most often occurs in people older than 40.

Around 60 million people in Europe have pre-diabetes. People with the condition have an increased risk of developing type 2 diabetes, heart disease and strokes.

Almonds are cholesterol-free and compared with other nuts, they are the highest in six essential nutrients – fibre, magnesium, protein, potassium, copper and vitamin E.

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Studies support 3 glasses of milk daily

Individuals who drink three glasses of milk a day decrease their risk of cardiovascular disease by 18 percent, according to new research published in the American Journal of Clinical Nutrition.Researchers at Wageningen University and Harvard University examined 17 studies from the United States, Europe and Japan and found no link between the consumption of regular or low fat dairy and any increased risk of heart disease, stroke or total mortality. “Milk and dairy are the most nutritious and healthy foods available and loaded with naturally occurring nutrients, such as calcium, potassium and protein, to name a few,” said Cindy Schweitzer, technical director of the Global Dairy Platform. “It's about going back to the basics; maintaining a healthy lifestyle doesn't have to be a scientific equation.”

Schweitzer said during the past three decades as research sought to understand influencers of cardiovascular disease, simplified dietary advice including consuming only low fat dairy products emerged. However, in 2010 alone, a significant amount of new research was published from all over the world, supporting the health benefits of dairy. From dispelling the myth that dairy causes heart disease, to revealing dairy's weight loss-benefits, the following is a roundup of select dairy research conducted in 2010:

  • U.S. researchers examined 21 studies that included data from nearly 350,000 and concluded that dietary intakes of saturated fats are not associated with increases in the risk of either coronary heart disease or cardiovascular disease. The study was published in the American Journal of Clinical Nutrition.
  • A study published in the American Journal of Epidemiology examined 23,366 Swedish men and revealed that intakes of calcium above the recommended daily levels may reduce the risk of mortality from heart disease and cancer by 25 percent.
  • An Australian study published in the European Journal of Clinical Nutrition concluded that overall intake of dairy products was not associated with mortality. The 16-year prospective study of 1,529 Australian adults found that people who ate the most full-fat dairy had a 69-percent lower risk of cardiovascular death than those who ate the least.
  • A Danish study published in Physiology & Behavior concluded that an inadequate calcium intake during an energy restricted weight-loss program may trigger hunger and impair compliance to the diet.
  • An Israeli study published in the American Journal of Clinical Nutrition showed that a higher dairy calcium intake is related to greater diet-induced weight loss. The study sampled more than 300 overweight men and women during two years and found those with the highest dairy calcium intake lost 38-percent more weight than those with the lowest dairy calcium intake.

The amount of dairy recommended per day varies by country and is generally based on nutrition needs and food availability. “In the US and some European countries, three servings of dairy foods are recommended daily, said Dr. Schweitzer.”

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Almonds can fight diabetes

Here is another reason to make the tasty almonds a part of your daily diet. The humble tidbit nuts that combine tons of essential nutrients in one delicious package are an effective weapon in fighting type 2 diabetes and cardiovascular diseases, claims a new study. According to researchers, almonds added to the diet have a favorable effect on blood cholesterol levels and insulin sensitivity, two vital risk factors that can trigger diabetes and heart problems.

Lead author of the study, Dr. Michelle Wien, Assistant Research Professor in Nutrition at Loma Linda University’s School of Public Health stated, “We have made great strides in chronic disease research from evidence of effective treatment to evidence of effective prevention. “It is promising for those with risk factors for chronic diseases, such as type 2 diabetes and cardiovascular disease, that dietary changes may help to improve factors that play a potential role in the disease development.”

In a bid to assess the impact of almond enriched diet as a prescription for physical wellness, the researchers conducted a study. The focus of the study was to analyze the effect of the humble nut on the progression of type 2 diabetes and cardiovascular disease. The investigators enrolled a group of 65 adults comprising 48 women and 17 men with pre-diabetes in their mid-50s. The study subjects were split into two groups. As a part of the study, one group was assigned to almonds while the second formed the control group. The control group followed a diet recommended by the American Diabetes Association (ADA).The group assigned to almonds conformed to a similar diet but also added 20 percent calories from almonds. All the participants were asked to consume the same amount of calories from carbohydrate-containing foods, such as pasta, bread, and rice. However, those consuming the almond-enriched diet reported a lower intake of carbohydrate-containing food items.

After a period of 16 weeks, the investigators compared the insulin and cholesterol levels of both the groups. It was noticed that people consuming almond-enriched diet exhibited marked improvement in their insulin sensitivity and a dramatic reduction in LDL cholesterol as opposed to those eating the nut-free regular diet.

The study was conducted at the University of Medicine and Dentistry of New Jersey. The findings of the research are published in the ‘Journal of the American College of Nutrition

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Ten major advances in heart disease in 2010

The American Heart Association has compiled its annual list of the top 10 major advances in heart disease. “We have come far in the past decade, reducing heart disease deaths by more than 27 per cent,” said Ralph Sacco of the University of Miami. “But we know there is still much to be done in improving the lives of heart disease and stroke patients – and more importantly, in preventing these devastating diseases in the first place. Scientific research will help us lead the way,” said Sacco.

The highlights of the top ten advances in cardiovascular research in 2010:

1. Tailoring treatment for people with diabetes to reduce their risk of cardiovascular disease
New research from the ACCORD Study Group offered insight into specific treatments that can reduce their risk of cardiovascular disease (CVD). The first study found that aggressive blood pressure control does not reduce CVD risk in people with type 2 diabetes at high risk for CVD. In a second study, a combination therapy with a statin plus a fibrate was no better at reducing risk than a statin alone in patients with type 2 diabetes at high risk for CVD.

2. New advances for patients who aren't candidates for conventional valve surgery
Two new studies have supported evidence that Transcatheter aortic valve implantation (TAVI) can improve symptoms and outcomes – including quality of life – even over the course of several years. While there are some risks associated with TAVI, including strokes and other major cardiovascular events, the catheter-based procedure offers significant progress in this area.

3. Improving the way we reverse sudden cardiac arrest
Significant studies reported that chest compression only, or ''Hands Only CPR'' for adults by bystander lay rescuers improves survival outcome. Public awareness campaigns resulted in increased use of hands only CPR, as well as improved survival rates. While the new procedure appeared successful in adults, it is important to note that using conventional chest compressions with rescue breathing is still important for children stricken with sudden cardiac arrest.

4. More options for reducing stroke risk in atrial fibrillation
For the first time in more than 20 years there are viable alternatives to the primary prevention of stroke for patients with atrial fibrillation (AF). Warfarin (Coumadin) has long been the standard anti-clotting drug used to reduce the risk of stroke for these patients. But it carries its own complications from bleeding, and managing the dose requires regular blood tests, making it difficult to manage for both patients and doctors. Now, several new drugs have been found to work as well as warfarin – and are simpler for patients to take – offering an important advance in this field.

5. Adjusting pacing therapies can improve outcomes for heart failure patients
New studies showed that adding additional resynchronization pacing to ICD therapy could lead to improved outcomes in an expanded group of heart failure patients. In addition, new types of ICDs (defibrillators without leads, for example) can offer options that reduce some of the risks associated with traditional devices.

6. Hopeful new procedure for infants with congenital heart disease
The Pediatric Heart Network's randomized trial of Norwood shunt types in infants with single-ventricle lesions showed that the type of shunt used makes a difference in outcomes. Better transplantation-free survival at 12 months is a possibility with this new understanding of the better shunt choice for these patients. This was the first large-scale randomized trial in congenital heart surgery, offering an approach that should provide answers to other questions in the future.

7. Finding the right anti-clotting (anti-platelet) therapy
New research from the PLATO investigators has found that ticagrelor may improve outcomes and reduce adverse events better than the current standard, clopidogrel. The CURRENT-OASIS 7 Trial is exploring the optimal dosing of clopidogrel and aspirin in patient undergoing invasive surgery. These studies will help providers better understand the situations where new choices and dosages may improve results for the patient.

8. Basic science findings offer insight into future progress
Several studies this year brought the future of medicine closer to the present with new insight into emerging technologies. Findings from stem cell therapy have shown improved quality of life and survival in several early studies of patients with chronic heart failure and support the development of future cell-based therapeutics. A large animal study defined the basic mechanisms for heart muscle regeneration initiated by specific types of stem cells. The results demonstrated that these stem cells repair scarred myocardium through promotion of the generation of new heart muscle and blood vessel).

9. Using science to support healthy lifestyle behaviours
New science examining lifestyle behaviours in adults and children, with particular emphasis on physical activity and consumption pattern, show that such conditions as obesity and hypertension are positively influenced by a change in diet with decreasing sodium levels. Results from the school setting suggest that the earlier one starts to adopt healthy behaviours the better the effect on health outcomes.

10. Get With The Guidelines participation eliminates disparity gaps in care
Racial and ethnic disparities have been found in the quality of care delivered to patients with cardiovascular disease and achieving equity and addressing disparities has implications for quality, cost, risk management, and community benefit. These findings are the first to show that participating in a quality improvement program, such as Get With The Guidelines-Coronary Artery Disease, can eliminate racial and ethnic disparities of care while increasing the overall use of evidence-based care for heart attack patients.

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Vitamin B1 may prevent heart problems

A dietary supplement of the synthetic derivative of vitamin B1 has the potential to prevent heart disease caused by diabetes, according to new research from the University of Bristol, funded by Diabetes UK. Vitamin B1 may help the body to dispose of toxins and therefore protect cells of the heart from becoming damaged.

Diabetes leaves the heart more vulnerable to stress as less oxygen and nutrients are delivered to the heart and other organs. Heart damage can be caused by high levels of glucose entering cardiovascular cells, which forms toxins that accelerate the ageing of the cell. Around 50 per cent of people with diabetes die from cardiovascular disease, and this complication is the leading cause of death among people with diabetes. Researchers warn that with increasing prevalence of diabetes ( around one in twenty people in the UK are now diagnosed with the condition ), diabetes will result in a new epidemic of heart failure unless new treatments are developed.

A team of researchers at the University of Bristol gave a synthetic derivative of vitamin B1 called benfotiamine to mice with and without diabetes. They found that treating mice with Type 1 or Type 2 diabetes with benfotiamine from the early stages of diabetes can delay progression to heart failure. They also found that the vitamin B1 derivative improved survival and healing after heart attacks in Type 1 mice ( and even in the mice without diabetes too ). Foods rich in vitamin B1 include Marmite, yeast and quorn, but it is not yet known whether changes to diet alone would provide enough of the vitamin to see the same effects as supplements achieved in mice.

Previous Diabetes UK-funded research at the University of Warwick was the first to show that people with Type 1 and Type 2 diabetes have around 75 per cent lower levels of vitamin B1 than people without diabetes. It is thought that this may not be due to diet, but due to the rate at which the vitamin is cleared from the body. Small scale clinical trials of people with Type 2 diabetes have also discovered a link between taking vitamin B1 supplements and a reduction in the signs of kidney disease.

The latest research has been published in the Journal of Molecular and Cellular Cardiology. Professor Paolo Madeddu who led this research at the University of Bristol said “Supplementation with benfotiamine from early stages of diabetes improved the survival and healing of the hearts of diabetic mice that have had heart attacks, and helped prevent cardiovascular disease in mice with both Type 1 and Type 2 diabetes. We conclude that benfotiamine could be a novel treatment for people with diabetes, and the next step in this research will be testing whether similar effects are seen in humans.”

Dr Victoria King, Head of Research at Diabetes UK said “Diabetes UK is pleased to have supported this research and is encouraged by these promising results which now need to be tested and confirmed in human trials. We would like to note that it’s still too early to draw any firm conclusions about the role of vitamin B1 in the prevention of complications and we would not advise that people look to vitamin supplements to reduce their risk of cardiovascular complications at this stage. Taking your prescribed medication, eating a healthy balanced diet and taking regular physical activity are key to good diabetes management and therefore reducing your risk of diabetes associated complications.”

Source

Benfotiamine improves functional recovery of the infarcted heart via activation of pro-survival G6PD/Akt signaling pathway and modulation of neurohormonal response by Rajesh Katare, Andrea Caporali, Costanza Emanueli, Paolo Madeddu in the Journal of Molecular and Cellular Cardiology.

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Change lifestyle to reduce diabetes

Experts have suggested that an intensive lifestyle intervention helps individuals with type 2 diabetes lose weight and keep it off, along with improving fitness, control of blood glucose levels and risk factors for cardiovascular disease. Improving blood glucose control and cardiovascular risk factors in patients with type 2 diabetes is critical in preventing long-term complications of the disease.

The Look AHEAD (Action for Health in Diabetes) Research Group conducted a multicenter randomized clinical trial comparing the effects of an intensive lifestyle intervention to diabetes support and education among 5,145 overweight individuals with type 2 diabetes.

Of these, 2,570 were assigned to the lifestyle intervention, a combination of diet modification and physical activity designed to induce a 7 percent weight loss in the first year and maintain it in subsequent years. The 2,575 individuals assigned to the diabetes support and education group were invited to three group sessions each year. On average, across the four-year period, individuals in the lifestyle intervention group lost a significantly larger percentage of their weight than did those in the diabetes support group.

They also experienced greater improvements in fitness, hemoglobin A1c level (a measure of blood glucose), blood pressure and levels of high-density lipoprotein. Individuals in the diabetes support group, on the other hand, experienced greater reductions in low-density lipoprotein, owing to greater use of cholesterol-lowering medications in this group.

The report was published in the September 27 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

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