Long Term Effect of Intensive Lifestyle Intervention on Cerebral Blood Flow.

Long Term Effect of Intensive Lifestyle Intervention on Cerebral Blood Flow.

J Am Geriatr Soc. 2017 Oct 30;:

Authors: Espeland MA, Luchsinger JA, Neiberg RH, Carmichael O, Laurienti PJ, Pi-Sunyer X, Wing RR, Cook D, Horton E, Casanova R, Erickson K, Nick Bryan R, Action for Health in Diabetes Brain Magnetic Resonance Imaging Research Group

Abstract
OBJECTIVES: To determine whether long-term behavioral intervention targeting weight loss through increased physical activity and reduced caloric intake would alter cerebral blood flow (CBF) in individuals with type 2 diabetes mellitus.
DESIGN: Postrandomization assessment of CBF.
SETTING: Action for Health in Diabetes multicenter randomized controlled clinical trial.
PARTICIPANTS: Individuals with type 2 diabetes mellitus who were overweight or obese and aged 45 to 76 (N = 310).
INTERVENTIONS: A multidomain intensive lifestyle intervention (ILI) to induce weight loss and increase physical activity for 8 to 11 years or diabetes support and education (DSE), a control condition.
MEASUREMENTS: Participants underwent cognitive assessment and standardized brain magnetic resonance imaging (MRI) (3.0 Tesla) to assess CBF an average of 10.4 years after randomization.
RESULTS: Weight changes from baseline to time of MRI averaged -6.2% for ILI and -2.8% for DSE (P < .001), and increases in self-reported moderate or intense physical activity averaged 444.3 kcal/wk for ILI and 114.8 kcal/wk for DSE (P = .03). Overall mean CBF was 6% greater for ILI than DSE (P = .04), with the largest mean differences between ILI and DSE in the limbic region (3.39 mL/100 g per minute, 95% confidence interval (CI) = 0.07-6.70 mL/100 g per minute) and occipital lobes (3.52 mL/100 g per minute, 95% CI = 0.20-6.84 mL/100 g per minute). In ILI, greater CBF was associated with greater decreases in weight and greater increases in physical activity. The relationship between CBF and scores on a composite measure of cognitive function varied between intervention groups (P = .02).
CONCLUSIONS: Long-term weight loss intervention in overweight and obese adults with type 2 diabetes mellitus is associated with greater CBF.

PMID: 29082505 [PubMed - as supplied by publisher]

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