Diet, Diabetes, And Doubt: Is Preventive Medicine Lost In Space?
Posted Oct 26 2012 4:27pm
From US News & World Report…..
A large federal trial, looking at lifestyle—diet and exercise—for the treatment of diabetes was just terminated because, after 11 years, it wasn’t working as intended. The Look AHEAD study was stopped early because it was not reducing the rate of heart attack and stroke in the intervention group relative to the control. The termination was reported in a press release by the National Institutes of Health, and picked up by mainstream media. The findings suggest that diet and exercise are not effective for reducing the cardiovascular complications of diabetes.
And so, AHEAD, or at least the media coverage of it, is inviting us to look back, and doubt what we thought we knew about diet as the best medicine we’ve got—for diabetes, at least. We thought we knew that lifestyle was among the most powerful determinants of health outcomes. We thought we knew that diet and exercise together could prevent heart attacks in high-risk people. Participants in the AHEAD intervention lost 8 percent of their body weight by the end of the first year of the trial and were still down 5 percent from their baseline weight at the four-year mark. We thought we knew that diet, exercise, and weight management like this exerted important influences on the course of diabetes. Now, the AHEAD findings suggest we were wrong. Right? Not so fast.
For one thing, the trial did generate many noteworthy benefits. Prior papers in the Archives of Internal Medicine and the New England Journal of Medicine have reported significant benefits of lifestyle intervention related to weight loss, fitness, blood glucose levels, blood pressure, cholesterol levels, and mobility. The study was terminated for failing to prevent heart attacks and strokes, but it did reduce medication use, and conferred other benefits—such as a significant reduction in sleep apnea.