Traditional Diet and Exercise Failed to Reduce Heart Attacks , Stroke and Mortality in Type 2 Diabetics: Unexpected Results of a Landmark Trial, Known as Look AHEAD.
The Action for Health Diabetes (Look AHEAD) study, a trial comparing an intensive lifestyle-intervention program versus the standard diabetes support and education had to be stopped, as it failed to show any improvement in cardiovascular events or death rate. It is interesting to note that previously, the investigators were all excited that the trial would show a reduction in cardiovascular events, as it had shown improvement in cardiovascular risk factors.
The study began in
2001 and was funded by the NIH (National Institute of Health). It
enrolled 5145 Type 2 diabetic patients, who were roughly, equally
divided into two groups: The intensive lifestyle-intervention arm, which
included individual sessions
with a nutritionist and/or personal trainer, as well as group sessions
and refresher courses versus the control group that received standard
diabetes support and education.
lifestyle-intervention did show an improvement in cardiovascular risk
factors, but it did not translate into reduction in cardiovascular
morbidity or mortality. In other words, intensive diet and exercise
conducted with the help of dietitians and exercise trainers did not make
any difference, as far as cardiovascular events are concerned.
It is an excellent
study that brings out several points: Current diet and exercise
recommendations can improve cardiovascular risk factors, but do not
prevent heart attacks, strokes and deaths. Isn't it time, we reevaluate
our so called cardiovascular risk factors? Perhaps we are missing
something. One such major factor is stress, which is well known to cause
heart attacks and stroke. We don't even mention stress management when
we talk of lifestyle intervention. Interesting, isn't it? Perhaps our
recommendations about diet and exercise are also flawed.
I came to these
conclusions about fifteen years ago and developed my own treatment
strategy for my Type 2 diabetic patients. It consists of five steps: My
own recommendations about diet, exercise, stress management,
vitamins/herbs and medications, in that order. The results have been
astounding. Heart attack or stroke is a rare event in my Type 2 diabetic
patients. When some of my Type 2 diabetic patients get hospitalized for
elective surgery, usually some orthopedic surgery, they are shocked to
see the kind of food on their tray (like cake, cereal, juice and
pancakes) at the hospital. They refuse
to eat half of those food items. Sadly, they also see the high charges
of the dietitian's consultation fee on their discharge bill.
I Have discussed my revolutionary, comprehensive and scientific treatment strategy in my book, "Take Charge of Your Diabetes."
Written by Dr. Zaidi on october 21, 2012.
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