99 men aged x = 60 years, randomized 12-month follow-up; analyzed like nonrandomized study
Weight loss (N = 73): 3 months on American Heart Association Step 1 diet, then 9 months hypocaloric diet. Weight maintenance (N = 26): 12 months of AHA Step change in F glucose (—0.04 mmol/L)
Weight loss: decreased IGT
prevalence from 57% to 41%. F and 2 hr glucose, F insulin and insulin AUC decreased (p <0.001). Lipids and BP improved in weight loss versus control. Exercise: IGT prevalence stable (47% versus 49% pre-post); glucose levels and AUC increased in exercise group, but 2 h insulin area decreased. BP did not change versus controls. TG decreased, but prevalence of CVD risk profiles did not. Control: IGT increased from 44% to 67% (p = 0.06 versus weight loss) and all glucose and insulin parameters increased Diet: no weight loss. Exercise:
—0.3 BMI unit weight loss, lower F insulin and insulin AUC. Diet + exercise: —0.6 BMI unit weight loss, lower F insulin and insulin AUC. 6-8% increase in F glucose, no significant change in OGTT, no differences between groups. Higher IGF binding protein-1 in all intervention groups, but greatest in D+E, suggesting improved insulin resistance and secretion Weight loss: IGT RR = 0.3 (0.10-0.91)1 among normals at entry; 25-28% decrease in OGTT glucose and insulin areas, 20% decrease in fasting insulin levels. 21% increase in hyperglycemic clamp M value (more insulin glucose >6.1 mmol/L and 2 hr >7.7 mmol/L) - probably includes many subjects with IGT rather than diabetes
Healthy subjects with negative stress or thallium ETT. Allocation masking and randomization method not stated. Less than one year of follow-up. Not blinded. Lipid changes in exercise group were completely due to weight loss, not exercise. Fewer changes in older men than younger ones. Diet and exercise groups were ^ evaluated at —10 months, controls at ^ -1 year. Dropouts = 33% in weight S
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