A study of 5,000 adults with type 2 diabetes found losing fat instead of muscle as well as weight around the waist each correlated with a reduced risk for heart failure. The research, partially supported by the National Heart, Lung, and Blood Institute, appears in Circulation, and is part of the NIH-supported Look AHEAD (Action for Health in Diabetes) trial.
Earlier Look AHEAD studies found lifestyle interventions, like diet and exercise, helped participants with type 2 diabetes who were overweight or obese lose weight, inclusive of lean and fat mass. The researchers were curious: Would targeted interventions, such as losing fat instead of muscle or trimming inches around the waist, be more effective in helping someone with type 2 diabetes reduce the risk of heart failure or a heart attack? After analyzing 12 years of data from the trial, the researchers found reducing fat mass and waist circumference, instead of lean mass, each correlated with a reduced risk for heart failure. Losing weight around the waist was associated with a reduced risk for heart failure from an enlarged or stiff heart as opposed to the heart’s inability to quickly pump blood throughout the body. The three weight-loss metrics—lean mass, fat mass, and waist circumference—did not correlate with changes in heart attack risk over the 12-year period.
More research would be needed to alter clinical practice guidelines, but author Ambarish Pandey, M.D., suggests that people with type 2 diabetes who are overweight or obese may benefit from incorporating strategies, like resistance training, into targeted weight-loss efforts to lose fat instead of muscle or to change body composition.