How much body fat a person has was found to be a strong predictor of their exercise capacity — the ability of the heart and lungs to function during exercise — in people with type 2 diabetes, according to a new study published in the journal PLOS ONE.
As the study authors note, exercise capacity in people with type 2 diabetes has been shown in past research to be a predictor of cardiovascular events, like a heart attack or stroke. So knowing what factors lead to diminished exercise capacity could be an important step toward identifying who should be tested for their exercise capacity, and possibly screened for other cardiovascular risk factors.
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For this study, researchers used data from the LOOK AHEAD study, which studied an intensive lifestyle intervention aimed at weight loss that focused on dietary changes and physical activity. It was performed at 16 different locations between 2001 and 2004, and its participants were all people ages 45 to 75 with type 2 diabetes who were overweight or obese. In the latest analysis, there were 1,348 included participants whose data was complete enough for researchers to perform their analysis. Researchers used machine learning (artificial intelligence or AI) to look at the relationship between their measured exercise capacity and a number of factors, including their cardiovascular history, medications, blood pressure, demographic information (age, sex, race and more), body measurements (including waist circumference), and body composition (including body fat percentage and muscle mass percentage).
The analysis showed that using all of this baseline data in a given person, it was possible for a computer to predict a person’s exercise capacity to a high degree of accuracy, compared with what their actual measured exercise capacity turned out to be. While the most accurate model for predicting exercise capacity included a number of different factors — including age, blood triglyceride level, and blood pressure — the single biggest predictor of exercise capacity was a person’s body fat percentage, which was true for both men and women. The researchers noted that using indirect, somewhat crude measures to estimate a person’s body fat percentage — like body-mass index (BMI, a measure of body weight that takes height into account) or waist circumference — is currently very common, since directly measuring body composition is somewhat more time-consuming and expensive. But since directly measuring body fat was so helpful in this study as a way to predict exercise capacity, this type of testing may be important to consider in some situations for many people with type 2 diabetes.
Body composition is typically measured using a technique called dual-energy X-ray absorptiometry (DXA), in which X-rays are used to measure both the soft tissue and the bone in your body. It’s typically done as you lie on your back, with a machine passing over your body to do the necessary measurements.
Until now, there has been “a relative under-appreciation of body composition metrics” as a way to predict who will develop cardiovascular disease, the researchers wrote. This study, they note, “sets the stage for cross-validation with other large prospective datasets and future research in this regard.”
Want to learn more about exercising with diabetes? Read “Add Movement to Your Life,” “Picking the Right Activity to Meet Your Fitness Goals” and “Seven Ways to Have Fun Exercising.”
Living with type 2 diabetes? Check out our free type 2 e-course!