OBJECTIVE To conduct post hoc secondary analysis examining the association between change in physical activity. Measured with self-report and accelerometry, from baseline to 1 and 4 years and cardiovascular disease (CVD) outcomes in the Look AHEAD Trial. RESEARCH DESIGN AND METHODS Participants were adults with overweight/obesity and type 2 diabetes with physical activity. Data at baseline and year 1 or 4 (n = 1,978). Participants were randomized to diabetes support and education or intensive lifestyle intervention. Measures included accelerometry-measured moderate-to-vigorous physical activity (MVPA), self-reported physical activity, and composite (morbidity and mortality) CVD outcomes. RESULTS In pooled analyses of all participants, using Cox proportional hazards models, each 100 MET-min/week increase in accelerometry-measured MVPA from baseline to 4 years was associated with decreased risk of the subsequent primary composite outcome of CVD. Results were consistent for changes in total MVPA (hazard ratio 0.97 [95% CI 0.95, 0.99]) and MVPA accumulated in ≥10-min bouts (hazard ratio 0.95 [95% CI 0.91, 0.98]), with a similar pattern for secondary CVD outcomes. Change in accelerometry-measured MVPA at 1 year and self-reported change in physical activity at 1 and 4 years were not associated with CVD outcomes. CONCLUSIONS Increased accelerometry-measured MVPA from baseline to year 4 is associated with decreased risk of CVD outcomes. This suggests the need for long-term engagement in MVPA to reduce the risk of CVD in adults with overweight/obesity and type 2 diabetes.

中文翻译：

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Look AHEAD 试验中加速度计测量和自我报告的身体活动变化与心血管疾病之间的关联。

目的 进行事后二次分析，检查身体活动变化之间的关联。在 Look AHEAD 试验中，通过自我报告和加速度计测量从基线到 1 年和 4 年的结果以及心血管疾病 (CVD) 结果。研究设计和方法 参与者是患有超重/肥胖和 2 型糖尿病并进行体育锻炼的成年人。基线和第 1 年或第 4 年的数据 (n = 1,978)。参与者被随机分配到糖尿病支持和教育组或强化生活方式干预组。措施包括加速度计测量的中度至剧烈身体活动 (MVPA)、自我报告的身体活动和复合（发病率和死亡率）CVD 结果。结果 在所有参与者的汇总分析中，使用 Cox 比例风险模型，从基线到 4 年，加速度测量法测量的 MVPA 每增加 100 MET-min/周与随后 CVD 主要复合结果的风险降低相关。结果与总 MVPA 的变化（风险比 0.97 [95% CI 0.95, 0.99]）和 MVPA 在 ≥ 10 分钟的比赛中累积（风险比 0.95 [95% CI 0.91, 0.98]）的变化一致，具有类似的二次模式CVD 结果。1 年时加速度测量法测量的 MVPA 的变化以及 1 年和 4 年时自我报告的身体活动变化与 CVD 结果无关。结论 从基线到第 4 年，加速度计测量的 MVPA 增加与 CVD 结果风险降低相关。这表明需要长期参与 MVPA 以降低超重/肥胖和 2 型糖尿病成人患 CVD 的风险。