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Resistance exercise maintains significant net reduction in T2D risk at 1 yearResistance exercise may help prevent type 2 diabetes risk rebound

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Key Takeaway
Consider resistance exercise in weight loss programs to potentially maintain T2D risk reduction at 1 year.

This randomized controlled trial enrolled 221 sedentary women with overweight to evaluate the impact of different exercise modalities on metabolic risk. Participants were assigned to one of three groups: Diet plus Aerobic, Diet plus Resistance, or Diet-only (an 800 kcal/day diet until BMI < 25 kg/m). The primary outcomes were predicted 10-year risks for major adverse cardiovascular events (MACE) and type 2 diabetes (T2D) over a 1-year follow-up period.

Results showed that mean BMI decreased from 28.3 to 23.9 kg m post-weight loss, but rebounded to 25.8 at 1 year across all groups. MACE risk decreased from baseline to post-weight loss but rebounded in all groups (p < 0.001). Notably, the Diet-only group achieved a greater MACE reduction than the Diet plus Resistance group (p = 0.022).

Regarding T2D risk, all groups showed an initial decrease followed by a rebound (p < 0.001) except for the Diet plus Resistance group, which maintained a significant net reduction at 1 year (p = 0.003). Additionally, follow-up exercise adherence was associated with lower T2D risk rebound (p = 0.024). No safety data or specific limitations were reported. Resistance exercise may be beneficial in weight loss interventions to prevent progression to T2D.

How this fits prior evidence

How this fits prior evidence: This finding addresses a gap in managing progression to type 2 diabetes in overweight populations. While prior coverage noted that oral semaglutide shows specific MACE and coronary revascularization benefits in patients with type 2 diabetes, this study highlights a specific role for resistance exercise in maintaining T2D risk reduction. It also relates to the reported prevalence of sarcopenia in adults with type 2 diabetes, as resistance training may address the underlying muscle mass concerns associated with that condition.

When people lose weight to manage their health, they often face a difficult hurdle: keeping those health gains over the long term. For women with overweight and sedentary lifestyles, the risk of developing type 2 diabetes can fluctuate as weight fluctuates. This study looked at how different types of exercise impact that risk after a period of intentional weight loss.

Researchers followed 221 women who followed a calorie-restricted diet. Some added aerobic exercise, while others added resistance exercise. While all groups saw an initial drop in their risk for heart issues and type 2 diabetes, many saw those risks start to climb again after one year. However, there was a notable difference in the group that performed resistance exercises.

Specifically, the group that did resistance training maintained a significant reduction in their risk for type 2 diabetes at the one-year mark. This suggests that while diet is the first step, adding strength-building movements might provide a more stable defense against diabetes progression. Because the study was small and specific to sedentary women, talk to your doctor about the best exercise plan for your personal health goals.

What this means for you:
Resistance exercise may help women maintain lower type 2 diabetes risk after weight loss compared to other methods.

Common questions

What kind of exercise helped keep diabetes risk low?

The study found that resistance exercise helped women maintain a significant reduction in their risk for type 2 diabetes at the one-year mark. While other groups saw their risk levels rebound after their initial weight loss, the resistance group showed a more stable result.

Who was included in this study?

The study included 221 sedentary women who were overweight. These women followed a specific calorie-restricted diet until they reached a lower body mass index before the one-year follow-up period began.

How did the risk for heart issues change?

In all groups, the risk for major adverse cardiovascular events decreased during the weight loss phase but then increased again by the one-year follow-up. The study noted that the diet-only group actually saw a greater reduction in this specific risk than the resistance group.

Study Details

Study typeRct
EvidenceLevel 2
Follow-up120.0 mo
PublishedOct 2026
View Original Abstract ↓
OBJECTIVE: This study aimed to quantify changes in predicted 10-year risk for major adverse cardiovascular events (MACE) and type 2 diabetes (T2D) across weight loss, post-weight loss (Post-WL), and 1-year follow-up and to determine whether trajectories varied by exercise modality. METHODS: Sedentary women with overweight (21-49 years) were randomized to Diet+Aerobic, Diet+Resistance, or Diet-only and completed an 800 kcal/day diet until BMI < 25 kg m. Predicted 10-year MACE and T2D risks were calculated using cardiometabolic disease staging equations. Longitudinal changes and adherence effects were analyzed using fractional logit models fit with generalized estimating equations. RESULTS: Among 221 women (115 African American), mean BMI decreased from 28.3 to 23.9 kg m, with regain to 25.8 at 1 year. MACE risk decreased from Baseline to Post-WL and rebounded from Post-WL to 1 year in all groups (all p < 0.001). Diet-only achieved greater MACE reduction than Diet+Resistance (p = 0.022). T2D risk decreased in all groups (all p < 0.001) but rebounded in Diet+Aerobic and Diet-only. The Diet+Resistance group maintained a significant net reduction at 1 year (p = 0.003). Follow-up exercise adherence was associated with lower T2D risk rebound (p = 0.024). CONCLUSIONS: Weight loss reduced MACE and T2D risks, but both rebounded with weight regain. Resistance exercise may be beneficial in weight loss interventions to prevent progression to T2D. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00067873.
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