Gains in Muscle Mass, Not Just Weight Loss, May Help Lower Diabetes Risk

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Lose weight. That’s often the first advice from doctors to their pre-diabetic patients. But while losing excess fat can help reverse Type 2 diabetes risk factors like insulin resistance and high blood-sugar levels, a new study finds that increasing muscle mass may also help lower risk of the metabolic disease.

According to lead researcher, Dr. Preethi Srikanthan, this may be good news for many people with pre-diabetes — a condition that results in higher-than-normal blood sugar, but does not qualify as diabetes — who have difficulty slimming down.

“Our findings suggest that beyond focusing on losing weight to improve metabolic health, there may be a role for maintaining fitness and building muscle mass,” Srikanthan, an assistant professor of medicine at the University of California, Los Angeles, David Geffen School of Medicine, said in a statement. “This is a welcome message for many overweight patients who experience difficulty in achieving weight loss, as any effort to get moving and keep fit should be seen as laudable and contributing to metabolic change.”

Srikanthan and colleagues based their study on data on 13,644 adults who participated in the U.S. National Health and Nutrition Examination Survey (NHANES) III between 1988 and 1994. Looking at the participants’ skeletal muscle index (SMI), a ratio of muscle mass to total body weight, researchers found an association between increasing SMI and a reduction in certain diabetes risk factors: for each 10% increase in SMI, there was an 11% decrease in insulin resistance and a 12% decrease in pre-diabetes.

The findings are in line with what is already known about the metabolic effects of muscle and fat. “Extra fat has bad effects, but more muscle has good effects. These data are also consistent with data we see on exercise, that it helps decrease diabetes risk, and that a lack of exercise and weight gain increase risk,” Daniel Rubin an assistant professor of medicine at Temple University School of Medicine, told USA Today.

The research was an extension of a 2009 study by the same UCLA team that found that people with high waist-to-hip ratios were at greater risk for diabetes. The team then began examining a subset of patients who had “sarcopenic obesity,” a condition marked by unusually high body fat and unusually low muscle mass.

The following year, using data from NHANES, the team was able to show that sarcopenic obesity was associated with pre-diabetes and diabetes risk. But in this latest study, the team found that the association between muscle mass and pre-diabetes held, even among those who did not suffer from sarcopenic obesity.

The study will be published in the September issue of the Journal of Clinical Endocrinology and Metabolism.

Meredith Melnick is a reporter at TIME. Find her on Twitter at @MeredithCM. You can also continue the discussion on TIME’s Facebook page and on Twitter at @TIME.