Population and Analytical Sample
obesity, overweight or obesity
OBESITY, EVENTS, METABOLIC SYNDROME
Participants were recruited between October 23, 2013, and December 23, 2016, in 23 Spanish centers. Eligible participants were middle-aged and older men (age 55-75 years) and women (age 60-75 years) without previous cardiovascular events. The inclusion criteria included the presence of overweight or obesity (body mass index for overweight: 27-29; for obesity: 30-39 [calculated as weight in kilograms divided by height in meters squared]) and metabolic syndrome.Of the total cohort (N = 6874), the subsample of participants (n = 1556) who underwent dual energy x-ray absorptiometry (DXA) measurements in 7 of the 23 recruiting centers having access to DXA scanners (DXA substudy) was used for the present study. In each of these 7 centers, either all or a subsample of participants were invited for DXA scans (details provided in eTable 1 in We excluded individuals with missing values in variables of interest at baseline, resulting in 1521 participants included in the final analyses (intervention group, n = 760; control group, n = 761). The percentages of participants with the baseline DXA scans completing the follow-up visits were 79.9% for 1 year and 74.5% for 3 years (flowchart in eFigure 1 in 