*2.2. Glucose Outcomes*

A 2-h oral glucose tolerance test (OGTT) was performed at each visit, using a glucose load of 1.75 g of glucose per kg of body mass (max 75 g). Blood was sampled before the glucose challenge and at 30-, 60-, 90- and 120-min post-challenge. Glucose concentrations at each time point were measured in plasma. Fasting glucose was also measured using a glucometer before the glucose challenge, and the OGTT was not completed if participants had a fasting value greater than 126 mg/dL. Hemoglobin A1c (HbA1c) was measured in fasting whole blood samples. Glucose area under the curve (AUC) was calculated from the five glucose measurements using the trapezoidal method [32].

Prediabetes and type 2 diabetes were based on clinical cutoffs for HbA1c, fasting plasma glucose, or 2-h plasma glucose [33]. Participants having either HbA1c values of 6.5% or higher, fasting glucose of 126 mg/dL or higher, or 2-h glucose of 200 mg/dL or higher were considered to have type 2 diabetes, while those with HbA1c between 5.7% and 6.4%, fasting glucose between 100 mg/dL and 125 mg/dL, or 2-h glucose between 140 mg/dL and 199 mg/dL were categorized as prediabetic.

#### *2.3. Adiposity Outcomes*

Weight and height were measured at each visit, and BMI calculated as kg per meter squared (kg/m2). Body composition was assessed using dual-energy X-ray absorptiometry (DEXA) whole body scans. Baseline scans were performed on either a Hologic QDR 4500W or Horizon W machine at baseline, while all follow-up scans were performed on the Horizon W. Body composition measures included total body fat percentage, fat mass to height ratio, fat free mass index (FFMI, kg/m2), android to gynoid ratio, trunk to leg ratio, trunk to limb ratio, and visceral adipose tissue (VAT, in3). Only body fat percentage and fat mass to height ratio were measured on the QDR 4500W machine.
