Browse the evidence

Orthopedic manual physical therapists demonstrate high confidence and knowledge regarding lifestyle screening but exhibit significantly lower actual practice frequency, with alcohol counseling being the most neglected lifestyle topic.

If you are a physical therapist, your confidence in discussing lifestyle factors does not guarantee you are discussing them. Specifically, check your own habits and comfort levels regarding alcohol and smoking, as these are the most likely topics to be skipped despite your knowledge. Prioritize brief, routine screening for these high-impact factors during every patient interaction, regardless of your specialty.

Tobacco smoking significantly increases the prospective risk of developing depression in both adults and adolescents.

Smoking is a significant risk factor for developing depression in both adults and adolescents. Quitting smoking can help reduce this risk. While quitting may be challenging, the long-term mental health benefits are substantial.

Increased exposure to media content related to weight gain, diet culture, and pandemic stress, combined with increased use of video-conferencing, increases eating disorder risk by heightening body image concerns and social comparison.

Be mindful of your media consumption, especially on social media. Limit exposure to content that promotes thin ideals or diet culture. If you use video-conferencing, try to focus on the conversation rather than your appearance, and take breaks from screens to reduce body image preoccupation.

Fears of contagion and health concerns related to the pandemic can increase eating disorder risk by promoting restrictive diets focused on immunity or avoiding foods perceived as contaminated.

Avoid restrictive diets based on fear of contamination. Focus on a balanced diet that supports your immune system. If you have health anxiety, seek professional support to manage your fears and eating behaviors.

Lower education level is inversely associated with weight gain during lockdown, suggesting socioeconomic factors influence food choices.

If you have less formal education, be aware that socioeconomic factors may make it harder to access fresh, healthy food. Focus on affordable, shelf-stable healthy options like canned beans, frozen vegetables, and whole grains to mitigate weight gain.

Good social engagement is modestly protective against dementia, particularly in long-term studies (≥10 years) and when adjusted for depression.

Maintain regular social interactions and a supportive social network, as this may offer modest protection against dementia, especially over the long term. Focus on activities that provide social support and network strength, as these are more consistently linked to reduced risk than subjective feelings of loneliness.

The decline in physical activity is slightly more pronounced in males than in females during the transition to adulthood.

Males may experience a steeper drop in activity (approx 6.5 min/day less) compared to females (approx 5.5 min/day less) during this life transition. Pay extra attention to maintaining activity levels if you are male.

The method of diagnosing diabetes significantly impacts the observed prevalence in PCOS, with self-report or administrative records doubling the odds ratio compared to prospective blood-based techniques.

If you are looking at statistics about PCOS and diabetes, be careful about how 'diabetes' was defined. Studies using blood tests (OGTT) find lower rates than those using medical records, because many women with PCOS are undiagnosed. This highlights the need for active screening.

Experiencing weight bias in primary healthcare negatively influences patient engagement and utilization of health services, leading to avoidance or delay of care.

If you have obesity, you may face weight bias in healthcare, which can lead you to avoid or delay seeking care. This is a common and documented barrier. To overcome this, seek providers who focus on health behaviors rather than just weight, and remember that avoiding care due to fear of judgment can worsen health outcomes.

Smoking cessation during lockdown was observed in 3.3% of smokers, potentially driven by fear of COVID-19 respiratory complications.

For smokers, the heightened awareness of respiratory health risks during the pandemic may serve as a powerful motivator to quit. Leverage this awareness to support cessation efforts.

Current and former tobacco smoking is associated with significantly increased odds of developing incident chronic kidney disease (CKD).

Do not smoke, and if you do, quit. Both current and former smoking are associated with an increased risk of developing kidney disease. Public health messages should support smoking cessation to prevent CKD.

Moderate alcohol consumption is associated with a reduced risk of developing incident chronic kidney disease (CKD) compared to no or low consumption.

If you drink alcohol, do so in moderation. The study suggests that moderate consumption is associated with a reduced risk of CKD compared to no consumption. However, heavy drinking may be harmful. Follow public health guidelines for alcohol consumption.

Transitioning to telehealth for eating disorder treatment during lockdown was associated with perceived lower quality of care compared to face-to-face interactions, though continuity of care was maintained for many.

If you are receiving telehealth for an eating disorder, recognize that it may feel less effective than in-person care. Communicate this to your provider. They can adapt strategies to make remote sessions more effective, but you must be proactive in discussing what is and isn't working.

Cash incentives for physical activity via wearables may be less effective than charity incentives or no incentives, and can even reduce physical activity compared to control groups.

Be cautious with cash-based fitness challenges. Evidence suggests they may be less effective than charity-based incentives or no incentives, and can even reduce activity levels. Focus on intrinsic motivation or social/charitable rewards instead.

Government-imposed public life restrictions and lockdowns during the COVID-19 pandemic caused a substantial, global decrease in physical activity levels, specifically moderate-to-vigorous (MVPA) and vigorous physical activity (VPA).

If you are facing lockdowns or facility closures, expect your activity levels to drop significantly. Proactively plan home-based or outdoor activities to mitigate this loss, as the default response to restrictions is a ~40% drop in exercise volume.

Pandemic-related lockdowns led to a significant decrease in compliance with WHO physical activity guidelines, dropping from 80.9% to 62.5% of the population.

Check if you are still meeting the 150 minutes of moderate or 75 minutes of vigorous activity per week. Lockdowns make this harder, so you need to be intentional about scheduling movement.

Social media influencers promote a cognitive association between body perfection (low body fat, visible musculature) and happiness/health, driving followers to adopt restrictive dieting and exercise behaviors to achieve this ideal.

Be critical of fitness influencers on Instagram. Recognize that their content is often designed to sell products (supplements, sportswear) and create a dependency on their lifestyle advice. If you feel inadequate after viewing their posts, remember that their images are curated and edited. Seek health advice from certified professionals who do not have a financial stake in selling you specific products.

There is insufficient evidence to set specific, quantified (time-based) recommendations for total sedentary time.

Do not worry about hitting a specific number of sitting hours. Instead, focus on the general principle of limiting sedentary time and breaking up long periods of sitting with light movement. The exact threshold varies by individual and health outcome.

Current standardized assessment of muscle quality is lacking, with no single ideal endpoint measure, necessitating consensus on definitions and standardized imaging or functional tests.

There is currently no single, standardized, widely available clinical test for 'muscle quality.' Clinicians use proxies like grip strength and gait speed. Research is ongoing to standardize imaging (ultrasound, MRI) for routine use. Patients should be aware that 'muscle quality' is a distinct concept from 'muscle mass' and may require specialized assessment.

Sugar-sweetened beverage taxes are economically justified if they correct for externalities (healthcare costs) and internalities (self-control issues/misinformation), potentially exceeding their costs even if regressive in direct financial impact.

For policymakers: Implement SSB taxes to correct for health externalities and internalities, not just to raise revenue. Target taxes on grams of sugar, not just volume, and consider revenue recycling to benefit low-income communities. The net social benefit likely exceeds the costs.

More green space in a neighborhood tends to be associated with a lower risk and prevalence of type 2 diabetes mellitus (T2DM), although the evidence is not as strong as for walkability.

While the evidence is not conclusive, living in an area with more green space may be associated with a lower risk of type 2 diabetes. This could be due to increased physical activity or stress reduction.

Engagement with 'fitspiration' social media content is associated with high levels of psychological distress, disordered eating risk, and compulsive exercise behaviors, despite users perceiving positive motivational benefits.

If you follow fitness influencers, be aware that while it may motivate you to exercise, it is also strongly linked to psychological distress and disordered eating patterns. Prioritize content from qualified experts or relatable 'everyday' people who discuss challenges honestly, rather than those promoting unattainable aesthetic ideals. Monitor your mental health and eating habits closely if you feel pressure to achieve a specific look.

Nudging interventions that alter only the properties of fruit and vegetables (e.g., labeling, sizing, functional design) do not have a statistically significant overall effect on increasing selection.

Relying solely on changing labels, sizes, or design features of fruit and vegetables is unlikely to significantly increase their selection. These changes should be combined with strategic placement to be effective.

Gastrointestinal side effects (nausea, vomiting, feeling sick) are the primary drivers of discontinuation for GLP-1 receptor agonists in real-world practice, with patient-reported rates significantly higher than physician perceptions.

If you are taking a GLP-1 medication and stopping because of stomach issues, you are not alone. GI side effects are the most common reason patients quit, often more so than lack of effectiveness. These symptoms are frequently under-recognized by doctors. Talk to your provider about these specific issues; managing expectations and side effects can help you stay on the medication longer.