Browse the evidence

Sodium bicarbonate supplementation (0.2-0.4 g/kg body mass) improves performance in high-intensity sprints lasting ~60 seconds by buffering acid buildup, but causes gastrointestinal distress in many users.

Take 0.2-0.4g of sodium bicarbonate per kg of body weight 60-150 minutes before a ~60 second high-intensity effort. To avoid stomach upset, split the dose, take it with a small carb meal, or use a loading protocol over 2-4 days. Test this in training first, as responses vary widely.

Dysbiosis, characterized by an altered gut microbiota composition, contributes to the development of diabetes and obesity by disturbing energy balance and promoting inflammation.

Your gut health is a key player in your metabolic health. A diverse and balanced microbiome helps regulate energy, inflammation, and insulin sensitivity. Focus on a diet rich in fiber and diverse plant foods to support a healthy gut ecosystem.

Ultra-processed foods are significantly more energy-dense, less nutrient-dense, and cheaper per calorie than unprocessed foods, creating an economic incentive for overconsumption.

Ultra-processed foods are engineered to be cheap, energy-dense, and nutrient-poor. This combination makes them highly palatable and economically attractive, driving overconsumption. To improve diet quality, prioritize unprocessed foods which, while more expensive per calorie, offer better nutrient density and lower energy density, helping to regulate caloric intake.

Caloric restriction (CR) is the only intervention shown to increase health span and decrease the risk of age-related diseases in nonhuman primates.

Caloric restriction, specifically a 15% reduction in calories, has been shown to slow metabolic aging and reduce oxidative damage in humans over a 2-year period. It is the only intervention proven to extend health span in nonhuman primates. However, adherence is difficult, leading to interest in mimetics and fasting-mimicking diets.

Acetyl-L-carnitine (ALC) supplementation improves symptoms of diabetic neuropathy, including pain and nerve conduction, by enhancing neuronal energy metabolism and promoting nerve fiber regeneration.

If you have diabetic neuropathy, Acetyl-L-carnitine (ALC) may help reduce nerve pain and improve nerve function. It works by supporting the energy needs of nerve cells and promoting regeneration. It is generally well-tolerated.

Combining two specific night eating habits—dinner within 2 hours of bedtime and snacks after dinner (each occurring ≥3 times/week)—significantly increases the odds of developing obesity (BMI ≥25 kg/m²) and dyslipidemia in both men and women, with a supra-additive interaction effect observed in women.

If you frequently eat dinner within 2 hours of bed and snack after dinner (3+ times a week), you are at a significantly higher risk for obesity and high cholesterol, especially if you are a woman. To mitigate this, try to finish your last meal earlier in the evening and avoid late-night snacking. This is particularly important for women, where the combination of these habits showed a synergistic negative effect.

Intermittent fasting and time-restricted feeding activate AMPK and improve health outcomes by mimicking some benefits of caloric restriction without necessarily reducing total calories.

Try eating all your meals within a restricted window of time each day (e.g., 8 hours). This activates AMPK, a key energy sensor, which can improve health and function even if you don't count calories.

Long-term caloric restriction (25% reduction) slows the pace of biological aging as measured by DunedinPACE in healthy adults, though it does not significantly alter static biological age estimates from PhenoAge or GrimAge clocks.

If you can sustain a moderate calorie deficit (even around 10-15%), it may slow the rate at which your body ages biologically, as measured by specific epigenetic markers. This does not necessarily reverse your current biological age, but it may slow the accumulation of age-related damage. Consistency over two years is key, and behavioral support helps maintain the deficit.

Mitochondrial/ER localization of 1,2-DAGs is positively related to insulin sensitivity, whereas mitochondrial ceramide accumulation is inversely related.

Mitochondrial health is crucial for insulin sensitivity. The presence of certain lipids (1,2-DAGs) in the mitochondria is associated with better insulin sensitivity, possibly by supporting mitochondrial dynamics. This suggests that supporting mitochondrial function through exercise may be more important than simply lowering total muscle fat.

Low-Calorie Diets (LCD), specifically very low-calorie diets (VLCD) of 600-853 kcal/day, can induce Type 2 Diabetes remission in the short term (up to 2 years), particularly in patients with shorter diabetes duration (<4-6 years).

Very Low-Calorie Diets (600-853 kcal/day) using meal replacements for 3-5 months can reverse Type 2 Diabetes in nearly half of patients, especially if diagnosed recently. This approach works by reducing liver and pancreas fat. However, maintaining remission long-term is challenging, and success is highest in those with shorter diabetes duration.

High fructose consumption, particularly from High-Fructose Corn Syrup (HFCS), promotes NAFLD by inducing gut microbiota dysbiosis, increasing intestinal permeability, and directly causing hepatic steatosis through de novo lipogenesis.

Limit intake of added sugars, especially HFCS. High fructose intake is directly linked to liver fat accumulation and gut barrier dysfunction.

Maximum mitochondrial capacity is directly related to muscle contractile performance and physical function in older adults, regardless of chronological age.

Improving your mitochondrial capacity through physical activity can directly improve your muscle strength and physical function. This means that exercises that boost mitochondrial health (like aerobic exercise) are not just good for your heart, but also for your ability to perform daily tasks and maintain muscle strength.

Mitochondrial efficiency (P/O ratio) is positively related to exercise efficiency (Gross and Net Efficiency) in older adults, and both are reduced by physical inactivity.

Your body's ability to convert oxygen into energy (mitochondrial efficiency) directly impacts how efficiently you move during exercise. Staying physically active helps maintain this efficiency, making your workouts feel easier and less taxing. This link highlights why consistent aerobic activity is beneficial for overall movement quality.

Resistance exercise preferentially increases circulating lactate and purine metabolites (inosine, hypoxanthine, xanthine) compared to endurance exercise, suggesting a higher demand for glycolytic ATP turnover and nucleotide degradation during anaerobic efforts.

Resistance training creates a unique metabolic environment with high lactate and purine breakdown. This signals your body to adapt to high-intensity demands. Embrace the burn as a sign of effective glycolytic training, not just fatigue.

Weight loss of 7-10% is required to resolve NAFLD, but achieving this through lifestyle changes alone is difficult as only 10-20% of individuals succeed, and weight loss is less effective for NASH resolution in diabetic patients.

To resolve fatty liver disease, you need to lose 7-10% of your body weight. This is a high bar, and most people struggle to reach it with diet and exercise alone. If you have diabetes, this is even harder. Because lifestyle changes alone often fail to hit this target, you should discuss pharmacological options (like GLP-1 agonists) with your doctor to help you reach this weight loss goal.

BCAAs can stimulate mitochondrial biogenesis via the eNOS/NO/SIRT1/PGC-1α and mTOR/YY1 pathways, but this effect is tissue-specific and can be overridden by high levels of saturated fatty acids which suppress PGC-1α.

BCAAs can support mitochondrial health by stimulating biogenesis pathways, but this benefit can be canceled out by a diet high in saturated fats. To support mitochondrial function, combine BCAA intake (or natural sources) with a balanced diet low in saturated fats.

Diet order effects on energy balance and body composition are not observed when comparing Ultra-Processed Foods (UPF) to Minimally Processed Foods (MPF) if the diets are matched for macronutrients, energy density, and fiber.

When comparing ultra-processed foods to minimally processed foods, the physical properties of the food (energy density, fiber, volume) matter more than the processing status itself for determining intake. In this study, when UPF and MPF were matched for these properties, there was no difference in weight loss or energy intake based on which diet was eaten first. This suggests that formulating UPF to match the fiber and density of whole foods may mitigate overeating behaviors.

Intensive lifestyle intervention does not significantly improve objective physical examination measures of diabetic peripheral neuropathy (such as vibration sense or monofilament light touch) compared to control, except for a slight preservation of light touch sensation when both feet are considered together.

While lifestyle changes improve how patients *feel* (less pain, numbness), they may not always reverse objective nerve damage detectable by standard physical exams like monofilament testing. This highlights the importance of symptom management and prevention of progression, even if structural reversal is not achieved.

Adding a Very Low-Calorie Diet (VLCD) to a Weight-Management Programme (WMP) is not cost-effective compared to a WMP alone, despite producing greater short-term weight loss.

For those with severe obesity, adding a Very Low-Calorie Diet to a standard weight management program provides more weight loss in the first year but is not considered cost-effective. Standard WMPs are a more economically sound approach.

GLP-1 receptor agonists do not significantly increase energy expenditure in humans, despite evidence in animal models.

Don't expect GLP-1 drugs to burn extra calories at rest. They work by reducing food intake.

Adding Very Low Calorie Diets (VLCD, ≤800 kcal/day) to a standard low-intensity weight management program (WMP1) is not cost-effective compared to WMP1 alone.

For patients with severe obesity, adding very low-calorie diet meal replacements (≤800 kcal/day) to a standard 12-week behavioral weight management program is not a cost-effective strategy. The standard program alone provides better value for money. Patients should focus on sustainable behavioral changes rather than expensive, restrictive meal replacements.

Supervision has a trivial and statistically non-significant impact on body composition outcomes (body fat %, fat mass, fat-free mass) compared to unsupervised training.

Do not expect a coach to help you lose fat or gain muscle mass more than you would on your own, provided you follow the program. Focus on consistency and progressive overload. Supervision is more valuable for learning complex lifts and maximizing strength than for changing body composition.

In healthy adults, total energy expenditure (TEE) is a repeatable, durable trait that is not associated with short-term changes in body weight or body composition, meaning low TEE is not a risk factor for weight gain and high TEE is not protective against fat gain.

Stop blaming your weight on a 'slow metabolism.' This study shows that in healthy adults, metabolic rate is a stable trait and does not predict who gains weight or fat. Whether you burn calories fast or slow, it doesn't inherently protect you from or cause you to gain fat. Focus on the net energy balance (what you eat vs. what you move) rather than trying to 'boost' your metabolism, as your baseline expenditure is likely fixed and repeatable.

Bariatric surgery is the most effective intervention for reducing epicardial fat volume and improving HFpEF outcomes, superior to modest lifestyle changes.

For obese HFpEF patients, bariatric surgery is the most effective way to reduce epicardial fat and improve heart function. It reduces EAT more effectively than modest lifestyle changes. Consult with a bariatric specialist to see if you are a candidate.