Browse the evidence

Persistent low energy availability (EA <125 kJ/kg FFM/day) in female athletes causes functional hypothalamic amenorrhea (FHA), impaired bone mineral density, and increased risk of musculoskeletal injuries, collectively known as the Female Athlete Triad.

If you are a female athlete training frequently, ensure you are eating enough to support your activity level. Ignoring this can lead to missed periods, weaker bones, and more injuries, even if you don't have an eating disorder. Use screening tools like the LEAF-Q to check for early signs.

Lifestyle changes, specifically weight reduction and physical exercise, are the first-line approach for overweight and obese men with functional hypogonadism because weight loss can increase testosterone concentrations.

If you are overweight or obese and have low testosterone, lose weight and exercise before starting testosterone therapy. Weight loss can naturally raise your testosterone levels. This is the recommended first step.

Metabolic and fitness adaptations gained from exercise are rapidly lost within days to weeks of inactivity, but can be restored upon resuming normal activity.

If you stop exercising, you will lose your fitness quickly. However, when you start exercising again, your fitness will return to where it was. Try to maintain some level of activity to avoid the loss.

Lifestyle interventions combining calorie restriction and moderate-intensity exercise are the primary recommended treatment for NAFLD, with weight loss of >7% body weight improving NASH histology and ~10% weight loss leading to fibrosis regression in 45% of patients.

Focus on losing 7-10% of your body weight through a combination of eating fewer calories and doing moderate exercise. This is the most effective way to improve liver health and potentially reverse fibrosis. Even if you don't lose all the weight, regular exercise alone can reduce liver fat.

Weight loss interventions improve obesity-related inflammatory markers (ORIM), with the greatest improvements occurring when weight loss exceeds 10%.

To significantly reduce inflammation associated with obesity, aim for a weight loss of at least 10% of your body weight. While smaller losses may have some benefit, the most robust improvements in inflammatory markers like CRP and IL-6 are consistently seen when this 10% threshold is met through diet, exercise, or surgery.

Reallocating time from sedentary behavior to moderate-to-vigorous physical activity (MVPA) significantly reduces all-cause mortality risk, with the magnitude of benefit increasing as the intensity of the substituted activity increases.

To lower your risk of death, prioritize replacing sitting time with moderate-to-vigorous activity (like brisk walking, jogging, or cycling) over light activity. The more intense the activity you swap in, the greater the mortality benefit. You do not need to find extra time; simply displace sedentary time with this higher-intensity movement.

Reallocating time from sedentary behavior to physical activity (both LPA and MVPA) is associated with reduced adiposity markers, including body mass index (BMI), body fat percentage, and waist circumference, with MVPA showing greater effects than LPA.

To reduce body fat and waist circumference, replace sitting time with physical activity. While moderate-to-vigorous activity (MVPA) offers the greatest benefit, even light physical activity (LPA) substitutions can help reduce BMI and body fat percentage across all age groups.

A 12-month intensive lifestyle intervention (ILI) inducing ~8% weight loss significantly reduces hepatic steatosis and prevents incident NAFLD in adults with type 2 diabetes compared to diabetes support and education (DSE).

For adults with type 2 diabetes, losing about 8-10% of body weight through a structured program combining moderate exercise (aiming for ~3.5 hours/week) and calorie-controlled eating significantly reduces liver fat and prevents the development of fatty liver disease. This benefit occurs even if liver enzyme blood tests remain normal, so relying on blood tests alone is insufficient to assess liver health.

Weight loss through lifestyle interventions (hypocaloric diet and physical activity) significantly improves hormonal, metabolic, and reproductive outcomes (including ovulation and fertility) in obese women with PCOS, with benefits correlating to the amount of weight lost.

For obese women with PCOS, losing weight is the most effective way to restore ovulation and fertility. Focus on a hypocaloric diet and regular physical activity. The amount of weight you lose directly correlates with how well your ovulation improves. While medications like Metformin exist, the primary driver of success is the weight loss itself, not just the drug. Your metabolic rate is likely normal for your weight; the difficulty is in maintaining the caloric deficit.

Higher volume exercise (longer duration, more frequency, longer total weeks) is associated with greater reductions in cancer-related fatigue, while intensity alone does not show a significant dose-response relationship.

To combat fatigue, focus on the total amount of exercise rather than how hard you work. Aim for longer total durations (e.g., 40+ minutes per session), more frequent sessions (e.g., 3x/week), and longer overall programs (e.g., 28+ weeks). You do not need to exercise at high intensities (near max heart rate) to see benefits; moderate intensity is sufficient if the volume is high.

Short sleep duration (typically <6-7 hours) is independently associated with an increased risk of obesity in both children and adults, with a dose-response relationship where shorter sleep correlates with higher BMI.

Aim for 7-9 hours of sleep. For children, ensure 10-11 hours. Consistently sleeping less than these amounts is a significant, independent risk factor for gaining excess body weight, regardless of diet or exercise habits.

Four months of supervised resistance training significantly reduces hepatic fat content in sedentary type 2 diabetic patients with NAFLD, achieving a reduction magnitude equivalent to aerobic training.

If you have type 2 diabetes and fatty liver, doing resistance training three times a week for four months can significantly reduce the fat in your liver, just as effectively as doing cardio. You do not need to change your diet or lose significant body weight to see this benefit; the exercise itself drives the change in liver fat.

Weight loss of 5% or more induces histological resolution of non-alcoholic steatohepatitis (NASH), while weight loss of 10% or more promotes fibrosis regression.

To reverse liver inflammation (NASH), aim to lose 5% of your body weight. To reverse liver scarring (fibrosis), aim for 10% weight loss. This is best achieved through a combination of dietary changes and exercise, supported by professional guidance (dietician) and tools (apps/support groups).

Intensive lifestyle modification (diet and exercise) is the most effective intervention for preventing type 2 diabetes in women with PCOS who have impaired glucose tolerance, outperforming pharmacological agents like metformin.

If you have PCOS and impaired glucose tolerance, prioritize lifestyle changes over medication. Aim to lose 5-7% of your body weight through a healthy, low-fat diet and at least 150 minutes of moderate exercise per week. This approach is more effective at preventing diabetes than taking metformin alone. Metformin may be considered if lifestyle changes are insufficient, but lifestyle is the primary treatment.

Resistance training reduces body fat and increases basal metabolic rate, with high-volume workouts using large muscle masses and short rest periods being most conducive to fat loss.

To lose fat with resistance training, focus on high-volume workouts that use large muscle groups (like squats or deadlifts) and keep rest periods short. This approach maximizes energy expenditure and metabolic rate increases, helping you reduce body fat more effectively than low-volume or long-rest routines.

Resistance training improves glucose tolerance and insulin sensitivity, and modifying body composition through resistance training can delay the onset of insulin resistance.

To improve your blood sugar control, include resistance training in your routine. It improves glucose tolerance and insulin sensitivity, but these benefits fade within 72 hours if you stop exercising, so consistency is key.

Combination exercise significantly improves cardio-respiratory fitness (VO2max) by 13.3% compared to no exercise, whereas aerobic or resistance training alone did not show statistically significant improvements in this specific 12-week moderate-intensity protocol.

To improve your heart's pumping efficiency (VO2max), combining 15 minutes of moderate cardio with 15 minutes of weight training five days a week is more effective than doing just cardio or just weights for 30 minutes. This approach leverages both systems to boost fitness faster.

Lifestyle interventions, specifically calorie-restricted diets combined with at least 150 minutes of weekly aerobic exercise, are the first-line treatment for improving insulin sensitivity in women with PCOS.

Start with lifestyle changes before medication. Focus on eating fewer calories and aiming for 150 minutes of aerobic exercise per week, ensuring at least 90 minutes are vigorous. Prioritize sleep and mental health, as these support metabolic health. If lifestyle changes are too difficult to sustain alone, consider adding insulin-sensitizing drugs like Metformin as a chronic treatment option.

Ketogenic diets result in significantly greater weight loss and improvements in metabolic markers (insulin, HbA1c) compared to standard low-fat or non-ketogenic calorie-restricted diets in overweight or obese individuals, particularly those with type 2 diabetes.

If you are overweight or have Type 2 Diabetes, a ketogenic diet (very low carb, moderate protein, high fat) is likely to produce faster and more significant weight loss and metabolic improvements than a standard low-fat diet. This is driven by lower insulin levels, which allows your body to access fat stores more easily.

Weight loss of 10% or more through lifestyle interventions (hypocaloric diet and exercise) is necessary to achieve regression of liver fibrosis in patients with NAFL/NASH.

To reverse liver scarring (fibrosis), you need to lose at least 10% of your body weight. This requires a daily calorie deficit of about 750 calories combined with 200 minutes of walking per week. While losing 3-5% helps fat and 5-7% helps inflammation, hitting that 10% mark is what actually reverses fibrosis. This is the most effective treatment available, but it is hard to maintain.

Dehydration exceeding 2% of body mass impairs aerobic performance in warm-hot environments, contradicting the 'drink to thirst' approach for severe events.

Start your event well-hydrated (drink 6ml/kg every 2-3 hours before). During the event, try to replace sweat losses. After the event, drink fluids with meals and electrolytes to recover fully. Don't rely solely on thirst if you are sweating heavily.

Weight loss, particularly through bariatric surgery or intensive diet, significantly reduces the severity of Obstructive Sleep Apnea (OSA) and Obesity Hypoventilation Syndrome (OHS), though complete resolution is not guaranteed.

Losing weight is the most effective way to reduce the severity of sleep apnea. Even if you don't achieve complete remission, significant weight loss (via surgery or diet) can drastically reduce the number of breathing pauses and lower the pressure needed for CPAP therapy.

A low-glycemic load diet during caloric restriction attenuates the decline in resting energy expenditure (REE) and reduces hunger compared to a low-fat diet, while improving cardiovascular risk factors, despite achieving similar weight loss.

If you are struggling with hunger and fatigue while trying to lose weight, consider shifting from a standard low-fat diet to a low-glycemic load diet. This involves choosing carbohydrates with a lower glycemic index (like whole grains, legumes, and non-starchy vegetables) and managing portion sizes of carbs. This approach may help you feel less hungry and preserve your metabolic rate better than simply cutting fat, potentially making your weight loss journey more sustainable and improving heart health markers like blood pressure and inflammation.

Initial weight loss goal of 5-10% within 6 months via caloric restriction (1200-1500 kcal/day for women, 1500-1800 kcal/day for men) and moderate aerobic/resistance exercise is the standard lifestyle intervention for obesity management.

Aim to lose 5-10% of your body weight in the first 6 months. For women, this likely means eating 1200-1500 calories a day; for men, 1500-1800. Combine this with 30-60 minutes of moderate exercise (like brisk walking) 5 days a week and basic strength training twice a week. This is the standard, evidence-based first step.