Browse the evidence

Lifestyle interventions, specifically caloric restriction and exercise, are the foundational first-line treatment for NAFLD, capable of inducing 5-10% weight loss and improving insulin resistance and hepatic steatosis.

Start with lifestyle changes as your primary treatment. Aim for a 5-10% reduction in body weight through a combination of a Mediterranean-style diet (high in plants, healthy fats) and regular exercise (both resistance and aerobic). This is the foundational step recommended by major guidelines before considering medications.

Obesity is a modifiable risk factor for breast and colorectal cancer progression and survival, and excess body weight is a primary mechanism through which diet and physical activity confer benefits.

Maintaining a healthy weight is crucial for breast and colorectal cancer survivors. While specific dietary compositions (like low-fat) may help, the primary benefit of diet and exercise comes from managing body weight. Survivors should focus on sustainable lifestyle changes to avoid excess body weight, as this is a key modifiable risk factor for recurrence and progression.

Physical activity has a dose-response relationship with better cancer outcomes, and there is more support for physical activity interventions than for dietary interventions in improving survival.

Engaging in regular physical activity is beneficial for cancer survivors, with greater activity levels leading to better outcomes. This is supported by more evidence than dietary interventions alone. Survivors should aim to incorporate physical activity into their routine, as it helps manage body weight and may improve survival.

Exercise doses of 4-8 kcal/kg/week (72-136 min/week) produce weight loss that closely matches predicted caloric expenditure without triggering significant compensatory mechanisms, whereas a high dose of 12 kcal/kg/week (194 min/week) triggers compensation, resulting in only ~53% of the predicted weight loss.

If you are a sedentary, overweight postmenopausal woman, aiming for 72-136 minutes of moderate exercise per week (e.g., 30-45 minutes, 3-4 times a week) is likely more effective for weight loss than exercising for nearly 3 hours a week. Higher doses trigger compensatory mechanisms (likely increased hunger/intake) that blunt weight loss, resulting in only half the expected loss. Stick to moderate doses to maximize efficiency.

Exercise training significantly reduces waist circumference independently of total body weight loss, with reductions observed even in individuals who did not lose weight.

Don't rely solely on the scale. If you are exercising, you are likely reducing your waist circumference (visceral fat) even if your total body weight stays the same. This is a significant health benefit, particularly for postmenopausal women, as abdominal fat is linked to higher risks of metabolic disease.

Weight reduction of 5-10% is the primary and most powerful dietary intervention for treating metabolic syndrome, as it significantly improves insulin sensitivity and corrects associated metabolic abnormalities.

Focus on losing 5-10% of your current body weight. This modest reduction is sufficient to significantly improve insulin sensitivity and metabolic health, often outperforming medication effects. You do not need to reach an 'ideal' weight to see these benefits.

In patients with type 2 diabetes, a very low-calorie diet (VLCD) of 500 kcal/day achieves early improvements in insulin sensitivity and beta-cell function equivalent to Roux-en-Y gastric bypass (RYGB) when matched for the rate and magnitude of weight loss.

For patients with type 2 diabetes, achieving a very low-calorie intake (around 500 kcal/day) for about three weeks can restore insulin sensitivity and beta-cell function just as effectively as gastric bypass surgery, provided the weight loss is rapid and significant. This suggests that the early metabolic 'reset' is driven by the intensity of caloric restriction rather than surgical changes to the gut.

High-dose, high-intensity aerobic exercise (600 kcal/session) without dietary restriction can achieve clinically meaningful weight loss (>3-5%) in young, obese adults.

For young, obese individuals, high-volume aerobic exercise (5x/week, ~600 kcal/session) can achieve >5% weight loss without dieting. This requires significant time and effort.

Short sleep duration (defined as <7 hours per night) is consistently associated with an increased risk of developing obesity and type 2 diabetes mellitus (T2DM) in adults and children, with a dose-response relationship where shorter sleep correlates with higher risk.

Aim for 7-8 hours of sleep per night. Consistently getting less than 7 hours is a significant risk factor for gaining weight and developing type 2 diabetes. This is not just about feeling tired; it affects your body's energy balance and insulin sensitivity. Protecting your sleep duration is as critical for metabolic health as your diet and exercise habits.

Adherence to physical activity routines is efficacious in reducing weight regain after weight loss treatment.

To keep weight off, sticking to a regular exercise routine is effective. You don't need a specific intense program, but you do need to adhere to physical activity. This helps prevent weight regain.

Adopting a flexitarian or semi-vegetarian diet (SVD) is associated with lower body weight, reduced BMI, and lower body fat percentage compared to non-vegetarian diets.

If you want to lose weight or improve metabolic health, you don't need to go fully vegan. Adopting a flexitarian diet—where you eat meat occasionally (e.g., less than once a week) or exclude red meat but eat poultry/fish—is associated with lower BMI and body fat compared to standard non-vegetarian diets. Focus on reducing red and processed meats while increasing plant-based foods.

Energy intake is more critical than protein intake for maintaining nitrogen equilibrium and lean body mass during training.

Ensure you are eating enough total calories to support your training. If you are not gaining muscle, increasing your total energy intake may be more effective than simply adding more protein.

Physical food structure (e.g., intact kernels vs. flour) and processing methods (e.g., parboiling, cooling) significantly lower the Glycemic Index (GI) and postprandial glucose response compared to refined forms.

Pay attention to how your food is processed. Eating intact cereal kernels (like barley or rye kernels) or parboiled rice results in a lower blood sugar spike than eating the same grains milled into flour or white rice. Try to keep food in its most natural physical form.

An intensive weight loss intervention (approx. 8.7% loss) combined with exercise significantly improves physical function (pain, stiffness, walking distance, stair climb) in older obese adults with knee osteoarthritis, despite a concurrent loss of fat-free mass.

For older adults with knee pain and obesity, a structured program combining a significant calorie deficit (approx. 1000 kcal/day below maintenance) with regular exercise (3 times a week) can significantly reduce pain and improve walking ability. While you may lose some muscle along with fat, the reduction in stress on your knees leads to better overall function and less disability. Consistency with meal replacements and self-monitoring is key to success.

Midage women gain an average of 0.5 kg per year, driven by a daily energy imbalance of approximately 10 kcal, which can be prevented by small, sustained changes in physical activity, sitting time, and energy intake.

To prevent the typical midage weight gain of 0.5 kg per year, you do not need extreme diets or intense workouts. Focus on small, sustainable changes: increase your physical activity slightly, reduce sitting time, and monitor energy intake. These small shifts are sufficient to counteract the tiny daily energy imbalance that drives weight gain.

Reduction in body weight is an independent determinant of reduced intrahepatic lipid in patients with T2DM and NAFLD, regardless of the specific antidiabetic agent used.

Losing weight is the key to reducing liver fat, regardless of whether you use a GLP-1, a DPP-4 inhibitor, or lifestyle changes. The drug helps you lose weight, and the weight loss reduces the liver fat.

Adopting a vegan diet is associated with significantly lower systolic and diastolic blood pressure and a lower prevalence of hypertension compared to a meat-based diet, primarily mediated by a lower body mass index (BMI).

If you are looking to lower your blood pressure, adopting a vegan diet is associated with significantly lower rates of hypertension and lower blood pressure readings compared to meat-eating diets. The study indicates this benefit is largely driven by a lower body weight (BMI). However, vegans in the study also tended to have lower sodium and alcohol intake, suggesting that dietary quality supports the weight-related benefits. To replicate these results, focus on a whole-food plant-based diet that naturally supports a healthy weight.

A 12-month moderate-intensity home-based exercise program significantly increases total energy expenditure and time spent in physical activity in older family caregivers compared to a nutrition education control.

To increase your daily energy expenditure, aim for 4 sessions of 30-40 minutes of brisk walking per week. This specific routine has been shown to significantly increase total energy expenditure in older caregivers.

A 3-month low-calorie lacto-ovo vegetarian diet and a low-calorie Mediterranean diet produce equivalent reductions in body weight, BMI, and fat mass in overweight omnivores.

If you are overweight and want to lose weight, both a low-calorie vegetarian diet (including eggs and dairy) and a low-calorie Mediterranean diet will work equally well over 3 months. The key is the caloric deficit, not the specific exclusion of animal products, provided you follow a structured plan.

Weight loss reverses the metabolic and autonomic alterations associated with obesity, including sympathetic overactivity.

Achieving weight loss is not just about reducing mass; it actively reverses the harmful nervous system adaptations (like high sympathetic tone) that contribute to heart disease risk in obesity.

Maintaining euhydration and minimizing dehydration (body mass loss <2%) during exercise in the heat is critical to prevent impaired aerobic performance and exacerbated cardiovascular strain.

Start your event well-hydrated by drinking 6 mL of water per kg of body weight every 2-3 hours before you start. During the event, drink fluids containing 0.5-0.7 g/L of sodium. Do not rely solely on thirst, as you will likely be dehydrated by the time you feel it, which hurts performance.

Caloric restriction leading to ≥5% weight loss significantly reduces inflammatory biomarkers (hs-CRP, IL-6, SAA, neutrophils) in overweight/obese postmenopausal women, whereas exercise without weight loss does not.

For postmenopausal women, simply exercising more will not significantly reduce inflammation. To lower inflammatory markers like CRP and IL-6, you must achieve a weight loss of at least 5% of your body weight through caloric restriction. Exercise is beneficial for fitness but is not a substitute for weight loss when the goal is reducing inflammation.

Higher objectively measured daily step counts are linearly associated with lower all-cause mortality in free-living adults, with increasing steps from sedentary levels to 10,000 per day reducing mortality risk by 46%.

To reduce your long-term mortality risk, focus on increasing your daily step count. If you are currently sedentary, aiming for 10,000 steps per day can reduce your risk of death by nearly half over a decade. You do not need high-intensity exercise; simply walking more throughout your day provides substantial protection.

Increasing daily step count over time (temporal change) is independently associated with a substantial reduction in mortality risk, even after adjusting for baseline step count.

If you are currently active, continuing to increase your daily steps over time provides additional mortality benefits. Even if you start with a lower step count, making an annual increase in your walking volume can significantly lower your risk of death.