Browse the evidence

Altered gut microbiota in obesity increases digestible energy uptake from food through enhanced expression of nutrient transporters and fermentation enzymes, leading to increased caloric absorption.

Your gut bacteria can extract more calories from the same amount of food if they are altered. This is one reason why two people might eat the same diet but have different weights. Focusing on gut health through fiber and diverse foods might help optimize energy extraction.

In severe diabetes, reduced cardiac lipoprotein lipase (LPL) activity forces cardiomyocytes to rely on non-esterified fatty acids (NEFA) from adipose tissue, causing mitochondrial overload, lipid metabolite accumulation, and cardiac lipotoxicity.

In severe diabetes, the heart's ability to process fat from blood lipids (via LPL) drops. This forces the heart to burn fat directly from the blood (NEFA), which it cannot handle efficiently, leading to damage. Treatments must focus on restoring this specific fat-processing pathway in the heart, not just lowering overall blood fat.

The new user rate of semaglutide (Ozempic ® ) remained stable at approximately 4 per 1000 adult person-years between 2019 and 2021 and then peaked at 10 per 1000 in the first quarter of 2023.

Practitioners should be aware of the increasing trend in semaglutide prescriptions, particularly in 2023.

1.2% of boys and men aged 15 to 35 reported use of prescription weight loss medication in the past 12 months.

Practitioners should be aware of the low prevalence of prescription weight loss medication use in this demographic.

68% of respondents who took protein supplements were males and 32% were females.

Understanding the gender distribution can help tailor marketing and educational efforts regarding protein supplements.

There is no relationship between protein intake and nutritional status.

Protein intake may not be a critical factor in assessing nutritional status in this population.

HIIT and MICT produce comparable changes in body composition, lipid profiles, fasting blood glucose, HbA1c, and blood pressure in patients with diabesity.

For weight loss, blood sugar control (HbA1c), and blood pressure, both HIIT and moderate steady-state exercise appear to work equally well for people with diabesity. You do not need to do HIIT to see improvements in these specific areas; moderate exercise is sufficient.

Increasing the intake of low- and no-calorie sweetened beverages (LNCSB) without substitution (i.e., adding them to the diet) is associated with lower body weight and waist circumference, but shows no significant association with type 2 diabetes risk.

Simply drinking more diet soda than you used to, without cutting out sugary drinks, might lead to a very small amount of weight loss over time. However, this increase in intake does not appear to lower your risk of developing type 2 diabetes.

100 g/hr of carbohydrate may be advisable for the Olympic Cycling Road race.

Consider recommending carbohydrate intake strategies for endurance athletes.

The Expert Group Statement advocates for an evidence-based approach to nutrition in high-performance tennis.

Practitioners should implement evidence-based nutritional strategies for tennis players.

The statement emphasizes a 'food first' philosophy, prioritizing food over supplements.

Nutritionists should focus on whole foods to meet players' nutrient needs.

Short-term adoption of a vegan diet (e.g., 3 weeks) leads to significant weight loss and reduced caloric intake without negatively impacting fitness scores or sports performance.

If you switch to a vegan diet, expect to lose weight, likely fat, due to lower calorie density. Your strength and fitness scores should remain stable in the short term (3 weeks) if you keep training. Monitor your energy levels and adjust portions if you feel fatigued.

Time-restricted eating (TRE), lower meal frequency, and earlier caloric distribution result in statistically significant but small weight loss compared to control groups when implemented for 12 weeks or longer.

If you want to try meal timing for weight loss, expect a modest result (around 1-2 kg loss over 12+ weeks) rather than a dramatic transformation. The key is likely that restricting your eating window naturally reduces the amount of food you consume, not a magical metabolic shift. Focus on consistency for at least 12 weeks, and do not expect it to replace the fundamental need for a caloric deficit.

HIIT does not significantly improve body mass or BMI in patients with diabesity compared to standard treatment.

Do not expect HIIT to drastically change your weight or BMI if you have diabesity. The primary benefit of this training style for your condition is metabolic (blood sugar and lipids), not weight loss. Manage your expectations regarding the scale.

Diabetes, obesity and cardiorenal/metabolic disease often occur in the same patient.

Healthcare providers should be aware of the interconnectedness of these conditions in patients.

Early intensive combination intervention can prevent disease progression and events.

Implementing early and intensive interventions may improve patient outcomes.

Suboptimal metabolic control has not improved in past 20 years despite new medications.

There is a need for improved strategies to manage metabolic control in patients.

GLP-1 agonists have drawbacks in treating obesity.

Practitioners should be aware of the limitations of GLP-1 agonists in obesity treatment.

An alternative approach to GLP-1 agonist treatment includes long-term lifestyle programming.

Incorporating lifestyle changes alongside GLP-1 treatment may enhance effectiveness.

The approach of 'Food Is Medicine' is suggested to address obesity burdens.

Utilizing appropriate food choices can be a key strategy in obesity management.

Ultrasonography is recommended as the initial screening tool for hepatic steatosis in Latin America.

Practitioners should use ultrasonography for initial screening of MASLD patients.

Complete alcohol abstinence is recommended for patients with significant fibrosis.

Practitioners should advise patients with significant fibrosis to abstain from alcohol.

Future clinical trials with other incretin mimetics may further emphasize the importance of an obesity phenotype-based approach in treating HFpEF.

Clinicians should stay informed about upcoming trials that may validate obesity phenotype-based treatments.

Final proof of efficacy for incretin therapies on primary clinical liver outcomes may come from large database analyses.

Future studies should focus on analyzing large datasets to confirm the efficacy of incretin therapies for NAFLD.