Browse the evidence

Women who reported ever doing shift work had an age-adjusted relative risk of coronary heart disease (CHD) of 1.38 compared to those who had never done shift work.

Practitioners should consider the potential cardiovascular risks associated with shift work in women.

The multivariate adjusted relative risk of CHD was 1.51 among women reporting 6 or more years of rotating night shifts.

Longer durations of shift work may significantly increase cardiovascular risk in women.

The excess risk of CHD associated with shift work persisted after adjustment for cigarette smoking and other cardiovascular risk factors.

Shift work may pose a significant risk for heart disease regardless of other lifestyle factors.

Men with low plasma adiponectin levels had a higher risk of colorectal cancer than men with higher levels.

Practitioners should consider monitoring plasma adiponectin levels as a potential risk factor for colorectal cancer.

There is a statistically significant inverse association between plasma adiponectin levels and risk of colorectal cancer.

The findings suggest that higher adiponectin levels may be protective against colorectal cancer.

The association between adiponectin levels and colorectal cancer risk was slightly attenuated after adjusting for body mass index and other risk factors.

Adjustments for body mass index and other factors should be considered when interpreting the relationship between adiponectin and cancer risk.

Breast cancer risk increased with duration of unopposed estrogen use.

Longer durations of unopposed estrogen therapy may necessitate closer monitoring for breast cancer risk.

Women who worked 15 or more years of night shifts had a geometric mean level of estradiol of 10.1 pg/mL compared to 8.8 pg/mL for women who never worked night shifts (P for trend = 0.03).

Practitioners should be aware that long-term night shift work may influence estradiol levels in women.

A single morning urinary melatonin measurement is a reasonable marker for long-term melatonin levels among premenopausal women.

Practitioners can use a single morning urinary melatonin measurement to estimate long-term melatonin levels in premenopausal women.

High body mass index (BMI ≥30 kg/m2) is a strong independent risk factor for the development and progression of Chronic Kidney Disease (CKD), primarily driven by compensatory glomerular hyperfiltration and increased intra-glomerular pressure.

Maintaining a healthy weight is one of the most effective ways to prevent kidney disease. Excess body weight forces your kidneys to work harder (hyperfiltration), which damages them over time. Focus on sustainable lifestyle changes like balanced nutrition and physical activity to lower your BMI, especially if you have central adiposity (large waist circumference), as this directly reduces the risk of developing chronic kidney disease.

Obesity causes chronic kidney disease through compensatory hyperfiltration and intraglomerular hypertension, leading to obesity-related glomerulopathy, independent of diabetes or hypertension.

High body weight increases pressure inside your kidneys (hyperfiltration), which damages them over time. This happens even if you don't have diabetes or high blood pressure. To protect your kidneys, focus on reducing visceral fat through diet and exercise, as this lowers the mechanical and hormonal stress on your kidney filters.

Roux-en-Y gastric bypass (RYGB) surgery reduces the hedonic 'wanting' (appetitive drive) for energy-dense foods without necessarily altering the 'liking' (consumatory pleasure) of those foods.

If you have had RYGB, your brain's drive to seek out high-calorie foods is biologically reduced, even if you still enjoy the taste. Trust this biological shift rather than fighting cravings with willpower alone, as the surgery has altered your reward pathways.

SGLT2 inhibitors reduce the risk of hospitalization for heart failure and all-cause mortality in patients with type 2 diabetes compared to DPP-4 inhibitors.

If you have type 2 diabetes, ask your doctor about SGLT2 inhibitors (like empagliflozin). They are proven to lower the risk of heart failure hospitalization and death more effectively than DPP-4 inhibitors, offering significant cardiovascular protection beyond just blood sugar control.

Maternal obesity during the first trimester of pregnancy increases the risk of congenital heart defects and cardiovascular issues in offspring, mediated in part by maternal pregestational diabetes.

For women planning pregnancy, managing weight and blood sugar before conception is critical to protecting the child's long-term heart health. This is a preventative measure that starts before pregnancy.

Lasting remission of type 2 diabetes is not feasible in real-world settings due to the progressive nature of the disease, lack of consensus on definitions, and high rates of weight regain and treatment discontinuation.

Do not expect type 2 diabetes to be 'cured' or stay in remission without ongoing effort. Biological mechanisms will push your body to regain weight and increase hunger. Focus on sustainable management rather than a one-time fix, and maintain regular monitoring of cardiovascular and microvascular health even if your glucose levels are normal.

GLP-1 agonists and bariatric surgery can achieve high rates of remission, but these are not true remission as they require ongoing treatment, and long-term sustainability is low without continuous intervention.

GLP-1 agonists and surgery are effective for achieving remission, but they are not cures. You will likely need to continue treatment or accept the risks of surgery. Discuss with your doctor whether the benefits of these interventions outweigh the need for ongoing management.

Among adults aged 50 and older with newly diagnosed type 2 diabetes, the prevalence of undiagnosed (silent) hypertension reaches 50%, significantly higher than in younger diabetic cohorts.

If you are over 50 and have just been diagnosed with type 2 diabetes, you have a 1 in 2 chance of having high blood pressure that you don't know about. Because you likely have no symptoms, you must get your blood pressure checked immediately at diagnosis to prevent long-term heart and kidney damage.

In older adults (≥50 years) with newly diagnosed type 2 diabetes, mean systolic blood pressure often remains below the clinical hypertension threshold (140 mmHg) despite a high prevalence of silent hypertension, indicating subclinical vascular changes.

If you are over 50 with type 2 diabetes, do not assume your blood pressure is safe just because it is under 140 mmHg. Your blood vessels may already be stiffening, and your risk for heart disease is high even without a formal hypertension diagnosis. Monitor your BP closely and manage other risk factors like cholesterol and weight.

Age, BMI, HbA1c, family history of hypertension, and waist circumference are independent predictors of silent hypertension in newly diagnosed type 2 diabetes patients.

Your risk of having undiagnosed high blood pressure when you get diabetes depends on your age, weight, blood sugar control, family history, and waist size. If you have these risk factors, you are more likely to have silent hypertension and should be screened aggressively.

SGLT2 inhibitors provide significant cardiovascular and renal protection in type 2 diabetes patients through mechanisms independent of glycemic control, including metabolic reprogramming and fuel switching.

If you have type 2 diabetes, ask your doctor about SGLT2 inhibitors. They protect your heart and kidneys through mechanisms beyond just lowering blood sugar, such as helping your body use different fuels. This can significantly reduce your risk of serious complications.

In patients with type 2 diabetes, the magnitude of weight loss achieved through semaglutide treatment (ranging from no loss to >10% loss) does not correlate with the risk of major adverse cardiovascular events (MACE), indicating that the drug's cardioprotective effects are independent of weight reduction.

If you are taking semaglutide for type 2 diabetes and cardiovascular risk, do not stop the medication if you are not losing as much weight as expected. The drug provides cardiovascular protection through direct effects on your blood vessels and heart, independent of how much weight you lose. Focus on the long-term heart health benefits rather than the number on the scale.

Postprandial glucose metabolism parameters derived from an Oral Glucose Tolerance Test (OGTT) do not predict anthropometric changes (weight, fat mass, or fat-free mass) following an 8-week low-calorie formula diet in adults with obesity.

If you are on a strict, low-calorie diet for 8 weeks, your body's specific glucose and insulin response to a sugar test (OGTT) will not help predict how much weight you will lose. The study found that baseline fat-free mass and sex were much better predictors of weight loss than metabolic phenotyping. Focus on adhering to the caloric deficit rather than seeking metabolic tests to guide short-term weight loss.

Consumption of a high-fat diet (HFD) induces rapid, transient hypothalamic inflammation and neuronal injury (specifically in POMC neurons) in rodents, which eventually leads to permanent gliosis and neuronal loss with sustained exposure, a process also observed in obese humans via MRI.

Sustained consumption of high-fat diets can cause physical injury to the brain's weight-regulation centers, leading to permanent changes that make weight control more difficult. This suggests that early dietary interventions are critical to prevent this neurological damage.

Elevated serum alanine aminotransferase (ALT) activity in the absence of viral hepatitis or excessive alcohol consumption is associated with an increased calculated 10-year risk of coronary heart disease (CHD), with the association being more prominent in women.

If your blood tests show elevated ALT levels (above 43 IU/L for men, above 30 IU/L for women) and you do not have viral hepatitis or drink heavily, this is a strong indicator of underlying metabolic issues like insulin resistance or fatty liver. These conditions significantly increase your 10-year risk of heart disease, especially for women. You should address this by focusing on metabolic health improvements, such as weight management and reducing refined carbohydrates, rather than ignoring the lab result.