Browse the evidence

The weight loss benefit of reducing sugar-sweetened beverages is significantly greater in Hispanic adolescents than in non-Hispanic adolescents, suggesting ethnic-specific physiological or behavioral responses.

Hispanic adolescents may benefit more significantly from reducing sugary drinks than non-Hispanic adolescents. This suggests that personalized nutrition strategies might be more effective than generic guidelines.

FDA-approved weight loss medications (liraglutide, lorcaserin, naltrexone-bupropion, orlistat, phentermine-topiramate) produce greater weight loss and diabetes risk reduction than placebo, but are associated with higher rates of adverse events and dropout.

If behavioral interventions alone are insufficient, FDA-approved weight loss medications can provide greater weight loss and diabetes risk reduction. However, be prepared for a higher likelihood of side effects and discontinuation. These medications should be used in conjunction with behavioral interventions.

An ad libitum reduced-glycemic load (GL) diet produces greater reductions in body mass index (BMI) and fat mass in obese adolescents compared to an energy-restricted reduced-fat diet.

For obese teens, switching to a diet focused on low-glycemic load foods (like nonstarchy vegetables, fruits, legumes, nuts, and dairy) without counting calories can lead to better fat loss than traditional calorie-restricted low-fat diets. This approach works by managing hunger hormones, allowing teens to eat until satisfied while naturally reducing energy intake, which may improve adherence by respecting their need for autonomy.

Reducing dietary glycemic load improves insulin resistance in obese adolescents independently of weight loss.

Reducing the glycemic load of your diet can improve insulin sensitivity in obese teens, even if they don't lose as much weight as expected. This suggests that food quality (GL) has direct metabolic benefits beyond just calorie counting.

Older women exhibit anabolic resistance, showing a reduced capacity for muscle hypertrophy and a smaller increase in MPS in response to resistance exercise and protein feeding compared to young men and women.

As women age, their muscles become less responsive to protein and exercise. To maintain muscle, older women may need to focus on higher protein intake or specific training strategies to overcome this natural resistance.

Higher serum 25(OH)D levels (>=30 ng/ml) are associated with a lower incidence of hypertension and lower blood pressure.

Maintaining Vitamin D levels above 30 ng/ml may help lower blood pressure and reduce the risk of hypertension, potentially through regulating the renin-angiotensin system.

Higher dietary intake of alpha-linolenic acid (ALA) is inversely associated with the risk of sudden cardiac death (SCD) in women, independent of long-chain n-3 fatty acid intake.

If you are a woman, increasing your intake of alpha-linolenic acid (ALA) from plant sources like flaxseed, soybean, or canola oil may help lower your risk of sudden cardiac death. This benefit appears specific to sudden death and does not necessarily extend to preventing heart attacks or other heart disease deaths. Aim to include these plant oils in your diet regularly.

Behavioral programs for type 2 diabetes are more effective for individuals with suboptimal or poor glycemic control (baseline HbA1c ≥7.0%) compared to those with good control.

If your blood sugar levels are currently high (HbA1c ≥7.0%), you are likely to see greater improvements from behavioral programs than if your levels are already well-controlled. This is because there is more room for improvement in glycemic control.

Gradual, individualized dose escalation of GLP-1 receptor agonists is the primary clinical strategy to mitigate gastrointestinal side effects (nausea, vomiting, constipation) and improve treatment persistence in obesity management.

When starting a GLP-1 injection for weight loss, do not rush to the full dose. Start at the lowest possible dose and wait until you feel completely comfortable before asking your doctor to increase it. Eat smaller, low-fat meals and stay hydrated. If you feel nauseous, pause the increase; this is normal and usually goes away.

Alternate day fasting (36-hour fasts on alternating days for 3 weeks) impairs glucose tolerance in nonobese women while improving insulin sensitivity in nonobese men.

If you are a nonobese woman considering alternate day fasting, monitor your blood sugar response to meals, as this protocol may worsen glucose tolerance. Men may experience improved insulin sensitivity under the same conditions. The lack of control over feasting day calories may also mask true metabolic adaptations.

Alternate day fasting for 3 weeks significantly increases skeletal muscle SIRT1 mRNA expression in nonobese humans, independent of sex.

Alternate day fasting increases SIRT1 gene expression in muscle, a marker associated with stress resistance and longevity in rodents. However, this study did not measure actual stress resistance or lifespan, so the practical health benefit remains uncertain.

Long-term testosterone replacement therapy in hypogonadal men produces substantial, sustained, and progressive weight loss, waist circumference reduction, and BMI decline.

If you are a hypogonadal man with low testosterone, testosterone replacement therapy (specifically testosterone undecanoate) can lead to significant and sustained weight loss, waist reduction, and improved BMI over several years. This effect is observed even without intentional lifestyle changes, suggesting that correcting hormonal deficits is a primary driver of body composition in this population. Consult a healthcare provider to determine if you are a candidate for this therapy.

Overweight adults with high baseline insulin secretion lose significantly more weight on a low-glycemic load diet compared to a high-glycemic load diet, whereas those with low insulin secretion show no significant differential benefit.

If you are overweight, standard weight loss advice might not be enough. Consider getting your insulin response tested. If you have high insulin secretion, a low-glycemic load diet (lower carbs, higher protein/fat) may help you lose more weight than a standard high-carb diet. If your insulin secretion is low, the type of glycemic load matters less.

For obese women, matching dietary macronutrient composition to insulin sensitivity status significantly enhances weight loss: insulin-sensitive individuals lose more weight on high-carbohydrate/low-fat diets, while insulin-resistant individuals lose more weight on low-carbohydrate/high-fat diets.

If you are obese and trying to lose weight, your insulin sensitivity matters. If your fasting insulin is low (insulin-sensitive), a higher-carb, lower-fat diet will likely help you lose more weight. If your fasting insulin is high (insulin-resistant), a lower-carb, higher-fat diet is likely more effective for you. Both diets should be hypocaloric.

An 8-week very low carbohydrate ketogenic diet (VLCKD) significantly reduces body fat mass in competitive natural bodybuilders without compromising maximal strength, despite blunting lean mass accretion and reducing anabolic hormones.

If you are a competitive bodybuilder looking to cut fat, an 8-week ketogenic diet can help you lose significant fat mass while maintaining your strength and muscle size. However, do not expect to build new muscle mass on this diet; that requires carbohydrates. Ensure you are eating enough protein (2.5g/kg) and monitoring ketones to stay in ketosis.

Sodium intake between 3 and 5 g/day is associated with the lowest risk of cardiovascular disease and mortality, whereas intake below 3 g/day or above 5 g/day is associated with increased risk.

Aim for a sodium intake of 3 to 5 grams per day (approx. 0.75 to 1.25 teaspoons of salt). This range is associated with the lowest risk of heart disease and death. Avoid extreme restriction below 3 grams, which may increase risk, and excessive intake above 5 grams, which raises blood pressure and risk, especially if you have hypertension.

Performing repeated sprint exercise immediately after resistance training attenuates acute anabolic signaling (p70 S6K phosphorylation) and increases muscle protein breakdown markers (MuRF mRNA), suggesting that sprint activities should be isolated from resistance training to optimize hypertrophic adaptation.

If you train both strength and speed/sprints, do not perform them in the same session back-to-back. The molecular signals for muscle growth (p70 S6K) are suppressed when you sprint after lifting. Separate these modalities by at least 6 hours or place them on different days to ensure you get the full adaptive benefit from your resistance training.

Consuming carbohydrates last in a mixed meal significantly reduces postprandial glucose and insulin excursions compared to consuming carbohydrates first or all components together in individuals with type 2 diabetes.

If you have type 2 diabetes, try eating your vegetables and protein before your carbohydrates (like bread, rice, or fruit) during meals. In this study, this simple change reduced blood sugar spikes by over 50% compared to eating carbs first. You do not need to cut out carbs; just delay them until the end of your meal. This strategy works by slowing down digestion and boosting hormones that help regulate blood sugar.

EPA and DHA supplementation improves muscle function (strength, torque, EMG) and may increase muscle mass in elderly or wasting conditions, but has unclear effects on muscle protein synthesis in trained young adults.

If you are older or dealing with muscle loss, fish oil might help maintain or build muscle mass when combined with training. If you are a young, trained athlete, fish oil is unlikely to boost your muscle growth or protein synthesis beyond what your training already does.

GLP-1 analogues (Semaglutide and Liraglutide) are recommended for MASLD patients with BMI >27 kg/m2 and CVD risk factors when lifestyle intervention is insufficient, offering significant weight loss and CVD risk reduction.

If lifestyle changes alone haven't reduced your weight or CVD risk, and your BMI is above 27, ask your doctor about GLP-1 analogues like Semaglutide or Liraglutide. These medications can help you lose significant weight (up to 15% with Semaglutide) and improve your heart health.

Achieving a state of nutritional ketosis (β-hydroxybutyrate ≥ 0.3 mmol/L) during a low-carbohydrate diet is associated with greater reductions in visceral adipose tissue, total body fat, and inflammation (CRP), but also with greater loss of lean muscle mass.

If you are doing a low-carb diet, aiming for ketosis (measured by blood ketones ≥ 0.3 mmol/L) may lead to greater fat and visceral fat loss and lower inflammation. However, be aware that this state is also associated with greater lean muscle loss, so maintaining your exercise routine, especially resistance training, is crucial.

The dual GLP-1R/GCGR agonist BI 456906 produces clinically meaningful body weight loss (up to 13.8% over 16 weeks) in adults with overweight/obesity, driven by target engagement at both receptors.

BI 456906 is a once-weekly injection for people with overweight or obesity that works by targeting two hormones (GLP-1 and Glucagon). In early studies, it led to significant weight loss (nearly 14% over 4 months). The main side effects are gastrointestinal (nausea, vomiting), which are common but often manageable. It is designed for people who may not achieve sufficient weight loss with single-target therapies.

In patients with type 2 diabetes duration greater than 10 years, GLP-1RA plus basal insulin fixed-ratio combinations (iDegLira, iGlarLixi) may be numerically more effective for HbA1c reduction than tirzepatide, suggesting tirzepatide is better suited for early-stage disease.

For patients with type 2 diabetes for more than 10 years, GLP-1RA plus basal insulin fixed-ratio combinations may offer better glycemic control than tirzepatide alone, making them a strong option for long-standing disease.

Withholding GLP-1 receptor agonists for at least three half-lives before elective surgery is recommended for weight management patients to minimize retained gastric contents.

For weight loss patients: Check the half-life of your specific drug (e.g., Semaglutide ~7 days, Dulaglutide ~5 days). Stop taking it at least 3 times that duration before your scheduled surgery. For example, if you take Semaglutide (7-day half-life), stop at least 21 days before surgery. Consult your doctor for a bridge plan for blood sugar if applicable.