Browse the evidence

A Mediterranean diet supplemented with extra virgin olive oil or nuts mitigates the deleterious effect of elevated plasma ceramide concentrations on cardiovascular disease risk, effectively neutralizing the increased risk associated with high ceramide levels.

If you have high ceramide levels, switching to a Mediterranean diet rich in olive oil or nuts can effectively cancel out the increased heart disease risk associated with those levels. This dietary pattern brings your risk down to the same level as people with naturally low ceramide levels.

Ketogenic diets (≤10% carbs) produce greater weight loss but also greater increases in LDL and total cholesterol compared to moderate-carb diets (26-45% carbs).

If you choose a strict ketogenic diet (under 10% carbs), expect greater weight loss but also a significant rise in LDL and total cholesterol. If you want a balance of weight loss and heart health markers, a moderate-carb diet (26-45% carbs) might be a better choice.

While weight loss is similar across macronutrient groups, specific diets produce distinct improvements in cardiovascular risk factors (e.g., LDL, HDL, Triglycerides).

If you have high cholesterol or cardiovascular risk, choose a diet that aligns with your specific biomarkers. Low-fat/high-carb diets tend to lower LDL (bad cholesterol) more effectively, while high-fat/low-carb diets may raise HDL (good cholesterol) more. Since weight loss is similar across all, use your lipid profile to guide your macronutrient choice.

A 12-month healthy low-carbohydrate diet and a healthy low-fat diet produce statistically equivalent weight loss in overweight adults, with no significant difference between the two approaches.

For overweight adults, both a healthy low-fat diet and a healthy low-carbohydrate diet lead to similar weight loss over 12 months. The specific macronutrient ratio matters less than the quality of food (whole foods, minimal processing) and the ability to adhere to the diet long-term. You do not need genetic testing or insulin measurements to choose between them; pick the one you can sustain.

A low-carbohydrate diet is associated with greater reductions in triglycerides and VLDL cholesterol in the first 6 months compared to a low-fat diet, but these differences diminish by 2 years.

If you start a low-carb diet, you may see a quick improvement in triglycerides and VLDL cholesterol within the first 6 months. However, as you gradually increase carbohydrates over the year, this specific benefit may fade. It is still a positive early marker, but not a permanent differentiator from low-fat diets.

Low carbohydrate diets are not significantly superior to low fat diets for weight loss when protein content is held constant.

You do not need to choose between low-carb and low-fat based on efficacy; both work equally well if you stick to them. Focus on adherence and protein intake rather than eliminating entire food groups, as no single diet is superior.

Ad libitum low-carbohydrate diets promote weight loss without significant fat mass reduction, whereas ad libitum low-fat diets promote significant fat mass loss, indicating that early weight loss on low-carb diets does not necessarily reflect negative energy balance or fat loss.

If your goal is fat loss, a low-fat diet may be more effective than a low-carb diet when eating ad libitum, as low-carb diets may result in weight loss driven by water and glycogen depletion rather than fat loss. Focus on body composition changes (like DEXA scans or progress photos) rather than just scale weight when starting a low-carb diet.

There is no significant difference in the reduction of absolute fat mass (kg) or waist circumference between low-carbohydrate and low-fat diets.

While LCDs may lower BMI and body fat percentage more than LFDs, they do not necessarily reduce absolute fat mass (kg) or waist circumference more effectively. If waist circumference is your primary goal, either diet may be equally effective.

Aggressive LDL-lowering therapy reduces recurrent coronary heart disease (CHD) events in patients with diabetes, even if their baseline LDL cholesterol is not markedly elevated.

If you have diabetes and heart disease, you likely need a statin even if your LDL cholesterol isn't extremely high. Clinical trials show that aggressive LDL lowering significantly reduces the risk of future heart attacks in diabetics. Aim for an LDL level below 100 mg/dL through medication and diet, as your blood vessels are more susceptible to damage from LDL.

Reduced muscle mass is a key phenotypic criterion for malnutrition, measurable by DXA, BIA, CT, MRI, or anthropometric proxies like calf/arm circumference.

Assess muscle mass using available tools like DXA, BIA, CT, or MRI. If these are unavailable, use anthropometric measures like calf or arm circumference, or functional assessments like grip strength.

Replacing dietary saturated fat with refined carbohydrates or sugars does not reduce cardiovascular disease risk and may be neutral or harmful.

Do not replace saturated fats with refined carbs or sugars if your goal is heart health. This substitution does not lower cardiovascular risk. Instead, replace saturated fats with unsaturated fats (polyunsaturated or monounsaturated).

A low-fat dietary intervention significantly reduces LDL cholesterol, diastolic blood pressure, and Factor VIIc levels, but does not significantly affect HDL cholesterol, triglycerides, glucose, or insulin levels.

If you follow a low-fat diet, you can expect a modest drop in LDL cholesterol and blood pressure. However, do not expect significant improvements in HDL cholesterol, triglycerides, or blood sugar control from this dietary pattern alone.

Replacing animal-source foods with plant-based foods in high-income countries reduces greenhouse gas emissions by up to 84% and premature mortality by up to 12%, but may increase freshwater use by up to 16%.

In high-income countries, reducing your intake of animal-source foods and replacing them with plant-based options (especially legumes, fruits, and vegetables) can significantly lower your carbon footprint and improve your health. Be aware that this might increase your water usage, so choosing water-efficient plant foods can help mitigate this. This strategy is most effective where current meat consumption is high.

Inulin-type fructans selectively stimulate the growth of beneficial gut bacteria, particularly Bifidobacteria, acting as prebiotics.

Regularly consume prebiotic fibers like inulin and oligofructose to support beneficial gut bacteria. Don't obsess over high doses; consistency and your existing gut health are key.

The absolute mass of n-6 and n-3 fatty acids consumed is more important for cardiovascular health than the n-6/n-3 ratio.

Stop obsessing over the ratio of your vegetable oils to fish oils. Instead, ensure you are eating enough linoleic acid (5-8% of calories) and enough EPA/DHA (500-1000 mg/day). If you meet these absolute targets, the ratio will naturally fall into a healthy range (~6:1).

Despite improvements, US adults continue to consume disproportionately high energy from low-quality carbohydrates and saturated fat remains above recommended levels.

Do not assume that 'healthy eating' is complete. Actively monitor and reduce your intake of added sugars and saturated fats, as these remain the primary dietary challenges for the average US adult.

High dietary fructose intake promotes non-alcoholic fatty liver disease (NAFLD) and hepatic insulin resistance by stimulating de novo lipogenesis via GLUT2 and GLUT5 transporters.

Limiting high-fructose corn syrup and excessive free fructose in processed foods is more effective for preventing liver fat accumulation than limiting glucose alone, as fructose uniquely drives hepatic lipogenesis.

Sleep restriction increases the percentage of calories derived from fat during late-night hours (22:00-03:59) compared to daytime and evening hours.

When you are sleep-deprived, you tend to eat more fat during late-night hours. To manage your fat intake, try to avoid eating late at night, especially if you are sleep-restricted.

Higher intake of polyunsaturated fatty acids (PUFA), particularly linoleic acid (omega-6), and monounsaturated fatty acids (MUFA) is associated with lower total mortality and cause-specific mortality.

Increase your intake of polyunsaturated (PUFA) and monounsaturated (MUFA) fats. Sources include nuts, seeds, vegetable oils (like soybean, corn, and olive oil), and fish. Higher intake of these fats is linked to lower total mortality. Specifically, linoleic acid (omega-6) and MUFA show strong inverse associations with mortality. Replace saturated fats with these unsaturated fats for the best health outcomes.

Adopting a low-fat dietary pattern (targeting 20% of energy from fat) with increased intake of vegetables, fruits, and grains does not cause weight gain in postmenopausal women over a 7.5-year period, and is associated with modest weight loss compared to a control group.

If you are a postmenopausal woman, switching to a diet lower in fat (around 20% of calories) and higher in vegetables, fruits, and whole grains will not cause you to gain weight, even if you do not count calories. In fact, you may lose a small amount of weight (approx. 2kg in the first year) compared to staying on your usual diet. Focus on replacing fat calories with plant-based carbohydrates rather than restricting total food volume.

Reducing dietary saturated fatty acid intake leads to a decrease in HDL cholesterol, with the magnitude of decrease depending on the degree of SFA reduction.

Lowering saturated fat will lower your HDL ('good') cholesterol. However, it lowers LDL ('bad') cholesterol more significantly, which is the primary goal for heart health. This effect is consistent across most demographic groups.

Adherence to an energy-unrestricted Mediterranean diet supplemented with extra-virgin olive oil or nuts significantly increases the likelihood of metabolic syndrome reversion compared to a low-fat diet, without preventing new-onset incidence.

If you are at high risk for heart disease or metabolic syndrome, switching to a Mediterranean diet rich in olive oil or nuts can help reverse your condition, even if you do not lose weight. Focus on adding these specific fats to your diet rather than restricting calories. While this may not stop new cases of metabolic syndrome from developing, it significantly increases your chances of reversing existing symptoms like central obesity and high blood sugar.

Visceral adipose tissue (VAT) and epicardial adipose tissue (EAT) accumulation is a primary driver of cardiovascular injury in obesity and diabetes, independent of overall body mass index (BMI), through the release of pro-inflammatory factors and free fatty acids.

For individuals with obesity or Type-2 Diabetes, focusing solely on BMI is insufficient for assessing heart disease risk. Visceral and epicardial fat are more dangerous indicators. Reducing these specific fat depots through lifestyle changes or medication is crucial for preventing heart failure and other cardiovascular injuries.

Macrofungi are a source of high-quality protein, unsaturated fatty acids, and minerals, making them a low-calorie functional food suitable for general health.

Eat mushrooms regularly as a source of protein and fiber. They are low in calories but nutrient-dense, making them a good addition to a balanced diet.