Browse the evidence

Proximity to failure (4-6 RIR vs 1-3 RIR vs 0 RIR) does not significantly affect muscle hypertrophy (muscle thickness) in trained men over an 8-week period.

For muscle growth, it does not matter much whether you train to failure or stop with 1-3 reps left. Both approaches can yield similar hypertrophy. Focus on consistency and progressive overload rather than chasing failure on every set.

Modifying the physical structure of beef (minced vs. steak) while keeping nutrient composition identical does not significantly alter muscle protein synthesis (MPS) rates, but it does significantly improve whole-body net protein balance by enhancing digestion and absorption kinetics.

If you are eating enough protein (around 26g+ per meal) and engaging in resistance training, the physical form of your meat (minced vs. steak) likely does not change how much muscle you build directly. However, minced meat may be easier to digest and absorb, leading to better overall protein retention in the body, which might be beneficial for older adults or those with chewing difficulties.

Phytotherapeutic agents (e.g., Green Tea, Nigella Sativa, Bofu Tsusho San) produce statistically significant but clinically less relevant weight loss compared to modern AOMs.

Herbal supplements like Green Tea or Black Seed may help with modest weight loss, but they are not as effective as prescription medications like Semaglutide or Tirzepatide. Manage your expectations accordingly.

Adherence to a zero-carbohydrate diet (consuming exclusively animal-sourced foods) is associated with self-reported improvements in metabolic health, digestive function, mood, and physical composition, driven by the elimination of plant-based antinutrients and the induction of nutritional ketosis.

If you are considering a zero-carb diet, expect a significant social adjustment. You will likely face skepticism from healthcare providers and peers. The paper suggests that engaging with online communities can provide necessary support and validation. Physically, you may experience an initial 'adaptation phase' with GI distress, which typically resolves. The diet involves eating only animal products (meat, fish, eggs, dairy) and potentially fasting, with no carbohydrates.

In women, initial skeletal muscle size (leg fat-free mass and quadriceps CSA) is positively associated with the magnitude of muscle atrophy following 14 days of immobilization.

For women undergoing immobilization, having larger muscles prior to injury may be associated with greater absolute muscle loss. However, this finding is based on a small group and needs confirmation. Do not let this discourage building muscle; focus on proper rehabilitation.

Metabolic and bariatric surgery (MBS) improves depressive, anxiety, and non-normative eating symptoms, as well as attention, compared to nonsurgical controls, though evidence certainty is low to very low.

If you have obesity and struggle with depression, anxiety, or disordered eating, metabolic and bariatric surgery (MBS) may help improve these symptoms more than nonsurgical treatments. However, the evidence is not yet high-quality, and you should be aware that MBS might slightly increase the risk of substance use disorders or suicide in the long term (>2 years). Regular mental health monitoring is essential after surgery.

For upper extremity musculature, there is insufficient evidence to recommend full or partial ROM over the other, as results are conflicting.

For upper body muscles, you can use either full or partial ROMs without significant disadvantage. Focus on consistency, volume, and progressive overload rather than obsessing over the specific range of motion.

Combining plyometric and resistance training does not produce additive effects on muscle hypertrophy or anabolic signaling compared to resistance training alone.

Do not expect to build muscle faster by mixing jumping exercises with weightlifting compared to just lifting weights. The current evidence suggests you get the same muscle growth from resistance training alone, so you can save time by focusing on one modality if your goal is purely hypertrophy.

Sarcopenic obesity (high fat mass combined with low muscle mass and function) is a distinct and high-risk phenotype in chronic liver disease (CLD) and IBD, associated with worse prognosis, higher mortality, and increased surgical complications compared to obesity alone or sarcopenia alone.

For people with liver disease or IBD, being obese is risky, but losing muscle makes it much worse. This combination, called 'sarcopenic obesity,' leads to higher death rates and surgery complications. You need to check your muscle mass, not just your weight. If you are losing weight, make sure it's fat, not muscle.

GLP-1 receptor agonists (GLP-1RAs) may reduce the severity of Obstructive Sleep Apnoea (OSA) as measured by the Apnoea-Hypopnoea Index (AHI), primarily through weight loss mechanisms, though evidence quality is currently low and results are conflicting.

If you have OSA and are considering GLP-1RAs (like semaglutide or liraglutide), expect a modest improvement in sleep breathing (AHI) rather than a cure. The benefit is largely tied to weight loss. Do not stop using your CPAP machine unless your doctor advises it, as CPAP is currently more effective. Be prepared for potential stomach side effects, which are common but often subside. The evidence is not yet strong enough to make this a standard first-line treatment for OSA alone.

Current evidence does not support a definitive superiority of pre- versus post-exercise creatine timing for muscle creatine loading or performance gains, as existing studies suffer from methodological limitations and conflicting results.

Do not stress about whether you take creatine before or after your workout. The current scientific consensus is that there is no definitive advantage to either timing. Focus on taking your daily dose (e.g., 3-5g) consistently every day to saturate muscle stores, rather than trying to optimize the timing relative to your exercise session.

Sleeve gastrectomy (SG) combined with a left ventricular assist device (LVAD) serves as a feasible and effective pathway to cardiac transplantation in morbidly obese patients with end-stage heart failure.

If you have severe heart failure and are too heavy for a heart transplant, getting an LVAD (heart pump) and sleeve gastrectomy (stomach reduction) together is a viable medical pathway. This combination can significantly reduce your weight and make you eligible for a transplant, which was previously impossible due to your size. This requires specialized surgical care.

Human observational studies on MSG and obesity show inconsistent results, with some finding positive associations and others finding no association or inverse associations, largely due to measurement errors and confounding factors.

Human studies on MSG and weight are mixed. While animal studies suggest risks, human data is not conclusive. Reducing intake of processed foods with hidden MSG is a low-risk strategy for overall health.

South Asian ethnicity is predisposed to 'thin-fat' obesity (normal weight obesity), leading to higher risks of diabetes, hypertension, and dyslipidemia at lower BMIs.

If you are South Asian, your risk for diabetes and heart disease starts at a lower weight than other ethnicities. Even if your BMI is normal, you might have 'thin-fat' obesity. Get regular check-ups for blood sugar, blood pressure, and cholesterol, and focus on building muscle and staying active.

Creatine supplementation trends toward increasing lean muscle mass in prostate cancer patients undergoing ADT.

Creatine supplementation may help preserve lean muscle mass in prostate cancer patients on hormone therapy, though the evidence is not yet definitive. It is worth discussing with your healthcare provider as a potential supportive measure.

Bariatric surgery (Roux-en-Y gastric bypass or sleeve gastrectomy) is technically feasible and safe for patients with pre-existing ileostomy or colostomy, without causing increased ostomy output or dehydration.

If you have an existing ostomy (ileostomy or colostomy) and are considering bariatric surgery, current preliminary evidence suggests it is feasible and safe, with no increased risk of dehydration or output changes compared to patients without an ostomy. Consult with a bariatric surgeon to evaluate your specific case, as individual factors like the cause of your ostomy and overall health status will determine your candidacy.

Carnivore and animal-based diets do not consistently improve athletic performance and may impair high-intensity exercise capacity due to reduced muscle glycogen and constrained metabolic flexibility.

Do not switch to a carnivore or animal-based diet expecting better performance, especially if your sport involves sprinting, lifting, or high-intensity intervals. These diets reduce muscle glycogen and make it harder to produce energy quickly. While you might lose weight or feel less bloated, your high-intensity performance will likely suffer. Stick to established sports nutrition guidelines that prioritize carbohydrate availability for intense training.

The renal safety of long-term low-carbohydrate diets in obese individuals remains undetermined due to insufficient reporting of renal function data in clinical trials.

Do not start a low-carb diet if you have existing kidney disease. For healthy obese individuals, current data does not show harm, but long-term safety is not proven because most studies don't track kidney function. Monitor your health with a doctor.

The impact of a ketogenic diet on endurance performance is controversial and context-dependent, with some studies showing improvement and others showing impairment.

If you are an endurance athlete, switching to keto is risky for performance. Some people improve, but many see a drop in high-intensity performance. It requires a long adaptation period and may not be suitable for all types of endurance sports.

Faecal Microbiota Transplantation (FMT) from lean donors shows promise for improving insulin sensitivity in metabolic syndrome, but current human evidence is limited, small, and unreplicated.

FMT from lean donors may improve insulin sensitivity, but it is not yet a standard or proven treatment for diabetes due to limited and unreplicated human data. Do not pursue this outside of clinical trials.

Plant-based diets modulate the gut microbiome towards a favorable diversity of bacteria species, but the functional 'bottom up' signaling from these microbial changes to host health remains highly speculative.

While plant-based diets likely increase gut microbiome diversity, the direct health benefits of these changes are not yet fully understood or proven.

Consumption of fermented foods is associated with beneficial effects on weight management, cardiovascular disease, type 2 diabetes, and mood/brain activity.

Include fermented foods like yogurt in your diet. Observational studies link regular consumption to better weight management, lower risk of heart disease and type 2 diabetes, and improved mood. While not a cure-all, these foods are a low-risk addition to a healthy diet.

Gut microbiota composition and metabolite production are associated with obesity and type 2 diabetes, but current human evidence is largely associative and causality remains unproven due to scarcity of intervention data.

Current science does not support gut microbiota as a standalone, proven cause of obesity or diabetes in humans. While diet and lifestyle significantly shape the microbiome, interventions like probiotics or FMT are not yet standard, effective treatments for these conditions in humans. Focus on established factors: diet, physical activity, and medical management.

Early mobilization or active exercise in the ICU does not currently have sufficient evidence to confirm improvements in physical function, muscle strength, or quality of life for critically ill adults, despite being feasible and generally safe.

While early movement in the ICU is considered safe and feasible, current evidence does not strongly confirm that it significantly improves physical function, muscle strength, or quality of life compared to usual care. Clinicians should prioritize safety and feasibility, but should not expect guaranteed functional improvements based on current data.