Browse the evidence

Standard diagnostic thresholds for natriuretic peptides (BNP/NT-proBNP) are less sensitive in individuals with obesity, potentially missing cases of HFpEF, necessitating adjusted cutoffs or alternative screening scores.

If you have obesity, standard blood tests for heart failure (BNP/NT-proBNP) might not be sensitive enough to detect early problems. Ensure your doctor interprets these results in the context of your weight or uses specialized scoring systems (like the HFpEF-ABA score) that account for obesity.

Over an 8-year period, middle-aged adults of African origin across diverse geographic and socioeconomic settings experienced significant increases in the prevalence and incidence of obesity, high blood glucose, and high blood pressure, with the steepest increases occurring in low- and middle-income countries (Ghana, Jamaica, Seychelles) compared to the USA.

If you are of African descent, your risk for obesity, high blood sugar, and high blood pressure is actively increasing as you age, regardless of whether you live in a wealthy or developing country. The rate of increase is often faster in lower-income settings. This is not inevitable fate but a result of environmental and lifestyle shifts; proactive monitoring and lifestyle interventions are critical to mitigate this rising risk.

Hamstring hypertrophy plays a minimal role in strength transfer between the Nordic hamstring exercise and the stiff-leg deadlift in resistance-untrained individuals.

If you want to improve strength in both Nordic curls and deadlifts, doing only one will not automatically make you strong at the other, even if you build muscle. To maximize strength across both movements, you should train both exercises within the same training block, as neural adaptations specific to each movement pattern are likely more important than muscle size for transferring strength.

Intensive lifestyle interventions (ILI) targeting weight loss and physical activity in older adults (≥70 years) with type 2 diabetes and obesity are associated with increased odds of severe mobility disability compared to diabetes support and education (DSE).

For adults over 70 with type 2 diabetes, aggressive weight loss programs may increase the risk of severe mobility disability compared to standard diabetes education. Focus should shift towards preserving functional status and muscle mass rather than prioritizing significant weight reduction, as the loss of lean mass can outweigh the benefits of fat loss for mobility in this age group.

Endoscopic gastric plication (POSE procedure) produces modest, statistically significant weight loss (approx. 4.9% at 1 year) superior to sham, but remains significantly less effective than bariatric surgery and comparable to pharmacotherapy.

Endoscopic gastric plication is a valid option for Class I-II obesity if you want something more effective than lifestyle changes alone but less invasive than surgery. Expect about 5% weight loss at one year, which is similar to taking weight-loss drugs. It is a one-time procedure but may need repeating as the stomach remodels. Discuss the $11,000 cost and potential risks (like infection) with your doctor, and weigh them against the long-term cost of managing obesity-related conditions.

Pre-training bone characteristics (bone mineral content, bone area, shoulder/hip widths) do not meaningfully predict the magnitude of appendicular lean tissue mass hypertrophy following 10-12 weeks of resistance training in untrained adults.

Do not let your bone structure (shoulder width, hip width, or bone density) dictate your expectations for muscle growth. While larger bones are associated with more muscle at rest, they do not predict how much muscle you will gain from training. Focus on progressive overload and consistency; your skeletal frame is not a limiting factor for hypertrophy potential.

Pre-exhaustion resistance training (single-joint immediately before multi-joint) does not produce superior muscle hypertrophy or strength gains compared to traditional resistance training and may result in slightly lower hypertrophy due to reduced volume load.

If your goal is maximum muscle growth, stick to traditional resistance training (performing all sets of one exercise before moving to the next). While pre-exhaustion (doing a single-joint exercise right before a compound one) is time-efficient and viable for strength and endurance, it likely results in slightly less muscle growth because you lift less total weight (volume load) on the compound movements due to fatigue. Do not sacrifice volume load on compound lifts for the sake of pre-fatiguing muscles if hypertrophy is your primary goal.

Pre-training bone characteristics (bone mineral content, bone area, shoulder/hip width) do not significantly predict the magnitude of appendicular lean tissue mass gains following 10–12 weeks of resistance training in untrained adults.

Do not worry about your bone structure or frame size when starting resistance training. Whether you have wide shoulders or narrow hips, your potential for muscle growth is not determined by your skeleton. Focus on consistent training with progressive overload (increasing weight/reps over time) and adequate protein intake, as these are the drivers of hypertrophy, not your baseline bone density or width.

The adverse association between elevated BMI (>27 kg/m²) and mortality in HFrEF patients is significantly stronger in those with ischemic cardiomyopathy compared to non-ischemic cardiomyopathy.

If your heart failure is caused by coronary artery disease (ischemic), keeping your BMI under 27 is particularly important for your survival. In patients with non-ischemic heart failure, the link between higher BMI and death was not statistically significant in this study, suggesting that weight management strategies might need to be tailored to your specific heart condition.

Bariatric surgery (RYGB, Sleeve Gastrectomy) provides superior and more sustained weight loss (25-35%) and metabolic remission compared to pharmacotherapy, but carries higher surgical risks and potential for long-term complications.

Bariatric surgery (like gastric bypass or sleeve gastrectomy) is the most effective treatment for severe obesity, typically resulting in 25-35% weight loss. It offers significant improvements in diabetes and hypertension. However, it is invasive, carries surgical risks, and requires lifelong nutritional monitoring. It is generally recommended for those with BMI ≥ 40 or ≥ 35 with comorbidities who have not succeeded with other methods.

Bariatric surgery (specifically Roux-en-Y Gastric Bypass and Sleeve Gastrectomy) is the most effective intervention for sustained weight loss and metabolic improvement, significantly altering gut microbiota diversity and reducing systemic inflammation.

Bariatric surgery, such as Roux-en-Y Gastric Bypass or Sleeve Gastrectomy, offers the most significant and durable weight loss for severe obesity. It works by restricting stomach size and altering gut hormones and microbiota. Patients must commit to lifelong vitamin supplementation to prevent deficiencies.

Hamstring hypertrophy plays a minimal role in strength transfer between the Nordic hamstring exercise (NHE) and the stiff-leg deadlift (SDL) in resistance-untrained individuals.

If you want to improve strength in both Nordic Hamstring Exercises and Stiff-Leg Deadlifts, do not rely on just one. Training one exercise will not significantly boost your strength in the other, even if you build muscle. To maximize strength across both knee-flexion and hip-extension movements, you must train both exercises within the same training block.

Commercially available phytosteroid supplements containing 20-hydroxyecdysone (20E) and diosgenin (DSG) provide no additional hypertrophic or performance benefits over resistance training alone because the actual active compound concentrations are drastically lower than labeled amounts.

Do not rely on commercial phytosteroid supplements (specifically those combining 20E and DSG) to boost muscle growth or strength beyond what you achieve through consistent resistance training. This specific study found that the tested product contained less than 1% of the labeled 20E and only 10.4% of the labeled DSG, resulting in no biological activity or performance benefit compared to placebo. Focus on your training and nutrition instead.

When resistance profiles, elbow range of motion, and effort are matched, altering shoulder extension angle (neutral vs. maximally extended) does not produce meaningful differences in elbow flexor hypertrophy in untrained men.

For most recreational lifters, whether you perform bicep curls with your arms by your side (neutral) or slightly behind your torso (extended shoulder) makes no meaningful difference to muscle growth, provided you train to failure and manage the weight similarly. Choose the variation that feels best for your shoulders and allows you to lift consistently. Don't overcomplicate your exercise selection based on shoulder angle alone.

Supplementation with fish protein, vitamin D, and omega-3 fatty acids provides no additional benefit to physical performance adaptations (strength, endurance, workout duration) compared to whey protein or maltodextrin during a 6-week high-intensity functional training (HIFT) program in recreationally trained individuals.

If you are doing high-intensity functional training (like CrossFit), switching to a complex supplement with fish protein, vitamin D, and omega-3s will not give you better strength or endurance gains than taking whey protein or even just carbohydrates (maltodextrin), provided your overall diet is adequate. Focus on consistent training and basic protein intake rather than expensive multi-ingredient stacks for performance enhancement.

In individuals with ideal cardiovascular health (high CVHS), elevated BMI (≥35.0 kg/m²) does not significantly increase the risk of incident atherosclerotic cardiovascular disease (ASCVD) compared to normal BMI, whereas low cardiovascular health strongly predicts ASCVD regardless of BMI.

If you have ideal cardiovascular health (normal blood pressure, lipids, blood sugar, no smoking, active, healthy diet), your body weight (even if obese) may not significantly increase your risk of heart disease or stroke. Focus on maintaining these healthy habits rather than solely on weight loss.

Non-invasive mechanical ventilation (NIV) is superior to Continuous Positive Airway Pressure (CPAP) for treating Obesity Hypoventilation Syndrome (OHS) in patients without severe Obstructive Sleep Apnea (OSA), as CPAP fails to adequately correct daytime hypercapnia in this subgroup.

If you have Obesity Hypoventilation Syndrome but do not have severe sleep apnea, standard CPAP machines may not be enough to fix your high carbon dioxide levels. You likely need Non-Invasive Ventilation (NIV), which actively helps you breathe out more CO2. This is the standard of care for your specific profile.

Higher deficit accumulation frailty index (FI) scores are strongly associated with increased total health care costs, including medication, outpatient, and hospitalization expenses, in adults with type 2 diabetes and overweight/obesity.

For individuals with type 2 diabetes and obesity, monitoring for 'frailty' (defined as the accumulation of health deficits like blood pressure, mobility issues, and chronic conditions) is critical. Higher frailty scores predict significantly higher medical bills. Interventions that slow the progression of frailty, such as the intensive lifestyle intervention in this study, can lead to substantial annual savings in healthcare costs ($437-$461/year), primarily through reduced medication and hospitalization needs.

Very low-carbohydrate diets (ketogenic) pose long-term sustainability, health, and environmental risks, including potential nutrient deficiencies and increased LDL cholesterol.

Be cautious with very low-carb diets. They can lead to nutrient deficiencies, increased LDL cholesterol, and are difficult to sustain long-term. Focus on balanced, high-quality diets instead.

Bariatric surgery (Roux-en-Y gastric bypass and sleeve gastrectomy) provides long-term weight loss and high diabetes remission rates (51% at 12 years) by altering gut microbiota diversity and increasing specific beneficial bacteria like Bacteroides uniformis.

For severe obesity with type 2 diabetes, bariatric surgery (Roux-en-Y or Sleeve Gastrectomy) is the most effective long-term treatment, offering sustained weight loss (~35kg) and a 51% chance of diabetes remission after 12 years. This is achieved partly by reshaping the gut microbiome to favor beneficial bacteria.

The observed 'obesity paradox' in diabetes is likely non-causal and explained by biases such as reverse causation, confounding by fitness, and body composition differences (muscle mass).

Do not interpret the 'obesity paradox' as a reason to gain weight. The survival advantage seen in obese diabetics is likely due to them having more muscle, being fitter, or having less severe disease at diagnosis, not the fat itself. Weight loss interventions are safe and recommended.

Among older adults (aged 65+), higher consumption of fish or EPA+DHA is not associated with a reduced risk of hip fracture, and higher EPA+DHA intake may be associated with slightly lower femoral neck bone mineral density (BMD) in those with high linoleic acid intake.

For adults over 65, increasing fish or EPA+DHA intake is unlikely to significantly reduce the risk of hip fractures. While fish is nutritious, it should not be relied upon as a primary strategy for bone protection. Instead, focus on evidence-based interventions such as weight-bearing exercise, fall prevention, and ensuring adequate calcium and vitamin D intake, as other factors appear more critical for bone health in this age group.

Implementation of front-of-package warning labels on high-sugar foods drives food industry reformulation by replacing added sugars with non-nutritive sweeteners (NNS), particularly sucralose and stevia, rather than simply reducing total sugar content.

Regulations forcing sugar reduction often lead manufacturers to add artificial sweeteners instead of just cutting sugar. If you are trying to reduce sugar intake, check the ingredients list for sweeteners like sucralose or stevia; their presence indicates the product was reformulated to meet sugar limits, not necessarily to be healthier overall.

Products that reformulate to avoid 'high in sugar' warning labels are significantly more likely to introduce non-nutritive sweeteners (NNS) than products that do not change their sugar status.

If a product used to have a 'High in Sugar' warning but no longer does, it likely added artificial sweeteners to maintain taste. Look for ingredients like sucralose, aspartame, or stevia on the label to confirm this substitution.