Browse the evidence

In clinical settings such as hospitals and long-term care, highly processed foods (HPF) are necessary to prevent malnutrition, support recovery, and improve quality of life for residents with poor appetite, chewing, or swallowing difficulties.

In clinical settings, prioritize caloric and nutrient density over strict avoidance of processed foods. Use HPF to help patients with poor appetite or swallowing difficulties meet their nutritional needs and prevent malnutrition, while carefully selecting products to manage sodium content.

Avoiding all highly processed foods (HPF) can lead to unintended nutritional deficiencies, such as inadequate fiber and folic acid, because many healthy foods like whole grain bread and ready-to-eat cereals are classified as HPF.

Do not avoid all processed foods. Include whole grain bread, ready-to-eat cereals, and yogurt in your diet, as they provide essential nutrients like fiber and folic acid. Focus on choosing processed foods low in sodium, saturated fat, and added sugars.

In overweight/obese individuals with type 2 diabetes free from complications, peak oxygen consumption (VO2peak) is impaired due to reduced skeletal muscle oxygenation and blood volume during exercise, despite normal pulmonary function and arterial oxygen transport.

If you have Type 2 Diabetes without complications, your reduced exercise stamina is likely not due to lung problems but rather how your muscles handle blood flow and oxygen during intense effort. To improve your fitness, focus on exercise programs that enhance skeletal muscle perfusion and blood flow, such as combining aerobic exercise with resistance training, rather than focusing on respiratory mechanics.

Increasing lean body mass (LBM) below 52.26 kg is negatively associated with the risk of osteoarthritis, suggesting a protective effect, whereas increasing LBM above this threshold provides no statistically significant additional benefit.

If you have low muscle mass, building it up to around 52 kg (for women, likely higher for men depending on height/build, but the study uses absolute kg) can significantly lower your risk of developing osteoarthritis. Once you have a substantial amount of lean mass, adding more muscle won't necessarily protect your joints further, but maintaining it is still important for overall health. Focus on resistance training to build muscle if you are currently lean.

Indexing peak oxygen consumption (VO2peak) to total body mass systematically underestimates cardiorespiratory fitness (CRF) in women, older adults, and individuals with obesity, whereas a novel scaling metric called Exercise Body Mass (EBM) mitigates this bias.

If you are a woman, over 40, or have obesity, your standard fitness test result (VO2peak divided by your total weight) likely makes you look less fit than you actually are. To get a fair comparison of your cardiorespiratory fitness against others or your past self, use a scaling method that accounts for your height, age, and sex (like the Exercise Body Mass metric) rather than just dividing by your total body weight.

Adherence to the American Heart Association's Life's Essential 8 (LE8) score is inversely associated with the risk of developing new-onset abdominal aortic aneurysm (AAA).

To lower your risk of abdominal aortic aneurysm, focus on optimizing your overall cardiovascular health using the Life's Essential 8 framework. This means aiming for ideal levels in blood pressure, cholesterol, blood sugar, and BMI, while never smoking, staying physically active, eating a healthy diet, and getting 7-9 hours of sleep. You don't need to be perfect; even small, consistent improvements in these areas can significantly reduce your risk over time. Prioritize quitting smoking and increasing physical activity, as these had the strongest individual effects in the study.

In men under 50 without baseline hypertension or hyperglycemia, longitudinal increases in abdominal circumference and systolic blood pressure significantly increase the risk of major adverse cardiac and cerebrovascular events (MACCE).

If you are a man under 50, monitor your waist size and blood pressure regularly. Even small increases in waist circumference (e.g., 1 cm) and blood pressure over time are linked to a higher risk of heart attacks and strokes, regardless of your current weight. Preventing these increases through lifestyle management is critical for long-term heart health.

A 4 cm increase in abdominal circumference in men under 50 is associated with a 1.48 hazard ratio for developing MACCE, independent of systolic blood pressure changes.

For men under 50, gaining 4 cm around the waist over a few years nearly doubles the relative risk of a major cardiac or cerebrovascular event. Maintaining waist circumference is a key preventive strategy.

Reducing meat consumption, particularly ruminant meat, is necessary to lower greenhouse gas emissions and blue water use while simultaneously reducing the risk of cardiovascular disease, type 2 diabetes, and certain cancers.

To improve your health and reduce your environmental footprint, focus on reducing red and processed meat intake. Replace some meat meals with plant-based options like legumes, nuts, and whole grains. This shift lowers the risk of chronic diseases and reduces your diet's environmental impact.

Ultra-processed foods (UPF) contribute to negative health outcomes (obesity, diabetes, CVD, mortality) and environmental impacts, yet are often perceived as healthy due to marketing.

Limit ultra-processed foods, even if they are plant-based. Focus on whole, minimally processed foods for better health and environmental outcomes.

Obesity (BMI ≥ 25 kg/m²) is a critical, modifiable independent risk factor that drives the bidirectional overlap between asthma and obstructive sleep apnea (OSA) through mechanisms including altered lung mechanics, airway hyperresponsiveness, and adipokine production.

If you have asthma or sleep apnea and carry excess weight, weight management is likely the most impactful single intervention you can make. Losing even a small percentage of body weight can significantly reduce the severity of sleep apnea events and improve asthma control. Focus on sustainable weight loss strategies as a primary treatment adjunct.

Metabolic bariatric surgery is the most effective therapy for severe obesity, providing greater weight loss and mortality reduction than pharmacotherapy.

For severe obesity, surgery offers the highest chance of significant, sustained weight loss and resolution of comorbidities. Discuss eligibility with a bariatric specialist.

Tirzepatide treatment in adults with obesity or overweight results in a body composition change where approximately 75% of total weight loss is fat mass and 25% is lean mass, a proportion consistent with placebo and other weight loss modalities.

If you take tirzepatide, expect to lose about 3 pounds of fat for every 1 pound of muscle. This is the same ratio you would get from dieting alone. You do not need to worry that the medication is uniquely damaging to your muscles. To protect your strength, focus on the recommended lifestyle changes: eat 500 calories less per day and move for 150 minutes a week.

Bariatric surgery (RYGB or SG) produces significantly greater weight loss and higher treatment success rates than structured medical treatment including very low energy diet (VLED) at 2-year follow-up, though both interventions improve cardiovascular risk factors and safety profiles similarly.

For individuals with BMI ≥35, bariatric surgery (RYGB or SG) is significantly more effective than structured medical treatment (including very low energy diets) for achieving substantial weight loss and metabolic improvement at 2 years. However, medical treatment remains a viable option that yields positive cardiovascular and safety outcomes, with about 45% of patients achieving >10% weight loss. The choice involves trading the higher efficacy of surgery for the non-invasiveness of medical management.

Baseline anthropometry (initial BMI/weight) is the strongest predictor of treatment success for both surgical and medical obesity interventions, followed by psychiatric health and lifestyle factors.

Your starting weight and BMI are the best predictors of how much weight you will lose, regardless of whether you choose surgery or medical treatment. Higher baseline BMI often correlates with greater absolute weight loss. Mental health and lifestyle habits are also significant factors.

Current anti-obesity medications improve weight and metabolic parameters but do not yet have data supporting a reduction in hard cardiovascular outcomes.

While these drugs significantly reduce weight and improve metabolic markers, they have not yet been proven to reduce hard cardiovascular events like heart attacks or strokes. Weight loss itself is a key factor in long-term health.

Clinical staging of obesity should utilize systems like the Edmonton Obesity Staging System (EOSS) or Waist Circumference (WC) thresholds, as BMI alone fails to capture the severity of obesity-related complications and mortality risk in Asian populations.

Do not rely on BMI alone. Ask your doctor to measure your waist circumference and assess your overall health status (blood pressure, blood sugar, etc.) using a staging system like EOSS. This provides a more accurate picture of your health risks, especially if you are Asian and have 'normal' BMI but carry weight around your midsection.

GLP-1 receptor agonists for obesity treatment cause significant loss of lean body mass (including muscle) and bone density, with muscle loss accounting for approximately 20% of total weight reduction in the absence of structured resistance training.

If you are taking GLP-1s for weight loss, you must incorporate resistance training (weight lifting or bodyweight exercises) at least 2-3 times per week. Without this, roughly 20% of the weight you lose will be muscle, not just fat. Ensure you are eating enough protein to support muscle retention during the caloric deficit.

GLP-1 receptor agonists for obesity treatment cause significant loss of lean body mass (approximately 38% of total weight loss) and muscle mass, increasing the risk of sarcopenia and bone loss, particularly in the absence of structured resistance training and adequate protein intake.

If you are taking a GLP-1 medication for weight loss, expect to lose some muscle along with fat. To protect your strength and metabolism, you must prioritize resistance training (weight lifting or bodyweight exercises) and ensure you are eating enough protein. Without these steps, you risk losing significant muscle mass, which can happen with any rapid weight loss method.

Short-term muscle disuse atrophy (4 days) in humans is driven by declines in muscle protein synthesis (MPS), not by increased muscle protein breakdown (MPB).

If you are immobilized or inactive for a few days, your muscle loss is caused by a drop in your body's ability to build new muscle protein, not by an increase in muscle destruction. To mitigate this, interventions should focus on stimulating muscle protein synthesis (e.g., through protein intake or resistance stimuli if possible) rather than just trying to block breakdown pathways.

Replacing saturated fatty acids (SFA) from dairy foods with polyunsaturated fatty acids (PUFA) reduces LDL cholesterol but does not consistently reduce cardiovascular disease (CVD) risk or mortality, suggesting that LDL-C reduction alone is not a reliable predictor of CVD outcomes when the source is dairy.

Current guidelines suggest limiting saturated fats to reduce heart disease risk. However, this review indicates that replacing dairy saturated fats with polyunsaturated fats lowers LDL cholesterol but does not necessarily lower your actual risk of heart attacks or death. This suggests that simply counting saturated fat grams may be less important than the overall food matrix (e.g., eating whole dairy products) and other lipid markers like the LDL particle size.

High intake of saturated fatty acids from dairy foods is associated with neutral or negative (protective) associations with cardiovascular disease risk, unlike SFAs from other sources which may increase risk.

You do not need to restrict dairy foods to manage heart health risk. While general guidelines limit saturated fats, evidence suggests that the specific fats found in dairy (like C15:0 and C17:0) are associated with neutral or even protective effects on cardiovascular disease, unlike saturated fats from other sources.

Behavioral weight management programs (BWMPs) produce sustained improvements in cardiometabolic risk factors (blood pressure, lipid profile, glycemic control) for at least 5 years after program end, despite significant weight regain.

If you participate in a structured weight loss program, expect your blood pressure, cholesterol, and blood sugar to improve significantly. Even if you regain some weight after the program ends, these health benefits will likely persist for at least five years. Do not be discouraged by partial weight regain; the metabolic improvements are durable.

Short-term consumption of fast-food meals (a subset of UPFs) increases bile-tolerant bacteria (Collinsella, Parabacteroides, Bilophila) and decreases fiber-fermenting bacteria (Lachnospiraceae, Butyricicoccus).

Eating fast food for just 4 days can shift your gut bacteria, increasing bile-tolerant types and decreasing fiber-fermenting types. To maintain a healthy microbiome, limit fast food frequency and prioritize fiber-rich foods.