Browse the evidence

Expert consensus identifies 14 biomarkers of aging suitable for use as outcome measures in human intervention studies, spanning physiological, inflammatory, functional, and epigenetic domains.

When designing an aging intervention study, use one or more of the 14 consensus biomarkers (IGF-1, GDF15, hsCRP, IL-6, muscle mass/strength, grip strength, TUG, gait speed, balance, frailty index, cognitive health, blood pressure, or DNA methylation/epigenetic clocks) as your primary outcome measures. These are validated by expert consensus for detecting changes in biological age.

Blood-based inflammatory biomarkers (IL-6, TNF-α) are suitable for field testing using dry blood spot sampling, unlike DNA methylation-based biomarkers which require advanced laboratory processes.

For field studies, consider using dry blood spot sampling to measure IL-6 and TNF-α, as these can be collected remotely and analyzed, unlike DNA methylation which requires advanced lab processing.

High post-diagnostic consumption of ultra-processed foods (UPFs) is associated with a significantly increased risk of cardiovascular disease (CVD) mortality in patients with stages I–III colorectal cancer (CRC), but not with CRC-specific or all-cause mortality.

For colorectal cancer survivors, reducing ultra-processed food intake (aiming for <3.6 servings/day) is strongly linked to a lower risk of cardiovascular death, which is a major cause of mortality in this group. While this reduction did not show a direct link to preventing cancer recurrence in this study, prioritizing whole foods over processed options supports heart health, a critical component of long-term survivorship.

Coronary Microvascular Dysfunction (CMD) is a significant predictor of adverse cardiovascular events, heart failure with preserved ejection fraction (HFpEF), and mortality in diabetic patients, even in the absence of obstructive coronary artery disease.

Normal results on a standard angiogram (looking for big blockages) do not guarantee heart health if you have diabetes. Microvascular dysfunction can still cause heart failure and heart attacks. Monitoring for symptoms like shortness of breath and chest pain is crucial, as these may signal microvascular issues.

Selective, long-acting NK2R agonists (e.g., EB1002) reduce body weight and improve insulin sensitivity in obese mice and diabetic macaques by simultaneously increasing energy expenditure and suppressing appetite without causing aversive side effects.

This research identifies a new drug target (NK2R) that could lead to medications for obesity and type 2 diabetes. These drugs work by making your body burn more energy and reducing your appetite, without causing the unpleasant side effects often associated with other weight loss treatments. While promising in animals, this is not yet a human treatment.

Epicardial adipose tissue volume is a stronger predictor of atrial fibrillation risk than general anthropometric indices like BMI or waist circumference.

Fat stored directly around the heart (epicardial fat) is a major driver of atrial fibrillation in obese people. This risk is higher than what BMI alone suggests. Weight loss reduces this fat and improves heart rhythm.

In patients with established incident cardiovascular disease, higher body mass index (overweight and obesity) is associated with a more favorable prognosis for subsequent stroke, peripheral vascular disease, and mortality (CVD-related and all-cause) compared to normal BMI, regardless of metabolic health status.

If you have had a heart attack, stroke, or peripheral vascular disease, being overweight or obese is not necessarily a bad thing for your survival. In fact, this large study shows that having extra weight is linked to a lower risk of dying from heart issues or other causes compared to being normal weight. Do not aggressively try to lose weight without consulting your doctor, as maintaining energy reserves might be protective. Instead, focus on controlling blood pressure, cholesterol, and diabetes.

In patients with incident cardiovascular disease, increasing the number of metabolic risk factors (hypertension, dyslipidemia, diabetes) is associated with increased risk of subsequent non-fatal coronary heart disease (CHD) and incident heart failure (HF), regardless of BMI.

While having extra weight might help you survive a heart event, having high blood pressure, high cholesterol, or diabetes makes it much more likely you will have another heart attack or develop heart failure. You must manage these metabolic risk factors aggressively, regardless of your weight.

High-fat diets (HFD) induce obesity and metabolic dysfunction by altering gut microbiota composition and downregulating tight junction proteins (claudin-1, claudin-2, claudin-3, ZO-1, occludin), leading to increased intestinal permeability ('leaky gut') and systemic inflammation.

Diets very high in fat (over 35% of calories) can damage your gut lining by reducing the proteins that hold gut cells together, allowing toxins into your bloodstream and causing inflammation. This process contributes to obesity and metabolic issues. To protect your gut barrier, focus on balanced fat intake rather than extreme high-fat diets, and consider fats that support microbiome health.

Capsaicin or capsiate supplementation does not significantly improve aerobic endurance performance (time-trials or time-to-exhaustion) in healthy adults.

Do not rely on capsaicin or capsiate to improve your running or cycling times. The evidence shows no benefit for aerobic endurance, regardless of whether you do a time trial or exercise until exhaustion.

BMI is an inadequate and potentially harmful sole metric for assessing obesity severity and treatment response.

Do not rely on BMI alone. Your health is determined by your metabolic markers and fat distribution, not just your weight. Seek a comprehensive assessment that looks at your overall health risks.

GLP-1 medicines for obesity are predominantly tested in white/Caucasian populations (79%) with significant under-representation of non-white, Black, Asian, and Indigenous groups compared to their prevalence in multiethnic national populations.

Current GLP-1 obesity trials heavily feature white participants (79%). If you belong to a racial or ethnic minority, be aware that the standard dosing and efficacy data may not fully reflect your specific physiological response or risk profile. Advocating for or seeking out diverse clinical data is important for personalized care.

GLP-1 obesity trials are geographically concentrated in high-income countries (84.2% of sites), contrasting with the global prevalence of obesity which is highest in low- and middle-income countries (LMICs).

Most GLP-1 trials were conducted in high-income countries, yet most people with obesity live in low- and middle-income countries. This geographic gap means that treatment guidelines and availability may not reflect the needs of the majority of the global population.

Lifelong endurance training preserves skeletal muscle oxidative capacity and capillarization in men aged 82-92, whereas physical function level does not correlate with these morphological markers.

For men in their 80s, maintaining a history of endurance training is associated with better muscle blood supply and energy production than simply being strong. While you cannot change your past, the data suggests that consistent aerobic activity preserves muscle quality better than inactivity, regardless of current strength levels.

Endurance training does not preserve satellite cell numbers or markers of muscle regeneration/denervation in very old men compared to sedentary peers.

Do not expect exercise to restore youthful muscle repair capabilities (satellite cells) in your 80s. While training improves blood flow and energy use, the cellular machinery for regeneration appears to decline with age regardless of activity level.

Current randomized controlled trials of nutrient-stimulated hormone-based therapies (NuSHs) for obesity predominantly fail to assess nutritional and functional outcomes, focusing almost exclusively on body weight.

If you are participating in or designing a NuSH trial, you must include nutritional and functional assessments (body composition, muscle strength, bone health) alongside weight. Relying solely on weight masks potential risks like sarcopenia and bone loss.

Obesity (BMI ≥30 kg/m2) significantly increases annual health care resource utilization (HCRU) and causes substantial premature mortality, resulting in billions of pounds in lifetime economic loss and quality-adjusted life year (QALY) deficits.

Obesity imposes a massive financial and health burden on society, costing billions in healthcare resources and causing significant premature death. While losing weight reduces annual healthcare costs, the benefit is largely negated by the increased life expectancy of formerly obese individuals, meaning the total lifetime cost remains high. Public health policy must account for this lifetime cost, not just short-term annual savings.

Males in the US have consistently higher diabetes incidence and prevalence than females across all age groups, with a significant disparity that becomes more pronounced in older cohorts.

Men in the US are diagnosed with diabetes more often than women, and this gap widens with age. This may be partly due to biological factors and partly due to less frequent healthcare engagement. Men should prioritize regular screening and not delay care due to cultural norms.

High consumption of artificially-sweetened beverages (ASBs) is not significantly associated with increased cardiovascular disease risk in physically active individuals.

If you are physically active, drinking two or more artificially-sweetened beverages a day does not appear to increase your cardiovascular disease risk in this study. However, this does not mean they are 'healthy,' and they should not be relied upon as a primary health strategy.

Lower drug prices for semaglutide and tirzepatide could significantly improve their cost-effectiveness, potentially making them competitive with surgical and behavioral interventions.

If drug prices for semaglutide and tirzepatide were reduced, these medications could become cost-effective options for managing class III obesity, potentially offering a non-surgical alternative.

Spinach thylakoid supplementation does not significantly improve renal function markers (urea, creatinine, total protein) in obese PCOS women compared to placebo, despite improvements in other metabolic indices.

Do not take spinach thylakoid extract expecting it to improve kidney function. While it helps with metabolic markers, this study showed no benefit for renal markers like urea or creatinine in obese PCOS women.

The lack of a unified definition for resistance exercise (RE) in scientific literature leads to heterogeneous inclusion criteria in systematic reviews, which obscures the true magnitude of effects and impairs the development of evidence-based guidelines.

When evaluating resistance training advice or research, check if the definition of 'resistance' is explicit. If a study or program mixes bodyweight exercises, plyometrics, and weighted lifting without distinguishing them, the results may be less precise. For optimal strength or hypertrophy, ensure the training modality matches your specific goal (e.g., traditional strength vs. plyometrics) rather than assuming all 'resistance' is equal.

Performing 1 or 2 sets of 3-4 repetitions at 55-75% of 10RM as a specific warm-up provides no performance benefit over no warm-up for resistance-trained individuals performing multiple sets to failure at ~10RM loads.

If you are training with moderate weights (around 10 reps max) and doing multiple sets to failure, you likely do not need a specific warm-up. Skipping it saves 2-5 minutes per exercise without hurting your performance. However, if you are lifting very heavy (1-3RM) or are concerned about injury, you may still want to warm up. Listen to your body, but don't feel obligated to warm up if it's just for performance gains at moderate loads.

Training at longer mean muscle lengths does not produce greater regional muscle hypertrophy compared to shorter mean muscle lengths when using typical contrasts in resistance training.

You do not need to train through a full range of motion to maximize muscle growth. Partial reps performed at long muscle lengths (lengthened partials) are just as effective as full reps for hypertrophy. Focus on consistency and volume rather than forcing full depth if it causes joint pain or technical breakdown.