Browse the evidence

Using a single, universal velocity loss (VL) threshold to prescribe resistance training volume is unreliable and fails to control the actual amount of work completed across individuals.

Do not use a single, fixed velocity loss threshold (like stopping at 20% velocity loss) to dictate your training volume for everyone. The study shows that men, women, and individuals with different personality traits (like emotional stability) perform different numbers of reps to reach the same velocity loss. To control volume accurately, you must individualize the threshold based on sex, training history, and strength levels, or accept that the volume will vary significantly.

Sex, emotional stability, and training history significantly influence the number of repetitions performed to reach a specific velocity loss threshold, making universal thresholds invalid.

When using velocity-based training, account for individual differences. Women tend to perform more reps to reach the same velocity loss than men. Additionally, individuals with higher emotional stability may perform more reps. Adjust your velocity loss targets or volume expectations based on these factors rather than applying a single rule.

Endoscopic Sleeve Gastroplasty (ESG) is a highly cost-effective, less invasive alternative to surgery for Class I obesity, with an ICER well below willingness-to-pay thresholds.

For Class I obesity, ESG offers a durable, cost-effective alternative to surgery with a favorable safety profile. It is particularly valuable for patients who want more than lifestyle changes but are not candidates for or willing to undergo surgery.

Performing static hamstring stretching immediately before sets of the barbell back squat acutely increases biceps femoris muscle thickness without impairing total training volume or exercise performance.

If you want to target your hamstrings during squats, add a 40-second static hamstring stretch right before each squat set. Sit with legs extended, hinge forward until you feel a strong stretch (pain rating >7/10), hold for 40 seconds, then immediately perform your squat set. This will increase blood flow and muscle thickness in the hamstrings without hurting your performance or total volume.

Electromagnetic resistance devices (including variable resistance and eccentric overload settings) produce myoelectric activity (sEMG) amplitudes that are statistically similar to traditional dumbbell resistance training, with observed differences being modest (~5-10%) and of minimal practical significance for muscle excitation.

If you are using or considering an electromagnetic resistance device (like Tonal) with variable or eccentric overload settings, you can expect muscle activation levels that are largely comparable to using dumbbells. While there may be slight differences in shoulder (deltoid) or forearm (brachioradialis) activation, the primary arm muscle (biceps) receives similar stimulation from both. You do not need to switch to dumbbells to get results, nor do you need to buy expensive tech to get better results than dumbbells offer for this movement.

A poly-metabolite score derived from serum and urine metabolomics can accurately predict and discriminate between high (80% energy) and low/zero (0% energy) ultra-processed food (UPF) intake in free-living populations.

Current dietary self-reporting methods for ultra-processed foods are prone to error and misclassification. This research identifies specific blood and urine metabolite patterns that serve as objective biomarkers for UPF intake. For researchers, these scores improve the accuracy of studying UPF's health impacts. For individuals, it underscores that 'ultra-processed' is a biological reality detectable in the body, not just a label on a package, highlighting the metabolic complexity introduced by industrial food processing.

Higher consumption of sugar-sweetened beverages (SSBs) is associated with a greater increase in type 2 diabetes risk compared to artificially sweetened beverages (ASBs).

If you must choose between sugary and artificially sweetened drinks, sugary drinks pose a much higher risk for type 2 diabetes. However, both are associated with increased risk compared to not drinking them. The best choice for diabetes prevention is water or unsweetened beverages.

Obesity should be managed as a chronic, relapsing disease with long-term structured medical interventions (pharmacotherapy, surgery, behavioral therapy) rather than relying on short-term lifestyle changes, mirroring the established management model for Type 2 Diabetes Mellitus (T2DM).

Stop treating obesity as a short-term lifestyle issue. Seek a healthcare provider who recognizes it as a chronic disease. This means expecting long-term management with evidence-based tools like GLP-1 receptor agonists (e.g., semaglutide, tirzepatide), behavioral therapy, and potentially surgery, rather than just being told to 'eat less and move more.'

Metabolic bariatric surgery (MBS) procedures, specifically Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), single anastomosis duodenal-ileal bypass (SADI), and biliopancreatic diversion (BPD), provide superior long-term total body weight loss (TBWL) compared to obesity management medications (OMM) and endoscopic bariatric procedures (EBP).

If you are struggling with obesity and lifestyle changes alone have not provided sufficient long-term results, metabolic bariatric surgery (specifically RYGB, SG, SADI, or BPD) offers the highest probability of significant, sustained weight loss. While newer medications (semaglutide, tirzepatide) are excellent short-to-medium term options and comparable to surgery initially, surgery tends to maintain higher efficacy over the long term (3+ years). Consult a specialist to determine if you are a candidate for these procedures, especially if your BMI is >= 40 kg/m2.

The EMP16 combination therapy significantly improves the Fatty Liver Index (FLI) and reduces visceral adiposity index (VAI) more effectively than conventional orlistat, suggesting specific benefits for liver health beyond general weight loss.

If you have fatty liver or high visceral fat, this specific combination pill (EMP16) may offer better liver health improvements than standard orlistat. It significantly reduces the Fatty Liver Index compared to conventional treatments.

High sodium intake is the leading dietary risk factor for mortality globally, responsible for 3 million deaths annually.

High sodium intake is a major driver of early death globally. To protect your health, aim to reduce your sodium intake to the optimal range of 1-3 grams per day, as excessive consumption significantly increases your risk of cardiovascular disease and mortality.

GLP-1-based therapies (semaglutide, tirzepatide) cause lean mass loss proportional to total weight loss (approx. 15-45%), but this reduction is adaptive and accompanied by improved muscle quality (reduced fat infiltration), resulting in preserved or improved muscle function and strength.

If you are taking a GLP-1 medication like semaglutide or tirzepatide, expect to lose some muscle along with fat. This is normal and proportional to your weight loss. Crucially, these drugs often improve muscle quality by reducing fat inside the muscle, which helps preserve your strength and function. To maximize muscle retention, ensure you are consuming adequate protein and engaging in resistance training if possible.

Nationwide substitution of regular discretionary salt with potassium-enriched salt substitutes (20-30% KCl) in China yields a substantial net reduction in cardiovascular disease mortality by lowering systolic blood pressure, even when accounting for the increased risk of hyperkalemia in individuals with chronic kidney disease.

Replace your regular table salt and cooking salt with a potassium-enriched salt substitute (containing 20-30% potassium chloride). Use it in the same amounts you currently use regular salt, but try to use it slightly more sparingly if possible. This change lowers blood pressure and significantly reduces the risk of heart disease and stroke for the general population. If you have advanced kidney disease, consult your doctor, but note that even for kidney patients, the cardiovascular benefits of this switch generally outweigh the risks of potassium toxicity.

Combining moderate-to-vigorous exercise with GLP-1 receptor agonist (liraglutide) treatment preserves hip and lumbar spine bone mineral density (BMD) during significant weight loss, whereas GLP-1 RA treatment alone reduces BMD at these sites despite similar weight loss.

If you are using a GLP-1 medication like liraglutide or semaglutide for weight loss, you must incorporate regular exercise to protect your bones. This study shows that while the medication alone might reduce bone density at the hip and spine, adding moderate-to-vigorous exercise (like cycling and circuit training) completely preserves bone density, even when you lose a significant amount of weight. Do not rely on the medication alone for skeletal health.

Short-term high-volume resistance training induces muscle hypertrophy primarily through sarcoplasmic expansion (increased sarcoplasmic proteins and glycolytic enzymes) rather than myofibrillar accretion, often accompanied by a decrease in actin and myosin concentrations.

If you are new to resistance training or returning after a break, your initial muscle size gains may come largely from increased fluid and metabolic enzymes (sarcoplasm) rather than thicker muscle fibers. This means you might see visual size increases before significant strength gains. This is a normal, healthy adaptation to high-volume training and does not negate the value of the training.

Short-term step reduction (<1000 steps/day) in older adults triggers rapid metabolic perturbations indicating muscle energy decline and protein degradation, which are not fully reversible after two weeks of resumed normal activity.

If you are an older adult, even a short break from your normal walking routine (less than 1,000 steps a day) can trigger metabolic changes in your muscles that suggest protein breakdown. These changes don't always bounce back quickly when you start moving normally again. To protect your muscle health, try to maintain a baseline level of daily movement rather than taking long breaks, especially if you are already at risk for metabolic issues.

Subgingival instrumentation (periodontal therapy) significantly reduces glycated hemoglobin (HbA1c) levels in patients with type 2 diabetes, demonstrating a bidirectional benefit where treating periodontitis improves metabolic control.

If you have diabetes and gum disease, getting your gums treated by a dentist is not just about saving your teeth; it helps lower your blood sugar levels. Standard cleaning (subgingival instrumentation) has been shown to reduce HbA1c by nearly 0.3%, which is clinically meaningful for metabolic control.

Tenofovir alafenamide (TAF) is associated with greater weight gain compared to Tenofovir disoproxil fumarate (TDF), which appears to have a weight-mitigating effect.

If your HIV medication contains TAF (tenofovir alafenamide), you may gain more weight than if you were on TDF (tenofovir disoproxil fumarate). TDF seems to help mitigate weight gain. If you are concerned about weight, ask your doctor if switching your tenofovir prodrug from TAF to TDF is an option for you, keeping in mind that TDF may have other side effects like kidney or bone issues.

Low-load resistance training (20-30 RM) produces hypertrophic and strength adaptations in predominantly slow-twitch muscles (soleus) that are equivalent to heavy-load training (6-10 RM), refuting the hypothesis that fiber type composition dictates optimal loading strategy.

You do not need to lift heavy weights to build calf muscle. If you can perform 20-30 repetitions to failure, you will gain muscle and strength just as effectively as if you were lifting 6-10 repetitions. Focus on reaching failure with controlled form, regardless of the weight used.

Eight months of moderate-intensity exercise produces a 10-year legacy effect on metabolic health markers (blood pressure, fasting insulin, waist circumference), whereas vigorous-intensity exercise produces a legacy effect on cardiorespiratory fitness (peak VO2).

If your goal is better metabolic health (blood pressure, insulin sensitivity), prioritize moderate-intensity exercise (40-55% max effort). If your goal is maintaining aerobic fitness (VO2 max), prioritize vigorous-intensity exercise (65-80% max effort). You don't need to maintain the exact same volume or intensity you trained with initially to retain benefits; the initial adaptation creates a 'legacy' that persists for years, though recent activity levels also play a role.

Body composition assessment (quantifying fat-free mass, fat mass, and visceral adipose tissue) provides a more accurate assessment of cardiometabolic disease risk than Body Mass Index (BMI) alone, particularly for identifying 'normal weight obesity' and sarcopenic obesity.

Stop relying solely on the scale. If you are maintaining a 'normal' BMI but feel weak or have high blood sugar, ask for a body composition assessment (like DXA or BIA). This will reveal if you have 'normal weight obesity' (high fat, low muscle) or sarcopenic obesity (high fat, low muscle), which are high-risk conditions that BMI misses. Prioritize resistance training and protein intake to build muscle, as this is the most effective way to lower metabolic risk when BMI is misleading.

Epigenetic interventions, pharmacotherapy, and bariatric surgery are emerging as important tools for obesity management, alongside lifestyle changes.

Consult with a healthcare provider about advanced treatment options like pharmacotherapy or bariatric surgery if lifestyle changes alone are insufficient. These are valid medical tools, not last resorts.

Bariatric surgery (gastric bypass, sleeve gastrectomy, or adjustable gastric banding) is cost-effective over a 10-year horizon and cost-saving over a lifetime compared to conventional medical management, primarily by reducing the incidence of type 2 diabetes and cardiovascular events.

For obese individuals with BMI >40 (or >35 with Type 2 Diabetes) who have failed conservative weight loss, bariatric surgery is a clinically and economically superior long-term strategy compared to medical management alone. It significantly reduces the risk of diabetes and cardiovascular disease, leading to cost savings and improved quality of life over a lifetime. However, access barriers like insurance restrictions and waiting lists should be minimized, as delays result in lost health benefits.

Equating total training volume, resistance training performed 2 days per week produces similar increases in muscular strength and hypertrophy compared to 3 days per week in resistance-trained men.

If you are an experienced lifter, you do not need to train every muscle group 3+ times a week to maximize gains. As long as you are hitting the same total number of hard sets per week, splitting those sets across 2 days (e.g., Upper/Lower or Push/Pull/Legs) works just as well as hitting them 3 times. Focus on getting your total weekly volume in, rather than obsessing over high frequency.