Browse the evidence

Metabolic and bariatric surgery (MBS) provides significantly greater reduction in major adverse cardiovascular events (MACE) and all-cause mortality compared to GLP-1 receptor agonist (GLP-1 RA) therapy in patients with obesity and type 2 diabetes.

If you have obesity and type 2 diabetes, metabolic surgery (like gastric bypass or sleeve gastrectomy) is currently shown to be more effective than GLP-1 medications (like semaglutide or liraglutide) at preventing heart attacks, strokes, and death. While GLP-1 drugs are important for those who cannot have surgery, surgery offers greater long-term cardiovascular protection and more sustained weight loss, though it carries surgical risks and requires lifelong nutritional monitoring.

Microbiome-targeted interventions like prebiotics, probiotics, and synbiotics show potential antihypertensive effects, but results are heterogeneous and require larger randomized trials.

While probiotics and prebiotics show promise, they are not yet a proven standalone treatment for hypertension. Focus on a healthy diet and lifestyle first, and consider these supplements as potential adjuncts under medical guidance.

Combining different weight-lowering drugs with complementary mechanisms (e.g., GLP-1 RA with activin receptor antagonist) can enhance weight loss and preserve lean body mass, potentially offering superior cardiovascular protection compared to monotherapy.

For some patients, taking a single weight-loss drug might lead to muscle loss, which isn't ideal for heart health. New combination therapies, such as pairing a GLP-1 drug with a muscle-preserving agent, are being developed to prevent this. These combinations can lead to greater fat loss and better preservation of muscle mass, which is crucial for metabolic health. While these are still emerging, they represent a promising approach for those who struggle with muscle loss on standard treatments.

CrossFit practitioners who use supplements primarily target performance enhancement and muscle hypertrophy, with whey protein and creatine being the most frequently used substances, despite a lack of scientific consensus supporting their specific necessity for all practitioners.

Most CrossFit users take whey protein or creatine to build muscle or perform better. While these are common and generally safe, they are not strictly necessary for everyone. Focus on your training and whole-food nutrition first; use supplements only if they fill a specific gap or support a specific goal you have discussed with a professional.

In people living with HIV (PLWH), systemic inflammation, metabolic disorders, and mitochondrial dysfunction caused by antiretroviral therapy (ART) increase the susceptibility to sarcopenia.

For PLWH, maintaining muscle mass requires addressing the underlying inflammatory and metabolic environment created by HIV and ART, not just eating protein. Regular exercise and managing metabolic health are key.

Bodybuilders who consume dietary supplements report side effects such as skin rashes, increased liver enzymes, and hair loss.

Be vigilant about potential side effects from dietary supplements. If you experience skin rashes, increased liver enzymes, or hair loss, consider stopping the supplement and consulting a healthcare provider. Regular health check-ups can help detect these issues early.

MMA fighters exhibit body composition (skeletal muscle mass, body fat percentage, visceral fat mass, and phase angle) statistically indistinguishable from elite powerlifting athletes, despite fundamentally different training methodologies.

If you are an MMA fighter, you do not need to sacrifice muscle mass to maintain your conditioning. Your body composition (muscle and fat levels) can be just as favorable as a powerlifter's, provided you train with sufficient intensity and volume. Focus on maintaining high tissue quality (phase angle) through balanced aerobic and anaerobic training rather than cutting muscle for weight classes.

Younger age (<65 years) and shorter duration of severe neutropenia are the strongest independent predictors of lean mass gain during adapted physical activity in hematology inpatients.

Younger hematology patients (<65) and those with shorter periods of severe neutropenia are likely to see the greatest lean mass benefits from adapted physical activity. Older patients or those with prolonged neutropenia may see minimal gain, but activity remains safe and improves physical function.

Higher dietary diversity, specifically protein-enriched and anti-inflammatory dietary diversity, is associated with a lower prevalence of low muscle mass (LMM) in older Chinese adults.

For older adults, simply increasing the variety of foods consumed—specifically ensuring regular intake of protein-rich sources (meat, fish, eggs, dairy, beans, nuts) and anti-inflammatory foods (vegetables, fruits, tea)—is associated with a significantly lower risk of low muscle mass. Aim for a diverse plate rather than focusing on a single supplement or food group.

A fully health-insurance-financed, long-term (4-year) conservative multimodal obesity therapy program achieves clinically significant weight loss (average 5 kg or 4% of body weight) and metabolic improvements in patients with obesity grades 2 and 3 under real-world conditions.

If you have obesity grade 2 or 3, a comprehensive, long-term conservative therapy program, fully covered by health insurance in Germany, can help you lose an average of 5 kg (4% of body weight) and improve your metabolic health. This program includes dietary, exercise, and behavioral therapy sessions over several years. It is designed to be flexible and affordable, addressing common barriers like cost and adherence.

A personalized, integrative, long-term (5-year) coaching program based on a systems health perspective significantly improves health-related quality of life, physical outcomes (weight, waist circumference, aerobic capacity), and psychosocial well-being (fatigue, self-esteem) in adults with obesity compared to baseline.

If you have obesity and have struggled with standard diet/exercise programs, consider a long-term, personalized coaching approach that addresses not just weight but also mental health, social support, and physical activity. Expect a significant time commitment initially, but the goal is to build sustainable habits. Progress may be slow, but improvements in quality of life and physical function are possible.

A carbohydrate-reduced telemedicine nutrition intervention significantly reduces the incidence of major adverse cardiovascular events (MACE) and new-onset cardiovascular disease in adults with type 2 diabetes or obesity compared to matched controls.

If you have type 2 diabetes or obesity, a telemedicine program that helps you restrict carbohydrates to under 30 grams per day and maintain nutritional ketosis can significantly lower your risk of heart attacks, strokes, and other cardiovascular events compared to standard care. This approach works by improving overall metabolic health, which appears to protect the heart even if cholesterol levels change.

A 12-week canteen-based intervention marginally improves lipid metabolism (decreased TG, LDL-C, ApoB; increased HDL-C) but does not significantly affect blood pressure, glucose, or insulin resistance in middle-aged adults.

While this intervention improves lipid profiles, it may not significantly impact blood pressure or blood glucose in the short term. Focus on lipid management through dietary changes if you have mild dyslipidemia.

Uniform dietary interventions fail to deliver consistent metabolic benefits in individuals with metabolic syndrome due to biological heterogeneity, whereas food-based dietary patterns emphasizing whole foods and limiting ultra-processed foods provide relatively consistent metabolic benefits across diverse phenotypes.

Stop looking for a single 'best' diet for metabolic syndrome. Instead, focus on the quality of your food: eat more whole foods (vegetables, fruits, legumes, whole grains) and minimize ultra-processed foods. This approach is more likely to benefit you regardless of your specific metabolic profile.

High scores on the Chinese Empirical Dietary Inflammatory Index (CEDII), characterized by high intake of refined carbohydrates, meat, and eggs, are associated with accelerated biological aging, evidenced by shorter leukocyte telomere length (LTL) and lower mitochondrial DNA copy number (mtDNAcn).

If you live in a region with a high-carbohydrate, grain-based diet, prioritize coarse grains over refined grains and increase vegetable and fat (healthy sources) intake. This specific dietary pattern is linked to lower systemic inflammation and slower biological aging markers like telomere shortening. Standard Western dietary advice may not capture these nuances, so focus on local food quality and inflammatory potential.

The association between high inflammatory dietary patterns (high CEDII) and accelerated aging (short LTL) is significantly stronger in individuals with abnormal metabolic status, specifically those who are overweight, have raised blood pressure, or elevated triglycerides.

If you have metabolic issues like high blood pressure, high triglycerides, or excess weight, your diet's inflammatory potential matters even more for your aging process. Prioritizing an anti-inflammatory diet is crucial for this subgroup to mitigate accelerated biological aging.

A higher Dietary Inflammatory Index (DII) score is positively and nonlinearly associated with an increased risk of stroke in the general US population.

To lower your stroke risk, prioritize an anti-inflammatory diet. This means eating more fruits, vegetables, whole grains, and healthy fats (like olive oil and fish) while minimizing processed foods, refined sugars, and excessive alcohol. The study shows that diets high in inflammatory potential are linked to nearly double the odds of having a stroke compared to anti-inflammatory diets.

Obesity is a significant independent predictor of multimorbidity (two or more chronic non-communicable diseases), increasing the likelihood by 1.87 times compared to normal-weight individuals, even after adjusting for socioeconomic and demographic factors.

Maintaining a healthy weight is a critical strategy for preventing the accumulation of multiple chronic diseases, such as hypertension and diabetes. In this population, obesity nearly doubles the risk of having two or more conditions compared to normal weight. Public health interventions should prioritize weight management and access to care for obese individuals to reduce the overall burden of disease.

In older adults with sarcopenia, those with higher baseline functional reserve (Gait Speed ≥ 0.8 m/s or SPPB = 8) experience significant functional decline over 6 months, whereas those with lower baseline function do not show significant change in gait speed.

For older adults with sarcopenia, functional decline is not uniform. Those who still have some mobility reserve (walking speed ≥ 0.8 m/s) are actively losing function and are at higher risk for rapid decline. Those with very low function may appear stable simply because they have reached a functional floor. Monitoring should focus on those with residual capacity who are losing it.

Sarcopenic Obesity (SO) is associated with significant deterioration in functional exercise capacity (6MWD) over 6 months, even when gait speed changes are not statistically significant.

For older adults with both sarcopenia and obesity, functional decline may manifest as reduced walking distance rather than slower walking speed. Regular assessment of walking capacity (like the 6-minute walk test) is important to detect deterioration in this group.

A well-planned vegan diet is compatible with and supports athletic performance, offering benefits such as increased glycogen storage, reduced oxidative stress, and improved blood flow, without compromising strength or aerobic capacity compared to omnivorous diets.

If you are an athlete considering a vegan diet, focus on high-carbohydrate plant foods to maximize glycogen stores and include a variety of protein sources to meet amino acid needs. You must supplement Vitamin B12 and likely Vitamin D, especially in winter. Monitor iron and zinc levels, as absorption is lower from plant sources. The diet supports endurance and recovery through reduced oxidative stress and inflammation, provided you plan your meals carefully.

Short-term body mass manipulation (SBM) in powerlifting should be limited to approximately 3% body mass loss when the weigh-in-to-competition window is two hours, as larger losses impair rehydration capacity and performance.

If you must cut weight for a powerlifting meet with a 2-hour weigh-in, do not lose more than 3% of your body weight. Losing more than this amount makes it physically impossible to rehydrate and refuel enough to perform safely and effectively in the short window available. Focus on water loading and sodium manipulation within this 3% limit rather than extreme dehydration.

Electronic health record (EHR) data collected prior to anti-obesity medication (AOM) initiation can be used to identify distinct obesity subtypes (clusters) with specific clinical comorbidities, which may inform precision medicine strategies.

Current obesity treatment often relies on BMI, which fails to predict how individuals will respond to medications. This research suggests that using detailed electronic health records (labs, vitals, diagnoses) before starting treatment can identify distinct obesity subtypes with specific health profiles. This 'deep phenotyping' approach could help doctors choose more effective, personalized treatments, moving away from a one-size-fits-all model.

Combined obesity medicine and metabolic bariatric surgery care produces more optimal outcomes and reduces costs compared to siloed practice.

Seek a clinic that offers both medical weight loss management and surgical options under one roof or coordinated care plan. This ensures you are evaluated for all treatments, not just one.