Browse the evidence

Intermittent fasting (5:2 protocol) is a viable weight loss strategy for night shift workers, with the hypothesis that aligning fasting days with night shifts (5:2N) may improve insulin resistance compared to continuous energy restriction.

If you work night shifts, try fasting for 2 days a week. You can choose which days to fast, so pick the days that include your night shifts. On those days, eat very little (about 2100-2500 kJ). On the other 5 days, eat normally but don't overeat to make up for the fast days. This approach might help manage your weight and blood sugar better than just cutting calories every day.

Exercise is an effective treatment for major depressive disorder, with walking/jogging, yoga, and strength training showing moderate to large reductions in symptoms compared to active controls.

Exercise is a valid, evidence-based treatment for depression, comparable to medication and therapy. For best results, choose modalities like walking, jogging, yoga, or strength training. While vigorous intensity yields stronger effects, even light activity provides clinically meaningful benefits. Prioritize modalities you find tolerable, such as yoga or strength training, to ensure adherence.

Engaging in muscle-strengthening activities (e.g., resistance training) for 30-60 minutes per week is associated with a 10-20% lower risk of all-cause mortality, cardiovascular disease, and total cancer compared to no muscle-strengthening activity.

To lower your risk of death and major diseases, aim for 30-60 minutes of muscle-strengthening activities (like lifting weights or bodyweight exercises) per week. You don't need to do it all at once; breaking it into 2-3 sessions is effective. This benefit exists even if you already do aerobic exercise like walking or running.

Combined muscle-strengthening and aerobic activities provide greater reductions in all-cause, cardiovascular, and total cancer mortality than either activity alone or neither.

For the best protection against death and major diseases, combine muscle-strengthening exercises with aerobic exercise. This combination offers significantly greater benefits (40% lower all-cause mortality) than doing either one alone.

Carbohydrate manipulation (loading) increases muscle size in physique athletes primarily through intramuscular glycogen supercompensation and associated water binding, but this strategy lacks experimental validation for aesthetic performance and carries risks of gastrointestinal distress and subcutaneous water retention.

If you are a physique athlete peaking for competition, do not blindly copy endurance athlete carb-loading protocols. Your body may not handle the same loads, leading to 'spilling over' (subcutaneous water) and bloating. Instead, experiment with moderate carbohydrate loads (3-6 g/kg) during training camp to see how your body responds. Minimize the number of variables you change at once (e.g., don't change carbs, water, and sodium simultaneously) to reduce psychological stress and make it easier to identify what works for your specific physiology.

High-volume static stretching is a viable therapeutic alternative or supplement for counteracting immobilization-induced muscle atrophy in patients who are bedridden, post-surgery, or have mobility restrictions.

If you are recovering from surgery or an injury and cannot lift weights, use a stretching device or manual stretching for 30 minutes to 2 hours daily. This can help prevent muscle loss during immobilization. Consult your doctor before starting.

Proximity to failure (4-6 RIR vs 1-3 RIR vs 0 RIR) does not significantly affect muscle hypertrophy (muscle thickness) in trained men over an 8-week period.

For muscle growth, it does not matter much whether you train to failure or stop with 1-3 reps left. Both approaches can yield similar hypertrophy. Focus on consistency and progressive overload rather than chasing failure on every set.

Modifying the physical structure of beef (minced vs. steak) while keeping nutrient composition identical does not significantly alter muscle protein synthesis (MPS) rates, but it does significantly improve whole-body net protein balance by enhancing digestion and absorption kinetics.

If you are eating enough protein (around 26g+ per meal) and engaging in resistance training, the physical form of your meat (minced vs. steak) likely does not change how much muscle you build directly. However, minced meat may be easier to digest and absorb, leading to better overall protein retention in the body, which might be beneficial for older adults or those with chewing difficulties.

Phytotherapeutic agents (e.g., Green Tea, Nigella Sativa, Bofu Tsusho San) produce statistically significant but clinically less relevant weight loss compared to modern AOMs.

Herbal supplements like Green Tea or Black Seed may help with modest weight loss, but they are not as effective as prescription medications like Semaglutide or Tirzepatide. Manage your expectations accordingly.

In women, initial skeletal muscle size (leg fat-free mass and quadriceps CSA) is positively associated with the magnitude of muscle atrophy following 14 days of immobilization.

For women undergoing immobilization, having larger muscles prior to injury may be associated with greater absolute muscle loss. However, this finding is based on a small group and needs confirmation. Do not let this discourage building muscle; focus on proper rehabilitation.

Metabolic and bariatric surgery (MBS) improves depressive, anxiety, and non-normative eating symptoms, as well as attention, compared to nonsurgical controls, though evidence certainty is low to very low.

If you have obesity and struggle with depression, anxiety, or disordered eating, metabolic and bariatric surgery (MBS) may help improve these symptoms more than nonsurgical treatments. However, the evidence is not yet high-quality, and you should be aware that MBS might slightly increase the risk of substance use disorders or suicide in the long term (>2 years). Regular mental health monitoring is essential after surgery.

Sarcopenic obesity (high fat mass combined with low muscle mass and function) is a distinct and high-risk phenotype in chronic liver disease (CLD) and IBD, associated with worse prognosis, higher mortality, and increased surgical complications compared to obesity alone or sarcopenia alone.

For people with liver disease or IBD, being obese is risky, but losing muscle makes it much worse. This combination, called 'sarcopenic obesity,' leads to higher death rates and surgery complications. You need to check your muscle mass, not just your weight. If you are losing weight, make sure it's fat, not muscle.

GLP-1 receptor agonists (GLP-1RAs) may reduce the severity of Obstructive Sleep Apnoea (OSA) as measured by the Apnoea-Hypopnoea Index (AHI), primarily through weight loss mechanisms, though evidence quality is currently low and results are conflicting.

If you have OSA and are considering GLP-1RAs (like semaglutide or liraglutide), expect a modest improvement in sleep breathing (AHI) rather than a cure. The benefit is largely tied to weight loss. Do not stop using your CPAP machine unless your doctor advises it, as CPAP is currently more effective. Be prepared for potential stomach side effects, which are common but often subside. The evidence is not yet strong enough to make this a standard first-line treatment for OSA alone.

Human observational studies on MSG and obesity show inconsistent results, with some finding positive associations and others finding no association or inverse associations, largely due to measurement errors and confounding factors.

Human studies on MSG and weight are mixed. While animal studies suggest risks, human data is not conclusive. Reducing intake of processed foods with hidden MSG is a low-risk strategy for overall health.

South Asian ethnicity is predisposed to 'thin-fat' obesity (normal weight obesity), leading to higher risks of diabetes, hypertension, and dyslipidemia at lower BMIs.

If you are South Asian, your risk for diabetes and heart disease starts at a lower weight than other ethnicities. Even if your BMI is normal, you might have 'thin-fat' obesity. Get regular check-ups for blood sugar, blood pressure, and cholesterol, and focus on building muscle and staying active.

Creatine supplementation trends toward increasing lean muscle mass in prostate cancer patients undergoing ADT.

Creatine supplementation may help preserve lean muscle mass in prostate cancer patients on hormone therapy, though the evidence is not yet definitive. It is worth discussing with your healthcare provider as a potential supportive measure.

Bariatric surgery (Roux-en-Y gastric bypass or sleeve gastrectomy) is technically feasible and safe for patients with pre-existing ileostomy or colostomy, without causing increased ostomy output or dehydration.

If you have an existing ostomy (ileostomy or colostomy) and are considering bariatric surgery, current preliminary evidence suggests it is feasible and safe, with no increased risk of dehydration or output changes compared to patients without an ostomy. Consult with a bariatric surgeon to evaluate your specific case, as individual factors like the cause of your ostomy and overall health status will determine your candidacy.

Carnivore and animal-based diets do not consistently improve athletic performance and may impair high-intensity exercise capacity due to reduced muscle glycogen and constrained metabolic flexibility.

Do not switch to a carnivore or animal-based diet expecting better performance, especially if your sport involves sprinting, lifting, or high-intensity intervals. These diets reduce muscle glycogen and make it harder to produce energy quickly. While you might lose weight or feel less bloated, your high-intensity performance will likely suffer. Stick to established sports nutrition guidelines that prioritize carbohydrate availability for intense training.

The renal safety of long-term low-carbohydrate diets in obese individuals remains undetermined due to insufficient reporting of renal function data in clinical trials.

Do not start a low-carb diet if you have existing kidney disease. For healthy obese individuals, current data does not show harm, but long-term safety is not proven because most studies don't track kidney function. Monitor your health with a doctor.

Bariatric surgery (RYGB, sleeve gastrectomy) does not result in clinically significant improvements in semen volume, sperm concentration, morphology, or DNA damage in men with obesity.

Do not expect bariatric surgery to improve your fertility. While it helps with weight, studies show it does not significantly improve sperm quality or DNA integrity. If fertility is a priority, lifestyle changes are a more reliable first step.

An intensive weight loss intervention combining total diet replacements (TDR), behavioral support, and weight loss medications (WLM) as needed achieves and maintains ≥20% weight loss in adults with obesity class I or II, significantly outperforming usual care.

To achieve significant weight loss (≥20%), you need a structured, long-term (2-year) program that combines strict initial calorie restriction (via meal replacements), regular coaching, and physical activity. If you don't lose enough weight in the first month, the program adds medication support. This is more intensive than typical 'eat less, move more' advice, which usually results in minimal weight loss.

A 12-week online intervention combining tailored protein intake counseling with progressive resistance training improves physical function, muscle strength, and health-related quality of life in older cancer survivors compared to general education and stretching.

If you are an older cancer survivor experiencing physical weakness, consider a program that combines specific dietary advice on protein intake with structured resistance exercises. This study protocol suggests that doing this online with professional guidance for 12 weeks may help improve your strength and quality of life, though results are not yet available.

Combining resistance training with progressive whey protein supplementation (up to 60g/day) initiated 3 weeks post-surgery counteracts disproportional fat-free mass loss in patients undergoing metabolic bariatric surgery.

If you have had bariatric surgery, standard care may not be enough to protect your muscle. This protocol suggests starting resistance training (both home and supervised) and gradually increasing whey protein intake to 60g per day, starting 3 weeks after surgery. This combination aims to preserve muscle mass, which is crucial for long-term health and metabolic function.

An intensive weight loss intervention combining total diet replacement (800-850 kcal/day), behavioral support, and weight loss medication achieves and maintains >20% weight loss and improves cardiometabolic risk in adults with severe obesity (BMI ≥35 kg/m²) over 2 years.

For severe obesity, standard 'eat less, move more' advice often fails. This protocol uses a 2-year structured approach: start with a very low-calorie formula diet (800-850 kcal) for 12 weeks with weekly support. If you don't lose enough weight, add a GLP-1 medication. Then, gradually transition to a healthy, low-calorie diet while maintaining exercise. The key is the intensive support and the ability to 'rescue' the plan with formula meals or medication if you regain weight.