Browse the evidence

Sleeve gastrectomy is associated with a higher risk of new-onset or worsening gastroesophageal reflux disease (GERD) compared to Roux-en-Y gastric bypass (RYGB).

If you have existing or severe acid reflux, Roux-en-Y gastric bypass is likely a safer choice than sleeve gastrectomy, as the sleeve procedure carries a higher risk of causing or worsening reflux.

Metabolic/bariatric surgery (MBS) is the most cost-effective intervention for class II and III obesity, often demonstrating dominance (cost-saving) over non-surgical management.

For individuals with Class II or III obesity, metabolic/bariatric surgery is the most economically and clinically effective long-term solution, often paying for itself through reduced healthcare costs from comorbidity remission. It should be prioritized over pharmacotherapy for this group.

Increases in lean mass (hypertrophy) are not significantly associated with improvements in muscle strength, endurance, or power in resistance-trained young males, indicating that functional adaptations occur independently of muscle size gains.

If you are a trained individual, do not assume that your strength gains are limited by your muscle size. You can improve your strength, power, and endurance significantly without necessarily gaining large amounts of lean mass. Focus on technical proficiency and neural adaptation (e.g., heavy loads, specific power drills) rather than just volume for hypertrophy, as these functional improvements can occur independently of muscle growth.

Improvements in cardiorespiratory fitness (VO2peak) do not consistently correlate with improvements in Metabolic Syndrome risk factors (blood pressure, lipids, glucose) following exercise training.

Do not assume that an increase in your maximum oxygen uptake (VO2peak) means your blood pressure or cholesterol has automatically improved. This study shows these two improvements are not consistently linked. You must monitor your specific risk factors (blood pressure, lipids, glucose) separately to assess the metabolic benefit of your exercise routine.

Obesity pharmacotherapy is recommended against for compounded medications or unapproved medications due to safety and efficacy concerns.

Avoid compounded weight loss medications. They are not approved, may be unsafe, and are not proven to work. Stick to FDA/Health Canada-approved medications prescribed by your doctor.

Grip strength is not significantly associated with prostate cancer mortality, although it is associated with the incidence of prostate cancer.

For men, low grip strength does not predict death from prostate cancer. However, it is associated with a higher *incidence* of prostate cancer, possibly because stronger men are more health-conscious and get screened more often. Do not use grip strength to rule out prostate cancer risk.

Initiation of modern antiretroviral therapy (ART), specifically integrase strand transfer inhibitors (INSTIs) like dolutegravir and bictegravir combined with tenofovir alafenamide (TAF), causes significant, sustained weight gain in people living with HIV, disproportionately affecting women and Black patients.

If you are living with HIV and starting or taking modern medication (specifically drugs ending in '-gravir' like dolutegravir or bictegravir, and TAF), expect significant weight gain, especially if you are a woman or Black. This is not just 'getting older' or 'eating too much'; it is a known side effect of the medication's interaction with your metabolism. Talk to your doctor about your risk factors. They may consider regimens with TDF (which mitigates weight gain) or other alternatives, though these may have other side effects. Be aware that standard diet and exercise might be less effective for this specific type of gain, and emerging weight-loss medications might be considered in the future.

Caffeine does not significantly enhance upper-body muscle endurance (bench press repetitions) at any tested dose (2, 4, or 6 mg/kg).

If you are doing single-set upper-body endurance tests (like bench press to failure at 60% 1RM), caffeine is unlikely to help you perform more repetitions, regardless of the dose. This contrasts with lower-body endurance, where caffeine is effective.

Biomarker-based personalized nutrition plans do not result in greater weight loss or improvements in cardiometabolic health compared to a generic, generally healthy diet in individuals with overweight or obesity.

If you have overweight or obesity, following a generally healthy, balanced diet that provides enough food to satisfy you will result in similar weight loss and health improvements as following a highly personalized, biomarker-driven diet plan. You do not need to undergo expensive metabolic testing or follow complex personalized rules to achieve significant health benefits; consistency with a healthy, isocaloric diet is sufficient.

Chronic inflammation, oxidative stress, and gut dysbiosis form a reciprocal triad that perpetuates the pathophysiology of obesity.

Focus on reducing inflammation through diet (anti-inflammatory foods, fiber) and managing stress, as these factors directly impact gut health and oxidative stress, which in turn affect weight regulation.

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.

The degree of food processing (classified by NOVA or Poti systems) is not a reliable proxy for nutritional quality, as calorie- and nutrient-dense foods exist across all levels of processing.

Stop assuming that 'ultra-processed' means 'unhealthy' and 'unprocessed' means 'healthy'. Look at the Nutrition Facts table. A highly processed snack might have less sugar and more protein than a minimally processed fruit juice. Base your food choices on the actual calorie and nutrient density, not the processing label.

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.

In people with diabetes, maintaining an overweight or obese BMI (≥23.0 kg/m²) is associated with a significantly lower risk of major adverse cardiovascular events (MACE) and all-cause mortality compared to a normal-weight BMI (18.5–22.9 kg/m²).

If you have diabetes, do not strive for a 'normal' BMI if it requires losing weight. This study shows that being overweight or obese is associated with lower heart event and death risks compared to being normal weight in diabetic patients. Focus on managing blood sugar and blood pressure rather than weight loss, unless advised otherwise for other reasons. Being underweight is a significant risk factor for mortality.

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.

Long-term elevated plasma TMAO levels are associated with a higher risk of incident atherosclerotic cardiovascular disease (ASCVD), but this association is significantly modified by renal function, being present only in individuals with impaired renal function (eGFR <60 mL/min/1.73 m2).

If you have impaired kidney function (eGFR <60), high TMAO levels are a significant warning sign for heart disease risk. If your kidney function is normal, high TMAO levels may not carry the same risk. Focus on maintaining kidney health and discussing TMAO testing with your doctor if you have known renal impairment.

Elevated plasma TMAO levels are associated with a higher risk of recurrent ASCVD in individuals with preexisting cardiovascular disease, independent of renal function status.

If you have a history of heart disease, higher TMAO levels are linked to a higher risk of another heart event. This risk exists regardless of your kidney function. Discussing TMAO levels with your cardiologist may help tailor your prevention strategy.

Replacing sugar-sweetened beverages (SSBs) with unsweetened beverages (USBs) or artificially sweetened beverages (ASBs) for 12 months does not significantly improve cardiometabolic risk factors (specifically the TG:HDL-C ratio) in the general adult population.

If you drink sugary beverages daily, switching to water or diet soda for a year won't necessarily fix your cholesterol or triglyceride ratios on its own. However, if you carry excess weight around your midsection, switching to either water or diet soda can help you lose weight compared to continuing sugary drinks. Water is better if you want to reduce your craving for sweet tastes.

Higher circulating levels of very-long-chain saturated fatty acids (VLSFAs), specifically lignoceric acid (24:0), behenic acid (22:0), and arachidic acid (20:0), are associated with a lower risk of incident heart failure in older adults.

For older adults, maintaining higher levels of very-long-chain saturated fatty acids (like 24:0, 22:0, and 20:0) in the blood is linked to a lower risk of developing heart failure. These fatty acids come from both diet (e.g., peanuts, macadamia nuts, canola oil) and the body's own metabolism. While this doesn't mean you should aggressively supplement saturated fats, it suggests that a diet including these specific fatty acids may be protective. Focus on whole food sources like nuts and seeds rather than processed fats.

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.

Increases in multimorbidity and frailty indices over an 8-year period are associated with subsequent poorer cognitive function, reduced physical function (gait speed), and increased mortality risk in adults with type 2 diabetes.

For adults with type 2 diabetes, keeping track of the number of chronic diseases and physical deficits (frailty) is a strong predictor of future cognitive decline, mobility issues, and death. However, simply improving these specific counts through lifestyle changes may not be enough to guarantee better long-term cognitive or survival outcomes, suggesting a need for a broader approach to healthspan.

In type 2 diabetes patients, maintaining a lower body mass index (BMI) does not provide greater protection against vascular complications and may increase the risk of specific complications like peripheral neuropathy and peripheral arterial disease.

If you have Type 2 Diabetes, do not assume that losing as much weight as possible is the best strategy for your health. This study shows that being too thin (BMI < 21.6) increases your risk of nerve damage (neuropathy) and circulation problems (PAD) just as much as being overweight. Aim for a moderate BMI range (around 23.5–25.2 kg/m2) to minimize vascular risks, rather than pursuing extreme weight loss.

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.