Browse the evidence

In overweight or obese adults with diabetes, unintentional or general weight loss is associated with a statistically significant increase in all-cause and cardiovascular disease mortality compared to weight stability.

If you have diabetes and are overweight or obese, do not pursue weight loss unless it is explicitly intentional and monitored, as general weight loss is linked to higher mortality in this group. Focus instead on glycemic control and avoiding muscle loss. Consult your endocrinologist before attempting any weight reduction strategy.

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.

Implementing FDA voluntary sodium reduction targets in processed foods yields a net positive economic and health benefit for the broader food system workforce, primarily through reduced cardiovascular disease incidence and healthcare costs.

For policymakers and industry leaders: Implementing gradual, national sodium reduction targets in processed foods is economically beneficial for the food system as a whole. The health savings and productivity gains for workers outweigh the costs of reformulation. For consumers: Gradual sodium reduction in processed foods does not significantly impact taste or sales because human taste adapts over time. The primary benefit is a reduction in cardiovascular disease risk.

For workers specifically in the processed food industry, the net monetary benefit of sodium reformulation is negative, meaning the costs of reformulation exceed the health-related cost savings realized by this specific subgroup.

For processed food industry executives: Sodium reformulation may not be economically beneficial for your specific workforce in the short-to-medium term, as the costs of reformulation exceed the health savings for your employees. However, for the broader food system, it is beneficial. Policymakers should consider incentives to offset these costs for the processed food industry.

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.

Breast cancer survivors have significantly reduced cardiorespiratory fitness (peak VO2) compared to healthy controls, primarily due to impaired central cardiovascular function (lower stroke volume and cardiac output) rather than peripheral muscle extraction deficits.

Breast cancer treatment can reduce your heart's ability to pump blood during exercise, leading to lower fitness levels. This is a physiological change, not just 'being out of shape.' Targeted aerobic exercise can help improve this cardiovascular function.

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.

Under volume-matched conditions, increasing resistance training frequency from two to four sessions per week does not result in greater maximal strength gains in trained men.

If you are a trained lifter, you do not need to train every muscle group 4 times a week to maximize strength. Training 2 times per week is equally effective for strength gains as training 4 times per week, provided you perform the same total number of sets and intensity. You can choose the frequency that best fits your schedule and recovery capacity without sacrificing strength gains.

Joining US Free Trade Agreements (FTAs) causes a statistically significant increase in the per capita sales of ultra-processed foods, processed culinary ingredients, and infant formula.

If you are involved in policy or public health advocacy, recognize that Free Trade Agreements with the US are a key driver of increased ultra-processed food and infant formula sales in partner countries. To protect public health, advocate for health exemptions in trade agreements, similar to tobacco carve-outs, to allow governments to regulate or tax these products without fear of legal challenges from corporations.

Under volume-matched conditions, increasing resistance exercise training frequency from once per week to five times per week does not increase daily myofibrillar protein synthesis rates in young men.

If you are trying to build muscle, you do not need to train each muscle group every day. As long as you are doing the same total amount of work (volume) and lifting with sufficient intensity, training a muscle once a week will build muscle just as effectively as training it five times a week. Focus on getting your total reps and sets in, rather than worrying about frequency.

Vertical sleeve gastrectomy (VSG) induces durable metabolic benefits and weight loss in nonhuman primates that are independent of caloric intake, mediated by early increases in bile acids and short-chain fatty acids, reduced visceral adipose tissue inflammation, and a polarization of immune cells toward regulatory phenotypes.

Vertical sleeve gastrectomy (VSG) is a highly effective intervention for obesity that works through complex biological mechanisms beyond simple stomach size reduction. It triggers early increases in beneficial metabolites (bile acids, short-chain fatty acids) and shifts the immune system in fat tissue to reduce inflammation and improve insulin sensitivity. These changes occur even if caloric intake remains the same, indicating that VSG fundamentally alters how the body regulates energy and metabolism. For patients, this means VSG offers durable metabolic benefits, including improved glucose control and reduced visceral fat inflammation, which are critical for long-term health independent of weight loss alone.

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.