Browse the evidence

Combining neuromuscular electrical stimulation (NMES) with high protein supplementation (HPRO) and physical therapy (PT) mitigates lower extremity muscle loss and restores positive nitrogen balance in critically ill, mechanically ventilated patients compared to standard care.

For critically ill patients who cannot actively exercise, combining high protein intake (approx 1.3g/kg/day) with twice-daily neuromuscular electrical stimulation (NMES) on the legs and physical therapy significantly reduces muscle loss compared to standard care. This multimodal approach helps maintain muscle mass and improves nitrogen balance, which is crucial for recovery in the ICU.

Resistance training significantly improves muscle strength and physical function in older adults with sarcopenia, but the magnitude of improvement often fails to exceed the Minimal Important Difference (MID) thresholds for clinical relevance.

For older adults with sarcopenia, resistance training is beneficial for strength but may not be enough to restore full functional independence on its own. To maximize benefits, aim for a high frequency (3 times/week) and a total weekly volume around 1220 MET-min/week for grip strength, or 600 MET-min/week for walking speed. However, manage expectations: these improvements might not be large enough to drastically change daily functional status without additional interventions.

Higher training frequency (3 times/week vs. 2 times/week) and specific resistance types (Constant for knee extension, Combined for gait speed) are key effect modifiers for optimizing resistance training outcomes in sarcopenia.

To maximize strength gains from resistance training, aim for 3 sessions per week rather than 2. If your goal is knee strength, constant resistance machines may be best. If your goal is walking speed, a mix of resistance types (combined) might be superior. Individualize your program based on these specific goals.

High egg intake (up to 12 eggs/week) does not significantly increase cardiovascular risk, inflammatory biomarkers, or blood sugar levels in type 2 diabetic patients when part of a weight-loss diet.

You can likely include eggs in your diet. A study showed that eating up to 12 eggs a week did not worsen blood sugar or heart health markers in diabetics.

Cluster sets (CS) elicit similar muscular hypertrophy to traditional sets (TS) when volume (sets/reps) and effort (RIR 0-1) are equated.

If you prefer cluster sets (pausing between reps/blocks), you can build muscle just as effectively as traditional sets, provided you match the total number of reps and train close to failure (0-1 reps in reserve). Don't worry about the total weight moved being lower in CS; focus on hitting your rep targets with high effort.

Nutritional supplementation can attenuate quadriceps muscle atrophy and promote hypertrophy following ACL injury and reconstruction through three primary mechanisms: direct stimulation of muscle protein synthesis, indirect enhancement of training capacity, and direct effects on satellite cell proliferation.

If you have had ACL surgery, do not rely on exercise alone to rebuild your thigh muscle. Incorporate nutritional strategies that support muscle protein synthesis (like adequate protein intake) and potentially supplements like creatine or caffeine (if appropriate for your rehab phase) to help your muscles grow and recover more effectively than exercise alone.

Creatine supplementation may enhance muscle hypertrophy following ACL injury by increasing intramuscular phosphocreatine, thereby improving high-intensity exercise capacity, and potentially stimulating mTOR and satellite cell proliferation.

Consider creatine supplementation during the later stages of your ACL rehab when you start doing more intense exercises. It can help your muscles generate energy faster and may support muscle growth.

Dietary cholesterol intake between 216 and 373 mg/day is associated with the lowest all-cause mortality risk, forming a U-shaped curve where both lower and higher intakes increase mortality risk.

Aim for a daily dietary cholesterol intake of approximately 300 mg (roughly 1-2 eggs) to potentially minimize all-cause mortality risk. Avoid both very low intake (under 124 mg/day) and very high intake (over 373 mg/day), as both are associated with higher mortality risks in this study. This suggests that moderate consumption of cholesterol-rich foods is healthy, and extreme restriction may be detrimental.

Longer-muscle length resistance training (LML-RT) produces greater longitudinal hypertrophy (fascicle length increases) and overall muscle size compared to shorter-muscle length resistance training (SML-RT).

To maximize muscle growth, especially in terms of muscle length (fascicle length), prioritize exercises that allow you to train at longer muscle lengths (e.g., deep squats, overhead extensions). While shorter-range training can build muscle, training through a fuller or lengthened range of motion appears to offer a superior hypertrophic advantage, particularly for longitudinal growth.

Combining pharmacotherapy with lifestyle interventions (diet/exercise) or bariatric surgery yields superior weight loss and maintenance compared to either intervention alone.

For the best long-term results, do not rely on medication or diet/exercise alone. Use medication to help manage hunger while you establish sustainable diet and exercise habits. This combination is proven to help you keep the weight off after you stop the medication.

Primary Obesity Surgery Endoluminal (POSE) 2.0 and Endomina Gastric Plication are effective endoscopic gastric remodeling techniques that produce significant weight loss and metabolic improvements, though with varying efficacy profiles compared to ESG.

POSE 2.0 and Endomina are endoscopic options that use full-thickness plications to reduce stomach size. They are effective for weight loss and metabolic improvement, though ESG may offer higher weight loss percentages in some studies. They are suitable for patients seeking minimally invasive alternatives to surgery.

In individuals with pre-diabetes or metabolic syndrome, incorporating meal replacements into a weight loss intervention yields small, clinically important reductions in body weight, BMI, LDL-c, non-HDL-c, and systolic blood pressure compared to conventional food-based diets.

If you have pre-diabetes or metabolic syndrome, using meal replacements for 1-2 meals a day as part of a calorie-restricted diet will help you lose more weight and improve your cholesterol and blood pressure than just eating a standard healthy diet. Aim for replacements to make up about 28% of your daily calories. This is a short-term tool to jumpstart your health before transitioning to regular food.

Adherence to a healthful plant-based diet pattern is associated with a statistically significant reduction in both the risk of contracting COVID-19 and the severity of the disease.

Adopting a diet rich in fruits, vegetables, and whole grains (high healthful plant-based diet score) is associated with a lower risk of getting COVID-19 and a significantly reduced risk of severe outcomes. This benefit appears to be especially important for individuals in areas with higher socioeconomic deprivation, suggesting that improving access to healthy foods is a key public health strategy.

Administration of a novel amino acid formulation (AXA2678) containing essential and non-essential amino acids, including N-acetylcysteine, attenuates skeletal muscle atrophy and prevents intramuscular fat accumulation during short-term (7-day) limb immobilization in healthy young men.

If you are facing a period of forced inactivity (like a cast or bed rest), standard protein or leucine supplements may not be enough to stop muscle loss. A specific blend of essential and non-essential amino acids, including antioxidants like NAC, appears to protect muscle mass and prevent fat infiltration in the muscle during short-term immobilization. This is not a substitute for movement, but a mitigation strategy.

Combining a ketogenic diet with resistance training promotes fat mass reduction in strength-trained individuals, but it does not support muscle mass accretion and may impair absolute strength and power gains compared to conventional diets.

If your goal is to lose fat while maintaining your current strength, a ketogenic diet combined with resistance training is a viable short-term strategy (up to 12 weeks). However, do not expect to build significant new muscle mass or maximize absolute strength/power gains; conventional diets with adequate carbohydrates are superior for those specific hypertrophy and power goals. Monitor protein intake closely (1.6-2.0 g/kg/day) to mitigate potential muscle loss.

Low-bar back-squats (LBBS) allow for greater load lifting compared to high-bar back-squats (HBBS) due to increased hip flexion and posterior hip displacement, which shifts emphasis to stronger hip musculature and decreases the trunk lever arm.

If your goal is to lift the maximum possible weight in a squat, switch to a low-bar back-squat position. Place the bar lower on your traps (over the posterior deltoids) rather than high on your neck. This position allows you to lean your torso forward slightly, which shifts the workload to your stronger hip muscles (glutes/hamstrings) and allows you to handle heavier loads than a high-bar squat. If your goal is to mimic Olympic weightlifting movements (snatch/clean) or emphasize knee-dominant muscles, stick with high-bar.

High-bar back-squats (HBBS) are biomechanically superior to low-bar back-squats (LBBS) for replicating Olympic weightlifting catch positions and emphasizing knee-dominant musculature.

If you are an Olympic weightlifter or want to improve your snatch and clean technique, use the high-bar back-squat. Place the bar high on your traps (below the C7 vertebra) to maintain an upright torso. This position closely mimics the 'catch' phase of Olympic lifts and places more emphasis on your quadriceps (knee musculature). Do not use this variation if your primary goal is to move the maximum possible weight; use low-bar for that.

Ten weeks of high-intensity interval training (HIIT) partially restores muscle proteostasis in obese, insulin-resistant men by increasing the turnover rates of specific proteins, although it does not fully mitigate indicators of poor proteome health.

If you have obesity and insulin resistance, 10 weeks of HIIT (3x/week, cycling at max effort for 1-minute intervals) can significantly improve the turnover and abundance of key muscle proteins. While this doesn't erase all metabolic risks or fully normalize your muscle proteome, it does partially restore a critical aspect of muscle health (proteostasis) that is typically compromised in obesity.

Regular glucosamine supplementation is associated with a statistically significant reduction in all-cause mortality (15% lower risk) and cause-specific mortality for cardiovascular disease, cancer, respiratory, and digestive diseases.

This observational study suggests that regular glucosamine use is linked to a lower risk of death from various causes, including heart disease and cancer. The authors propose this may be due to anti-inflammatory effects or metabolic changes similar to low-carb diets. However, because this is not a randomized trial, it does not prove glucosamine causes these benefits; users might simply have healthier lifestyles. It should not replace standard medical care for chronic diseases.

During the pre-contest phase, bodybuilders often use low-load, high-repetition resistance training with short rest intervals to preserve muscle mass while in a caloric deficit, potentially leveraging metabolic stress.

When cutting for a competition, you can use lighter weights with more reps and shorter rests to help preserve muscle, especially if you are in a large caloric deficit. However, some athletes still prefer heavy loads. Listen to your body and ensure you are training close to failure.

Gut microbiota composition and metabolites play a critical role in the crosstalk between dietary patterns and cardiometabolic health, suggesting personalized dietary strategies based on microbiota profiles.

While general healthy dietary patterns are beneficial, individual responses vary. Future personalized nutrition strategies may involve testing gut microbiota to tailor dietary patterns for optimal cardiometabolic health.

High baseline abundance of Bacteroides cellulosilyticus predicts significant weight gain (0.65 kg) in overweight subjects consuming 10.4 g/day of arabinoxylan oligosaccharides (AXOS) for 4 weeks, whereas low abundance predicts weight stability.

If you are overweight and trying to use high-fiber wheat bran supplements (like AXOS) to manage weight, your gut bacteria matter. If you have high levels of Bacteroides cellulosilyticus, you might stay stable. If you have low levels, you might actually gain weight. Standard 'eat more fiber' advice may need personalization based on gut health testing.

Resistance training adaptations (body composition, muscle strength, and functional capacity) are significantly attenuated in elderly women with sarcopenic obesity compared to those without the condition.

For elderly women with sarcopenic obesity, standard resistance training protocols (2x/week) may not yield the same body composition or functional improvements seen in non-obese peers. To see better results, these individuals may need higher training frequencies (3x/week), longer intervention durations, or combined dietary interventions to address the underlying lipotoxicity and anabolic resistance.

Adherence to a carnivore diet (eliminating plant foods) for at least 6 months is associated with self-reported improvements in metabolic health markers, including significant reductions in BMI and HbA1c, and high satisfaction rates, despite reported elevations in LDL-cholesterol.

If you adopt a carnivore diet (eating only animal products) for at least 6 months, you may experience significant weight loss and improved blood sugar control, with high satisfaction. However, be aware that your LDL cholesterol may rise significantly, although other heart health markers like triglycerides often improve. This data comes from a self-reported survey, so individual results may vary, and long-term safety is not fully established.