Browse the evidence

GLP-1 receptor agonists (GLP-1RAs) provide superior renal protection compared to insulin in early-stage diabetic kidney disease by reducing CD36 levels and urinary albumin excretion.

If you have type 2 diabetes and early kidney disease, ask your doctor about GLP-1 receptor agonists. They may protect your kidneys better than insulin while you continue taking metformin.

Maternal depression during pregnancy is significantly associated with an increased risk of gestational diabetes mellitus (GDM), suggesting that screening for depression may reduce GDM risk.

If you are pregnant, pay attention to your mental health. Depression during pregnancy is linked to a higher risk of gestational diabetes. Talk to your doctor about screening for depression to help protect your health and your baby's.

Public health reformulation of ultra-processed foods (UPF) fails to reduce population-level health harms because industry growth strategies (combatition, swotification, fashion spiral, demand-pumping) drive aggregate UPF consumption upward, negating individual product improvements.

Do not rely on 'reformulated' or 'light' UPFs as a health strategy. The food industry uses reformulation to maintain growth and market share, often increasing total consumption through strategies like smaller, more frequent portions ('portion paradoxes') and novelty marketing. To improve health, the most effective intervention is reducing the overall availability and consumption of the UPF category, not just tweaking its ingredients.

Whey protein supplements do not consistently provide superior body composition or strength benefits compared to whole milk or milk powder, and may carry risks of insulin resistance due to high branched-chain amino acid content.

You likely do not need expensive whey protein powder to build muscle. Whole milk or milk powder provide similar muscle-building benefits at a much lower cost and with additional nutritional advantages.

A DPP-inspired lifestyle intervention providing low-cost, minimal-support options (simplified diet plans, YMCA membership, weekly phone calls) fails to produce significant weight loss in indigent, obese adults, whereas behavioral engagement (using the provided YMCA membership) and older age are associated with success.

For low-income individuals, simply giving them gym access or diet sheets is not enough to drive weight loss. Success requires active behavioral engagement, such as actually using the gym membership, and often benefits from older age or more intensive, individualized support to overcome logistical barriers like transportation and childcare.

High financial costs of healthy food and gym memberships act as primary barriers to weight loss, making unhealthy lifestyle habits more accessible and affordable than healthy ones.

If you live in an area where healthy food is expensive, do not blame yourself for choosing cheaper options. Focus on reducing waste, buying in bulk, and utilizing free physical activities like walking or outdoor exercise, while avoiding the high cost of gym memberships.

Marathon running induces significant, transient cardiac stress markers (Hs-TnT, ST2, NT-proBNP) in both men and women, with values returning to baseline within 48 hours, indicating that acute cardiac damage is a normal physiological response to extreme endurance efforts rather than necessarily pathological.

Do not panic if your cardiac biomarkers (like troponin) are elevated immediately after a marathon. This is a common, transient physiological response to extreme exertion. In healthy individuals, these levels typically return to baseline within 48 hours. Persistent symptoms or failure of markers to normalize should be evaluated by a physician.

Restricting saturated fat intake does not consistently reduce cardiovascular disease risk and may be associated with lower mortality when replaced by carbohydrates, challenging blanket low-fat dietary guidelines.

Stop fearing saturated fat in whole foods like meat, dairy, and nuts. Current evidence suggests that restricting these foods does not lower heart disease risk and may be worse if you replace them with high-carbohydrate foods. Focus on eating whole, unprocessed foods rather than isolating fat content.

No single vegetable oil crop is inherently 'good' or 'bad'; the environmental and social impact depends entirely on the production system, trade practices, and local context.

Don't just look for 'palm oil-free' labels. Focus on supporting sustainable certification and production practices. No oil crop is inherently evil; the impact depends on how and where it is grown. Consider the broader environmental trade-offs of different oils.

Hunger states are associated with significantly increased regional cerebral blood flow (neuronal activity) in the hypothalamus, insular cortex, and limbic/paralimbic areas, while satiation states are associated with increased activity in the prefrontal cortex.

This research shows that hunger and fullness are complex brain processes involving multiple regions, not just a single signal. While this doesn't provide a direct diet plan, it highlights that metabolic signals like insulin and free fatty acids play a key role in how the brain perceives hunger and satiation.

Post-meal increases in plasma insulin and free fatty acids are negatively correlated with neuronal activity in the insular and orbitofrontal cortex (and anterior cingulate for FFA), suggesting these metabolic signals modulate postprandial brain activity.

The brain's response to eating is modulated by metabolic signals like insulin and free fatty acids. Higher levels of these markers after a meal are associated with reduced activity in brain areas linked to hunger processing (insula/orbitofrontal cortex).

Increased food intake during lockdown was primarily driven by increased consumption of bread and confectionary, with confectionary consumption increasing in 64.4% of those who ate more.

When food intake increases during lockdown, it is often driven by bread and confectionary. Be aware that even if you cook at home, the quality of food may shift towards carbohydrates.

Genetic loci on chromosomes 3, 4, 9, 11, and 22 are linked to prediabetic metabolic phenotypes (fasting insulin, insulin action, and fasting glucose) in Pima Indians, suggesting a strong genetic basis for type 2 diabetes susceptibility in this population.

If you are of Pima Indian descent, you may have a higher genetic risk for type 2 diabetes due to specific gene variants affecting insulin handling. This doesn't mean you will get diabetes, but it does mean you should be proactive about monitoring your blood sugar and maintaining a healthy weight, as your body may be more sensitive to insulin resistance.

Intensive glycaemic control in adolescents and young adults with Type 2 diabetes yields only modest gains in remaining life expectancy (0.98 years) and quality-adjusted life expectancy (0.44 QALYs) compared to conventional treatment, and may result in a net loss of QALYs when the disutility of intensive treatment (e.g., insulin) is accounted for.

For young people newly diagnosed with Type 2 diabetes, aggressive treatment with insulin offers very little extra life expectancy (less than 1 year) and may actually reduce overall quality of life due to the burden of treatment. A comprehensive plan focusing on cardiovascular risk factors (blood pressure, cholesterol) and lifestyle changes might be more beneficial than intensive insulin therapy alone, especially if the patient values quality of life highly.

Subclinical diabetic cardiac myopathy, characterized by reduced systolic and diastolic reserve during exercise, contributes to reduced exercise tolerance in T2DM.

Your heart may not pump as efficiently during exercise as a non-diabetic's, even if it looks normal at rest. This 'subclinical' dysfunction limits how much oxygen your muscles can use. Exercise training may help improve this cardiac reserve over time.

Skeletal muscle mitochondrial dysfunction and reduced capillary density contribute to early fatigue and reduced peripheral oxygen extraction in T2DM.

Your muscles may have fewer capillaries and less efficient mitochondria, making it harder to use oxygen during exercise. This leads to early fatigue. Resistance and aerobic training can help improve muscle capillary density and mitochondrial function.

Endothelial dysfunction and impaired vasodilation during exercise reduce muscle blood flow and oxygen diffusion in T2DM.

Your blood vessels may not dilate properly during exercise, limiting blood flow to your muscles. This is partly due to endothelial dysfunction. Regular exercise can help improve endothelial function over time.

Cardiac autonomic neuropathy and altered autonomic tone contribute to impaired heart rate adjustment and reduced exercise tolerance in T2DM.

Your nervous system's control over your heart rate may be impaired, leading to slower heart rate adjustments during exercise. This is more common in those with longer disease duration or poor blood sugar control. Monitoring heart rate during exercise can be helpful.

Genetic linkage near the TNF-alpha locus is associated with higher percent body fat in Pima Indians, suggesting a genetic contribution to obesity susceptibility in this population.

This research suggests that for Pima Indians, obesity may have a strong genetic basis linked to the TNF-alpha region. This doesn't mean weight loss is impossible, but it implies that biological factors play a significant role in body fat regulation for this group, potentially requiring tailored approaches to diet and activity.

In patients with type 2 diabetes, higher BMI (overweight/obese) is associated with lower all-cause mortality compared to normal weight, a phenomenon known as the 'obesity paradox'.

If you have type 2 diabetes, do not use the 'obesity paradox' as an excuse to maintain a high BMI. While some studies show obese diabetics live longer than lean ones, this is likely due to biases like muscle mass or fitness, not the fat itself. Standard medical advice remains to lose weight if overweight, as it improves metabolic markers and does not increase mortality risk.

Menstrual cycle phase and oral contraceptive use do not significantly influence exercise performance or muscular hypertrophy in response to resistance training.

Train consistently regardless of your cycle phase. There is no evidence that you will lose muscle gains or performance by training during your luteal phase or while on birth control. Focus on progressive overload and consistency rather than phase-specific modifications.

Basal muscle sympathetic nerve activity (MSNA) correlates positively with plasma leptin concentration in healthy men, suggesting leptin acts as a peripheral signal to increase sympathetic outflow.

This research suggests that higher body fat leads to higher leptin, which in turn stimulates your sympathetic nervous system (your 'fight or flight' energy expenditure system). While this is a natural regulatory mechanism, the correlation is moderate, meaning other factors also drive your metabolic rate. It highlights that obesity involves complex hormonal signaling, not just 'calories in vs. calories out' in isolation.

Skeletal muscle UCP3 gene expression is negatively correlated with BMI and positively correlated with resting metabolic rate (RMR) in humans, suggesting that reduced UCP3 expression contributes to lower energy expenditure and obesity risk.

Your body's ability to burn energy as heat is partly regulated by genes like UCP3 in your muscles. While you cannot directly 'take' UCP3, understanding that metabolic rate is flexible—and influenced by factors like diet (fasting, fatty acids) and hormones—suggests that metabolic adaptation is possible. Focus on maintaining muscle mass and metabolic health rather than assuming a permanently 'slow' metabolism.

US obesity prevalence is predicted to plateau independently of current prevention strategies due to demographic factors (birthrate and probability of being born into an obesogenic environment).

Current obesity prevention strategies in the US are not reversing the epidemic but are likely contributing to a predicted plateau. To achieve further reductions, new strategies must be significantly more effective than the natural demographic trends predicted by this model.