Browse the evidence

Consuming 30-60 g of carbohydrate per hour during endurance exercise lasting >70 minutes improves performance and maintains blood glucose.

For workouts longer than 70 minutes, drink a sports drink containing 6-8% carbohydrates. Aim for 30-60 grams of carbs per hour, sipping small amounts every 10-15 minutes.

Global adult consumption of healthful foods (fruits, vegetables, nuts/seeds, whole grains, seafood) is vastly insufficient, while consumption of less healthful foods (processed meats) is often excessive relative to optimal levels for chronic disease prevention.

Current global diets are significantly misaligned with optimal health guidelines. Most people do not consume enough fruits, vegetables, nuts, whole grains, or seafood, while many consume too much processed meat. To optimize health, individuals should aim to increase intake of plant-based foods and seafood while limiting processed meats, as current global averages fall far short of recommended targets for preventing chronic diseases.

Sarcopenia is a potentially reversible disease defined by the concurrent combination of reduced muscle mass and muscle strength, with muscle-specific strength also included as a component.

Sarcopenia is not just 'getting old'; it is a reversible condition defined by low muscle mass and strength. To address it, focus on resistance training and adequate protein intake to build muscle and strength, as these are the core components of the disease definition.

Eliminating sugar-sweetened beverages reduces body weight in adolescents and children.

If you are an adolescent or child, or if you are helping one, stop drinking sugary beverages. This simple change has been shown in large trials to reduce body weight over 1-1.5 years.

The DASH combination diet (rich in fruits, vegetables, low-fat dairy; reduced in saturated fat, total fat, and cholesterol) significantly lowers systolic and diastolic blood pressure in adults with high-normal blood pressure and stage 1 hypertension, independent of sodium reduction or weight loss.

Adopt the DASH combination diet for 8 weeks or more: eat more fruits, vegetables, and low-fat dairy, while reducing saturated fats, total fats, and cholesterol. Keep your weight and salt intake stable. This approach significantly lowers blood pressure, especially if you are African American or have hypertension, without needing to restrict sodium or lose weight.

The blood pressure-lowering effect of the DASH combination diet is significantly greater in African Americans and individuals with hypertension compared to their respective counterparts.

If you are African American or have hypertension, the DASH diet (high fruits/veggies/low-fat dairy, low saturated fat) is particularly effective for lowering blood pressure. You may see greater benefits than the average person following the same diet.

Post-exercise carbohydrate intake of approximately 1 g/kg body mass optimizes early-phase (0-4 h) muscle glycogen resynthesis rates.

To maximize glycogen recovery after intense exercise, consume about 1 gram of carbohydrates per kilogram of body weight within the first 4 hours. This is the most effective strategy for rapid refueling. If you cannot eat immediately, ensure you consume enough total carbohydrates over the next 8+ hours, as the total amount matters more than the exact timing in the later recovery phase.

Tirzepatide, a dual GLP-1/GIP receptor agonist administered once weekly (5-15 mg), significantly reduces body weight and improves glycemic control in patients with type 2 diabetes and obesity, outperforming placebo, GLP-1 receptor agonists (semaglutide, dulaglutide), and basal insulins.

Tirzepatide is a once-weekly injection approved for type 2 diabetes and obesity. It works by mimicking two gut hormones (GLP-1 and GIP) to lower blood sugar and reduce appetite. Clinical trials show it leads to significant weight loss (up to 22% in obesity) and better blood sugar control than many existing medications, including standard GLP-1 drugs and insulin. Treatment starts at a low dose to manage side effects like nausea, which usually decrease over time.

Tirzepatide, a dual GIP/GLP-1 receptor agonist, produces significantly greater reductions in HbA1c and body weight compared to semaglutide 1 mg and basal insulins in adults with type 2 diabetes.

Tirzepatide is a once-weekly injection that significantly lowers blood sugar and promotes substantial weight loss in people with type 2 diabetes, outperforming other common treatments like semaglutide and basal insulins in clinical trials.

GLP-1 receptor agonists and related incretin-based therapies are effective pharmacological interventions for obesity and type 2 diabetes, offering superior weight loss and cardiovascular benefits compared to previous treatments.

GLP-1 receptor agonists are a major advance in obesity treatment, offering significant weight loss and cardiovascular benefits. They work by mimicking gut hormones that regulate appetite and blood sugar. Consult a doctor to see if they are appropriate for you.

Sustained weight loss requires a permanent reduction in energy intake below the body's reduced energy expenditure, as metabolic adaptation lowers energy needs during weight loss.

To keep weight off, you must eat less than you did before you lost the weight, because your body burns fewer calories at a lower weight. This isn't a failure of willpower; it's biology. You need to permanently adjust your intake to match your new, lower energy needs.

Once-weekly subcutaneous semaglutide 2.4 mg significantly reduces systemic inflammation, measured by C-reactive protein (CRP), in adults with overweight or obesity compared to placebo.

If you have overweight or obesity, taking once-weekly semaglutide 2.4 mg significantly lowers your C-reactive protein (CRP), a key marker of systemic inflammation and cardiovascular risk. This benefit occurs alongside weight loss and is consistent regardless of your baseline BMI or diabetes status. The treatment involves a gradual dose escalation over 16 weeks to minimize side effects, followed by maintenance at 2.4 mg weekly for 68 weeks, combined with lifestyle changes.

Semaglutide 2.4mg weekly induces significantly greater weight loss (mean 14.9%) compared to lifestyle interventions alone (mean 2.4%) in adults without diabetes.

Semaglutide 2.4mg taken once weekly, combined with a modest caloric deficit, can lead to an average 15% body weight loss in people without diabetes. This is significantly more effective than lifestyle changes alone and helps counteract the biological drive to regain weight.

GLP-1 receptor agonists (GLP-1 RAs) and dual GLP-1/GIP agonists (e.g., tirzepatide) induce significant weight loss and improve glycemic control primarily through delayed gastric emptying, reduced appetite, and central nervous system-mediated satiety pathways.

GLP-1 and dual agonists are highly effective for weight loss and blood sugar control, working by slowing digestion and signaling fullness to the brain. Start with the lowest dose to minimize stomach upset, and increase gradually as tolerated. Expect significant weight loss (up to 20% in some trials) and improved glucose levels, but be prepared for potential gastrointestinal side effects like nausea.

Anti-obesity medications (AOMs) including orlistat, naltrexone/bupropion, phentermine/topiramate, liraglutide, and semaglutide are effective for long-term weight management in adults with BMI ≥ 25 kg/m² who have failed non-pharmacological treatments.

If you have obesity and lifestyle changes haven't worked, talk to your doctor about FDA-approved anti-obesity medications. Drugs like semaglutide (once-weekly injection or daily pill) and liraglutide (daily injection) can help you lose significant weight. Start with a low dose to minimize stomach upset, and work with your provider to find the right medication for your specific health needs.

Tirzepatide, a dual GIP/GLP-1 receptor agonist, demonstrates superior weight loss efficacy compared to other currently available AOMs in phase 3 trials.

Tirzepatide is a new once-weekly injection that targets two hormones (GIP and GLP-1) to help with weight loss. In clinical trials, it led to an average 22.5% body weight loss over 72 weeks. It starts at a low dose to minimize side effects and can be increased up to 15 mg weekly. Talk to your doctor about whether this advanced option is right for you.

Targeting specific neural circuits in the brainstem and hypothalamus using peptide-based pharmacotherapies (e.g., GLP-1 mimics) is an effective strategy for inducing weight loss and treating obesity.

Consult a healthcare provider about GLP-1 based treatments if lifestyle changes alone are insufficient. These medications work by targeting brain circuits to reduce appetite and increase satiety, offering a biologically targeted approach to weight loss.

Weekly administration of semaglutide (2.4 mg) and tirzepatide (15 mg) produces substantially greater weight loss (9.6% and 13.1% respectively) compared to pre-existing anti-obesity medications (approx. 5% weight reduction).

If you have type 2 diabetes and obesity, current guidelines suggest trying lifestyle changes first. If that fails, newer injectable medications like semaglutide (2.4 mg weekly) or tirzepatide (15 mg weekly) are significantly more effective at reducing body weight (around 10-13%) than older oral or injectable options (around 5%). These require a prescription and gradual dose titration to manage side effects.

Tirzepatide (15 mg) demonstrates superior weight loss efficacy compared to semaglutide (1 mg) in patients with type 2 diabetes, achieving 13.1% weight loss versus 9.7 kg (9.6%) for semaglutide 2.4 mg in direct comparison trials.

For patients with type 2 diabetes needing significant weight loss, tirzepatide (15 mg weekly) has shown higher weight loss percentages (13.1%) compared to semaglutide (1 mg weekly) in head-to-head trials. This requires a slow 20-week titration to manage side effects, which may impact adherence.

Lifestyle interventions (dietary changes and physical activity) are the foundational and preferred first-line treatment for obesity management, although they are difficult for many patients to maintain long-term.

Start with lifestyle changes: adjust your diet to reduce caloric intake and increase physical activity. This is the standard first step for treating obesity. If you find it difficult to maintain these changes, do not view this as a personal failure; the paper notes this is a common challenge. In such cases, consult a healthcare provider about adding pharmacological treatments or metabolic surgery as adjunctive or alternative options tailored to your specific needs.

Tirzepatide (5-15 mg subcutaneous once weekly) produces substantial body weight reduction (up to 21%) in adults with or without type 2 diabetes, with efficacy superior to GLP-1 mono-agonists like semaglutide.

Tirzepatide is a highly effective, once-weekly subcutaneous injection for weight loss, approved for adults with obesity or overweight with weight-related conditions. It works by mimicking hormones (GLP-1 and GIP) that regulate appetite and blood sugar. Clinical trials show significant weight loss (up to 21%) in people without diabetes and up to 15% in those with type 2 diabetes. Common side effects like nausea and diarrhea are usually temporary and can be managed by starting with a low dose and increasing gradually. It is superior to older GLP-1 medications in weight reduction.

Increasing potassium intake, particularly through salt substitution (25% KCl/75% NaCl) in populations with low potassium and high sodium intake, significantly reduces the risk of stroke and cardiovascular events.

If you live in a region where processed foods are common (high sodium) and fruit/vegetable intake is low, consider switching to a salt substitute containing 25% potassium chloride. This simple change has been shown in large trials to significantly reduce the risk of stroke and heart disease, especially if you have high blood pressure or a history of stroke. It is safe for most people, though those with advanced kidney disease should consult a doctor first.

Higher potassium intake is associated with lower blood pressure and reduced cardiovascular risk, independent of sodium intake levels, with benefits observed even when sodium reduction is modest.

Aim for a diet rich in potassium by eating more fruits, vegetables, legumes, and dairy. This helps lower blood pressure and reduces heart disease risk, even if you don't perfectly reduce your salt intake. If you use salt substitutes, choose ones with potassium chloride.

Semaglutide (2.4 mg/week) improves physical function and reduces body weight in patients with heart failure with preserved ejection fraction (HFpEF) and obesity.

If you have heart failure with preserved ejection fraction and obesity, semaglutide (2.4 mg weekly) can help you feel better, walk further, and lose weight. It is taken as a weekly injection, starting at a low dose to minimize side effects.