Browse the evidence

Moderate alcohol consumption (≤1 drink/day for women, ≤2 drinks/day for men) is acceptable for adults with diabetes, but requires education on the risk of delayed hypoglycemia, especially for those on insulin or secretagogues.

If you drink alcohol, do so in moderation (1 drink/day for women, 2 for men). Be aware that alcohol can cause delayed low blood sugar, especially if you take insulin or certain diabetes medications. Know the signs of hypoglycemia and manage it appropriately.

Multifactorial e- and mHealth interventions are an effective and scalable approach for modifying lifestyle-related cardiometabolic risk factors and improving self-management behaviors in adults without cardiovascular disease, potentially offering a scalable alternative to costly face-to-face interventions.

If you are at risk for heart disease but don't have it yet, using a digital health app or website that tracks multiple factors (like blood pressure, diet, and activity) is a viable way to manage your health. This approach can be as personalized as seeing a doctor in person but is easier to access for many people. Look for programs that target more than just one issue, like both diet and exercise, as this is more effective for preventing heart disease.

The combination of HIIT and TRE may induce synergistic improvements in glycaemic control and insulin sensitivity compared to either intervention alone, though this remains unproven.

This specific combination is currently under investigation. While early evidence suggests combining time-restricted eating (≤10h window) with high-intensity interval training (3x/week) might offer superior metabolic benefits compared to doing either alone, definitive proof for this specific population is not yet available. You may try combining these strategies, but monitor your health markers closely.

Pharmacological treatment for obesity is indicated for adults with a BMI ≥30 kg/m², or ≥27 kg/m² with at least one comorbidity, when lifestyle changes are insufficient to achieve or maintain weight loss objectives.

If your BMI is 30 or higher, or 27 or higher with a health condition like diabetes or high blood pressure, and diet and exercise haven't worked, you qualify for prescription weight-loss medication. This is a standard medical indication, not a failure of willpower. Discuss this with your doctor to see if it's appropriate for you.

Anti-obesity medications should be used as part of a multidisciplinary approach that includes lifestyle changes, behavioral management, and long-term follow-up, rather than as a standalone solution.

Medication is a tool, not a cure. It works best when combined with healthy eating, physical activity, and behavioral support. Your doctor will likely recommend a multidisciplinary approach to ensure long-term success.

An intensive 6-month cardiac rehabilitation program combining a moderate-carbohydrate Mediterranean diet, exercise training, and time-restricted eating (8:16) can reverse pre-diabetes to normal glucose concentrations in patients with coronary heart disease.

If you have heart disease and pre-diabetes, a structured 6-month program can help reverse your blood sugar levels. Start with a Mediterranean-style diet (less than 40% carbs, mostly plants/fish/olive oil) and reduce ultra-processed foods. Add supervised exercise (mix of steady cardio and high-intensity intervals plus strength training) 3 times a week. After 3 months, add an 8-hour eating window (16 hours fasting) 5 days a week. Do this under medical supervision.

Integrating dietary quality improvements with behavioral strategies focused on everyday-life agency and self-management capacity yields stronger effects on glucose control and dietary quality than standard counseling or single-modality interventions.

To manage Type 2 Diabetes effectively, move beyond just counting carbs or calories. Focus on building your ability to manage your health within your actual daily life and social situations. This involves active learning and developing 'agency' over your eating habits, supported by regular check-ins with healthcare providers, rather than just receiving static dietary advice.

Semaglutide 2.4 mg/week administered as an add-on to hospital-based non-pharmacological obesity care significantly reduces adiposity (BMI) in young adults (18-28 years) with childhood-onset obesity who have demonstrated low or medium treatment response to prior behavioral interventions.

For young adults with obesity who have not lost enough weight through standard diet and exercise programs, adding weekly semaglutide (2.4 mg) to their existing care plan is a clinically validated strategy to further reduce body mass index. The treatment involves a gradual dose increase over 16 weeks to minimize side effects, followed by 52 weeks of maintenance, all while continuing behavioral counseling.

Tirzepatide facilitates significant weight loss and improves lipid profiles in individuals with spinal cord injury (SCI) who are refractory to standard dietary and exercise interventions.

If you have a spinal cord injury and have tried strict diet and exercise without success, ask your doctor about tirzepatide. It is a weekly injection that helped this patient lose 33 pounds and improve his cholesterol, even when standard lifestyle changes failed. Be aware that GI side effects are possible, though this patient tolerated them well.

Consuming protein immediately before resistance training may increase lower body (leg press) strength gains more than consuming it immediately after.

If you are focusing on leg strength, try eating your protein 15 minutes before your workout. This might give you a slight edge in strength gains compared to drinking it after, possibly because it provides fuel for your legs. However, this finding is based on very limited data, so don't stress if you can't make it work.

Adding supportive accountability components (introductory video call, drop-in webchat, goal setting, food diary review) to a core digital behavioral weight loss program is hypothesized to enhance weight loss and engagement by increasing participant adherence through trust and accountability.

To get the most out of a digital weight loss program, look for one that offers flexible, on-demand access to a coach (like chat or video) and structured goal-setting. These features help keep you accountable without being overwhelming, which is key to sticking with the program long enough to lose weight.

Inpatient administration of GLP-1 receptor agonists (liraglutide and semaglutide) combined with a very low-calorie diet (800 kcal/day) produces rapid, substantial weight loss (25% of baseline) in severely obese patients (BMI > 100 kg/m2) who are hospitalized.

For severely obese patients (BMI > 100) who struggle with discharge or outpatient adherence, inpatient GLP-1RA therapy combined with a strict 800 kcal/day diet can produce rapid, substantial weight loss (approx. 25% in <8 months). This approach may serve as a bridge to bariatric surgery or functional independence when standard outpatient care fails due to socioeconomic or medical barriers.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) significantly reduce major adverse cardiovascular events (MACE) in non-diabetic adults with obesity, with benefits occurring through both weight-loss-dependent and independent mechanisms.

If you have obesity and are not diabetic, GLP-1 medications like semaglutide or liraglutide can significantly lower your risk of heart attack, stroke, and heart failure. This benefit is not just from losing weight; the drugs also directly protect your blood vessels and heart. While side effects like nausea are common, they are usually manageable with slow dose increases and dietary changes. For those who dislike injections, oral versions are also effective.

Tirzepatide (10-15 mg weekly) produces significantly greater total weight loss (-20.2%) compared to Semaglutide (1.7-2.4 mg weekly, -13.7%) in obese patients, as demonstrated in the SURMOUNT-5 trial.

If you are struggling with obesity and other medications have failed, Tirzepatide (10-15 mg weekly) offers superior weight loss compared to Semaglutide. Discuss this dual-agonist option with your doctor, especially if you have not achieved sufficient weight loss with other GLP-1 treatments.

Short-term use of betaine may be worth considering for athletes seeking improved body composition.

Athletes may consider short-term betaine supplementation for body composition goals.

Improvements in diet quality, with or without energy restriction, are associated with more favorable long-term metabolic and cardiovascular outcomes.

Practitioners should focus on improving diet quality for better health outcomes.

Consuming 30g of protein from lean beef immediately following resistance training may augment chronic adaptations in strength and lean tissue accretion compared to a placebo, though its efficacy relative to whey protein remains to be determined by this ongoing trial.

This study is currently a protocol and has not yet published results. However, it suggests that consuming ~30g of protein from lean beef immediately after resistance training is a viable strategy to potentially enhance strength and muscle gains. If you prefer whole foods over supplements, lean beef is a high-quality source of protein and micronutrients. Ensure you are doing consistent resistance training (3x/week) and consuming this protein within an hour post-workout.

Sodium-glucose cotransporter type 2 inhibitors (SGLT2is) reduce HbA1c, fasting plasma glucose, and body weight in Type 2 Diabetic athletes, but pose risks of hypovolemia, dehydration, and euglycemic DKA.

If you take SGLT2 inhibitors (like empagliflozin or dapagliflozin) for Type 2 Diabetes, you will likely lose weight and improve your blood sugar control. However, these drugs make you urinate more, which can lead to dehydration and dizziness during exercise. Drink extra water, watch for signs of low blood pressure, and be aware of the rare risk of euglycemic DKA (diabetic ketoacidosis with normal blood sugar).

A one-year person-centered and culturally sensitive intervention, incorporating continuous glucose monitoring (CGM) and extended healthcare provider time, improves glycemic control (HbA1c) and diabetes management in individuals with Type 2 Diabetes and non-Western backgrounds compared to usual care.

For individuals with Type 2 Diabetes from non-Western backgrounds, standard care may not be enough due to cultural and language barriers. This protocol suggests a specialized, one-year program that uses continuous glucose monitors (CGM) and culturally tailored education in native languages (Arabic, Turkish, Urdu). The key is building a long-term relationship with the same healthcare team to improve trust, understanding, and glycemic control.

Integrating intermittent Continuous Glucose Monitoring (CGM) with culturally-informed kaiāwhina support and optimized clinical care significantly reduces HbA1c levels in patients with Type 2 Diabetes compared to usual care.

For patients with Type 2 Diabetes who struggle with standard care, combining continuous glucose monitoring (CGM) with culturally tailored support (kaiāwhina) and optimized medical management can significantly improve blood sugar control. This approach addresses both the technical aspect of glucose tracking and the social/cultural barriers to care.

A 36-month complex lifestyle intervention combining digital tools, face-to-face group education, and individual consultations significantly reduces the incidence of type 2 diabetes in adults with prediabetes compared to usual care.

If you have prediabetes, a structured program combining regular group education, personal coaching, and digital tracking over 3 years is designed to help you lose weight, eat healthier, and exercise more to prevent diabetes. This approach is more comprehensive than digital tools alone.

Intensive lifestyle interventions, specifically achieving significant weight loss (≥10-15 kg or ≥10% body weight), can induce Type 2 Diabetes (T2DM) remission in overweight or obese patients by correcting insulin resistance and restoring beta-cell function.

If you have Type 2 Diabetes and are overweight, losing a significant amount of weight (at least 10-15 kg) through a structured diet and exercise program can potentially put your diabetes into remission. This means your blood sugar levels may return to normal without medication. However, this requires a strong commitment to maintaining that weight loss, as the condition can return if weight is regained. Consult a doctor to see if you are a candidate, especially if your diabetes was recently diagnosed.

Yoga intervention may delay or prevent the progression of type 2 diabetes in prediabetic or high-risk populations by improving glycemic control and reducing cardiovascular risk factors.

If you are at risk for Type 2 Diabetes, consider adding yoga to your routine. While this paper is a protocol for a future review, it highlights that yoga may help manage blood sugar and stress. It is presented as a less rigorous alternative to intense exercise, which might be easier to stick with if you find traditional workouts too demanding.

Tirzepatide (5, 10, or 15 mg weekly) produces superior, dose-dependent weight loss and glycemic improvements compared to insulin and GLP-1 receptor agonists in adults with type 2 diabetes and/or obesity.

Tirzepatide is currently the most potent pharmacological therapy for weight loss and blood sugar control in type 2 diabetes and obesity, outperforming both insulin and other GLP-1 drugs. It works by mimicking two gut hormones (GIP and GLP-1) to reduce appetite and improve insulin sensitivity. While effective, it carries a higher risk of gastrointestinal side effects like nausea compared to other treatments.