Browse the evidence

Commercially available phytosteroid supplements containing 20-hydroxyecdysone (20E) and diosgenin (DSG) provide no additional hypertrophic or performance benefits over resistance training alone because the actual active compound concentrations are drastically lower than labeled amounts.

Do not rely on commercial phytosteroid supplements (specifically those combining 20E and DSG) to boost muscle growth or strength beyond what you achieve through consistent resistance training. This specific study found that the tested product contained less than 1% of the labeled 20E and only 10.4% of the labeled DSG, resulting in no biological activity or performance benefit compared to placebo. Focus on your training and nutrition instead.

Commercial protein bars in Brazil frequently overestimate their protein content by more than 20% compared to laboratory analysis, primarily due to non-protein nitrogen compounds being counted as protein by standard testing methods.

Do not blindly trust the protein number on the bar's label. This study found that 35% of bars had protein levels significantly higher than stated (overestimation). While this means you might get more protein than expected, it indicates poor quality control. If you are tracking macros precisely, assume the label is an estimate, not a guarantee, and prioritize brands with transparent third-party testing.

Increasing protein intake to 1.6 g/kg body weight via whole foods for 17 weeks, with or without strength training, does not adversely affect gastrointestinal microbiota composition, richness, or diversity in community-dwelling older adults.

If you are an older adult (65-85) looking to maintain muscle, you can safely increase your protein intake to about 1.6 grams per kilogram of body weight daily. This study used whole foods (dairy, meat, plant proteins) rather than powders, and combined this diet with strength training for the last 8 weeks of a 17-week period. The key takeaway is that this level of protein does not harm your gut bacteria or cause inflammation, provided you are generally healthy and not on antibiotics. Focus on diverse protein sources like milk, soups, and lean meats.

When resistance profiles, elbow range of motion, and effort are matched, altering shoulder extension angle (neutral vs. maximally extended) does not produce meaningful differences in elbow flexor hypertrophy in untrained men.

For most recreational lifters, whether you perform bicep curls with your arms by your side (neutral) or slightly behind your torso (extended shoulder) makes no meaningful difference to muscle growth, provided you train to failure and manage the weight similarly. Choose the variation that feels best for your shoulders and allows you to lift consistently. Don't overcomplicate your exercise selection based on shoulder angle alone.

Supplementation with fish protein, vitamin D, and omega-3 fatty acids provides no additional benefit to physical performance adaptations (strength, endurance, workout duration) compared to whey protein or maltodextrin during a 6-week high-intensity functional training (HIFT) program in recreationally trained individuals.

If you are doing high-intensity functional training (like CrossFit), switching to a complex supplement with fish protein, vitamin D, and omega-3s will not give you better strength or endurance gains than taking whey protein or even just carbohydrates (maltodextrin), provided your overall diet is adequate. Focus on consistent training and basic protein intake rather than expensive multi-ingredient stacks for performance enhancement.

Among adults aged 50 and older with newly diagnosed type 2 diabetes, the prevalence of undiagnosed (silent) hypertension reaches 50%, significantly higher than in younger diabetic cohorts.

If you are over 50 and have just been diagnosed with type 2 diabetes, you have a 1 in 2 chance of having high blood pressure that you don't know about. Because you likely have no symptoms, you must get your blood pressure checked immediately at diagnosis to prevent long-term heart and kidney damage.

In older adults (≥50 years) with newly diagnosed type 2 diabetes, mean systolic blood pressure often remains below the clinical hypertension threshold (140 mmHg) despite a high prevalence of silent hypertension, indicating subclinical vascular changes.

If you are over 50 with type 2 diabetes, do not assume your blood pressure is safe just because it is under 140 mmHg. Your blood vessels may already be stiffening, and your risk for heart disease is high even without a formal hypertension diagnosis. Monitor your BP closely and manage other risk factors like cholesterol and weight.

Age, BMI, HbA1c, family history of hypertension, and waist circumference are independent predictors of silent hypertension in newly diagnosed type 2 diabetes patients.

Your risk of having undiagnosed high blood pressure when you get diabetes depends on your age, weight, blood sugar control, family history, and waist size. If you have these risk factors, you are more likely to have silent hypertension and should be screened aggressively.

SGLT2 inhibitors provide significant cardiovascular and renal protection in type 2 diabetes patients through mechanisms independent of glycemic control, including metabolic reprogramming and fuel switching.

If you have type 2 diabetes, ask your doctor about SGLT2 inhibitors. They protect your heart and kidneys through mechanisms beyond just lowering blood sugar, such as helping your body use different fuels. This can significantly reduce your risk of serious complications.

In patients with type 2 diabetes, the magnitude of weight loss achieved through semaglutide treatment (ranging from no loss to >10% loss) does not correlate with the risk of major adverse cardiovascular events (MACE), indicating that the drug's cardioprotective effects are independent of weight reduction.

If you are taking semaglutide for type 2 diabetes and cardiovascular risk, do not stop the medication if you are not losing as much weight as expected. The drug provides cardiovascular protection through direct effects on your blood vessels and heart, independent of how much weight you lose. Focus on the long-term heart health benefits rather than the number on the scale.

Very low-carbohydrate diets (ketogenic) pose long-term sustainability, health, and environmental risks, including potential nutrient deficiencies and increased LDL cholesterol.

Be cautious with very low-carb diets. They can lead to nutrient deficiencies, increased LDL cholesterol, and are difficult to sustain long-term. Focus on balanced, high-quality diets instead.

High intake of linoleic acid (LA) does not impair the conversion of alpha-linolenic acid (ALA) to long-chain omega-3s (EPA/DHA) to a clinically significant degree, and the ratio of LA to ALA is less important than absolute intake levels.

You do not need to restrict seed oils to improve your omega-3 status. If you want more EPA/DHA, eat fish or algae supplements directly, as the body's conversion from plant sources (ALA) is inefficient regardless of how much seed oil you eat.

Most dietary (poly)phenols are not absorbed intact in the small intestine but pass to the colon where gut microbiota catabolize them into absorbable metabolites, which then enter circulation and exert biological effects.

Eat a variety of plant-based foods rich in polyphenols (berries, tea, coffee, onions, citrus). You do not need to worry about the 'bioavailability' of the raw compound because your gut bacteria process them into active metabolites that enter your bloodstream. The specific benefits depend on your unique gut microbiome, so diversity in your diet helps ensure you have the right bacteria to process different polyphenols.

Handgrip strength reference values for European adults aged 50+ vary significantly by age, sex, and geographic region, with Northern and Western Europe showing higher absolute strength than Southern and Central/Eastern Europe, and standing position yielding higher values than sitting.

If you are over 50, do not compare your handgrip strength to a generic global average. Use the specific reference values for your age group, sex, and European region (Northern, Western, Southern, or Central/Eastern) to accurately assess your muscle health. Standing grip is typically higher than sitting; ensure you are comparing like with like.

Classifying individuals by a 'leptin phenotype' (relatively high or low leptin for a given body fat percentage) does not predict differential energy expenditure, metabolic adaptation, or susceptibility to weight change in response to caloric restriction or overfeeding.

Do not rely on fasting leptin levels to predict your weight loss success or failure. Whether your leptin is 'high' or 'low' for your body fat percentage does not appear to change how your body responds to dieting or overeating in terms of energy expenditure or weight change. Focus on sustainable caloric deficits and activity rather than hormonal profiling for prediction.

Markov models are the dominant methodological framework for economic evaluations of obesity interventions, with 85% of reviewed studies utilizing state-transition models.

When evaluating the long-term cost-effectiveness of obesity treatments, decision-makers should expect and look for Markov modeling. This is the standard approach for comparing interventions like bariatric surgery, pharmacotherapy, and lifestyle changes over a patient's lifetime.

Current Markov models for obesity interventions exhibit significant methodological heterogeneity, particularly in how they model the progression of obesity and its impact on costs and utilities.

When comparing economic evaluations of obesity treatments, be aware that different studies use different structures (direct BMI-to-cost vs. BMI-to-complications). This makes direct comparison difficult. Look for studies that use standardized validation and include a broad spectrum of complications.

Diabetes mellitus (DM) and cardiovascular disease (CVD) are the most frequently modeled obesity-related complications in Markov models, with DM appearing in 15/15 models focusing on complications and CVD in 14/15.

If you are looking at an economic evaluation of an obesity treatment, expect it to focus heavily on preventing diabetes and cardiovascular events. These are the main drivers of long-term cost savings and quality-of-life improvements in these models.

Validation practices in Markov models for obesity interventions are inconsistently reported, with only 43% of models reporting validation, limiting the reliability and comparability of these evaluations.

Be cautious when using economic evaluations of obesity treatments that do not report validation. Only 43% of the models reviewed reported validation, which limits their reliability. Look for studies that use standardized validation guidelines like ISPOR.

A 2-week exposure to either a low-carbohydrate (LC) or low-fat (LF) diet does not significantly alter sweet or salty taste detection thresholds or preferences compared to each other.

Switching to a low-carb or low-fat diet for just two weeks will not change your taste buds or your cravings for sweet and salty foods. If you are expecting your food preferences to shift quickly as a result of the diet itself, this short timeframe is likely too short to observe such changes.

Existing patient-reported outcome (PRO) measures for obesity fail to capture key appetite and eating behavior concepts (e.g., duration of fullness, satisfaction after eating, eating between meals) that are relevant to individuals with obesity and likely to change with treatment.

If you are managing obesity, standard questionnaires might miss how you actually feel after eating (satisfaction, fullness duration). This gap means your provider might not fully understand your specific challenges with cravings or portion control. A comprehensive assessment tool (like the EBAQ) can better capture these nuances to tailor your treatment plan.

Leucine-rich high protein supplementation (50.6 g protein and 6 g leucine daily) does not significantly improve body composition or muscle function in older adults with sarcopenia over a 12-week period, despite upregulating specific gene expression related to ATP production and DNA repair.

For older adults with sarcopenia, taking leucine-rich protein supplements alone for 12 weeks will not significantly increase muscle mass or improve physical function. While it may positively influence gene expression related to energy production, it is not a standalone solution for reversing sarcopenia. To see functional benefits, supplementation should likely be combined with resistance exercise.

In elderly patients with type 2 diabetes, maintaining the Triglyceride-Glucose index combined with a Body Shape Index (TyG-ABSI) within an optimal range (specifically avoiding both extremely low and extremely high values) is associated with the lowest all-cause mortality risk.

If you have Type 2 Diabetes, standard weight metrics like BMI might not fully capture your mortality risk. Research suggests that a combination of insulin resistance markers (Triglyceride-Glucose index) and body shape (ABSI) provides a more accurate prediction of health outcomes. Crucially, this risk follows a 'U-shape': both extremely high and extremely low values of this combined index are associated with higher mortality. Therefore, the goal is not simply to minimize these numbers, but to maintain them within an optimal, balanced range, while closely monitoring kidney function (eGFR) as it mediates this risk.

Approximately 11.5% of patients undergoing secondary metabolic bariatric surgery (MBS) transfer to a different hospital than their primary procedure, a rate that is underestimated in single-institution registries.

If you are considering secondary bariatric surgery, be aware that about 11% of patients switch hospitals for this procedure. This is often driven by dissatisfaction with weight regain or complications from the first surgery. You are not alone in seeking a second opinion or a different provider if you feel your current care is not meeting your expectations.