Browse the evidence

The association between Dietary Inflammatory Index (DII) and Coronary Heart Disease (CHD) is mediated by metabolic and lipid indicators, specifically Triglyceride-Glucose (TyG) index, Visceral Adiposity Index (VAI), Body Mass Index (BMI), Waist-to-Height Ratio (WHtR), High-Density Lipoprotein (HDL), and Glomerular Filtration Rate (GFR).

Managing weight, blood sugar, and cholesterol through diet can help mitigate the heart disease risk associated with inflammatory diets. Specifically, improving HDL and reducing visceral fat are key steps.

The adverse impact of Dietary Inflammatory Index (DII) on Coronary Heart Disease (CHD) is more pronounced in individuals aged <75 years, females, those with low cholesterol levels, and those with low Framingham risk scores.

If you are young, female, or have low traditional heart disease risk, your diet's inflammatory potential may have a disproportionately larger impact on your heart health compared to high-risk individuals.

Among dietary components contributing to the Dietary Inflammatory Index (DII), carbohydrate, vitamin C, and iron have the greatest impact on Coronary Heart Disease (CHD) risk, while vitamin D, alcohol, and monounsaturated fatty acids have the least impact.

To lower your DII and potentially reduce CHD risk, prioritize managing carbohydrate intake, ensuring adequate Vitamin C and Iron, while noting that alcohol and monounsaturated fats had less impact on CHD risk in this specific analysis.

GLP-1 receptor agonists (liraglutide, semaglutide, tirzepatide) administered as adjunct therapy to bariatric surgery significantly reduce BMI and total body weight in patients with insufficient weight loss or weight regain.

If you have had bariatric surgery but are not losing enough weight or are gaining it back, ask your doctor about adding a GLP-1 agonist (like semaglutide or tirzepatide) to your regimen. These medications, taken weekly or daily, have been shown to significantly boost weight loss and improve metabolic health (blood sugar, blood pressure) in this specific group. Be prepared for potential mild stomach issues, which usually subside, and discuss cost coverage with your provider.

GLP-1 receptor agonists improve metabolic outcomes, including glycemic control, blood pressure, and lipid profiles, in post-bariatric surgery patients.

Beyond weight loss, GLP-1 agonists can help normalize blood sugar, lower blood pressure, and improve cholesterol levels in patients who have had bariatric surgery. This makes them a valuable tool for managing overall metabolic health, not just weight.

GLP-1 receptor agonists (e.g., semaglutide, tirzepatide) show promising results for MASH resolution and weight loss, though phase 3 histological data is still emerging.

GLP-1 agonists like semaglutide and tirzepatide are showing strong promise for resolving MASH and reducing liver fibrosis, especially in those with obesity or diabetes. While not yet universally endorsed for MASH alone, they are beneficial for comorbidities.

SANA (a nitroalkene derivative of salicylate) promotes weight loss and improves glucose management in humans through creatine-dependent thermogenesis, independent of UCP1 and AMPK.

SANA is an experimental drug that appears to trigger weight loss by increasing energy expenditure through creatine-dependent thermogenesis, rather than by suppressing appetite or increasing physical activity. In early human trials, doses of 200-400mg daily led to weight loss and improved glucose control within two weeks with a good safety profile. It works independently of the traditional UCP1 pathway, offering a potential alternative for those who do not respond to other mechanisms. Consult a physician for clinical trials or future availability.

Caloric restriction (CR) and fasting improve cardiac health and mitigate heart failure with preserved ejection fraction (HFpEF) by inducing autophagy, mitophagy, and reducing systemic inflammation.

For HFpEF patients, caloric restriction and fasting regimens (like intermittent fasting) can improve heart function and reduce inflammation. However, these diets are hard to stick to long-term and may cause side effects like muscle loss in some older adults. Because of these challenges, doctors are exploring medications that mimic these benefits without requiring strict dieting.

Caloric restriction mimetics (CRMs) such as SGLT2 inhibitors, GLP-1 agonists, and specific compounds like spermidine and rapamycin can replicate the beneficial effects of caloric restriction on HFpEF without requiring dietary restriction.

If you have HFpEF and struggle with strict dieting, ask your doctor about medications that mimic the effects of fasting. Drugs like SGLT2 inhibitors and GLP-1 agonists, as well as emerging compounds, may help improve heart function and reduce inflammation without requiring you to eat significantly less.

Oral semaglutide 14 mg daily produces clinically significant weight loss (≥5%) in approximately half of non-diabetic obese adults, with an average loss of 5.7% and a favorable safety profile, though it is less effective than injectable semaglutide or tirzepatide.

If you are obese and do not have diabetes, taking 14mg of oral semaglutide daily for a year will likely result in about 6% body weight loss on average. While not as powerful as the injectable version, it is a safe option if you dislike injections or cannot access injectable medications. Expect mild nausea in some cases, but serious side effects are rare.

Switching from GLP-1 receptor agonists (dulaglutide or semaglutide) to tirzepatide for six months significantly reduces body weight, HbA1c, and markers of metabolic dysfunction-associated steatotic liver disease (MASLD) including the fatty liver index and FIB-4 index in patients with type 2 diabetes.

For patients with Type 2 Diabetes and fatty liver disease currently on GLP-1 RAs like dulaglutide or semaglutide, switching to tirzepatide (starting at 2.5mg weekly, increasing to 5mg after 4 weeks) for six months can lead to significant weight loss, improved blood sugar control, and reduced liver fat and fibrosis markers. This benefit persists even if the patient was previously on semaglutide, though appetite suppression may be less pronounced in that subgroup.

Dual and triple receptor agonists (Tirzepatide, Survodutide, Retatrutide) show promise in MASH resolution, with some demonstrating superior efficacy to single GLP-1 agonists in weight loss and MASH resolution, though long-term hepatic outcomes are still being established.

Newer multi-agonist drugs like Tirzepatide (5-15mg weekly) show strong results in resolving MASH and improving fibrosis in Phase 2 trials, often matching or exceeding the efficacy of single GLP-1 agonists. Patients should discuss access and cost with their providers, as these are newer, expensive therapies with robust but still maturing long-term data.

GLP-1 receptor agonists (GLP-1RAs) reduce systemic inflammation and improve metabolic parameters in patients with psoriatic disease (PsD) and its comorbidities (obesity, T2DM, cardiovascular disease).

If you have psoriasis or psoriatic arthritis along with obesity or type 2 diabetes, GLP-1 receptor agonists (like semaglutide or liraglutide) can help manage both your metabolic health and inflammation. These drugs not only promote significant weight loss but also reduce key inflammatory markers (TNF, IL-6) linked to psoriatic disease severity. While they are primarily known for diabetes and weight management, emerging evidence suggests they may also improve joint and skin symptoms, especially in patients who are obese. Consult your rheumatologist to see if adding a GLP-1RA to your current treatment plan is appropriate.

Increasing dietary protein intake alone does not overcome anabolic resistance in T2D, but protein supplementation combined with resistance exercise may improve lean mass gains compared to exercise alone.

For T2D patients, drinking protein shakes alone won't build muscle. However, if you are doing resistance training, adding a protein drink (especially with leucine) alongside your workout can help you gain a bit more lean mass than exercise alone. Aim for adequate daily protein (1.2-1.6 g/kg) and consider post-workout supplementation.

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.

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.

Semaglutide treatment (1.7-2.4 mg weekly) in patients with hypothalamic obesity secondary to craniopharyngioma produces sustained, clinically significant weight loss (median 16%) and improves metabolic biomarkers (HbA1c, LDL) over 24 months.

For patients with hypothalamic obesity, semaglutide (1.7-2.4 mg weekly) is an effective long-term treatment for weight loss and metabolic health. It is crucial to maintain consistent dosing, as interruptions can lead to fat mass regain. Side effects are generally mild and manageable.

Semaglutide treatment significantly reduces emotional and uncontrolled eating scores in patients with hypothalamic obesity, leading to improved quality of life and social functioning.

Semaglutide not only helps with weight loss but also significantly reduces emotional and uncontrolled eating, leading to improved quality of life and social functioning. Patients report feeling more confident and less isolated.

Multi-modal anti-obesity medication (mmAOM) therapy yields significantly greater preoperative percent total body weight loss (%TBWL) than GLP-1 receptor agonist monotherapy or non-pharmacologic medically supervised weight loss in patients with BMI ≥ 70 kg/m².

If you have a BMI of 70 or higher and are preparing for weight loss surgery, combining multiple weight loss medications (mmAOM) under medical supervision leads to significantly more weight loss than using just one GLP-1 medication or lifestyle changes alone. This approach helps reduce surgical risks. Discuss with your doctor if a combination therapy is appropriate for your insurance coverage and health profile.

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.

Low energy availability (energy deficit) following ACL injury can impair skeletal muscle hypertrophy and recovery, as the body may not have sufficient energy to support both healing and muscle growth.

After ACL surgery, avoid cutting calories to 'stay lean.' Your body needs sufficient energy to heal and rebuild muscle. Focus on eating enough to support your activity level and recovery, rather than restricting food intake.

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.

Weekly subcutaneous semaglutide (up to 2.4 mg) reduces BMI, HbA1c, and blood pressure, and improves self-rated quality of life in patients with schizophrenia or schizoaffective disorder and obesity.

For patients with schizophrenia or schizoaffective disorder and obesity, weekly semaglutide injections (up to 2.4 mg) can effectively reduce weight, improve blood sugar control, and lower blood pressure, while also improving quality of life. This treatment is feasible in inpatient settings, even for those with severe mental illness, though side effects like nausea may lead some to discontinue. It should be considered as part of a comprehensive care plan including dietary advice.