Browse the evidence

Tirzepatide enables a significant proportion of patients with type 2 diabetes to achieve normoglycemia (HbA1c < 5.7%) without clinically significant hypoglycemia, particularly when not combined with insulin or sulfonylureas.

Tirzepatide can help many patients with type 2 diabetes achieve normal blood sugar levels (HbA1c < 5.7%) without the high risk of dangerous low blood sugar episodes, especially if they are not taking insulin or sulfonylureas. This is a significant advantage over some other diabetes medications. Patients should still monitor their blood sugar as advised by their healthcare provider, but the risk of hypoglycemia is much lower with tirzepatide alone.

A 6-month dietary intervention producing a 500 kcal/day energy deficit yields similar weight loss outcomes regardless of an individual's high or low genetic predisposition to higher BMI, as measured by genome-wide polygenic scores.

If you are overweight or mildly obese, a standard dietary intervention creating a 500 kcal/day deficit will likely help you lose weight, regardless of your genetic risk for obesity. You do not need a specialized or 'genetic' diet to succeed; standard caloric restriction is effective for everyone in this range.

High body mass index (BMI) and high fasting plasma glucose are the leading risk factors for years lived with disability and injury in the United States, while high systolic blood pressure and smoking are the leading risk factors for years of life lost.

Focus on managing blood pressure, blood glucose, and body weight, as these are the top drivers of disability and premature death in the US, alongside smoking cessation.

Obesity increases the risk and severity of psoriasis through a pro-inflammatory state driven by adipokines (e.g., leptin), cytokines, and gut dysbiosis.

Your body fat is not just stored energy; it actively produces inflammatory signals (like leptin) that can trigger or worsen psoriasis. Managing your weight is not just about aesthetics; it is a direct medical intervention to reduce the inflammatory drive of your skin condition.

Intermittent Fasting (IF) is defined as repetitive fasting periods lasting up to 48 hours each, including Time-Restricted Eating (TRE) and Alternate-Day Fasting (ADF).

Intermittent Fasting means you fast repeatedly, with each fast lasting no more than 48 hours. This includes popular methods like Time-Restricted Eating (eating within a daily window) and Alternate-Day Fasting. You do not need to restrict calories during eating windows if you choose TRE.

Time-Restricted Eating (TRE) is defined as restricting food and caloric beverage intake to a specific daily period, resulting in a fasting window of at least 14 hours, with no explicit limit on energy intake during eating hours.

Practice Time-Restricted Eating by limiting your daily food and calorie-containing drink consumption to a window of at least 14 hours. You do not need to restrict the amount of food you eat during this window.

A Fasting-Mimicking Diet (FMD) is a specific diet composed to induce the metabolic effects of fasting while allowing for a potentially higher caloric intake, typically up to 1,000 kcal/day, and is not classified as modified fasting.

A Fasting-Mimicking Diet (FMD) is a specific, formulated diet that mimics the metabolic effects of fasting. It allows up to 1,000 kcal per day for 3-7 days and is distinct from modified fasting, which is capped at 25% of energy needs.

Resistance exercise studies must report specific training parameters (e.g., exercise selection, intensity, volume, rest intervals) to ensure scientific transparency and allow for replication.

If you are designing or reporting a resistance training study, use the PRIRES checklist to ensure you report all relevant training parameters, including exercise selection, intensity, volume, rest intervals, and progression rules.

Genetic loss-of-function variants in the GIP receptor are associated with lower body mass index (BMI) and protection against obesity in humans.

Large-scale genetic studies show that people with naturally reduced GIP receptor function tend to have lower body weight. This suggests that therapies designed to block or antagonize the GIP receptor could be effective for treating obesity and type 2 diabetes.

Weight loss interventions trigger physiological countermeasures, specifically adaptive thermogenesis (reduced resting energy expenditure) and increased appetite drive, which persist long-term and make weight maintenance difficult.

Understand that after losing weight, your body will biologically fight to regain it by lowering your calorie burn and increasing hunger. This is a normal physiological response, not a personal failure. Long-term maintenance requires strategies that account for these biological changes, such as higher protein intake or resistance training, rather than relying on willpower alone.

There is no universally superior diet (low-carb vs. low-fat) for long-term weight loss; both result in similar energy intake and weight loss outcomes when protein and calories are controlled.

Don't obsess over whether to cut carbs or fat. Both approaches work equally well for weight loss if you maintain a calorie deficit. Choose the dietary pattern that fits your lifestyle, preferences, and health markers (like blood sugar) best, as no single diet is superior for everyone.

Pitavastatin 4mg daily increases the risk of new-onset diabetes in people with HIV, but this effect is clinically significant primarily in individuals with multiple baseline metabolic risk factors (obesity, pre-diabetes, or metabolic syndrome).

If you have HIV and are considering statins for heart health, discuss your metabolic risk factors (weight, blood sugar) with your doctor. If you are healthy weight and have normal blood sugar, your risk of developing diabetes from the statin is very low. If you have existing metabolic risks, your doctor may monitor your blood sugar more closely or suggest lifestyle interventions to mitigate this small risk.

Baseline metabolic risk factors, specifically pre-diabetes, obesity (high BMI), and metabolic syndrome components, are the strongest predictors of new-onset diabetes in people with HIV, regardless of statin treatment.

Focus on managing your weight and blood sugar levels. These factors are much more important for your diabetes risk than your HIV status or specific medications. If you have pre-diabetes or are overweight, addressing these through diet and exercise is the most effective way to prevent diabetes.

Dapagliflozin, an SGLT2 inhibitor, significantly reduces cardiovascular risk and mortality in type 2 diabetes patients by correcting major risk factors like obesity and hypertension, unlike older therapies which may increase risk.

If you have Type 2 Diabetes and are at high risk for heart problems, ask your doctor about Dapagliflozin. It is a daily pill that not only helps control blood sugar but has been proven to significantly reduce the risk of heart attacks, strokes, and heart failure hospitalizations compared to older treatments. It also helps with weight loss and blood pressure.

GLP-1 receptor agonists (Liraglutide, Semaglutide, Dulaglutide, Albiglutide, Efpeglenatide) significantly reduce MACE-3 and cardiovascular death in patients with Type 2 Diabetes and high cardiovascular risk.

If you have Type 2 Diabetes and high heart disease risk, GLP-1 agonists (injectable or oral) are recommended to reduce the risk of heart attack, stroke, and cardiovascular death. Discuss these options with your provider.

Sleeve gastrectomy and Roux-en-Y gastric bypass (RYGB) produce clinically equivalent long-term excess BMI loss, though RYGB yields significantly higher total weight loss and superior resolution of dyslipidemia.

If you are considering bariatric surgery, understand that both sleeve gastrectomy and Roux-en-Y gastric bypass provide similar long-term excess weight loss results. However, RYGB offers better improvement in cholesterol levels (dyslipidemia) and a lower risk of developing new acid reflux (GERD). Sleeve gastrectomy has a lower rate of minor complications. Your choice should be based on your existing health conditions, particularly whether you suffer from reflux, rather than the assumption that one surgery is strictly 'better' for weight loss.

GLP-1 receptor agonists are associated with a higher frequency of gastrointestinal adverse events (nausea, vomiting, diarrhea) compared to placebo, although the risk of serious adverse events like pancreatitis remains comparable.

Expect gastrointestinal side effects like nausea and diarrhea when starting GLP-1 medications. These are common but usually mild to moderate. Serious side effects like pancreatitis are rare and occur at similar rates to placebo. Discuss management strategies with your provider to maintain treatment.

Obesity (BMI ≥30 kg/m²) is a major risk factor for the development, recurrence, and mortality of several solid-organ and hematological malignancies, including post-menopausal breast, colorectal, endometrial, kidney, esophageal, pancreatic, liver, and gallbladder cancers.

Maintaining a healthy body weight (BMI <25) is a critical strategy for reducing the risk of developing several common cancers, particularly post-menopausal breast, colorectal, and endometrial cancers. For cancer survivors, weight management is essential to reduce the risk of recurrence and improve survival outcomes.

GLP-1 receptor agonists (specifically liraglutide, subcutaneous semaglutide, and dulaglutide) significantly reduce major adverse cardiovascular events (MACE) in patients with type 2 diabetes, independent of glucose-lowering effects.

If you have Type 2 Diabetes and established heart disease or high risk, ask your doctor about GLP-1 receptor agonists like liraglutide, semaglutide, or dulaglutide. These drugs are proven to significantly lower your risk of heart attack, stroke, and cardiovascular death, regardless of how well they control your blood sugar. They are now a standard recommendation in guidelines for high-risk patients.

Long-term consumption of sugar-sweetened beverages (SSBs) is positively associated with increased total and cardiovascular disease (CVD) mortality in a graded, dose-dependent manner.

Limit sugar-sweetened beverages to less than one serving per month to minimize mortality risk. Each additional daily serving increases the risk of death by approximately 7%, primarily due to cardiovascular causes. Replace SSBs with water or unsweetened alternatives.

Higher circulating and tissue levels of linoleic acid (LA), the primary dietary omega-6 fatty acid, are associated with a significantly lower risk of total cardiovascular disease, cardiovascular mortality, and ischemic stroke.

Focus on maintaining healthy levels of linoleic acid (LA) through your diet, as higher biomarker levels of LA are linked to lower risks of heart disease and stroke. This suggests that current dietary guidelines recommending omega-6 intake are supported by large-scale evidence, and you do not need to fear omega-6 fatty acids for causing heart disease.

A Mediterranean diet supplemented with extra virgin olive oil or nuts mitigates the deleterious effect of elevated plasma ceramide concentrations on cardiovascular disease risk, effectively neutralizing the increased risk associated with high ceramide levels.

If you have high ceramide levels, switching to a Mediterranean diet rich in olive oil or nuts can effectively cancel out the increased heart disease risk associated with those levels. This dietary pattern brings your risk down to the same level as people with naturally low ceramide levels.

A 7-day dietary record (7DDR) provides higher relative validity for estimating nutrient intake compared to a single semiquantitative food frequency questionnaire (SFFQ) or averaged 24-hour recalls (ASA24) when validated against urinary and plasma biomarkers.

If you need to know your exact nutrient intake (especially sodium, potassium, or protein) for health reasons, a 7-day food diary is more accurate than a standard food frequency questionnaire or a single day's recall. While FFQs are convenient, they underestimate validity compared to biomarkers. Use a diary if precision matters; use an FFQ only for broad ranking.

Food Frequency Questionnaires (FFQs) and 24-hour recalls significantly underreport total energy intake and sodium intake compared to objective biomarkers (Doubly Labeled Water and urinary sodium).

Self-reported food diaries and questionnaires consistently underestimate how much you eat and how much salt you consume. If you are tracking sodium or calories, assume your report is lower than reality. Use this knowledge to be cautious with self-reported data for health decisions.