Browse the evidence

Waist circumference is a superior and necessary clinical metric for assessing cardiometabolic risk compared to BMI alone, as it identifies visceral adiposity and high-risk phenotypes that BMI misses.

Stop relying solely on your weight or BMI. Measure your waist circumference. If it is high (≥88 cm for women, ≥102 cm for men), you are at higher risk for heart disease and diabetes, even if your weight is 'normal'. Use this measurement to guide lifestyle changes.

Higher levels of total physical activity, regardless of intensity (including light activity), are associated with a substantially reduced risk of all-cause mortality in a non-linear dose-response pattern.

Focus on increasing your total daily movement volume rather than just high-intensity workouts. Aim for at least 10 hours of accelerometer wear time per day for 4+ days to capture accurate data, but practically, this means accumulating light activity (walking, standing) throughout the day. The biggest mortality risk reduction occurs with moderate increases in activity, particularly around 24 minutes of moderate-to-vigorous activity or 375 minutes of light activity per day. Do not neglect light activity; it is highly effective for longevity.

Diagnosing malnutrition requires the concurrent presence of at least one phenotypic criterion (weight loss, low BMI, or reduced muscle mass) and one etiologic criterion (reduced food intake/assimilation or disease burden/inflammation).

To diagnose malnutrition in a clinical setting, you must find evidence of physical changes (like weight loss, low BMI, or muscle loss) AND evidence of a cause (like reduced food intake or active inflammation). Neither alone is sufficient for a diagnosis.

Reduced muscle mass is a key phenotypic criterion for malnutrition, measurable by DXA, BIA, CT, MRI, or anthropometric proxies like calf/arm circumference.

Assess muscle mass using available tools like DXA, BIA, CT, or MRI. If these are unavailable, use anthropometric measures like calf or arm circumference, or functional assessments like grip strength.

Pharmacological treatment of hypertension significantly reduces major cardiovascular events, including heart failure, stroke, and mortality, regardless of baseline blood pressure levels.

If diagnosed with hypertension, adhere to prescribed pharmacological treatment. Fixed-dose combinations are often recommended to improve adherence and minimize side effects. The reduction in cardiovascular risk is substantial and consistent across different baseline risks.

Diagnosing malnutrition in adults requires the presence of at least one phenotypic criterion (non-volitional weight loss, low BMI, or reduced muscle mass) AND at least one etiologic criterion (reduced food intake/assimilation or disease burden/inflammation).

To diagnose malnutrition, you cannot rely on just one factor. You must find evidence of physical change (like weight loss, low BMI, or muscle loss) AND evidence of a cause (like poor eating or active inflammation/disease). Both must be present.

Television viewing time has a stronger association with mortality and type 2 diabetes risk than total sedentary time, with specific thresholds identified for increased risk.

Watching TV is particularly risky for your health. Try to limit TV time to under 3.5 hours a day, as this specific activity carries a higher risk of mortality and diabetes than other forms of sitting.

Replacing dietary saturated fat with refined carbohydrates or sugars does not reduce cardiovascular disease risk and may be neutral or harmful.

Do not replace saturated fats with refined carbs or sugars if your goal is heart health. This substitution does not lower cardiovascular risk. Instead, replace saturated fats with unsaturated fats (polyunsaturated or monounsaturated).

Chronic low-grade inflammation in adipose tissue, driven by M1 macrophage infiltration and pro-inflammatory cytokine secretion (TNF-α, IL-1β, IL-6), directly causes insulin resistance and contributes to the pathogenesis of Type 2 Diabetes.

For obese individuals, reducing body fat is critical not just for weight loss, but to reduce the chronic inflammation in fat tissue that blocks insulin. This inflammation directly impairs how your body uses glucose, increasing the risk of Type 2 Diabetes. Weight loss interventions that reduce this inflammation can improve insulin sensitivity.

In a general population, 1 g/day marine n-3 supplementation significantly reduces the risk of total myocardial infarction.

While fish oil didn't prevent all heart issues, it did significantly lower the risk of heart attacks in this study. It may be worth discussing with your doctor, especially if you have other risk factors.

Obesity increases the risk of postmenopausal estrogen receptor-positive (ER+) breast cancer and is associated with worse disease outcomes and higher mortality across all breast cancer subtypes.

For postmenopausal women, maintaining a healthy weight is critical to reducing the risk of developing estrogen-receptor-positive breast cancer and improving survival rates if diagnosed. This is achieved through lifestyle interventions that lower circulating estrogens and inflammatory markers.

Replacing animal-source foods with plant-based foods in high-income countries reduces greenhouse gas emissions by up to 84% and premature mortality by up to 12%, but may increase freshwater use by up to 16%.

In high-income countries, reducing your intake of animal-source foods and replacing them with plant-based options (especially legumes, fruits, and vegetables) can significantly lower your carbon footprint and improve your health. Be aware that this might increase your water usage, so choosing water-efficient plant foods can help mitigate this. This strategy is most effective where current meat consumption is high.

Muscle hypertrophy is driven by the PI3K-AKT-mTOR pathway, where IGF-1 and insulin signaling promote protein synthesis and inhibit degradation, while myostatin/activin signaling via Smad2/3 inhibits growth.

To build muscle, your body relies on specific hormonal signals like IGF-1 and insulin to activate the mTOR pathway, which drives protein synthesis and blocks breakdown. Conversely, myostatin acts as a brake on growth. Understanding this balance explains why resistance training (which stimulates these pathways) is effective, while conditions that elevate myostatin or impair insulin signaling can hinder growth.

High body mass index (BMI ≥ 25 kg/m²) is a major global cause of disease burden, contributing to 2.4 million deaths and 70.7 million disability-adjusted life years (DALYs) in females and 2.3 million deaths and 77.0 million DALYs in males in 2017, with cardiovascular disease, diabetes, and kidney diseases being the leading causes.

Maintaining a BMI within the healthy range (typically 18.5–24.9 kg/m²) is critical for preventing cardiovascular disease, diabetes, and kidney disease. Public health initiatives should target population-wide strategies to reduce high BMI, tailored to the development status of specific regions.

High BMI is the leading cause of disability-adjusted life years (DALYs) for cardiovascular disease, diabetes, and kidney diseases, accounting for 89.3% of all high-BMI-related DALYs.

Focusing on weight management is the most effective way to reduce the risk of heart disease, stroke, diabetes, and kidney disease, as these conditions are the primary drivers of health loss associated with high BMI.

Elevated levels of triglyceride-rich lipoproteins (TRL) and their remnants are causally associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD), including myocardial infarction, ischemic stroke, and aortic valve stenosis, independent of LDL cholesterol levels.

High triglycerides are not just a number; they represent particles that directly contribute to heart disease. If your triglycerides are consistently above 1.2 mmol/L (100 mg/dL), you have elevated cardiovascular risk, even if your LDL is normal. Managing this involves dietary changes to reduce carbohydrate and alcohol intake, and potentially medication if lifestyle changes are insufficient, especially if you have diabetes or existing heart disease.

Apolipoprotein CIII (apoCIII) acts as a key inhibitor of lipoprotein lipase (LpL), and its reduction leads to more efficient clearance of triglycerides from the blood, thereby lowering plasma triglyceride levels and potentially reducing cardiovascular risk.

High levels of apoCIII slow down the breakdown of fat particles in your blood. This is often driven by insulin resistance. Managing insulin sensitivity through diet and exercise can naturally lower apoCIII levels, helping your body clear triglycerides more efficiently.

Sarcopenic obesity is defined by the co-existence of excess adiposity and low skeletal muscle mass/function, requiring a two-step diagnostic algorithm of screening followed by functional and body composition assessment.

To identify sarcopenic obesity, first screen for high BMI or waist circumference. If positive, test muscle function (e.g., handgrip strength). If function is low, assess body composition (DXA or BIA) to confirm low muscle mass relative to fat. This two-step process ensures accurate diagnosis without unnecessary expensive testing for everyone.

Type 2 diabetes mellitus (T2DM) and insulin resistance are significant independent risk factors for the progression of NAFLD to NASH, fibrosis, and cirrhosis, and are associated with increased mortality.

If you have NAFLD and Type 2 Diabetes, managing your blood sugar and insulin resistance is critical to preventing liver damage. T2DM is an independent risk factor for progression to cirrhosis and liver-related mortality.

GLP-1 receptor agonists (GLP-1RAs) effectively treat type 2 diabetes and obesity by mimicking endogenous GLP-1 to stimulate glucose-dependent insulin secretion, suppress glucagon, delay gastric emptying, and reduce appetite via central nervous system signaling.

GLP-1 medications are highly effective for managing type 2 diabetes and obesity. They work by mimicking a natural hormone to boost insulin when needed, lower blood sugar, slow digestion, and reduce hunger. While they often require injections, many are now available as once-weekly shots or even pills. Side effects like nausea are common at first but usually fade. They are not for type 1 diabetes. Always combine with diet and exercise.

Obesity and insulin resistance are core drivers of NAFLD, leading to liver accumulation of triglycerides and free fatty acids.

Managing body weight and insulin sensitivity is the most critical step in preventing and treating NAFLD, as these conditions directly cause fat accumulation in the liver.

High sedentary time is a convincing risk factor for increased Type 2 Diabetes Mellitus (T2DM) incidence.

Reducing your sedentary time is a highly effective strategy to reduce your risk of Type 2 Diabetes. The evidence is very strong: people who spend more time being sedentary have a significantly higher risk of developing the disease. Try to incorporate more movement into your daily routine, even if you already exercise.

Serum 25-hydroxyvitamin D [25(OH)D] is the best indicator of vitamin D nutritional status, reflecting contributions from diet and dermal production, and should be standardized using programs like VDSP.

To check your Vitamin D status, ask for a serum 25-hydroxyvitamin D [25(OH)D] test. This is the gold standard. Ensure your lab participates in standardization programs like VDSP for accurate results.

Obesity (excess body fatness) is a convincing risk factor for at least 13 different cancer sites, including endometrial, postmenopausal breast, colorectal, esophageal, renal, meningioma, pancreatic, gastric cardia, liver, multiple myeloma, ovarian, gallbladder, and thyroid cancers.

Maintain a healthy body weight to reduce cancer risk. Focus on sustainable lifestyle changes like balanced nutrition and regular activity rather than rapid weight loss, as avoiding weight gain is a viable preventive measure.