Browse the evidence

Athletes who purchase nutritional supplements outside of their athletic department's provided inventory are at significantly higher risk of using non-third-party tested (TPT) supplements compared to those who rely on department-provided products.

If you buy supplements from your school's athletic department, you are statistically much safer regarding contamination risks than if you buy them yourself at a store or online. If you must buy your own, you are at higher risk of using untested products; prioritize finding and ordering from verified third-party tested sources.

Using caffeine supplements is associated with a significantly higher risk of using non-third-party tested supplements compared to other supplement types.

If you use caffeine supplements, you are at the highest risk of using untested products. Be extra vigilant: look for third-party testing logos (NSF, Informed Choice) on caffeine products, especially pre-workouts, as they are frequently adulterated.

Incretin-based pharmacotherapies (GLP-1, GIP, and triple agonists) significantly improve metabolic dysfunction-associated steatohepatitis (MASH) resolution and fibrosis regression compared to placebo, primarily through weight loss and insulin sensitization, with some agents showing direct hepatic benefits.

For patients with MASH, incretin-based therapies like Semaglutide (2.4mg weekly) are highly effective at resolving liver inflammation and improving fibrosis, often outperforming placebo in clinical trials. While gastrointestinal side effects are common, they can be managed with careful dosing and dietary adjustments, making these drugs a viable and potent option for those who struggle with lifestyle changes alone.

GLP-1 receptor agonists (specifically liraglutide and semaglutide) significantly improve histological features of NASH (steatohepatitis resolution) and reduce liver fat content in patients with Type 2 Diabetes, though they may not consistently improve fibrosis.

If you have Type 2 Diabetes and fatty liver, current guidelines prioritize GLP-1 agonists (like liraglutide or semaglutide) or SGLT2 inhibitors over older drugs like metformin for liver health. These medications not only lower blood sugar but actively reduce liver fat and inflammation. The most effective approach combines these medications with lifestyle changes: aim for 7-10% weight loss through a Mediterranean-style diet and regular aerobic exercise. This combination offers the best chance for resolving NASH and protecting your heart and kidneys.

Pioglitazone (a PPAR-gamma agonist) significantly improves liver inflammation and steatosis in NASH patients, including those with Type 2 Diabetes, but is limited by side effects like weight gain and heart failure risk.

Pioglitazone is an effective, low-cost option for improving liver inflammation in diabetic patients with NASH. However, it is not a first-line choice for everyone due to side effects like weight gain, bone loss, and potential heart failure exacerbation. It is best considered for patients who do not have heart failure or osteoporosis, and who are monitored closely by their doctor.

SGLT2 inhibitors (specifically empagliflozin and dapagliflozin) reduce liver fat content and may improve fibrosis markers in patients with Type 2 Diabetes, offering a cardioprotective and renoprotective alternative to GLP-1 agonists.

SGLT2 inhibitors (like empagliflozin or dapagliflozin) are effective for reducing liver fat and fibrosis in diabetic patients. They are particularly recommended for patients who also have heart failure or kidney disease, as these drugs offer significant protective benefits for these organs. They are a viable alternative to GLP-1 agonists, especially if injections are not preferred.

Tirzepatide provides clinically meaningful HbA1c reduction and dose-proportional weight loss in older adults (≥65 years) with type 2 diabetes who do not have obesity (BMI < 30 kg/m2), without increasing hypoglycemic risk compared to the general population.

If you are over 65 and have type 2 diabetes but are not obese (BMI under 30), tirzepatide is a viable treatment option. It effectively lowers blood sugar and promotes weight loss without increasing the risk of dangerous low blood sugar, provided you are not already on insulin or sulfonylureas. Be aware that gastrointestinal side effects are common, but generally mild, and discontinuation rates due to side effects are slightly higher in this group than in the general population.

GLP-1 receptor agonists (GLP-1RAs) such as semaglutide and liraglutide facilitate weight loss and glycemic control by delaying gastric emptying, stimulating insulin release, and suppressing glucagon secretion.

If you have obesity and struggle to maintain weight loss through diet and exercise alone, GLP-1 medications like liraglutide or semaglutide are FDA-approved options. They work by mimicking a hormone that regulates appetite and digestion. You will need to commit to lifestyle changes alongside the medication, as the drugs are adjuncts, not replacements. Be prepared for potential gastrointestinal side effects, which are common but often subside.

Early and intensive glycemic control, particularly within the first two years of diagnosis, is associated with a lower risk of long-term diabetes-related complications and can lead to diabetes remission in some patients.

If you are newly diagnosed with type 2 diabetes, starting treatment early is crucial. It can help prevent long-term complications and even lead to remission in some cases. Don't delay seeking medical advice or starting prescribed therapies.

During single-joint resistance training, non-recruited muscles undergo significant volume loss (atrophy), particularly when energy and protein intake are low, suggesting a localized reallocation of muscle mass from untrained to trained tissues.

If you are doing targeted resistance training (like arm curls or leg extensions) and not eating enough calories or protein, your untrained muscles may actually shrink. To maximize net muscle gain, ensure your energy and protein intake are sufficient to support the metabolic cost of building new tissue in your trained muscles, preventing your body from cannibalizing untrained muscles for energy.

Advanced resistance training systems (Rest-Pause and Sarcoplasmic Stimulating Training) induce significantly higher perceived exertion, pain, and displeasure compared to traditional multi-set training, despite producing lower post-exercise lactate concentrations.

If you are an experienced lifter, advanced techniques like Rest-Pause or Sarcoplasmic Stimulating Training can increase your total training load and volume, which are key for muscle growth. However, be aware that these methods will feel significantly more painful and unpleasant than standard training, even if they produce less lactate. Because of this high discomfort, these systems are best reserved for experienced athletes who can tolerate the psychological burden, rather than beginners.

A higher proportion of saturated fatty acids relative to total fat intake (SFA/TFAT) is associated with a 23% increased risk of all-cause mortality, whereas a higher proportion of polyunsaturated fatty acids relative to total fat (PUFA/TFAT) is associated with a 14% reduced risk, mediated partially by the neutrophil percentage-to-albumin ratio (NPAR).

To support longevity, focus on the ratio of fats in your diet rather than just cutting total fat. Ensure that polyunsaturated fats (found in fish, nuts, seeds, vegetable oils) make up a larger proportion of your total fat intake, while saturated fats (found in red meat, butter, cheese) make up a smaller proportion. This shift is associated with lower mortality risk, potentially by reducing systemic inflammation.

Higher dietary resistant starch (RS) intake is associated with significantly lower all-cause and cancer mortality, but not cardiovascular disease (CVD) mortality.

To potentially lower your risk of cancer and all-cause mortality, aim to increase your intake of resistant starch. The best sources are whole grains and legumes. A key strategy is to cook starchy foods (like potatoes, rice, or pasta) and then cool them before eating, as this process increases resistant starch content. Aim for the highest intake levels seen in the study (approx. 4.7 g per 1,000 kcal of energy), but do not do this by simply eating more total carbohydrates; instead, swap digestible carbs for RS-rich foods to avoid increasing total energy intake.

High starch intake (top quartile, >28.8 E%) is associated with a significantly higher risk of cardiovascular disease and all-cause mortality compared to moderate intake (22.8-25.3 E%), creating a U-shaped risk curve.

Aim for moderate starch intake, roughly 20-30% of your total daily energy, rather than very low or very high levels. This range is associated with the lowest risk of cardiovascular disease and death in this population. Focus on the source of starch (e.g., bread, potatoes) as the study notes specific protein associations.

For non-resistance trained women, distributing resistance training volume across four weekly split-body sessions yields equivalent maximal strength, muscle mass, and explosive power gains compared to two weekly full-body sessions, provided total weekly volume is equated.

If you are new to resistance training, you do not need to commit to four gym days a week to get strong or build muscle. You can achieve the same results with just two full-body sessions per week, as long as you perform the same total amount of work (sets and reps). Choose the schedule that fits your life best, as forcing four sessions may lead to dropping out.

Competition preparation in physique athletes, characterized by severe energy restriction and intense training, causes significant reductions in IGF-1, IGFBP-3, and testosterone, along with increased cortisol and SHBG, leading to decreased muscle strength and mood disturbances, all of which are reversible upon recovery.

If you are preparing for a physique competition, expect significant drops in IGF-1, testosterone, and strength, along with increased fatigue and mood disturbances. These are normal, adaptive responses to severe energy restriction and intense training. Do not panic about temporary hormonal suppression; they will fully recover during the post-competition refeeding phase. Monitor your energy availability, but understand that some performance and hormonal decline is inevitable during the peak week.

Performing one long resistance training session results in higher perceived effort and discomfort, but also higher session pleasure and preference compared to splitting the same workout into two shorter sessions.

If you enjoy feeling like you've worked hard, do one long session. If you prefer to feel less uncomfortable during the workout, split it. Both approaches are valid; choose based on your psychological preference.

GLP-1 receptor agonists (GLP-1RA) and dual/triple incretin agonists significantly improve metabolic dysfunction-associated steatohepatitis (MASH) resolution without worsening fibrosis in patients with MASLD, primarily through indirect mechanisms involving weight loss, improved insulin sensitivity, and reduced hepatic lipogenesis.

If you have fatty liver disease (MASLD/MASH), especially with type 2 diabetes or obesity, GLP-1 based medications (like semaglutide or tirzepatide) are currently the most promising pharmacological treatment. They work by reducing liver fat, inflammation, and improving insulin sensitivity. While they may cause temporary stomach issues, they significantly increase the chance of resolving liver inflammation (MASH). The goal is to stop liver damage progression; fibrosis reversal is still being studied in larger trials. Consult a hepatologist or diabetologist for eligibility.

Long-term stable use of GLP-1 receptor agonists results in attenuated gastric emptying effects (tachyphylaxis) compared to recent initiation, reducing perioperative risk.

If you have been on your GLP-1 shot for months, your body has likely adapted, and your stomach empties more normally than when you first started. This makes surgery safer for you than for someone who just started the drug two weeks ago.

GLP-1 receptor agonists (semaglutide, liraglutide) suppress food intake and induce weight loss by targeting distinct neural pathways in the brainstem (NTS, AP, LC, VTA) and hypothalamus, rather than solely relying on peripheral vagal signaling.

GLP-1 medications like semaglutide work by directly acting on specific areas of the brain (brainstem and hypothalamus) to reduce hunger and food intake, rather than just sending signals from the gut. This central action is key to their effectiveness in treating obesity.

Tirzepatide, a dual GIP and GLP-1 receptor agonist, produces superior weight loss (up to -20.9% at 15mg) compared to placebo and established GLP-1 agonists, though it is not yet fully approved for obesity treatment in all contexts.

Tirzepatide (5-15 mg weekly) is a powerful dual-action drug that can help you lose up to 21% of your body weight. It is more effective than current GLP-1 drugs like semaglutide. However, it may not be fully approved for obesity treatment in your region yet, so discuss with your doctor if it's an option for you.

Older anti-obesity medications (Orlistat, Phentermine/Topiramate, Naltrexone/Bupropion) provide modest weight loss (3-10%) but are limited by side effects and lower efficacy compared to newer GLP-1 based therapies.

Older medications like Orlistat, Phentermine/Topiramate, and Naltrexone/Bupropion can help with weight loss (3-10%), but they are less effective than newer GLP-1 drugs. They also have specific side effects like oily stools (Orlistat) or potential mood/cognitive changes (Topiramate/Bupropion). They remain options if newer drugs are inaccessible or unaffordable.

A high-protein breakfast (34g) significantly increases subjective satiety and reduces hunger compared to a low-protein breakfast (6g) in young women with overweight, but this does not translate to reduced daily energy intake.

If you switch to a high-protein breakfast, you will likely feel fuller and less hungry in the hours after eating. However, be aware that this feeling of fullness may not automatically lead to eating less food throughout the rest of the day, as this study showed no difference in total daily energy intake.

Resistance training under hypoxic conditions (RTH) provides a trivial but statistically significant benefit for strength development (1RM) compared to normoxic training (RTN) when specific methodological variables are optimized.

If you have access to hypoxic training, you can gain a small advantage in strength over normal air training, but only if you structure your workout correctly. Focus on multi-joint exercises, do at least 9 sets per muscle group per week, and stop short of muscle failure (non-failure). Do not train to failure in hypoxia, as it may increase fatigue without adding benefit.