Browse the evidence

A long-term intensive lifestyle intervention (ILI) focused on weight loss and physical activity significantly reduces the symptoms of diabetic peripheral neuropathy (DPN) in overweight or obese adults with type 2 diabetes, as measured by the Michigan Neuropathy Screening Instrument (MNSI) questionnaire.

For individuals with type 2 diabetes and excess weight, achieving and maintaining weight loss through diet and exercise can significantly reduce the symptoms of nerve pain and numbness associated with diabetic neuropathy. The benefits are linked to the amount of weight lost, suggesting that even modest, sustained weight loss efforts can protect nerve health over the long term.

Higher velocity loss (VL) thresholds during resistance training (typically >30-40%) are superior for inducing muscle hypertrophy, whereas lower VL thresholds (10-20%) are superior for optimizing power-related adaptations such as jumping, sprinting, and velocity against submaximal loads.

If your main goal is building muscle size, allow your bar speed to drop significantly (30-40% loss) by the end of your sets. If your main goal is jumping higher or sprinting faster, stop your sets earlier when your speed drops only a little (10-20%). Do not use high-velocity-loss sets for power exercises if you want to improve power, as the fatigue will hinder your performance gains.

Survodutide, a dual glucagon/GLP-1 receptor agonist, produces dose-dependent reductions in HbA1c and bodyweight in people with type 2 diabetes, with doses ≥1.8 mg once weekly yielding greater bodyweight loss than semaglutide 1.0 mg.

For individuals with type 2 diabetes seeking significant weight loss and glucose control, dual GLP-1/GCGR agonists like survodutide offer superior bodyweight reduction compared to standard GLP-1 therapies like semaglutide, particularly at doses of 1.8 mg/week or higher. Expect gastrointestinal side effects, which can be managed by starting with lower doses and escalating slowly.

Low-carbohydrate diets (<40% carbs) significantly reduce triglyceride levels and body weight, and increase HDL-C, with effects being most pronounced in interventions lasting less than 11 months.

Adopting a diet where less than 40% of calories come from carbohydrates can help lower triglycerides, reduce body weight, and improve HDL cholesterol, particularly if you stick with it for under a year. While LDL cholesterol might rise slightly, the overall shift in lipid particles and triglyceride reduction suggests a net benefit for heart health compared to standard diets.

Adherence to a dietary pattern high in chocolate, confectionery, butter, and low-fiber bread (and low in fruit/vegetables) is associated with a significantly increased risk of total and fatal cardiovascular disease and all-cause mortality.

Avoid combining high-fat, low-fiber foods (like butter on white bread, chocolate, confectionery) in your daily diet. This specific combination is strongly linked to higher risks of heart disease and early death. Prioritize fresh fruits, vegetables, and high-fiber cereals instead. If you consume these items, ensure they are part of a broader diet rich in fiber and plant foods to mitigate risk.

Once-weekly subcutaneous administration of GLP-1R/GIPR dual agonist tirzepatide (up to 15 mg/week) significantly reduces HbA1c and body weight in patients with type 2 diabetes, with efficacy exceeding current GLP-1RAs.

If you have type 2 diabetes and struggle with weight, ask your doctor about tirzepatide. It is a once-weekly injection that has been shown to lower blood sugar and reduce body weight more effectively than older GLP-1 drugs. While injections can be a barrier, oral options exist for other drugs in this class.

Combining the amylin analogue cagrilintide (4.5 mg/week) with semaglutide (2.4 mg/week) results in greater weight loss (15.4% reduction) than either agent alone in obese or overweight individuals.

For significant weight loss, combining cagrilintide and semaglutide has shown a 15.4% body weight reduction in 20 weeks. This combination therapy is an option for those who do not achieve sufficient weight loss with single-agent GLP-1 therapy.

Female athletes should maintain an energy availability of 40–45 kcal/kg fat-free mass per day to sustain eumenorrhea, bone health, and metabolic function, as habitual low energy availability leads to Relative Energy Deficiency in Sport (RED-S) or the Female Athlete Triad.

Calculate your daily energy needs by adding your basal metabolic rate to the energy cost of your exercise. Ensure the remaining calories (Energy Availability) are at least 40-45 kcal per kg of fat-free mass. If you are skipping meals or restricting calories to lose weight, you risk losing your period and bone density. Prioritize fueling your training to support your body's structural integrity.

Female endurance athletes should consume 8-10 g of carbohydrates per kg of body weight in the 3 days leading up to an event (carbohydrate loading) to maximize muscle glycogen stores, with particular emphasis on this strategy during the luteal phase of the menstrual cycle.

Three days before your big race or long event, increase your carbohydrate intake to 8-10 grams for every kilogram of your body weight. This means eating more pasta, rice, and fruits than usual. This strategy fills your muscle glycogen stores, giving you more energy for the event. This is especially important if you are in the luteal phase (second half) of your menstrual cycle, as your body may burn through glycogen faster.

Female athletes should consume 1 g of carbohydrates per kg of body weight in the hours prior to aerobic exercise to maximize carbohydrate availability, as pre-exercise feeding is likely more important during the follicular phase when carbohydrate oxidation rates are elevated.

One to four hours before your aerobic workout or race, eat carbohydrates equal to 1 gram per kilogram of your body weight. For example, if you weigh 60 kg, eat 60 grams of carbs (e.g., a banana and a small bowl of oatmeal). This helps ensure you have enough fuel for your muscles, especially if you are in the first half of your menstrual cycle.

Female athletes should consume 500-1000 mL of a 6% carbohydrate solution per hour during prolonged endurance exercise (>90 minutes) to experience ergogenic effects, regardless of menstrual cycle phase.

If you are exercising for more than 90 minutes, drink 500-1000 mL of a 6% carbohydrate solution (like a sports drink) every hour. This helps maintain your blood sugar and energy levels, improving your performance. This strategy works regardless of where you are in your menstrual cycle.

Female athletes should rapidly consume at least 0.75 g of carbohydrates per kg of body weight immediately following prolonged exercise to maximize muscle glycogen resynthesis rates.

Right after your long workout, eat carbohydrates equal to 0.75 grams per kilogram of your body weight. For example, if you weigh 60 kg, eat 45 grams of carbs (e.g., a chocolate milk and a granola bar). This helps your muscles recover and replenish their energy stores quickly.

Intensive lifestyle interventions, such as the Look AHEAD program, can produce significant long-term weight loss (6%) in people with type 2 diabetes, and are generally cost-effective compared to population obesity trends.

For individuals with severe obesity and type 2 diabetes, intensive lifestyle interventions like the Look AHEAD program can lead to significant long-term weight loss (6%) and are cost-effective. Consistency and intensity are key.

Insufficient or fragmented sleep reduces skeletal muscle protein synthesis rates and promotes a catabolic hormonal environment (elevated cortisol, reduced testosterone/GH), leading to potential loss of lean mass and strength over time.

Prioritize 7-9 hours of sleep nightly to protect muscle mass. Sleep loss directly reduces your body's ability to build muscle (protein synthesis) and shifts hormones toward breaking it down (catabolism). If you are training hard, poor sleep undermines your gains more than you might think. Consistency in sleep duration is as important as consistency in training.

High-intensity interval training (HIT) performed 3 times per week for approximately 15 minutes total induces rapid improvements in cardiovascular fitness, skeletal muscle mitochondrial density, and insulin sensitivity in previously untrained individuals.

If you are new to exercise or short on time, try High-Intensity Interval Training (HIT). Perform 4-10 bouts of 30 seconds to 4 minutes of intense effort, with 1-3 minutes of rest in between, 3 times a week. This totals about 15 minutes of intense work and can rapidly improve your fitness and insulin sensitivity.

Low-load (30% 1RM) high-volume resistance exercise until volitional failure stimulates muscle protein synthesis at rates similar to high-load (90% 1RM) exercise, making it suitable for maintaining lean mass in previously untrained and elderly individuals.

If you are elderly or new to resistance training, you can maintain muscle mass by performing low-load exercises (using bodyweight or light bands) until you reach muscle failure. Combine this with a daily protein intake of 1.2 g/kg body weight for best results.

Regular physical exercise training significantly improves insulin sensitivity and reduces cardiovascular risk factors (including blood pressure, HbA1c, and lipid profiles) in subjects with insulin resistance, metabolic syndrome, or type 2 diabetes.

Engage in regular physical activity, prioritizing aerobic exercise for metabolic syndrome components. Aim for higher volumes (approaching 170 minutes/week) if possible, as duration appears to drive insulin sensitivity improvements more than intensity alone. Combine exercise with dietary changes for best weight maintenance results. Do not abandon exercise if scale weight changes are modest; the cardiovascular and metabolic benefits (lower BP, better insulin sensitivity) are significant even without major weight loss.

Combined aerobic interval training (AIT) and weight loss via low-energy diet (LED) produces superior body composition improvements (weight, fat mass, waist circumference) compared to AIT alone in overweight CAD patients, while both interventions yield similar improvements in VO2peak and lipid profiles.

For overweight CAD patients, combining aerobic interval training with a short-term, supervised low-energy diet yields significantly better fat loss and waist reduction than exercise alone. Both approaches improve heart health (VO2peak, lipids), but adding a calorie-restricted diet is crucial for body composition goals.

Weight loss significantly reduces the risk of postmenopausal breast cancer, with a dose-response relationship where greater weight loss leads to greater decreases in estrogen and increased sex hormone-binding globulin (SHBG).

If you are postmenopausal and overweight, losing even a small amount of weight (more than 5% of your body weight) can significantly lower your risk of breast cancer. This happens because losing fat reduces the amount of estrogen your body produces and increases the protein that binds up remaining estrogen, protecting your breast tissue. You don't need to reach an 'ideal' weight to see benefits; the act of losing weight itself changes your hormonal environment in a protective way.

In-season Enhanced Negative Work-based Training (ENT) using a flywheel device significantly improves change of direction (COD) ability in semi-professional soccer players, whereas traditional weight training does not.

If you are a semi-professional soccer player in-season, adding one weekly session of flywheel-based eccentric training (focusing on controlled braking during squats) can significantly improve your change of direction speed. Traditional weight training at the same volume does not provide this specific benefit. Focus on controlling the descent phase of the squat to mimic the braking forces used in soccer.

Enhanced Negative Work-based Training (ENT) improves the hamstrings-to-quadriceps (H:Q) ratio in semi-professional soccer players, potentially reducing injury risk, while traditional weight training does not.

To reduce hamstring injury risk, incorporate flywheel-based eccentric training into your weekly routine. This specific type of training improves the balance between hamstring and quadriceps strength, which traditional weight training fails to do. This is particularly important during the competitive season.

High-frequency self-weighing (≥3 times per week) is a significant predictor of clinically significant weight loss (≥5% baseline weight) in commercial weight-loss interventions.

Weigh yourself at least three times a week. Do not weigh daily if it causes stress, but do not skip weeks. Consistency is the key predictor of success. Use the data to adjust your behavior, not to judge your worth.

Logging food intake on at least three days per week is a significant predictor of clinically significant weight loss (≥5% baseline weight).

Log your food on at least three days a week. You do not need to log every single day to see results. Consistency in logging, even if partial, is a strong predictor of weight loss success.

Achieving a minimum of 60 highly active minutes per week is a significant predictor of clinically significant weight loss (≥5% baseline weight).

Aim for at least 60 minutes of high-intensity activity per week. This can be broken into short bursts. This level of activity is a strong predictor of reaching a 5% weight loss goal.