Browse the evidence

In obese patients with type 2 diabetes, GLP-1 receptor agonists significantly reduce the risk of major adverse cardiovascular events (MACE) compared to placebo, whereas SGLT-2 inhibitors show a non-significant trend.

If you have type 2 diabetes and are obese, GLP-1 receptor agonists (like liraglutide, semaglutide, or dulaglutide) have been proven to significantly lower your risk of major heart events compared to a placebo. SGLT-2 inhibitors also help but did not reach statistical significance in this specific obese subgroup analysis. Discuss GLP-1 RAs with your doctor as a first-line treatment for cardiovascular protection.

Regular aerobic and resistance exercise training significantly improves cardiorespiratory fitness (VO2peak) in adults with type 2 diabetes, with greater relative improvements observed in those with lower baseline fitness.

If you have type 2 diabetes and feel too tired or uncomfortable to exercise, start with 'conditioning' rather than intense workouts. Focus on gentle stretching, warm-ups, and cool-downs. Supervised aerobic exercise (60 mins, 3x/week at 70-85% max heart rate) has been shown to significantly improve your fitness (VO2peak) even more than in non-diabetic peers. Use wearable trackers or continuous glucose monitors for real-time feedback to boost motivation and self-efficacy.

The use of Continuous Glucose Monitors (CGMs) as a real-time feedback tool increases self-efficacy, exercise attendance, and total exercise time in adults with type 2 diabetes, even in those not on intensive insulin therapy.

If you have type 2 diabetes, using a Continuous Glucose Monitor (CGM) during exercise can help you see how your body responds in real-time. This feedback can boost your confidence (self-efficacy) and motivate you to exercise more, even if you aren't on insulin. Look for programs that cover CGMs for behavior change, as they can lead to increased exercise time and better metabolic control.

Wearable activity trackers (e.g., Fitbit) significantly increase daily step count and walking minutes in adults with type 2 diabetes compared to non-tracker interventions.

Wearing a simple activity tracker like a Fitbit can help you walk more. Studies show it adds an average of 627 steps per day. Set simple step goals and use the real-time feedback to stay motivated. Social accountability, such as sharing progress with a coach or group, can further enhance adherence.

Optimizing resistance training in hypoxia with moderate loads (60-80% 1RM) and short inter-set rest intervals (≤ 60s) enhances muscle hypertrophy (CSA) compared to normoxia.

If you train in hypoxia, use moderate weights (60-80% 1RM) and keep rest periods short (under 60 seconds) to potentially maximize muscle growth. Without these specific settings, hypoxia offers no advantage over normal air.

Significant weight loss (induced by metabolic surgery, very-low-calorie diets, or intensive insulin therapy) prior to irreversible beta-cell damage can induce durable remission of type 2 diabetes, defined as HbA1c <6.5% without medication.

If you have recently been diagnosed with Type 2 Diabetes, especially if overweight, aggressive intervention is critical. This may involve significant weight loss through very-low-calorie diets, metabolic surgery, or short-term intensive insulin therapy. The goal is to restore beta-cell function before damage becomes irreversible, potentially allowing you to stop medication and maintain normal blood sugar levels.

Once-daily oral semaglutide (3–14 mg) significantly reduces HbA1c (mean -1.16%-points) and body weight (mean -5.84 kg) in adults with type 2 diabetes over 34–44 weeks, with 47.5% achieving HbA1c < 7.0% and 35.5% achieving composite targets (HbA1c reduction ≥ 1.0%-points plus body weight reduction ≥ 5%).

If you have Type 2 Diabetes and are struggling with blood sugar and weight, oral semaglutide is a proven, once-daily option that can significantly lower your HbA1c and help you lose weight. Most people find it easy to take, and while stomach issues can happen, they are usually mild. It is particularly useful if you want to avoid injections.

Older adults require higher per-meal protein doses (0.40 g/kg) compared to younger adults (0.24 g/kg) to achieve maximal muscle protein synthesis due to anabolic resistance.

If you are over 60, you likely need more protein per meal than you think to build or keep muscle. Aim for about 0.4 grams of high-quality protein per kilogram of your body weight at each main meal (breakfast, lunch, dinner). This is roughly double the amount needed by a 20-year-old to trigger the same muscle-building response. Combine this with resistance exercise for best results.

Current Recommended Dietary Allowance (RDA) of 0.8 g/kg/day for protein is likely an underestimate for older adults and should be increased to 1.0-1.2 g/kg/day to support healthy muscle ageing.

If you are an older adult, aim for 1.0 to 1.2 grams of protein per kilogram of body weight every day. This is higher than the standard government recommendation of 0.8 g/kg. Spread this protein evenly across your meals (about 0.4 g/kg per meal) and combine it with strength training. This helps maintain muscle mass and function without harming healthy kidneys or bones.

Suboptimal dietary patterns, specifically low intake of nuts, seeds, and fruits, and high intake of processed meat, are responsible for over half (53.8%) of all cardiometabolic disease mortality in Latin America and the Caribbean.

In Latin America and the Caribbean, fixing your diet is the single most impactful thing you can do to prevent heart disease and diabetes death. Focus on eating more nuts, seeds, and fruits, and cutting back on processed meats. These specific changes address the majority of diet-related risk in the region.

Increasing fruit consumption is the most effective dietary intervention for reducing diet-attributable cardiometabolic mortality trends over time, having driven the greatest decline (35%) in such deaths between 1990 and 2010.

If you want to lower your risk of heart disease or diabetes, eating more fruit is one of the most powerful steps you can take. Historical data from the region shows that increasing fruit intake has been the biggest driver in reducing diet-related deaths.

Internet-based personalised nutrition interventions yield greater dietary improvements in older adults, women, and individuals with lower baseline diet quality compared to general dietary advice.

If you are older, female, or currently eating a low-quality diet, you are statistically more likely to see significant dietary improvements from a personalised online nutrition program than younger men with already healthy diets. Look for programs that offer deep personalization (genetic/phenotypic data) if you fall into these high-benefit categories.

Psychological factors, specifically the desire to improve health and self-efficacy, are stronger predictors of benefit from personalised nutrition than genetic risk alleles.

Your mindset matters more than your DNA when starting a personalised nutrition plan. If you are motivated to improve your health and believe you can stick to healthy choices, you are more likely to succeed. Don't let genetic test results discourage you; focus on building self-efficacy.

Once-weekly subcutaneous semaglutide 2.4 mg injection is a cost-effective weight management therapy in the UK compared to diet and exercise alone, yielding an ICER of £14,827/QALY gained.

For patients in the UK with obesity and comorbidities, once-weekly semaglutide 2.4 mg combined with diet and exercise is a cost-effective treatment option approved by NICE. It offers significant health benefits over diet and exercise alone, with a stopping rule to ensure efficacy (5% weight loss at 6 months).

Supplementation with 15g of specific collagen peptides immediately following high-load resistance exercise significantly upregulates gene expression in the PI3K-Akt and MAPK anabolic signaling pathways in human skeletal muscle compared to placebo.

If you perform high-load resistance training, consuming 15g of specific collagen peptides immediately afterward may enhance the activation of key muscle-building signaling pathways (PI3K-Akt and MAPK) in your muscles compared to not taking them. This suggests collagen peptides can play a role in muscle adaptation when paired with exercise, even if they are not a complete protein source like whey.

Achieving a body weight loss of 5% or greater within 12 weeks of initiating SGLT2 inhibitor treatment significantly reduces the risk of new-onset atrial fibrillation in patients with type 2 diabetes.

If you are taking an SGLT2 inhibitor for Type 2 Diabetes, aim for a body weight loss of at least 5% within the first 3 months. This specific threshold is associated with a significantly lower risk of developing atrial fibrillation compared to those who do not lose weight. However, this weight loss benefit did not extend to reducing heart failure hospitalizations or other major cardiovascular events in this study.

Semaglutide 2.4 mg is the most cost-effective weight-management pharmacotherapy in Canada compared to standard of care (diet and exercise) and other approved drugs, primarily due to its superior ability to delay or prevent type 2 diabetes, sleep apnea, and cardiovascular events.

For adults in Canada with obesity (BMI ≥30 or ≥27 with comorbidities), Semaglutide 2.4 mg is currently the most cost-effective pharmacological treatment compared to diet/exercise alone or other drugs like Orlistat. It works by acting as a GLP-1 receptor agonist to promote weight loss and improve metabolic health. While it requires weekly injections and has a higher upfront cost, it significantly reduces the long-term risk of type 2 diabetes, cardiovascular events, and sleep apnea, making it a superior value for money in the Canadian healthcare system.

Weight loss interventions, including bariatric surgery, specific diets (Mediterranean, Low-Carbohydrate, VLCKD), and GLP-1 receptor agonists (Liraglutide, Semaglutide, Dulaglutide, Tirzepatide), improve renal outcomes by reducing albuminuria and improving eGFR.

If you have obesity and kidney concerns, weight loss is critical. Bariatric surgery, GLP-1 medications (like Semaglutide or Tirzepatide), and structured diets (Mediterranean or Low-Carb) can significantly reduce kidney damage risk. Consult a doctor before starting VLCKD if you have existing kidney disease.

A personalized, team-based lifestyle intervention (dietitian, kinesiologist, physician) improves dietary quality and reduces energy intake in patients with metabolic syndrome, with the most significant improvements occurring within the first 3 months and being maintained at 12 months.

If you have metabolic syndrome, don't try to force yourself into a rigid, one-size-fits-all diet. Instead, work with a team (doctor, dietitian, exercise expert) to make small, personalized changes to your food habits. Focus on increasing fruits, vegetables, and nuts, and reducing processed foods and sugars. You will likely see the biggest improvements in your diet quality within the first 3 months, and these changes can be maintained long-term without needing to be perfect.

Intermittent energy restriction (IER) using moderate energy restriction interspersed with diet breaks achieves equivalent fat loss and fat-free mass retention compared to continuous energy restriction (CER) in resistance-trained adults, while significantly reducing hunger and desire to eat.

If you are resistance-trained and want to lose fat, using an intermittent dieting strategy (e.g., 3 weeks of moderate restriction followed by 1 week of maintenance calories) is just as effective for preserving muscle and losing fat as continuous dieting. The key advantage is that this approach significantly reduces hunger and desire to eat, making the diet easier to follow psychologically. Ensure you consume 2.3g of protein per kg of body weight daily and maintain your resistance training routine.

Aggressive weight loss via lifestyle modifications or bariatric surgery is the key intervention to reverse adverse left ventricular remodeling and improve outcomes in the obese-diabetic phenotype of heart failure with preserved ejection fraction (HFpEF).

If you have HFpEF and are obese, losing weight is the most effective way to fix the heart's stiffness. This can be done through lifestyle changes or surgery. Standard heart failure drugs often don't fix the underlying structural changes in this specific group, so focusing on reducing fat mass is critical.

Combination therapy of semaglutide (2.4 mg) and cagrilintide (2.4 mg) (CagriSema) produces weight loss (~15.6%) and HbA1c reduction (~2.2%) comparable to the highest dose of tirzepatide (15 mg) in patients with Type 2 Diabetes.

For patients with Type 2 Diabetes and obesity, a new combination injection (CagriSema) containing semaglutide and cagrilintide (both 2.4 mg weekly) achieves significant weight loss (15.6%) and blood sugar control (HbA1c reduction 2.2%), comparable to the highest dose of tirzepatide. This offers a potent option for those who need both glucose and weight management.

Older adults require higher per-meal doses of high-quality, nutrient-dense protein (NDP) to overcome age-related anabolic resistance and maximize muscle protein synthesis (MPS).

Older adults should aim for 30-45 grams of high-quality protein (like eggs, meat, or dairy) at each main meal, paired with resistance exercise. This higher dose is necessary to overcome the body's reduced sensitivity to protein as we age, helping to preserve muscle mass and strength. Focus on nutrient-dense sources rather than just quantity.

A 1-year mHealth intervention using motivational interviewing calls and SMS text messages produces sustained, statistically significant reductions in body weight and BMI four years after the intervention concludes, with greater effects observed in participants receiving at least 50% of the scheduled calls.

If you have prehypertension and live in a resource-limited setting, a structured mobile health program involving monthly coaching calls and weekly text reminders can help you lose weight and keep it off for years. You don't need to be perfect; receiving half or more of the scheduled calls was enough to see significant, lasting benefits in body weight and BMI. Focus on the core behaviors: reducing sodium, fat, and sugar, while increasing fruits, vegetables, and physical activity.