Browse the evidence

Perivascular Fat Attenuation Index (FAI) measured via cardiac CT serves as a biomarker for coronary inflammation and predicts cardiac mortality, with values above -70.1 HU indicating a 6- to 9-fold higher adjusted risk of future cardiac mortality.

If you are getting a heart scan for chest pain, ask your doctor about the Fat Attenuation Index (FAI). This AI-enhanced measurement looks at the fat around your heart arteries to detect hidden inflammation. A high FAI score means your risk of a heart event is much higher, even if your arteries don't look blocked yet. This helps doctors treat you before a major problem occurs.

Semaglutide does not significantly impact renal outcomes, including nephrolithiasis, acute kidney injury, or chronic kidney disease, in patients with overweight or obesity.

If you are using semaglutide for weight management or cardiovascular risk reduction, do not expect it to protect your kidneys. This meta-analysis found no significant impact on renal outcomes like kidney stones or acute kidney injury in overweight or obese patients.

Pharmacological inhibition of Complement C3 using AMY-101 improves healthspan, metabolic fitness, and reduces inflammaging in aged mice.

In aged mice, weekly injections of a C3 inhibitor (AMY-101) improved metabolic health and physical function. This suggests that targeting the complement system could be a viable strategy to combat age-related decline, potentially mimicking the benefits of caloric restriction.

Age-associated elevation of C3a in visceral adipose tissue (VAT) is primarily driven by adipose tissue macrophages (ATMs) via an autocrine ERK-dependent signaling loop.

In aging, fat tissue (specifically visceral fat) becomes a source of inflammation due to immune cells (macrophages) producing complement proteins like C3a. This process is driven by specific signaling pathways within these cells.

Obesity heritability is estimated at 40-70%, driven by over 1000 genetic variants and complex interactions with environmental and epigenetic factors, with early-onset severe obesity strongly linked to specific genetic mutations.

Recognize that obesity has a strong biological basis, with heritability estimates up to 70%. For those with early-onset severe obesity, genetic factors play a major role. This understanding supports the use of targeted therapies and early screening rather than relying solely on lifestyle advice.

Chronic hyperglycemia and oxidative stress induce beta-cell dedifferentiation by altering the balance of PAX4 and ARX gene expression, causing beta-cells to lose insulin-secreting identity and adopt alpha-cell features.

In Type 2 Diabetes, high blood sugar and stress can cause insulin-producing beta-cells to 'forget' their job and turn into glucagon-producing alpha-like cells. This is driven by epigenetic changes to genes like PAX4 and ARX. This loss of identity contributes to worsening blood sugar control, suggesting that therapies aiming to restore beta-cell identity or function could be beneficial.

Tirzepatide attenuates alcohol-induced dopamine release in the nucleus accumbens and induces sustained synaptic depression in the lateral septum.

Tirzepatide's effect on alcohol reward involves reducing dopamine release in the nucleus accumbens and altering synaptic plasticity in the lateral septum.

Finerenone, a nonsteroidal mineralocorticoid receptor antagonist, reduces the risk of heart failure and kidney disease progression in patients with chronic kidney disease and type 2 diabetes.

If you have type 2 diabetes and kidney disease, ask your doctor about finerenone. It helps protect your kidneys and heart from further damage.

Bariatric surgery in older adults (≥65 years) is associated with significantly higher rates of in-hospital mortality and complications compared to younger adults, and should be reserved for refractory cases.

Surgery is the most effective weight loss method but carries higher risks for those over 65. It should only be considered if you have severe obesity and have failed all other treatments, after a thorough risk-benefit discussion with specialists.

Cardiovascular disease (CVD) is the leading cause of death in China, accounting for 36% of deaths.

Healthcare strategies in China should prioritize addressing CVD to reduce mortality.

No significant associations were found between LCD scores and mortality risk in other racial and ethnic groups.

Practitioners should be aware that LCD scores may not be relevant for mortality risk in non-Hispanic populations.

Despite extensive research, many unknowns remain in the field of nutrition due to the difficulty of studying lifestyle factors in isolation.

Practitioners should remain aware of the complexities and uncertainties in nutrition research.

Genetically predicted higher childhood obesity, adult obesity, and increased fat-free mass are causally associated with a reduced risk of Brugada syndrome.

If you have Brugada syndrome, maintaining a BMI in the upper-normal range and increasing fat-free mass through resistance training may help reduce your risk. This contrasts with general population advice to lose weight, so consult your cardiologist about personalized weight management.

Acquired hypothalamic obesity (HO) is driven by structural damage to medial hypothalamic nuclei (ARC, PVN), leading to hyperphagia, central insulin/leptin resistance, and reduced sympathetic energy expenditure, resulting in rapid, treatment-resistant weight gain.

If you have hypothalamic obesity due to brain tumor or surgery, standard diet and exercise will likely fail because the brain's 'thermostat' is broken. You need medical interventions that target the specific hormonal pathways (like GLP-1 agonists or MC4R agonists) rather than relying on willpower alone.

Continuous postoperative pulse oximetry (CPOX) monitoring without preoperative obstructive sleep apnea (OSA) screening is a safe and effective perioperative strategy for bariatric patients.

For bariatric patients, skipping preoperative sleep testing and relying on continuous pulse oximetry monitoring after surgery is a safe alternative. This approach avoids the cost and time of preoperative screening while maintaining low complication rates, provided patients receive supplemental oxygen and monitoring during the first postoperative night.

Menopausal hormone therapy (MHT) containing estrogen does not reduce cardiovascular disease risk and may increase stroke risk in women with type 2 diabetes, making it unsuitable for primary prevention.

Do not use estrogen patches or pills to protect your heart if you have diabetes. While they help with hot flashes, they do not prevent heart attacks and may increase stroke risk. Focus on blood pressure, lipids, and blood sugar control instead.

Bariatric surgery does NOT significantly reduce the incidence of esophageal, gastric, thyroid, kidney, prostate cancers, or multiple myeloma compared to conventional treatment.

While bariatric surgery reduces many obesity-related cancers, it does not appear to significantly lower the risk of esophageal, gastric, thyroid, kidney, prostate cancers, or multiple myeloma.

Traditional nontargeted weight management strategies (lifestyle changes, anti-obesity medications, and metabolic/bariatric surgery) are frequently inadequate for patients with highly penetrant monogenic or syndromic obesity caused by rare genetic variants in the melanocortin-4 receptor (MC4R) pathway.

If you have severe, early-onset obesity and insatiable hunger (hyperphagia) that persists despite strict dieting or surgery, standard approaches may not work because of a genetic disruption in your brain's hunger signals. You should seek genetic testing and specialized care to access targeted therapies (like setmelanotide) that address the root hormonal cause rather than just calories.

Engineered E. coli Nissle strains (SYNB1618 and SYNB1934) expressing phenylalanine-degrading enzymes successfully reduce fasting plasma phenylalanine levels in patients with Phenylketonuria (PKU) in Phase 1/2a and Phase 2 trials.

For PKU patients, engineered bacteria are showing promise in clinical trials to lower blood phenylalanine levels. This could eventually offer more dietary flexibility, but these treatments are not yet widely available.

Genetically proxied activation of the glucagon-like peptide-1 receptor (GLP1RA) is causally associated with a reduced risk of schizophrenia.

This study suggests that medications activating the GLP-1 receptor (like semaglutide or liraglutide) may lower the risk of developing schizophrenia, primarily through their effect on body weight. For individuals at high risk of schizophrenia who are overweight, using these medications for weight management might offer a dual benefit of metabolic health and reduced psychiatric risk. However, this is based on genetic data, not direct clinical trials, so it should not replace standard psychiatric care.

Non-sulfated CCK peptides stimulate gastric acid secretion via CCK2 receptors, acting similarly to gastrin, whereas sulfated CCK inhibits acid secretion via CCK1 receptors.

The form of CCK matters. In rare tumors (CCKoma), non-sulfated CCK can cause ulcers by stimulating acid. In healthy individuals, sulfated CCK inhibits acid. This distinction is crucial for understanding gastric pathologies.

Higher genetically predicted BMI does not increase the risk of cancer mortality.

While higher BMI increases risks for other causes of death, this study did not find a link to cancer mortality.

Twelve weeks of dapiglutide (4 mg or 6 mg) once weekly does not produce a statistically significant reduction in body weight compared to placebo in adults with obesity.

In this study, taking 4 mg or 6 mg of dapiglutide once weekly for 12 weeks did not lead to significant weight loss compared to a placebo in people with obesity. The drug was safe, but the dose might be too low or the treatment period too short to see results. Future studies may need higher doses or longer durations.

Emergency department exposures to GLP-1 and GLP-1/GIP receptor agonists predominantly result in mild, self-limiting gastrointestinal symptoms (nausea, vomiting) that typically resolve within 8 to 24 hours with supportive care.

If you or someone else takes too much of a GLP-1 medication (like Ozempic or Wegovy), expect nausea and vomiting. These symptoms are usually mild and go away within a day. Focus on hydration and rest. Seek medical help if you feel faint, have severe abdominal pain, or cannot keep fluids down.