Browse the evidence

Endurance athletes should consume a high-carbohydrate diet of 8-10 g CHO per kg body weight per day to enhance training and performance.

Endurance athletes should prioritize carbohydrate intake to improve their performance.

Lifestyle interventions (diet and exercise) remain the most cost-effective and durable strategy for weight loss and diabetes prevention, outperforming microbiome therapies in long-term weight management.

Diet and exercise are the most effective and affordable way to lose weight and prevent diabetes. They outperform probiotics and FMT for weight loss and provide durable benefits.

Achieving type 2 diabetes remission is possible through significant weight loss (≥15 kg) induced by a very low-calorie diet (825–853 kcal/day) without surgery.

To potentially reverse type 2 diabetes, you must lose a significant amount of weight (at least 15 kg or 33 lbs). This requires a strict, medically supervised very low-calorie diet (around 850 calories/day) for 3-5 months, followed by a careful reintroduction of food. This is not a standard diet but a specific medical intervention proven to put diabetes into remission for many people.

Regular physical activity (at least 150 minutes/week of moderate-intensity) reduces all-cause and cardiovascular mortality by 20-30% and lowers the risk of type 2 diabetes by 25-35%.

Aim for at least 150 minutes of moderate-intensity aerobic exercise per week (like brisk walking). This reduces your risk of dying from heart disease or other causes by 20-30% and lowers your diabetes risk by 25-35%. If you can't do 150 minutes, start with less; any activity is better than none, and even commuting by bike helps.

Lifestyle interventions targeting abdominal obesity and physical inactivity are the first-line therapy for metabolic syndrome, with a target weight loss of 7-10% over 6-12 months to reduce cardiovascular risk and prevent type 2 diabetes.

To manage metabolic syndrome, prioritize losing 7-10% of your body weight over the next 6-12 months. Do this by eating 500-1000 fewer calories daily and walking briskly for at least 30 minutes on most days. This single approach improves blood pressure, cholesterol, and blood sugar simultaneously, reducing your risk of heart disease and diabetes more effectively than medication alone.

For patients with type 2 diabetes and established atherosclerotic cardiovascular disease (ASCVD), sodium-glucose cotransporter 2 (SGLT2) inhibitors or glucagon-like peptide 1 (GLP-1) receptor agonists with proven cardiovascular benefit are recommended as part of glycemic management, regardless of baseline HbA1c.

If you have type 2 diabetes and a history of heart disease (like a heart attack or stroke), your doctor should prioritize medications that protect your heart, specifically SGLT2 inhibitors (like empagliflozin) or GLP-1 agonists (like liraglutide), even if your blood sugar is already reasonably controlled. This is a major shift from older guidelines that focused only on lowering blood sugar numbers.

Increasing physical activity from a sedentary lifestyle to an active one in middle adulthood significantly reduces the risk of coronary events compared to remaining sedentary.

If you have been inactive, starting to exercise in middle age still provides significant protection against heart disease. You do not need to have been active your whole life to benefit; the key is to transition from sedentary to active.

High intake of trans fatty acids from partially hydrogenated vegetable oils increases the risk of coronary heart disease and should be eliminated.

Avoid foods with 'partially hydrogenated oils' on the ingredient list, as these contain industrial trans fats which increase heart disease risk. You do not need to avoid small amounts of trans fats naturally found in meat and dairy, as these do not appear to increase risk.

Intensive lifestyle intervention targeting 7% weight loss and 150 minutes of weekly physical activity reduces the incidence of type 2 diabetes in prediabetic adults by 58% compared to placebo.

To prevent type 2 diabetes, aim to lose 7% of your body weight and get at least 150 minutes of moderate physical activity each week. This can be achieved through dietary changes and regular exercise, such as brisk walking. Consistency is key, and structured support programs can help maintain these habits over the long term.

Total daily protein intake of ~1.6 g/kg/day (up to 2.2 g/kg/day) is the primary determinant of chronic muscle hypertrophy, whereas per-meal timing, dose, and source have negligible impact on long-term muscle accretion if total daily intake is met.

Focus on hitting a total daily protein target of roughly 1.6 grams per kilogram of body weight. This is the most important lever for building muscle. You do not need to obsess over eating protein immediately after your workout or buying expensive 'anabolic' supplements. Simply distribute your daily protein across 3-4 meals to reach this total.

Postexercise protein consumption promotes a pronounced rise in muscle protein synthesis (MPS) and suppresses muscle protein breakdown (MPB), leading to increased net protein balance and hypertrophy.

Consume protein after your resistance training session to maximize muscle growth. This stimulates muscle protein synthesis and reduces breakdown, creating a positive net balance. While the exact timing is less critical than total daily intake, postexercise consumption is a key strategy for hypertrophy.

Lifestyle interventions combining diet and moderate-intensity physical activity (≥150 min/week) with a goal of modest weight loss (7%) are more effective than pharmacological intervention (metformin) in preventing or delaying type 2 diabetes in high-risk individuals (prediabetes).

If you have prediabetes, prioritize lifestyle changes over medication if possible. Aim for a 7% weight loss and 150 minutes of moderate exercise per week. This approach was shown to be nearly twice as effective as metformin in preventing type 2 diabetes in the Diabetes Prevention Program.

Resistance exercise and protein consumption synergistically stimulate muscle protein synthesis (MPS) and net protein balance (NPB) to a greater extent than either intervention alone.

To build muscle, you must combine resistance exercise with protein intake. Exercise alone stimulates muscle protein synthesis, but without dietary protein, your net protein balance remains negative, preventing growth.

Performing 10 or more sets per muscle group per week maximizes muscle hypertrophy compared to lower volumes, with a clear dose-response relationship observed across <5, 5–9, and 10+ set categories.

To maximize muscle growth, aim for at least 10 sets per muscle group per week. Start with this volume and adjust based on your recovery and progress. If you are short on time, 4 sets per muscle per week will still produce substantial gains, but 10+ is the target for maximum hypertrophy. Periodize your volume, increasing it over months to promote growth, then deload to recover.

Highly effective anti-obesity medications (AOMs), specifically nutrient-stimulated hormone-based therapies (NuSH-BTs) like semaglutide and tirzepatide, induce mean weight loss of 15% or more, significantly outperforming lifestyle interventions alone.

If you have obesity, lifestyle changes alone often result in modest, temporary weight loss. Newer hormone-based medications (like semaglutide or tirzepatide) are highly effective, causing an average 15-20% weight loss. These require a prescription and slow dose titration to manage side effects, but they offer a significant advantage over lifestyle changes alone for achieving substantial health improvements.

For adults with type 2 diabetes and established atherosclerotic cardiovascular disease or high risk, glucagon-like peptide 1 receptor agonists (GLP1RAs) or sodium glucose cotransporter 2 inhibitors (SGLT2is) should be initiated as first-line therapy regardless of baseline HbA1c levels to reduce major adverse cardiovascular events.

If you have type 2 diabetes and heart disease or high heart risk, ask your doctor about GLP-1 agonists (like semaglutide) or SGLT-2 inhibitors (like empagliflozin). These drugs protect your heart and kidneys and are recommended even if your blood sugar numbers look okay. They are often more effective for long-term health than older drugs like metformin alone, though insurance coverage can be a hurdle.

Weight loss of 5-10% achieved through caloric restriction and/or increased physical activity is the first-line, evidence-based treatment for NAFLD, with specific thresholds required for steatosis reduction (≥5%), inflammation improvement (7-10%), and fibrosis improvement (≥10%).

Aim for a 5-10% reduction in body weight through a caloric deficit. You do not need to follow a specific 'liver diet' like Keto or Low-Fat; choose a sustainable healthy pattern (like Mediterranean) that you can maintain. Combine this with at least 150 minutes of moderate exercise per week. Even if you are normal weight, losing 3-5% of your body weight can improve liver fat.

Trans fats (industrial trans-fatty acids) are unequivocally harmful and should be completely avoided as they raise LDL-C, TGs, and Apo B while lowering HDL-C.

Completely avoid industrial trans fats. Check labels for 'partially hydrogenated oils' and avoid fried foods, baked goods, and processed snacks containing them. Opt for fresh, unprocessed foods and healthy cooking oils like olive or canola oil.

SGLT2 inhibitors and GLP-1 receptor agonists provide significant cardiovascular risk reduction and should be considered first-line therapy for patients with type 2 diabetes and established cardiovascular disease.

If you have Type 2 Diabetes and existing heart disease, ask your doctor about SGLT2 inhibitors (like empagliflozin) or GLP-1 receptor agonists (like semaglutide). These drugs are now considered first-line because they protect your heart and reduce the risk of heart attack and stroke, in addition to controlling blood sugar. This is more important than just lowering your A1C number.

Lifestyle intervention (diet, physical activity, behavioral changes) is the cornerstone of obesity treatment and should be initiated in all patients, regardless of whether pharmacotherapy or surgery is added.

Start with lifestyle changes: diet, exercise, and behavior. This is the base for everyone. If you need medication or surgery, it only works well if you keep doing these lifestyle changes.

Resistance exercise is the only intervention capable of consistently restoring muscle function and strength in sarcopenia, partially overcoming age-related anabolic resistance.

You must lift weights to regain strength and function. Aim for 2-3 sessions per week at a moderate-to-vigorous intensity (70-85% of your max). This mechanical load is the key signal your body needs to rebuild muscle function, which nutrition alone cannot provide.

Statins are the first-line pharmacologic therapy for lowering LDL-C and reducing cardiovascular events in patients with Type 2 Diabetes, regardless of baseline cholesterol levels.

If you have Type 2 Diabetes, talk to your doctor about starting a statin. It is the most effective way to lower your risk of heart attack and stroke, even if your cholesterol numbers look okay. Lifestyle changes are important, but statins provide the strongest protection.

Lifestyle interventions (diet, exercise, weight loss, smoking cessation) significantly reduce the risk of developing Type 2 Diabetes, cardiovascular disease, and chronic kidney disease progression.

Adopting a healthy lifestyle is the most powerful tool for preventing heart, kidney, and metabolic disease. Focus on a balanced diet, regular physical activity (aiming for 150 minutes per week), maintaining a healthy weight, and quitting smoking. These changes can reduce your risk of developing diabetes by up to 72% and significantly lower your cardiovascular risk.

Comprehensive lifestyle interventions consisting of diet, physical activity, and behavior therapy produce clinically meaningful weight loss (6-8% of initial body weight) and reduce the risk of type 2 diabetes, provided a caloric deficit of at least 500 kcal/day is maintained.

To lose weight, you must create a daily caloric deficit of at least 500 calories. You can achieve this through various diets (low-carb, low-fat, etc.) as long as you stick to a calorie target (1,200-1,500 kcal for women, 1,500-1,800 kcal for men). Combine this with 150 minutes of weekly exercise and behavioral strategies like tracking food intake for best results.