Browse the evidence

Low Energy Availability (LEA), defined as energy availability < 30 kcal/kg fat-free mass (FFM) per day, causes detrimental physiological adaptations including endocrine suppression, reduced bone mineral density, and impaired performance in both male and female athletes.

Ensure your daily energy intake minus exercise expenditure is at least 30 kcal per kg of fat-free mass. If you are an athlete, especially in weight-sensitive sports, monitor for signs of LEA such as fatigue, menstrual irregularities (in females), or decreased performance. Consult with sports dietitians and medical professionals to adjust nutrition and training loads appropriately.

Eccentric resistance training produces greater neuromuscular adaptations (strength, power, hypertrophy) than concentric or traditional resistance training due to supramaximal force production and specific morphological changes.

Incorporate eccentric emphasis into your training to maximize strength and power. Use heavy loads or fast lengthening velocities for optimal results. Manage muscle soreness through proper planning and exposure.

Engaging in moderate-to-vigorous physical activity (MVPA) for at least 150 minutes per week is associated with a significantly higher probability of successful ageing in adults aged 60-83, regardless of whether the activity is accumulated in short bouts (<10 minutes) or long bouts (≥10 minutes).

To support successful ageing, aim for at least 150 minutes of moderate-to-vigorous physical activity each week. You do not need to exercise in continuous 10-minute blocks; short bursts of activity (even under 10 minutes) provide similar benefits. Focus on accumulating this total time through any means possible, such as brisk walking, gardening, or household chores.

Tirzepatide at 15 mg and maximum tolerated dose (MTD) provides superior weight loss efficacy compared to semaglutide (2.4 mg and MTD) in non-diabetic adults with obesity, but this benefit is offset by significantly higher rates of gastrointestinal side effects and treatment discontinuation.

If you are a non-diabetic adult with obesity seeking maximum weight loss, tirzepatide at 15mg or MTD is statistically more effective than semaglutide. However, you must accept a higher risk of gastrointestinal side effects and a higher chance of stopping the medication due to those side effects. Discuss your tolerance for potential side effects versus the desire for maximum weight loss with your provider.

Very Low-Energy Diets (VLEDs, <800 kcal/d) produce significantly greater short-term weight loss than Low-Energy Diets (LEDs, 800-1800 kcal/d), but this advantage diminishes and becomes statistically non-significant after 12 months.

If you need rapid weight loss (e.g., for surgery or diabetes remission), a medically supervised Very Low-Energy Diet (<800 kcal) works faster than standard diets. However, do not expect this advantage to last beyond a year. The key is using VLED as a short-term tool (12-20 weeks) to achieve a significant initial loss, then carefully transitioning to a sustainable maintenance diet to keep the weight off.

Low-Carbohydrate Diets (LCDs) produce greater short-term weight loss than Low-Fat Diets (LFDs), but this difference disappears after 12 months when both diets are isocaloric.

If you prefer eating less bread and pasta, a Low-Carbohydrate Diet will likely help you lose weight faster in the first 6 months than a low-fat diet. However, after a year, your results will likely be similar to someone eating a low-fat diet, provided you are eating the same number of calories. Choose the diet you can adhere to long-term.

Subcutaneous semaglutide (up to 2.4 mg weekly) produces a mean weight reduction of 11.85% in adults with obesity without diabetes compared to placebo, though it significantly increases the risk of gastrointestinal adverse events and treatment discontinuation.

If you have obesity without diabetes, semaglutide (up to 2.4 mg weekly) can help you lose about 12% of your body weight, which is significantly more than placebo. However, you must be prepared for a high likelihood of temporary stomach issues like nausea or diarrhea. These side effects are common but usually mild and go away. You will also need to follow a reduced-calorie diet and exercise plan alongside the medication for best results.

A low-carbohydrate diet (26% of calories) significantly reduces serum triglycerides when combined with calorie restriction, but not when low-carbohydrate is applied without calorie restriction.

If you want to improve your blood triglyceride levels, a low-carbohydrate diet alone may not be enough. You need to combine low-carbohydrate intake (26% of calories) with calorie restriction (1200-1500 kcal/day) to see significant reductions in triglycerides. This combination was the only one to significantly lower triglycerides in this study.

Increasing consumption of whole, fresh fruit promotes weight maintenance or modest weight loss and does not contribute to excess energy intake or adiposity.

You do not need to fear fruit for weight loss. Eating more whole, fresh fruit is likely to help you maintain your weight or lose a small amount of weight, rather than causing gain. Focus on whole fruits (apples, berries, etc.) rather than juices or dried fruits, as the fiber and water content help you feel full without consuming excess calories.

Semaglutide significantly reduces Major Adverse Cardiovascular Events (MACE) and hospitalization for heart failure (HHF) risk, while Tirzepatide significantly reduces HHF risk, offering cardiovascular protection beyond weight loss.

If you have obesity and cardiovascular disease or heart failure, Semaglutide and Tirzepatide are not just weight loss drugs; they offer proven cardiovascular protection. Semaglutide reduces the risk of major heart events, and Tirzepatide reduces hospitalizations for heart failure. These benefits are independent of, but additive to, the weight loss achieved.

Protein supplementation alone does not increase muscle strength; resistance training is an absolute prerequisite for protein to exert a synergistic effect on strength gains.

Do not expect muscle strength gains from protein supplements alone. If you are not lifting weights, increasing your protein intake will not make you stronger. Protein only amplifies the strength gains generated by resistance training.

Ultraprocessed food consumption is a primary driver of obesity due to high energy density, low satiety, and ease of overconsumption.

Reduce your intake of ultraprocessed foods (high in fats, sugars, and energy density). Focus on whole foods like fruits, vegetables, and grains to manage portion sizes and energy intake more effectively.

Low-fat diets (LFD) result in greater reductions in Total Cholesterol (TC) and Low-Density Lipoprotein (LDL) cholesterol compared to low-carbohydrate diets (LCD) over a duration of 6 to 23 months.

If your primary health concern is high LDL or Total Cholesterol, a low-fat diet (less than 30% of calories from fat) is likely more effective than a low-carb diet for lowering these specific numbers over the next 6-23 months. Note that this benefit disappears after 24 months.

After 24 months of adherence, there is no significant difference in weight loss or improvements in metabolic risk factors between low-carbohydrate diets and low-fat diets.

If you can stick to either a low-carb or low-fat diet for 2 years or more, you will likely achieve similar weight loss and metabolic improvements. The initial advantages of one over the other fade over time, so choose the one that fits your lifestyle and preferences best.

Weight loss triggers compensatory metabolic adaptations (hormonal and energy expenditure changes) that promote weight regain, making long-term maintenance difficult.

Expect that maintaining weight loss will be biologically challenging. Your body will fight back with increased hunger and decreased energy expenditure. This is normal and not your fault. Long-term success requires ongoing strategies to manage these biological drivers, such as regular self-monitoring and possibly higher protein intake to combat hunger hormones.

The weight loss efficacy of Tirzepatide is dose-dependent and increases with longer duration of treatment.

If you are taking Tirzepatide, sticking with the treatment for a longer duration and reaching the higher maintenance doses (like 15mg) will result in more significant weight loss than lower doses. The drug's effectiveness scales with the dose.

In crossover diet studies without washout periods, the order of macronutrient manipulation (specifically Low Carbohydrate vs. Low Fat) significantly affects energy balance and body composition outcomes due to carryover effects from gut adaptations.

If you are designing or interpreting a nutrition study that switches between two diets without a break, the order matters. Starting with a high-volume, high-fiber diet (like a Low Carb diet in this study) before switching to a lower-volume diet can lead to significantly greater weight loss than the reverse order, likely because the gut adapts to the volume/fiber of the first diet, reducing intake in the second. For individuals, this suggests that the sequence of dietary changes might impact long-term adherence and results, though this specific mechanism (gut adaptation to mass) is most relevant in controlled settings.

Medical nutrition therapy (MNT) provided by a registered dietitian is effective for improving weight outcomes and metabolic markers, but should not be used in isolation due to compensatory brain mechanisms.

Work with a registered dietitian for personalized nutrition advice. Do not rely on diet alone; combine it with physical activity and psychological support to manage the biological drive to regain weight.

Obesity accelerates the loss of pancreatic beta-cell function and insulin sensitivity through ectopic adipose expansion, systemic low-grade inflammation, and lipotoxicity, leading to Type 2 Diabetes Mellitus (T2DM).

Obesity is not just about weight; it actively damages the body's ability to use insulin and produce it via inflammation and fat accumulation in organs like the liver and pancreas. Managing obesity is critical to preventing or delaying T2DM, but it requires addressing metabolic health, not just scale weight.

High consumption of sugar-sweetened beverages (SSBs) causes an increased risk of coronary heart disease (CHD) and type 2 diabetes, independent of body mass index (BMI).

Stop drinking sugar-sweetened beverages. Even if you maintain your weight, the sugar in these drinks independently raises your risk of heart disease and type 2 diabetes. Choose water, unsweetened tea, or coffee instead.

High consumption of processed meats causes an increased risk of fatal coronary heart disease (CHD).

Limit processed meats like bacon, sausages, and deli meats. They are linked to a 37% higher risk of fatal heart disease per daily serving. Choose unprocessed meats, fish, or plant-based proteins more often.

High consumption of glycemic load causes an increased risk of type 2 diabetes.

Reduce your glycemic load by choosing whole, unprocessed foods. High glycemic load foods like white bread and sugary drinks increase the risk of type 2 diabetes. Opt for vegetables, fruits, and whole grains.

Type 2 diabetes should be managed as a component of Metabolic Dysfunction Syndrome (MDS) rather than solely as a hyperglycemic disorder, requiring holistic protection of target organs against all MDS-related metabolic disorders.

Do not treat Type 2 Diabetes as just a 'blood sugar problem.' Your risk of organ damage comes from the combination of high blood sugar, high blood pressure, high lipids, and excess weight. Effective management requires addressing all these metabolic factors together to protect your heart, kidneys, and eyes, rather than focusing on glucose alone.

Subsidizing healthy foods (specifically fruits and vegetables) by 10% increases their consumption by approximately 14%, and this price reduction is associated with a modest reduction in BMI.

To increase fruit and vegetable intake, policy-level subsidies that lower their price by 10% are effective. This economic lever directly drives a 14% increase in consumption. For individuals, this suggests that programs offering discounts on produce (like farmers market vouchers) are a viable strategy to improve diet quality.