Browse the evidence

Taxing sugar-sweetened beverages (SSBs) and fast food by 10% decreases their consumption by approximately 6-7%, though the effect on BMI is not statistically significant.

Implementing a 10% tax on SSBs and fast food reduces consumption by 6-7%. However, this alone does not significantly lower BMI. To maximize health impact, tax revenue should be used to subsidize healthy foods, leveraging the larger effect size of subsidies.

Women with type 2 diabetes are undertreated for cardiovascular risk factors (HbA1c, blood pressure, lipids) compared to men, contributing to worse outcomes.

Women with diabetes often receive less aggressive treatment for blood pressure and cholesterol than men. If you are a woman, advocate for yourself to ensure your risk factors are treated as aggressively as a man's, as undertreatment contributes to higher heart disease risk.

Higher dietary glycemic index (GI) and glycemic load (GL) are robustly associated with an increased risk of incident type 2 diabetes (T2D) in adults initially in good health.

To lower your risk of type 2 diabetes, prioritize foods with a lower glycemic index and load. This means choosing carbohydrates that digest more slowly, rather than just reducing the total amount of carbs. The evidence suggests that the quality of carbohydrates, specifically their impact on blood sugar rise, is a significant predictor of diabetes risk in healthy adults.

Triple hormone receptor agonist retatrutide (1-12 mg weekly) significantly reduces liver fat in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), achieving near-maximal reduction (~80%) at 24 weeks with high doses (8-12 mg).

For patients with MASLD, high-dose retatrutide (8-12 mg weekly) offers a highly effective treatment to significantly reduce liver fat, often normalizing it within 24 weeks. This hormonal intervention addresses the root metabolic drivers of liver fat accumulation more potently than current GLP-1 mono-agonists.

Higher circulating or adipose tissue levels of the dairy fat biomarkers pentadecanoic acid (15:0), heptadecanoic acid (17:0), and trans-palmitoleic acid (t16:1n-7) are associated with a significantly lower incidence of type 2 diabetes.

High levels of specific fatty acids (15:0, 17:0, and t16:1n-7) in your blood or fat tissue, which serve as biomarkers for dairy fat consumption, are linked to a lower risk of developing type 2 diabetes. This suggests that moderate consumption of dairy products may be metabolically beneficial, contrary to the general advice to avoid all saturated fats.

Novel plant-based meat alternatives should be treated as sensory meat alternatives but not as true nutritional replacements for animal meat due to differences in nutrient bioavailability and complex food matrix interactions.

If you are swapping animal meat for plant-based alternatives to improve health, recognize that you are gaining sensory satisfaction but may lose specific nutrient benefits. To maintain nutritional status, ensure your overall diet includes diverse plant sources to compensate for lower bioavailability of nutrients like B12, Iron, and Zinc, or consider supplementation if you are not consuming fortified products.

Plant-based meat alternatives generally provide lower bioavailability of key micronutrients (B12, Iron, Zinc) compared to animal meat, even when fortified, due to food matrix effects and anti-nutrients.

When eating plant-based meats, be aware that you might not absorb as much B12, Iron, or Zinc as you would from animal meat, even if the label says they are equal. To mitigate this, pair these foods with Vitamin C (to help iron absorption) and consider getting your B12 and Zinc status checked if you rely heavily on these products.

Anthropometric prediction equations using age, race, height, weight, and waist circumference provide a valid, high-accuracy estimate of lean body mass and fat mass, significantly outperforming BMI in predicting obesity-related biomarkers.

Stop relying solely on BMI to judge your health or body composition. You can get a highly accurate estimate of your lean and fat mass using simple measurements: height, weight, waist circumference, age, and race. This method is as effective as expensive scans for predicting metabolic health risks like cholesterol and blood sugar, making it a practical tool for anyone.

For resistance-trained individuals, training to failure may provide a significant advantage for muscle hypertrophy compared to non-failure training.

If you are an experienced lifter who has plateaued, incorporating sets to failure may help break through stagnation and stimulate additional hypertrophy. For beginners or untrained individuals, stopping short of failure is sufficient and likely more sustainable.

Current global agricultural production overproduces grains, fats, and sugars while underproducing fruits, vegetables, and protein, creating a nutritional imbalance that contributes to obesity and diabetes.

Stop assuming that having enough food means you are eating well. Current global diets are skewed heavily toward grains, fats, and sugars, which drives obesity and diabetes. To fix this, prioritize increasing the intake of fruits, vegetables, and plant-based proteins, and reduce reliance on energy-dense processed foods.

A complete shift to plant-based protein (vegetarian diet) reduces total agricultural land use and GHG emissions compared to the HHEP diet, despite requiring more arable land for crops.

Shifting to plant-based protein sources (legumes, seeds, nuts) reduces GHG emissions and pasture land use compared to animal-based proteins. While it may require more arable land for crops, the overall environmental footprint is lower.

Dietary interventions produce observable changes in gut microbiome composition within days, whereas microbiome-mediated effects on host phenotypes or biomarkers require interventions lasting weeks to months.

If you change your diet, your gut bacteria will likely adapt within a few days. However, do not expect to feel health benefits or see changes in blood markers immediately. You need to maintain the dietary change for several weeks or months to see the downstream health effects driven by those microbial changes.

Microbiome responses to dietary interventions are highly personalized, meaning the same diet can produce different microbial and metabolic outcomes in different individuals based on their baseline microbiome composition.

Standard dietary advice may not work for everyone because your gut bacteria are unique. If a specific diet (like high fiber) doesn't improve your health markers, it might be due to your baseline microbiome. Future personalized nutrition may involve testing your microbiome to predict which foods will work for you.

Ultra-processed foods contribute disproportionately to daily energy intake in high-income countries, often exceeding 50% of total calories.

Be aware that in many high-income countries, more than half of the calories consumed come from ultra-processed foods. Reducing this proportion is a key public health goal.

Tirzepatide, a dual agonist of GLP-1 and GIP receptors, achieves significant body weight and glucose control in patients with obesity and type 2 diabetes.

Tirzepatide, which activates both GLP-1 and GIP receptors, is an effective treatment for obesity and type 2 diabetes, leading to significant improvements in body weight and glucose control. It represents a newer class of therapy with promising clinical results.

Short-term time-restricted feeding (8h window) alters the rhythmicity of serum lipids and muscle amino acids without perturbing core clock gene expression in skeletal muscle.

If you practice time-restricted feeding, expect changes in how your body processes fats and amino acids throughout the day, specifically by increasing the 'peaks' of certain metabolic signals in muscle. This happens even if your body's core biological clock genes remain unchanged. Focus on the timing of nutrient availability rather than trying to 'reset' your biology.

Implementing a 30% financial subsidy on fruits and vegetables through Medicare and Medicaid is highly cost-effective, preventing cardiovascular disease events and generating substantial quality-adjusted life years (QALYs).

For policymakers, subsidizing fruits and vegetables by 30% for Medicare and Medicaid recipients is a highly cost-effective strategy to improve public health. The model predicts significant reductions in cardiovascular disease and diabetes cases, leading to substantial long-term healthcare cost savings that offset the initial subsidy costs.

A 30% financial subsidy on a broader basket of healthful foods (including fruits, vegetables, whole grains, nuts, seafood, and plant oils) is more cost-effective than a fruit and vegetable-only subsidy, preventing more cardiovascular and diabetes cases.

For policymakers, expanding the subsidy to include whole grains, nuts, seafood, and plant oils alongside fruits and vegetables is even more cost-effective than subsidizing fruits and vegetables alone. This broader approach prevents more cases of cardiovascular disease and diabetes, resulting in greater long-term healthcare savings and lower cost-per-QALY ratios.

Multi-targeting agonists (tirzepatide and peptide 20) that activate GIPR, GLP-1R, and GCGR provide superior metabolic efficacy compared to GLP-1 mono-agonists (like semaglutide) by leveraging distinct structural binding modes and retaining glucagon receptor function.

For individuals managing Type 2 Diabetes or Obesity, newer multi-targeting therapies (like tirzepatide) that activate multiple metabolic receptors (GIP, GLP-1, and Glucagon) have demonstrated superior weight loss and glucose control compared to older GLP-1-only medications. This suggests that targeting multiple hormonal pathways simultaneously may offer better clinical outcomes than single-pathway treatments.

Suboptimal intake of specific dietary factors (nuts/seeds, seafood omega-3, processed meats, whole grains, vegetables, fruits, SSBs, sodium, red meat, polyunsaturated fats) accounts for 18.2% of total cardiometabolic disease costs in the US, totaling $50.4 billion annually.

Focus on increasing intake of nuts, seeds, and seafood omega-3s, and reducing processed meats, sodium, and sugar-sweetened beverages. These changes have the highest potential to reduce cardiometabolic disease risk and associated healthcare costs.

Low consumption of nuts/seeds and seafood omega-3 fats imposes the highest per capita cardiometabolic disease costs ($81 and $76 respectively), while high consumption of red meat and polyunsaturated fats imposes the lowest ($3 and $20 respectively).

Increase intake of nuts, seeds, and seafood omega-3s, as these changes offer the greatest potential to reduce cardiometabolic disease costs. Reduce processed meats and sodium, and increase polyunsaturated fats, though their individual impact is smaller.

Training with low muscle glycogen availability augments the activation of signaling proteins and the resulting phenotypic adaptations for mitochondrial biogenesis compared to training with normal glycogen.

If you want to maximize mitochondrial growth, you can try training with lower muscle glycogen. This might mean doing your workout before eating a large carb-heavy meal, or doing a second session later in the day when glycogen is depleted. This state of 'low fuel' signals your body to build more mitochondria more aggressively than when you are fully fueled. However, this may reduce your performance output during the workout itself.

Adherence to a Mediterranean diet prevents long-term weight gain and abdominal obesity in individuals who are normal weight at baseline, but does not reverse existing overweight or obesity.

If you are currently a healthy weight, adopting a Mediterranean diet pattern is a strong strategy to prevent future weight gain and belly fat accumulation. However, if you are currently overweight or obese, this diet pattern alone is unlikely to result in significant weight loss or BMI normalization; you likely need to combine it with other interventions like caloric restriction or increased physical activity.

In free-living humans, increased physical activity triggers energy compensation, where basal metabolic rate (BEE) decreases such that only ~72% of the calories burned through activity translate into increased total energy expenditure (TEE).

When you exercise, your body naturally lowers your resting metabolism to save energy. On average, you only get 72% of the 'extra' calories burned from exercise added to your total daily burn. This doesn't mean exercise is bad, but it means you cannot simply 'eat back' all the calories you burned. Weight loss requires managing intake, as exercise alone faces a biological ceiling due to this compensation.