Browse the evidence

In patients with new-onset type 2 diabetes, weight change (gain or loss) of more than 10% is associated with higher all-cause mortality compared to stable weight.

If you have recently been diagnosed with type 2 diabetes, aim to maintain your weight. Both losing more than 10% and gaining more than 10% of your body weight in the first two years are associated with higher mortality. Stable weight is linked to the lowest risk of death.

A high-fat, low-carbohydrate diet (high dietary fat intake) increases whole-body fat oxidation and reduces skeletal muscle mitochondrial respiration in trained humans, whereas low carbohydrate availability alone does not drive these adaptations.

If you are a trained endurance athlete, consuming a diet with >65% of calories from fat (while keeping carbs low at <20%) for about 5 days will significantly increase your body's ability to burn fat during exercise and reduce mitochondrial respiration rates. This adaptation is driven by the high fat intake itself, not just by restricting carbohydrates. Performance in time trials remains unchanged despite these metabolic shifts.

Low-carbohydrate diets offer superior short-term glycaemic control (HbA1c reduction) compared to high-carbohydrate diets, but this benefit is not maintained at 12 months.

If you have type 2 diabetes, a low-carbohydrate diet can help lower your HbA1c significantly in the first 6 months. However, this advantage tends to disappear after a year, likely because it is hard to stick to. Focus on a sustainable dietary pattern that you can maintain long-term.

GIP has pleiotropic effects beyond glucose metabolism, including potential benefits for obesity, bone health, and neurodegenerative disorders, making it a candidate for pharmacotherapies.

GIP is not just a blood sugar hormone. It also influences fat storage, bone density, and brain health. This is why new drugs that mimic or modify GIP are being studied for obesity and even neurodegenerative diseases.

Targeting specific inflammatory pathways (IL-1beta, NLRP3) reduces cardiovascular disease events in patients with obesity and elevated inflammation, independent of lipid-lowering effects.

If you have obesity and high inflammation markers (like CRP), your risk of heart disease is significantly driven by inflammation, not just cholesterol. While lifestyle changes are primary, emerging treatments targeting inflammation (like IL-1beta blockers) can reduce heart events by ~15% in high-risk groups, though they carry infection risks and do not fix blood sugar issues.

Substantial weight loss (via bariatric surgery or intensive lifestyle) reduces systemic inflammation and cardiovascular risk, whereas modest weight loss may not translate to CVD benefits.

To protect your heart, you need to lose at least 10% of your body weight. Modest weight loss (5-10%) improves blood sugar and cholesterol but may not prevent heart attacks. Bariatric surgery is the most effective way to achieve this and reduce inflammation, but intensive lifestyle changes can also work if sustained.

Combining waist circumference (WC) and relative handgrip strength (HGS/BW) provides a significantly more accurate prediction of metabolic syndrome (MetS) risk than using either metric alone.

To better assess your risk for metabolic syndrome, do not rely on waist size or muscle strength alone. Measure your waist circumference and test your handgrip strength (normalized to your body weight). Combining these two simple, low-cost measurements provides a significantly more accurate risk profile than using either metric by itself.

Resistance training performed to momentary muscular failure does not produce superior muscle hypertrophy compared to non-failure training.

You do not need to train to momentary muscular failure to maximize muscle growth. Training with 1-3 reps in reserve (RIR) is likely sufficient for hypertrophy. This allows you to recover faster and perform more total work over time, which may be more beneficial than chasing failure on every set.

Higher velocity loss thresholds (>25%) do not produce superior muscle hypertrophy compared to moderate velocity loss (20-25%).

For resistance-trained individuals, stopping sets at moderate velocity loss (20-25%) is just as effective for muscle growth as stopping at high velocity loss (>25%). You can simplify your training by not obsessing over precise velocity loss metrics.

Resistance training performed to 'set failure' (defined as anything other than momentary muscular failure) provides a trivial advantage over non-failure training for muscle hypertrophy.

Training to 'set failure' (broadly defined) offers a trivial advantage over non-failure training. The practical benefit is minimal, so you can choose your failure definition based on comfort and recovery rather than expecting significant hypertrophy gains.

Pregnant women with obesity should not increase energy intake during the second and third trimesters; maintaining early-pregnancy energy intake levels achieves recommended gestational weight gain by mobilizing maternal fat mass.

If you have obesity and are pregnant, do not try to increase your daily calories in the second and third trimesters. Instead, aim to eat roughly the same amount you ate in early pregnancy. Your body will use your stored fat to support the baby's growth, which helps you stay within healthy weight gain limits without risking excess fat accumulation.

Men experience significantly greater weight loss, fat mass loss, and lean mass loss on a healthy low-carbohydrate (HLC) diet compared to a healthy low-fat (HLF) diet, whereas women achieve similar weight loss outcomes on both diets.

If you are a man, a healthy low-carbohydrate diet is likely to produce greater weight loss than a healthy low-fat diet. If you are a woman, both diets are equally effective for weight loss, so you should choose the one you can adhere to best. Men lose more weight and fat on HLC, while women lose similar amounts on either diet.

Tirzepatide, a dual GIP/GLP-1 receptor agonist, significantly reduces systolic and diastolic blood pressure in patients with type 2 diabetes and obesity.

If you have type 2 diabetes or obesity, tirzepatide (a once-weekly injection) can help lower your blood pressure, which reduces your overall cardiovascular risk. The blood pressure reduction is dose-dependent, meaning higher doses tend to lower BP more.

Tirzepatide reduces inflammatory markers associated with cardiovascular risk, including YKL-40, ICAM-1, leptin, and GDF-15.

Tirzepatide reduces inflammatory markers associated with cardiovascular risk, such as YKL-40, ICAM-1, leptin, and GDF-15. This reduction in inflammation may contribute to the overall cardiovascular benefits of the drug.

SGLT2 inhibitors produce modest weight loss (2-5 kg) in Type 2 Diabetes, which is significantly less than the ~10 kg/year predicted by caloric loss from glycosuria due to compensatory metabolic adaptations.

If you are taking an SGLT2 inhibitor for diabetes, expect a modest weight loss of 2-5 kg, not the dramatic loss you might calculate from urine sugar loss. This modest loss is still beneficial for your heart and kidneys. Use this weight change as a motivational anchor to support other healthy lifestyle changes, rather than relying on the drug alone for significant fat loss.

Higher cardiorespiratory fitness (CRF) causally reduces the risk of type 2 diabetes, independent of adiposity (BMI), with a 1-SD increase in genetically predicted fitness associated with an 11% lower risk.

Improving your cardiorespiratory fitness (VO2max) directly lowers your risk of type 2 diabetes, regardless of your weight. Focus on exercises that challenge your heart and lungs (like cycling or running) to improve your body's ability to use oxygen, as this has independent metabolic benefits beyond just burning calories.

SGLT-2 inhibitors reduce ectopic fat deposition, specifically liver fat (NAFLD) and visceral adipose tissue, in patients with T2DM.

SGLT-2 inhibitors not only lower blood sugar but also directly reduce fat stored in the liver and around organs. This is particularly beneficial if you have fatty liver disease, a common complication of Type 2 Diabetes.

Higher habitual physical activity (measured as Physical Activity Level, PAL) is associated with significantly higher fat-free mass (FFM) during growth (under 18 years) and in early adulthood, but this positive association diminishes and is counteracted by aging in older adults.

Stay physically active throughout your life to maximize your muscle mass. The biggest benefits for building fat-free mass occur during growth and early adulthood (up to age 30). In older age, exercise won't fully stop muscle loss, but active individuals still retain significantly more muscle than sedentary peers, which helps maintain independence and functional capacity.

Higher-quality protein sources lead to greater strength gains during resistance exercise training, but do not significantly increase lean body mass (LBM) compared to lower-quality proteins.

When doing resistance training, choosing high-quality protein (like whey or meat) may help you get stronger, but it won't necessarily make you bigger than if you ate lower-quality protein (like soy or wheat), as long as you eat enough total protein. Don't overspend on 'premium' protein if your total intake is adequate.

South Asian ethnicity is associated with a significantly higher risk of developing Type 2 Diabetes (T2D) and insulin resistance compared to White populations, driven by distinct metabolic signatures including elevated branched-chain amino acids (BCAAs) and altered lipid metabolism.

If you are of South Asian descent, your risk for Type 2 Diabetes is statistically higher than that of White populations, often manifesting at lower BMIs. This is linked to how your body metabolizes amino acids and fats. Focus on monitoring metabolic markers like fasting glucose and insulin sensitivity, and consider dietary patterns that manage carbohydrate intake and support healthy lipid metabolism, as personalized strategies based on these metabolic insights are more effective than generic advice.

Elevated levels of Branched-Chain Amino Acids (BCAAs) such as leucine, isoleucine, and valine are predictive markers for Type 2 Diabetes risk across multiple ethnic groups, with specific associations to insulin resistance.

High levels of circulating BCAAs (leucine, isoleucine, valine) are a strong predictor of Type 2 Diabetes risk, even in people with normal blood sugar. This suggests that how your body processes amino acids is key. If you have risk factors, focus on metabolic health through balanced nutrition and exercise rather than just high-protein supplementation, as elevated BCAAs may indicate underlying insulin resistance.

Weight loss interventions, including bariatric surgery and dietary changes, reduce the risk of ventricular arrhythmias and sudden cardiac death in obese patients by correcting electrophysiological abnormalities.

Losing weight through diet or surgery is a powerful way to protect your heart from dangerous rhythms. It doesn't just change your appearance; it physically corrects the electrical signals in your heart (shortening the QT interval) and reduces the metabolic stress that triggers arrhythmias. Discuss weight management strategies with your cardiologist.

Visceral obesity and metabolic syndrome increase the risk of esophageal adenocarcinoma (EAC) through both GERD-dependent mechanisms (increased acid exposure) and GERD-independent mechanisms (systemic inflammation, adipokine signaling, and microbiome alterations).

Maintain a healthy waist circumference and manage metabolic health markers (blood pressure, blood sugar, lipids) to reduce the risk of esophageal adenocarcinoma. This involves addressing visceral fat through diet and exercise, as it impacts cancer risk through both acid reflux and systemic inflammation.

Roux-en-Y gastric bypass (RYGB) surgery is the most cost-effective intervention for adults with severe obesity (BMI ≥ 35 kg/m2) compared to non-surgical weight management programs, primarily due to superior long-term weight loss and reduced incidence of obesity-related diseases.

For individuals with severe obesity (BMI ≥ 35), bariatric surgery (specifically RYGB) offers the best long-term health and economic value compared to diet and lifestyle programs alone. While surgery has high upfront costs and requires lifelong medical follow-up, it significantly reduces the risk of serious diseases like diabetes and heart disease, leading to more quality-adjusted life years. If surgery is not an option, a standard 12-week behavioral weight management program is the next most cost-effective choice, but adding very low-calorie diets to standard programs is not cost-effective.