Browse the evidence

An 8-week vegan diet significantly reduces epigenetic age acceleration (GrimAge, PhenoAge, DunedinPACE) and extends telomere length compared to an omnivorous diet in healthy adults.

Adopting a vegan diet for 8 weeks can significantly slow down biological aging markers, including epigenetic age and telomere length, compared to a healthy omnivorous diet. To maximize these benefits, ensure you are getting adequate nutrients, particularly B12 and other 'epi-nutrients' mentioned in the study, through supplementation or careful food selection.

Metabolic and bariatric surgery (MBS) is associated with a significantly lower risk of major adverse cardiovascular events (MACE) and all-cause mortality compared to treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RA) in patients with type-2 diabetes and severe obesity.

For patients with type-2 diabetes and severe obesity, metabolic surgery appears to offer better protection against major heart events and death than treatment with GLP-1 medications alone. While surgery carries a small risk of complications, the long-term cardiovascular benefits outweigh these risks compared to pharmacological management. Patients should discuss these specific cardiovascular outcomes with their healthcare providers when choosing between surgical and medical management.

Asian populations develop obesity-related cardiometabolic morbidities at lower BMI thresholds than white populations, necessitating lower diagnostic cutoffs (BMI ≥25 or 27.5 kg/m²) for accurate risk identification.

If you are of Asian descent, do not rely on the standard BMI of 30 to define obesity. Your risk for diabetes and heart disease increases at lower weights. Use region-specific guidelines (BMI ≥25 or 27.5 kg/m²) or waist circumference measurements to assess your health risk accurately.

Gut microbiota composition and function are altered in type 2 diabetes, characterized by reduced diversity and decreased abundance of butyrate-producing bacteria, which is associated with insulin resistance and increased diabetes risk.

People with type 2 diabetes often have less diverse gut bacteria and fewer bacteria that produce butyrate. This is a consistent finding, but it doesn't mean there's a single 'bad bacteria' to target. Focus on dietary patterns that support overall microbial diversity.

Regular active recovery (ACT) consisting of 15 minutes of moderate jogging immediately after high-intensity interval training (HIIT) does not attenuate training adaptations (specifically maximum running velocity, velocity at VO2max, and anaerobic lactate threshold) compared to passive recovery (PAS).

If you do HIIT, follow it with 15 minutes of easy jogging (approx. 50-55% of your max speed) rather than sitting still. This will clear lactate faster and may actually improve your lactate threshold more than doing nothing, without increasing your overall stress or hindering your fitness gains.

Acute endurance exercise stimulates skeletal muscle mitochondrial biogenesis through integrated retrograde signaling from mitochondria to the nucleus, involving the activation of kinases (AMPK, CaMK, MAPK, PKA) and the translocation of transcriptional coactivators like PGC-1α to regulate nuclear gene expression.

To boost your muscle's energy production capacity (mitochondrial biogenesis), engage in endurance exercise. This can be moderate intensity continuous exercise (MICE), high-intensity interval exercise (HIIE), or sprint interval exercise (SIE). The specific intensity determines which fuel sources are used and which signaling pathways are prioritized, but all forms of endurance exercise trigger the necessary retrograde signaling from mitochondria to the nucleus to increase mitochondrial content and function.

Full range of motion (fROM) resistance training yields trivial to small advantages over partial range of motion (pROM) for overall muscle hypertrophy, strength, power, and body composition outcomes.

For most people, full range of motion is the best default for building muscle and strength because it offers a slight edge. However, the difference is small. If you have an injury that hurts at full depth, partial range of motion is still highly effective and better than nothing. If you are a powerlifter or sport-specific athlete, train the specific partial ranges relevant to your sport, as strength gains are specific to the angle trained.

If initial double combination therapy fails to control HbA1c, a triple combination of metformin, SGLT-2 inhibitor, and GLP-1 receptor agonist is recommended as the best treatment to reduce cardiovascular events and mortality.

If your first two medications don't control your blood sugar, add a third: a combination of metformin, an SGLT-2 inhibitor, and a GLP-1 receptor agonist. This is the most effective way to protect your heart and kidneys based on current real-world evidence.

Insulin should be the first-line treatment if insulin deficiency is the predominant factor at the onset of type 2 diabetes, followed by cardio-renal protective medications.

If your body isn't making enough insulin, start with insulin therapy first. After stabilizing your blood sugar with insulin, add medications that protect your heart and kidneys (SGLT-2 inhibitors or GLP-1 receptor agonists).

Rest-pause and drop-set training do not produce superior hypertrophic adaptations compared to traditional resistance training when total training volume is equalized.

You do not need to use rest-pause or drop-sets to build muscle. If you perform the same total amount of work (sets x reps x weight) using traditional sets, you will gain the same amount of muscle mass as those using advanced techniques.

Resmetirom, a selective thyroid hormone receptor beta (THRβ) agonist, significantly reduces hepatic steatosis, liver fibrosis, and serum lipid levels (LDL, TG, ApoB) in patients with MASLD, particularly those with fibrosis.

For patients with fatty liver disease who have developed early scarring (fibrosis), Resmetirom is a new medication that targets the liver specifically to burn fat and reduce scarring. It also lowers bad cholesterol (LDL) and triglycerides. Clinical trials show it significantly improves liver health markers.

Reducing insulin resistance, rather than strictly lowering blood glucose, is the primary mechanism for reducing cardiovascular risk in type 2 diabetes.

For patients with Type 2 Diabetes, focusing solely on lowering blood sugar may not be enough to protect your heart. The key to reducing cardiovascular risk is improving your body's sensitivity to insulin. This can be achieved through lifestyle changes (weight loss, diet, exercise), specific medications like Metformin or Pioglitazone, or newer drugs like GLP-1 agonists (e.g., Liraglutide) and SGLT2 inhibitors (e.g., Empagliflozin), which offer cardiovascular benefits beyond glucose control.

Bariatric surgery (specifically Roux-en-Y gastric bypass and sleeve gastrectomy) induces greater magnitude of weight reduction and T2D remission than intensive medical therapy, though non-surgical interventions may offer better quality-of-life improvements.

If lifestyle changes fail after 6 months and you have Class 2/3 obesity, discuss bariatric surgery (RYGB or Sleeve) with a specialist. It offers the best chance for significant weight loss and T2D remission, but be aware of surgical risks and potential QoL trade-offs compared to medical management.

Rating of Perceived Exertion (RPE) correlates with blood lactate levels in high repetition resistance training protocols, suggesting RPE can be used as a non-invasive proxy for metabolic stress.

You can use how hard a set feels (RPE) to estimate your metabolic stress. In high-rep sets, if it feels very hard (high RPE), your lactate levels are likely elevated, indicating significant metabolic stress.

Contrave (naltrexone/bupropion) promotes weight loss (~6% TBWL) and may improve fertility by mitigating PCOS and endometriosis effects, though it is less effective than GLP-1 RAs.

Contrave is an oral option for weight loss that targets food cravings and reward pathways. It typically results in about 6% weight loss. It is less potent than GLP-1 injections but may help with emotional eating. You must stop taking it before trying to conceive.

GLP-1 receptor agonists (e.g., semaglutide, liraglutide) and dual/triple incretin agonists (e.g., tirzepatide, retatrutide) significantly reduce hepatic steatosis and liver enzymes in patients with MASLD, primarily through indirect mechanisms of weight loss and improved insulin resistance, though they may not consistently resolve fibrosis.

If you have MASLD, especially with diabetes or obesity, GLP-1 based therapies (like semaglutide or tirzepatide) are highly effective at reducing liver fat and inflammation. However, do not expect them to reverse advanced scarring (fibrosis) on their own. The benefit comes largely from the weight loss and metabolic control they provide, so they work best when combined with lifestyle changes.

Ketogenic diets produce superior short-term glycemic control (HbA1c reduction) compared to low-carbohydrate diets, but are not superior to other dietary patterns for long-term weight loss or metabolic outcomes.

If you have Type 2 Diabetes, a strict ketogenic diet (20-50g carbs/day) can lower your HbA1c faster than standard low-carb diets in the short term. However, do not expect it to help you lose more weight in the long run compared to other healthy diets. It is a tool for glycemic control, not a magic bullet for weight loss.

A higher variety score of dietary protein sources (consuming appropriate quantities from more of the eight major sources: grains, meat, poultry, fish, egg, legumes) is inversely associated with the risk of new-onset diabetes.

To lower your risk of type 2 diabetes, aim to include a variety of protein sources in your diet rather than relying on just one or two. The study suggests that consuming appropriate amounts from a mix of grains, legumes, fish, poultry, and eggs is associated with a significantly lower risk of developing diabetes compared to a diet with fewer protein sources. You do not need to eliminate any specific source, but rather ensure your diet includes a broad spectrum of these foods.

Total protein intake has a U-shaped association with diabetes risk, where both very low (<10.6% of energy) and very high (≥14.0% of energy) intakes are associated with higher risk compared to moderate intake (10.6-14.0% of energy).

Avoid both very low and very high total protein intakes. The study suggests that getting 10.6% to 14.0% of your daily calories from protein is associated with the lowest risk of developing diabetes. This means you should neither severely restrict protein nor consume excessive amounts, but rather aim for a moderate level.

Specific protein sources have non-linear associations with diabetes risk: fish and legumes show inverse J/L-shaped associations (lower risk with higher intake), while red meat and poultry show J/U-shaped associations (increased risk at high intakes).

Choose your protein sources wisely. Fish and legumes are associated with lower diabetes risk, especially at higher intakes. Red meat and poultry should be consumed in moderation, as high intakes are associated with increased risk. Eggs and whole grains are also beneficial when consumed in appropriate amounts.

Chronic resistance exercise training increases skeletal muscle LAT1 protein content, but this increase is significantly blunted by concurrent leucine or whey protein supplementation compared to a placebo.

If you are doing resistance training, you will build muscle regardless of whether you take leucine or whey protein supplements. Interestingly, your body's expression of the LAT1 transporter (which moves leucine into cells) increased significantly more when you took a placebo compared to when you took leucine or whey. This suggests that supplementing with these specific compounds might blunt this specific molecular adaptation, even though it doesn't stop muscle growth. You don't need to avoid them, but don't expect them to maximize every single molecular marker.

High intake of starch (primarily from rice) is inversely associated with total, cardiovascular, and non-cancer/non-cardiovascular mortality in Japanese men, whereas high intake of total sugars (including glucose, fructose, and sucrose) is positively associated with these mortality risks.

For Japanese men, prioritizing starch (like rice) over sugars (including glucose, fructose, and sucrose) is associated with lower mortality risk. High sugar intake, regardless of source (free or natural), is linked to higher mortality. Women showed no significant association for starch, but free sugar intake was positively associated with mortality. Focus on reducing total sugar intake rather than just free sugars, and maintain starch intake as a primary energy source.

In Japanese women, high starch intake is not significantly associated with mortality, but high free sugar intake is positively associated with total and non-cancer/non-cardiovascular mortality.

For Japanese women, reducing free sugar intake is associated with lower mortality risk, while starch intake (like rice) does not appear to increase mortality risk. Focus on minimizing free sugars rather than restricting starch.

High-volume resistance training increases non-myofibrillar protein synthesis rates more than high-load resistance training, suggesting a mechanism for sarcoplasmic hypertrophy.

High-volume training may promote muscle growth through increased non-myofibrillar protein synthesis, which contributes to sarcoplasmic hypertrophy. This suggests that volume-based protocols can drive muscle growth through mechanisms beyond just contractile protein accretion.