Browse the evidence

In young and middle-aged adults (18-55 years), the combination of obesity, diabetes, and hypertension increases the risk of COVID-19-related mortality to levels comparable to those observed in older adults (56-75 years) without these conditions.

If you are under 55, your age alone does not protect you from severe COVID-19 outcomes if you have obesity, diabetes, or high blood pressure. These conditions combine to elevate your mortality risk to that of an older adult. Prioritize managing these metabolic factors through lifestyle changes and medical care, and ensure you are prioritized for preventive measures like vaccination.

Targeting specific inflammatory pathways (e.g., IL-1, TNFα, IL-6) with pharmacological antagonists can improve insulin sensitivity and glycemic control in patients with obesity and related inflammatory conditions.

In clinical settings, reducing inflammation through targeted medications can help manage blood sugar and insulin resistance in obese patients, especially those with co-existing inflammatory diseases. This supports the broader goal of reducing metabolic risk.

In females with type 2 diabetes, the combination of low fat mass and low muscle mass is synergistically associated with higher glycated hemoglobin (A1C) levels compared to other body composition phenotypes.

If you are a woman with type 2 diabetes, do not assume that being thin means your blood sugar is well-managed. This research shows that having low body fat AND low muscle mass is a specific risk factor for higher blood sugar levels. To improve your A1C, focus on building muscle mass through resistance training, rather than just trying to lose weight or stay thin.

In males with type 2 diabetes, high fat mass is significantly associated with higher A1C, but muscle mass does not significantly influence A1C levels.

If you are a man with type 2 diabetes, your blood sugar levels are more closely linked to your body fat than your muscle mass. While building muscle is healthy, prioritizing fat loss through diet and exercise is likely to have a more direct impact on lowering your A1C levels.

High consumption of ultra-processed foods (UPF) in young adult women is associated with a long-term increase in fat mass and a decrease in lean mass by early middle age.

For women, consistently high intake of ultra-processed foods (over 35% of daily grams) in your 20s predicts higher fat mass and lower muscle mass in your late 30s. To mitigate this, prioritize whole foods and minimize UPFs, as they are linked to unfavorable body composition changes over time.

White common bean extract (WCBE) rich in alpha-amylase inhibitor, taken 1.5g before meals, significantly improves glycemic control (HbA1c) and ameliorates diabetic peripheral neuropathy in type 2 diabetes patients over 4 months by remodeling gut microbiota to enrich SCFA-producing bacteria.

If you have Type 2 Diabetes, taking 1.5 grams of white common bean extract half an hour before each meal may help lower your HbA1c and improve nerve health. This supplement works by blocking starch digestion and feeding beneficial gut bacteria that produce short-chain fatty acids, which help regulate blood sugar. It should be used alongside your prescribed medication and dietary guidance, not as a replacement.

Resistance training in hypoxia (RTH) yields similar muscle hypertrophy and strength gains compared to normoxia when protocols are not optimized for specific covariates.

If you are training in hypoxia, do not expect automatic superior gains in muscle size or strength compared to training in normal air. The overall benefit is negligible unless you specifically optimize your rest intervals and load.

Resistance training in hypoxia enhances strength development (1RM) when using long inter-set rest intervals (≥ 120s) and moderate loads.

To gain strength in hypoxia, use moderate weights and rest for at least 2 minutes between sets. This allows you to maintain the intensity needed for strength adaptations, which hypoxia may support better than normoxia under these specific conditions.

Tirzepatide improves cardiovascular risk factors, including lipid profiles and blood pressure, without increasing cardiovascular event risk in T2DM patients.

Beyond weight loss, Tirzepatide improves heart health markers by lowering bad fats (triglycerides, LDL) and raising good fats (HDL), while also lowering blood pressure. It does not appear to increase heart attack or stroke risk in T2DM patients.

In severely obese individuals, indexing estimated glomerular filtration rate (eGFR) to actual body surface area (BSA) rather than the standard 1.73m2 reveals renal hyperfiltration, which significantly improves following medical weight loss.

If you have severe obesity, your standard kidney function test (eGFR) might be misleadingly low because it doesn't account for your larger body size. This can hide early kidney stress (hyperfiltration). Ask your doctor if they can calculate your kidney function using your actual body surface area. This method often reveals higher kidney function that improves as you lose weight, providing a more accurate baseline for your health.

When essential amino acid profiles are equated, a novel plant-based protein matrix provides equivalent benefits to whey protein for body composition, strength, power, and aerobic performance in trained futsal players over an 8-week period.

If you are an athlete consuming enough total protein (over 1.6g/kg body weight per day), the specific source of your protein supplement (plant vs. whey) does not matter for muscle gain, strength, or performance, provided the plant protein is formulated to match the essential amino acid profile of whey. You can choose plant-based options without sacrificing results.

Women with PCOS exhibit metabolic inflexibility (impaired substrate switching) comparable to women with Type 2 Diabetes, independent of BMI differences.

For women with PCOS, metabolic inflexibility is a core feature similar to Type 2 Diabetes, not just a side effect of being overweight. This means your body struggles to switch between burning fat and sugar efficiently. Focus on strategies that improve insulin sensitivity (like resistance training and managing carbohydrate timing) rather than just calorie restriction, as the underlying hormonal environment (androgens) drives this inflexibility.

Within PCOS populations, metabolic inflexibility is strongly associated with higher visceral adipose tissue and hyperandrogenemia (free testosterone/free androgen index).

If you have PCOS and struggle with metabolic flexibility, check your visceral fat and hormone levels. High free testosterone and abdominal fat are key drivers of this inflexibility. Addressing these specific markers may help improve your body's ability to switch fuel sources.

High consumption of sugar-sweetened beverages (SSB) is associated with an increasing burden of cardiometabolic mortality, with attributable deaths rising by 7.2% between 1990 and 2010, despite being a smaller absolute contributor than nuts or fruit deficits.

Cutting out sugary drinks is crucial because their consumption is rising and driving up heart and diabetes deaths. Even though other factors like low nut intake cause more total deaths, the trend for sugary drinks is getting worse, so reducing them is a high-priority action.

Physical activity increases the competitive advantage of skeletal muscle cells by depleting their stored energy (glycogen/lipids), thereby improving insulin sensitivity and reducing the partitioning of nutrients to fat cells.

Engage in regular physical activity to deplete muscle glycogen and lipids. This forces muscle cells to compete more aggressively for blood nutrients, improving insulin sensitivity and reducing the amount of energy stored as fat. This is more effective than exercise alone for weight loss because it addresses the underlying cellular competition.

Fat cell hyperplasia (increase in number) is the primary competitive strategy of adipocytes, leading to increased partitioning of nutrients to fat and poorer treatment outcomes for weight loss compared to hypertrophy (increase in size).

If you have been obese for a long time, you may have more fat cells (hyperplasia). This makes weight loss harder because each cell competes for nutrients. Consistent physical activity and dietary management are crucial to manage this increased capacity for fat storage.

Common genetic variants explain only a small fraction (12-24%) of the variation in fish and EPA+DHA consumption, with non-genetic personal and environmental factors being the principal determinants of intake levels.

Do not rely on genetics to predict or change your fish intake. The study shows that where you live, your culture, and your habits matter far more than your DNA. Focus on modifying your environment (e.g., access, availability) rather than looking for a genetic reason why you can't or won't eat fish.

GLP-1 receptor agonists (semaglutide) and dual GLP-1/GIP agonists (tirzepatide) cause significant lean mass loss during weight loss, with semaglutide losing approximately 45% of total weight as lean mass and tirzepatide losing 25.7%, posing a specific risk of frailty and fractures in older populations.

If you are taking semaglutide or tirzepatide, be aware that a significant portion of your weight loss (up to 45% for semaglutide) comes from lean mass, not just fat. This is especially risky if you are over 60. Discuss strategies to preserve muscle, such as resistance training or potentially newer combination therapies, with your provider.

Socioeconomic status, demographic factors (sex, age, country of birth), lifestyle habits (binge eating, alcohol use), and specific biomarkers (TSH, triglycerides, calcium, HbA1c) are the strongest predictors of BMI levels, with psychological factors (anxiety/depression scores) having stronger predictive value than self-reported diagnoses.

If you are struggling with obesity, look beyond just calories. Your socioeconomic context, mental health (specifically anxiety and binge eating tendencies), and specific blood markers (like TSH and triglycerides) are powerful indicators of your BMI trajectory. Addressing psychological health through validated screening tools may be more predictive and actionable than relying solely on self-reported diagnoses or medication history.

Verbal instructions directing attention to the triceps (internal focus) significantly increase triceps brachii activation during the bench press, whereas instructions targeting the pectorals do not significantly increase pectoralis major activation.

When performing the bench press, if your goal is to emphasize your triceps, explicitly tell yourself to 'push with your triceps' or 'push your elbows away from each other.' This will increase triceps activation. However, do not expect this instruction to significantly increase chest activation; the chest will work regardless of the instruction. You cannot 'turn off' the chest by focusing on the triceps, nor 'turn on' the chest by focusing on it.

Using a single, universal velocity loss (VL) threshold to prescribe resistance training volume is unreliable and likely leads to variable acute physiological responses and divergent long-term adaptations because the volume of work completed at a given VL threshold varies significantly between individuals.

Do not use a single velocity loss threshold (like 20% or 30%) for everyone in your gym or program. The amount of work you do to hit that speed drop varies wildly between men and women, and between strong and less strong individuals. To ensure consistent training effects, you must individualize velocity loss targets based on sex, training status, and personality traits like emotional stability.

Sex significantly influences the volume of work completed at velocity loss thresholds, with females completing more repetitions than males at the same VL thresholds, while males perform repetitions at higher velocities.

If you are programming for mixed-sex groups, do not assume a 20% velocity loss means the same workload for men and women. Women will likely perform more repetitions to hit that speed drop, while men will maintain higher bar speeds. Adjust your targets or volume expectations based on sex.

Intensive weight loss via energy restriction and increased aerobic exercise induces adaptive thermogenesis (reduced resting energy expenditure beyond mass loss predictions) in both male and female physique athletes.

If you are cutting weight for a competition, expect your metabolism to slow down more than your weight loss would predict. This is a normal biological response called adaptive thermogenesis. It is driven by the energy deficit and increased exercise volume. The good news is that this adaptation is temporary and reverses during recovery.

Male physique athletes lose significantly more lean mass than female athletes during competition preparation, despite similar reductions in fat mass and muscle size.

Men preparing for physique competitions should be aware they may lose more muscle than women during a cut, likely because they reach lower body fat levels. Prioritizing protein and minimizing the depth of the cut may help preserve muscle.