Browse the evidence

An isocaloric ketogenic diet (5% carbohydrate, 80% fat) increases fasting inflammatory markers (CRP, adiponectin) and cholesterol (total, LDL, HDL) compared to a baseline diet (50% carbohydrate, 35% fat) in men with overweight or class I obesity.

If you switch to a strict ketogenic diet (80% fat, 5% carbs) while keeping your calories the same, expect your cholesterol (including LDL and HDL) and inflammatory marker (CRP) levels to rise compared to a standard diet. This effect was observed in men with overweight or obesity over 4 weeks. Monitor your lipids and inflammation if you adopt this diet.

An isocaloric ketogenic diet decreases insulin-mediated antilipolysis (the ability of insulin to suppress fat breakdown) compared to a baseline diet, regardless of the meal consumed.

On a ketogenic diet, your body's fat cells become less responsive to insulin's signal to stop breaking down fat. This means insulin is less effective at suppressing fat release, even if your blood sugar control remains stable. This is a key metabolic shift to understand when managing body composition on keto.

An isocaloric ketogenic diet significantly lowers fasting triglycerides but raises fasting total, HDL, and LDL cholesterol compared to a baseline diet in men with overweight or obesity.

Switching to a ketogenic diet will likely lower your triglycerides but raise your total, LDL, and HDL cholesterol. This mixed effect means you should monitor your full lipid panel, not just triglycerides, to assess cardiovascular risk.

Dietary composition, particularly high carbohydrate intake, can reduce post-weight-loss metabolic expenditure by approximately 200 kcal/day compared to higher fat intakes, contributing to weight regain.

After weight loss, be mindful of high-carbohydrate diets, especially if you have insulin resistance. Higher fat or lower carbohydrate intakes may help preserve metabolic rate, making it easier to maintain your weight.

AOM therapy requires monitoring and potential dose reduction of concomitant medications for diabetes and hypertension due to rapid weight loss and improved metabolic parameters.

If you take medication for diabetes or high blood pressure, tell your doctor you are starting an AOM. Your doses may need to be lowered quickly as you lose weight to prevent dangerous drops in blood sugar or blood pressure.

Higher resistance training volume (3 sets vs 1 set) yields greater muscle hypertrophy and strength gains, but this benefit is contingent upon the individual's capacity for ribosome biogenesis (total RNA accumulation).

If you are new to resistance training, doing 3 sets per exercise will likely yield better muscle and strength gains than doing just 1 set. However, your body's ability to produce ribosomes (total RNA) determines how much benefit you get from those extra sets. If you are short on time, 1 set is still effective, but 3 sets is superior for maximizing growth.

Abbreviated behavioral weight loss interventions (8 in-person sessions) supported by mobile technology or standard coaching produce clinically meaningful weight loss at 6 months, comparable to full-intensity programs, but this superiority over self-guided treatment dissipates by 12 months once intervention components cease.

An abbreviated weight loss program (8 sessions + coaching) using mobile technology or standard methods can help you lose a clinically meaningful amount of weight (approx. 5-6% of body weight) over 6 months. However, this benefit is not sustained after 12 months if you stop using the tools and coaching. To maintain weight loss, you likely need ongoing support or a transition to sustainable habits, as the 'boost' from the intervention fades when it ends.

In low-income regions (Sub-Saharan Africa), rising income significantly increases the intake of processed meat and sugar-sweetened beverages, whereas in high-income regions, these categories often become inferior goods (intake declines with rising income).

If you are in a developing economy, rising income does not automatically mean you will eat healthier. In fact, as income rises in these regions, people tend to buy more processed meats and sugary drinks. To maintain health, you must consciously prioritize whole foods and limit processed items, as market forces will naturally push you toward them.

Fruit intake is the food category most responsive to rising income globally, particularly among older women, suggesting it is a 'superior good' that increases with wealth.

For older women, increasing income is a powerful lever to improve diet quality by increasing fruit consumption. If you are in a low-income region, focus on adding fruit to your diet as your financial situation improves, as this is the category most likely to increase with your budget.

Metformin is the primary first-line oral treatment for type 2 diabetes across all age groups due to its efficacy, versatility, and cost-effectiveness, with benefits extending to cardiovascular and potential anti-neoplastic properties.

Start with metformin as your primary medication. It is the standard, effective, and affordable choice for managing blood sugar. While it may cause mild stomach issues initially, it is generally well-tolerated and helps protect your heart and kidneys over the long term.

In patients with type 2 diabetes or prediabetes and established cardiovascular risk, maintaining a BMI of 25–35 kg/m² (overweight to mild obesity) is associated with lower all-cause and cardiovascular mortality compared to a normal BMI of 22–24.9 kg/m².

If you have diabetes or prediabetes along with other heart disease risks, do not aggressively pursue weight loss to reach a 'normal' BMI (22-25). Your data suggests you are safest in the overweight to mild obesity range (BMI 25-35). Focus on cardiovascular health markers rather than the scale number.

Metabolic surgery reduces the 10-year risk of major adverse cardiovascular events (all-cause mortality, coronary artery events, heart failure, and nephropathy) in patients with type 2 diabetes and obesity compared to usual care, as quantified by the Individualized Diabetes Complications (IDC) Risk Scores.

If you have type 2 diabetes and obesity, ask your doctor about using a risk calculator (like the IDC Risk Scores) to compare your 10-year risk of heart failure, kidney disease, and death with current medications versus metabolic surgery. The data suggests surgery may significantly lower these risks for many patients, helping you make an informed decision based on your specific health profile.

Obesity without metabolic syndrome ('metabolically healthy obesity') significantly increases the 5-year cumulative incidence of hypertension and diabetes compared to lean subjects without metabolic syndrome.

If you are overweight or obese, even if your current blood pressure and blood sugar are normal, you are at a significantly higher risk of developing hypertension and diabetes within five years compared to someone of normal weight. You should not assume 'normal labs' mean 'no risk.'

Hyperuricemia is an independent risk factor for developing hypertension and diabetes, with every 1 mg/dL increase in serum uric acid increasing the risk of hypertension by 19% and diabetes by 27%.

High uric acid is not just about gout; it independently raises your risk of high blood pressure and diabetes. If your uric acid is high, addressing it (often through diet, specifically reducing fructose and purines) may help prevent these conditions.

GLP-1 receptor agonists improve cardiovascular risk factors (blood pressure, lipid profiles, endothelial function) and reduce cardiovascular events in patients with type 2 diabetes and obesity.

GLP-1 injections not only help with weight and blood sugar but also improve heart health by lowering blood pressure, improving cholesterol, and reducing inflammation. They are recommended for patients with T2DM and obesity to reduce cardiovascular risk.

Statins are safe and effective as first-line treatment for hyperlipidemia in MASLD patients, despite under-prescription, and may reduce cardiovascular events and liver disease burden.

If you have MASLD and high cholesterol or CVD risk, ask your doctor about statins. They are safe for your liver, even if you have some liver scarring, and are the first-line treatment to lower your risk of heart disease. Do not avoid them due to fear of liver damage.

Tirzepatide treatment significantly reduces the 10-year predicted risk of atherosclerotic cardiovascular disease (ASCVD) in adults with obesity or overweight without diabetes compared to placebo.

If you have obesity or overweight without diabetes, treatment with tirzepatide (a once-weekly injection) combined with lifestyle changes can significantly lower your calculated 10-year risk of heart disease compared to placebo. This benefit was observed across different baseline risk levels, suggesting it may be a valuable option for long-term cardiovascular health improvement in this population.

Intermittent fasting (including 16:8 and 5:2 protocols) produces weight loss equivalent to continuous energy restriction when total caloric intake is matched.

Intermittent fasting (like 16:8 or 5:2) is an effective weight loss strategy, but only because it helps you eat fewer calories. It is not superior to eating fewer calories every day. Choose the pattern that best fits your lifestyle and helps you maintain a caloric deficit.

Certain diabetes medications (GLP-1 agonists and SGLT2 inhibitors) promote weight loss, whereas others (insulin, sulphonylureas, thiazolidinediones) cause weight gain, influencing the choice of therapy in obese patients.

When choosing diabetes medication, ask your doctor about its effect on your weight. Some drugs (like GLP-1 agonists and SGLT2 inhibitors) help you lose weight, while others (like insulin and sulphonylureas) may cause weight gain. If you have obesity, your doctor should prioritize medications that support weight loss.

SGLT-2 inhibitors reduce body weight (0.9-2.5 kg) and improve cardiovascular and renal outcomes in patients with diabesity by inducing glycosuria, making them a valuable class of medication for managing both metabolic and organ-specific risks.

SGLT-2 inhibitors (like Jardiance or Farxiga) are oral diabetes medications that also help with modest weight loss (1-2.5 kg) and protect your heart and kidneys. They work by removing excess sugar through urine. While this can increase the risk of yeast infections or UTIs, good hygiene and doctor guidance can manage this. They are particularly beneficial if you have heart or kidney risks associated with your diabetes.

Higher dietary glycemic load (GL) is associated with a significantly increased risk of coronary heart disease (CHD), with a relative risk of 1.44 per 65 g/d increase in GL among populations using valid dietary instruments.

To lower your risk of heart disease, pay attention to the glycemic load of your diet. This means choosing carbohydrates that have less impact on your blood sugar. The study suggests that for every 65 grams of glycemic load you consume daily, your risk of coronary heart disease increases by about 44% compared to lower intake, assuming you use accurate dietary tracking. Prioritize low-GL foods like vegetables, legumes, and whole grains over high-GL refined carbs.

Higher dietary glycemic index (GI) is associated with an increased risk of coronary heart disease, with a relative risk of 1.24 per 10 unit increase in GI on the glucose scale.

Choose carbohydrates with a lower Glycemic Index (GI) to support heart health. The study indicates that for every 10-unit increase in GI, your risk of coronary heart disease increases by about 24%. This means prioritizing foods that digest slowly and cause a smaller spike in blood sugar, such as legumes, whole grains, and non-starchy vegetables, over refined grains and sugary foods.

The risk of coronary heart disease from carbohydrate intake is significantly dependent on the Glycemic Index (GI) of the carbohydrates consumed, with higher GI amplifying the risk.

When consuming carbohydrates, their quality (Glycemic Index) significantly impacts your heart disease risk. The study shows that for every 98 grams of carbohydrates consumed, the risk of CHD increases by 66% for every 10-unit increase in the GI of those carbs. To protect your heart, choose carbohydrates with a lower GI, such as whole grains, legumes, and vegetables, and limit high-GI refined carbohydrates.

Intensive lifestyle intervention (ILI) aimed at weight loss reduces the incidence of obesity-related cancers by 16% in adults with type 2 diabetes, although the result was not statistically significant due to insufficient statistical power.

For individuals with type 2 diabetes and obesity, engaging in a structured weight loss program involving calorie restriction (1,200-1,800 kcal/day), moderate exercise (175 mins/week), and behavioral counseling can significantly lower the risk of developing obesity-related cancers. While the statistical evidence in this specific trial was borderline due to sample size, the consistent trend toward reduced risk suggests that maintaining a healthy weight is a critical cancer prevention strategy for this population.