Browse the evidence

Combining a GLP-1 receptor agonist (GLP-1RA) with an SGLT2 inhibitor provides superior glucose control, greater weight loss, and greater reductions in systolic blood pressure compared to either drug alone.

If your blood sugar remains high despite taking metformin, ask your doctor about combining a GLP-1 receptor agonist (like exenatide) with an SGLT2 inhibitor (like dapagliflozin). This combination lowers blood sugar more effectively than either drug alone, helps you lose more weight, and reduces blood pressure.

Physical activity questionnaires (PAQs) and accelerometers demonstrate moderate validity for assessing total physical activity and moderate-to-vigorous physical activity (MVPA) in epidemiologic studies, with PAQs showing particularly strong correlations for vigorous activity.

For researchers and clinicians, using a well-designed physical activity questionnaire (PAQ) is a valid and scalable method for assessing moderate-to-vigorous physical activity in large groups, especially when gold-standard biomarkers like doubly labeled water are too costly. While accelerometers are useful, they may miss certain activities (like swimming or biking) and showed lower validity for vigorous activity compared to PAQs in this study. Combining methods or using validated questionnaires provides a robust estimate of physical activity levels for epidemiological purposes.

Consumption of fermented foods is associated with improved gut microbiome diversity, reduced inflammation, and metabolic health benefits, regardless of whether the product contains live microbes or is pasteurized.

Incorporate a variety of fermented foods (yogurt, kefir, sauerkraut, kimchi) into your diet. You do not need to worry if they are pasteurized; both live and dead microbes (postbiotics) offer benefits. If you have high blood pressure, choose lower-sodium options like yogurt or kefir over salty pickles, and consult your doctor if you are immunocompromised or have histamine intolerance.

A multidomain intensive lifestyle intervention (ILI) reduces the incidence of self-reported complaints about decision-making and problem-solving abilities in adults with type 2 diabetes who are overweight but not obese.

If you have Type 2 Diabetes and are overweight (but not obese), committing to a structured lifestyle program involving moderate calorie restriction and regular brisk walking (aiming for 175 minutes a week) can help protect your ability to make decisions and solve problems. This benefit was not seen in obese individuals in this study, so weight management strategies should be tailored carefully.

Primary care provider (PCP) referrals significantly increase the likelihood of men proceeding to screening and enrollment in behavioral weight loss trials compared to direct mailings, and PCP involvement is a critical lever for overcoming low male recruitment rates.

If you are a man interested in weight loss, do not rely on unsolicited mailings or ads. The most effective way to join a program is to ask your primary care doctor for a referral. Doctors have the authority to bypass your hesitation and directly connect you to evidence-based support, which significantly increases your chances of actually starting the program.

Omega-3 fatty acids (EPA/DHA) exert antiarrhythmic effects by incorporating into cardiomyocyte membranes and modulating ion channel function.

Consuming omega-3s (from fish or supplements) helps stabilize heart rhythm by changing heart cell membranes. This is a key reason why omega-3s are recommended for heart health.

Modifying the Health Star Rating algorithm to penalize ultra-processed foods (via negative points or score capping) significantly improves alignment with the NOVA classification system, but reduces alignment with current Australian Dietary Guidelines for core food categories like cereals and convenience foods.

Current front-of-pack labels may give a 'health halo' to ultra-processed foods that look nutritious on paper. If you are trying to eat whole foods, look for the NOVA classification or ingredient list complexity, not just the star rating. Be aware that some 'core' foods (like instant oatmeal or plant milks) are ultra-processed and might be penalized by new labeling systems, even if they are currently recommended.

Physical activity attenuates the genetic predisposition to obesity associated with the FTO rs9939609 variant, effectively neutralizing the increased risk of higher BMI and subcutaneous fat area found in carriers of the risk allele.

If you carry the FTO risk gene, you are genetically predisposed to higher BMI, but this risk is not fixed. Regular physical activity and maintaining a healthy energy balance can effectively cancel out this genetic disadvantage. Do not let a genetic test result discourage you; activity is the specific counter-measure for this gene.

Among people with HIV and prediabetes, higher BMI, larger waist circumference, hypertriglyceridemia, and lower CD4 counts are associated with a significantly increased risk of progression to type 2 diabetes.

If you have HIV and prediabetes, your waist size, body weight, and triglyceride levels are strong indicators of your risk of developing full diabetes. Additionally, maintaining a higher CD4 count is protective. You should prioritize lifestyle interventions aimed at weight loss and managing triglycerides, as these are modifiable risk factors that can help prevent progression to diabetes.

Low-carbohydrate diets improve cardiovascular risk markers (triglycerides, HDL, blood sugar, inflammation) and reduce 10-year ASCVD risk scores, despite potential increases in LDL-C in lean individuals.

If you are on a low-carbohydrate diet, expect improvements in triglycerides, HDL, and blood sugar. If your LDL-C rises, discuss with your provider whether it correlates with other risk factors, as overall cardiovascular risk may still decrease.

The 'keto flu' (flu-like symptoms during initial adaptation) can be avoided or alleviated by increasing sodium and mineral intake.

If you feel tired or have headaches when starting a low-carb diet, drink two cups of broth daily to replenish sodium and minerals. This simple step can prevent or alleviate the 'keto flu'.

New antidiabetic drugs with cardiovascular effects (GLP-1ra and SGLT2-in) are underutilized in primary care due to clinical inertia driven by physician uncertainty, guideline complexity, and patient-specific barriers, despite proven efficacy in reducing cardiovascular morbidity and mortality.

For family physicians managing T2D, prioritize prescribing GLP-1 receptor agonists (GLP-1ra) or SGLT2 inhibitors (SGLT2-in) for patients with established cardiovascular disease, heart failure, or chronic kidney disease, regardless of HbA1c levels. Address clinical inertia by using clinical decision support tools and clear guidelines that define specific indications for these drugs. Discuss cost and side effects (e.g., GI issues for GLP-1ra, genital infections for SGLT2-in) openly with patients to improve adherence.

Higher BMI categories (Class I-III obesity) are associated with adverse cardiometabolic profiles, including lower HDL-C, higher triglycerides, higher hsCRP, higher prevalence of hypertension and diabetes, lower physical activity (step counts), and higher mental health distress (PHQ-9/GAD-7 scores) compared to normal weight.

Maintaining a healthy weight is crucial for reducing cardiometabolic risk, but it is not the only factor. Individuals, especially those who are underweight or have obesity, should monitor blood pressure, lipids, inflammation (hsCRP), and mental health. Regular physical activity and managing stress are key components of overall health regardless of BMI category.

A community-based lifestyle intervention program (standard care or intensive) improves lipidemic profiles (cholesterol, triglycerides, HDL) in adults at high risk for type 2 diabetes, with greater effectiveness observed in women, those with higher socioeconomic status, and residents of Southeastern Europe.

If you are at high risk for diabetes, a simple annual health check and counseling session can significantly improve your cholesterol and triglycerides, often matching the results of more intensive programs. However, if you are overweight, live in a region with fewer resources, or struggle with emotional eating and underestimating your weight, you may need more targeted support to see these benefits.

Military operational factors including deployments, restricted food choices, and limited physical exercise opportunities significantly contribute to the development and maintenance of obesity among service members.

If you are in the military, especially in the Navy or on deployment, your environment is designed to promote weight gain through limited fresh food and exercise options. Focus on what you can control within those constraints, such as seeking out fresh food when possible and maximizing movement opportunities, while advocating for better food and exercise access at the unit level.

High energy expenditure during combat training and field exercises, often exceeding 4000-7000 kcal/day, combined with limited energy intake, leads to Relative Energy Deficiency in Sport (RED-S) syndrome, causing detrimental health and performance outcomes.

During intense training or deployment, your body may burn 4000-7000+ calories. If you don't eat enough to match this, you risk RED-S, which harms your hormones, bones, and immune system. Prioritize eating enough to cover your energy expenditure to maintain long-term health and performance.

Psychological therapies (CBT, MANTRA, SSCM, family therapy) and specific pharmacological treatments (fluoxetine, topiramate for BN/BED; lisdexamfetamine for BED) are effective interventions for eating disorders, though RCTs specifically in the military context are lacking.

If you have an eating disorder, rely on evidence-based psychological therapies (like CBT or MANTRA) and prescribed medications (like fluoxetine or lisdexamfetamine) rather than just diet and exercise. These treatments address the root psychological and neurobiological factors of EDs.

Self-directed learning of cooking skills through independent resources (internet, books, TV) significantly increases the likelihood of possessing high cooking skills compared to not using these methods.

If you are a student or busy adult, you can significantly improve your cooking skills by actively seeking out recipes and techniques online, via books, or TV, rather than waiting for formal instruction. This self-directed approach is statistically linked to higher culinary competence, which in turn supports better diet quality and food security.

High availability and accessibility of fruits and vegetables at home is strongly associated with higher cooking skills, likely by providing the necessary ingredients to practice and refine culinary techniques.

To improve your cooking skills, ensure your kitchen has easy access to fruits and vegetables. The study suggests that having these ingredients available encourages you to practice and refine your cooking techniques, leading to higher overall culinary competence.

High knowledge of cooking terms and techniques is associated with higher cooking skills, suggesting that theoretical understanding supports practical culinary competence.

Learn the names of cooking techniques and terms. This theoretical knowledge is not just academic; it is strongly associated with higher practical cooking skills because it builds confidence and provides a mental framework for preparing food.

Higher percentage of energy from plant protein is associated with a lower risk of stroke, but not overall CVD or CHD.

If you want to reduce your risk of stroke, increasing the percentage of your calories from plant-based proteins (like beans, lentils, nuts) may be beneficial. However, this did not lower the risk of heart attacks or overall cardiovascular disease in this study.

Low-dose empagliflozin (2.5-5 mg) as adjunct therapy to hybrid closed-loop systems improves postprandial glycemic control and reduces insulin requirements in adults with type 1 diabetes, though it increases the risk of hypoglycemia and requires management of side effects like increased urination.

If you have Type 1 Diabetes and use a hybrid closed-loop system but still struggle with post-meal spikes or high insulin doses, low-dose empagliflozin (2.5-5mg) can significantly improve your time in range and reduce insulin needs. Be aware that it may cause more frequent urination and a higher risk of post-meal lows, which you can manage by adjusting your pump settings. The benefit of better control often outweighs the inconvenience of taking one extra pill.

Primary care clinicians refer approximately 71% of eligible patients (BMI ≥ 30) to intensive behavioral weight loss interventions, but patient enrollment rates remain low (19% of invited, 40.6% of contacted).

If you are in primary care with a BMI over 30, expect your doctor to refer you to a weight loss program if they have a list of patients like you. However, be prepared that enrollment might be low because doctors often prioritize other medical issues or feel they don't know you well enough. To increase your chances, explicitly express interest in weight management during visits.

For middle-aged and elderly adults with type 2 diabetes, maintaining a longitudinal BMI within 18.5–26.9 kg/m² significantly reduces all-cause, cardiovascular, and cancer mortality compared to lower or higher sustained BMI levels.

If you have type 2 diabetes, aim to keep your BMI between 18.5 and 26.9 kg/m² over the long term. This range is associated with the lowest risk of death from all causes, heart disease, and cancer. Avoid sustained periods where your BMI is consistently above 27 kg/m², as this increases mortality risk.