Browse the evidence

Moderate to vigorous physical activity reduces the likelihood of micro- and macrovascular events by 15–22% in type 2 diabetic patients at increased cardiovascular risk.

For diabetics with heart risks, moving at a moderate to vigorous pace significantly lowers the chance of heart and blood vessel damage. Aim for activity that raises your heart rate, not just light movement.

Lifestyle interventions (caloric restriction and physical activity) reduce the risk of incident chronic kidney disease in obese diabetic patients by approximately 30% compared to standard care.

If you are overweight and have diabetes, combining a healthier diet with regular physical activity can cut your risk of developing kidney disease by 30%. This is a highly effective, drug-free way to protect your kidneys.

Intensive, frequent dietitian-supported nutritional education significantly reduces total energy and carbohydrate intake in patients with type 2 diabetes compared to standard annual education.

For patients with Type 2 Diabetes, especially those with kidney issues, seeing a dietitian frequently (at every visit) is more effective for reducing calorie and carb intake than seeing them once a year. This frequent support helps patients make better food choices, such as eating more fish and fewer sweets, leading to significant reductions in total energy intake over two years.

Higher protein diets during weight loss improve glycemic variables (fasting triglycerides and insulin) compared to standard protein diets, with benefits persisting to some degree long-term.

When losing weight, choosing a diet with higher protein content can help improve your metabolic health, specifically by lowering fasting triglycerides and insulin levels. This benefit may persist even after the diet ends. Focus on increasing protein intake as part of a balanced approach to weight loss.

Phenotype-guided pharmacotherapy using naltrexone/bupropion extended-release (NB-ER) is the preferred treatment for obesity patients with emotional hunger, as it addresses both weight and depression symptoms.

If you struggle with emotional eating and depression, ask your doctor about NB-ER (naltrexone/bupropion). It is specifically shown to help with both weight loss and mood in this subgroup, unlike many standard antidepressants which may cause weight gain.

GLP-1 receptor agonists (liraglutide, semaglutide, tirzepatide) are effective for weight loss in patients with obesity and may improve depression scores, with a low rate of adverse psychiatric events.

GLP-1 agonists (like Semaglutide or Tirzepatide) are highly effective for weight loss (15-21%) and may also improve depression. They have a low risk of psychiatric side effects. Discuss these with your doctor if you have no thyroid cancer history.

Semaglutide (2.4 mg once-weekly) produces significant, sustained weight loss (10-15%) and improves cardiometabolic markers in non-diabetic individuals with obesity or overweight, primarily by mimicking GLP-1 to reduce appetite and energy intake.

If you have obesity or are overweight without diabetes, semaglutide (2.4 mg weekly) is a highly effective medical treatment that can help you lose 10-15% of your body weight and improve your metabolic health. It works by reducing your appetite. While it can cause temporary stomach issues like nausea, these often subside. It works best when combined with diet and exercise, but it is significantly more effective than lifestyle changes alone for substantial weight loss.

GLP-1 receptor agonists (semaglutide) and dual incretin agonists (tirzepatide) achieve 15-20% total body weight loss, rivaling the efficacy of bariatric surgery.

If you have obesity, these medications offer a powerful, non-surgical path to significant weight loss (15-20%). They require a weekly injection and likely lifelong use, but they can improve metabolic health and may be more accessible than surgery for some. Discuss with your doctor if you are a candidate.

GLP-1 receptor agonists (semaglutide and tirzepatide) produce significantly greater average weight loss (14.9% and 18.5%, respectively) than physicians estimate (9.22%), and are associated with high rates of gastrointestinal side effects (80-90%) that are significantly underestimated by prescribers.

If you are prescribing GLP-1 agonists, ensure you are counseling patients on the high likelihood of gastrointestinal side effects (up to 90%) and the significant magnitude of weight loss (15-18%). Underestimating these factors leads to poor adherence and unrealistic expectations.

Health Behavior Intervention (HBI) consisting of 13 dietician-led counseling sessions over 1 year is a cost-effective strategy for managing class III obesity compared to no treatment.

For individuals with class III obesity, engaging in 13 dietician-led counseling sessions over a year is a cost-effective way to manage weight and prevent complications, especially if surgery is not an option.

Incretin medications (GLP-1 RAs and dual agonists) are the most effective class of AOMs for older adults, achieving 15-25% weight loss, but require careful titration to manage side effects.

Incretin drugs like Semaglutide and Tirzepatide are currently the most effective weight loss medications for older adults, often resulting in 15-25% body weight loss. They work by mimicking gut hormones to reduce hunger. Doctors usually start with a low dose to minimize side effects like nausea and gradually increase it.

Achieving a 5% weight loss over one year results in substantial direct medical cost savings for people with obesity, with savings increasing alongside higher obesity severity.

You do not need to achieve massive weight loss to see financial benefits. Losing just 5% of your body weight within a year can lead to substantial savings in direct medical costs, with the greatest savings seen in those with higher obesity severity (Class II and III). Focus on achieving this modest, sustainable reduction.

Phentermine/topiramate and naltrexone/bupropion are effective alternative pharmacotherapies for weight loss (4-10%) in patients without cardiovascular contraindications, offering oral administration options.

If you cannot take or afford weekly injections, oral medications like phentermine/topiramate or naltrexone/bupropion are effective alternatives. They typically result in 4-10% weight loss. Side effects like nausea or insomnia are common but often improve over time, especially if you start with a low dose and increase slowly. These are not suitable if you have heart disease, high blood pressure, or a history of seizures.

Resistance training over a full range of motion is superior to partial range of motion for hypertrophy.

To build the most muscle, perform your exercises through a full range of motion. Partial reps are less effective for hypertrophy.

Supplementation with 5g/day spinach-derived thylakoid membranes combined with a hypo-caloric diet significantly improves atherogenic indices (AIP, CRI-I, CRI-II) and insulin resistance surrogates (TyG-BMI, METS-IR) in obese women with PCOS compared to placebo.

If you have PCOS and are overweight, adding 5 grams of spinach thylakoid extract daily to your calorie-restricted diet may help improve your blood vessel health markers and insulin sensitivity more than dieting alone. Take it 30 minutes before lunch.

Tirzepatide (5, 10, or 15 mg once weekly) provides significantly longer continuous time in glycaemic control (HbA1c <7.0% and ≤6.5%) and sustained body weight reduction (≥5%) compared to placebo, semaglutide 1 mg, and insulin therapies in patients with type 2 diabetes.

For patients with Type 2 Diabetes, tirzepatide (5, 10, or 15 mg once weekly) offers significantly longer periods of stable blood sugar (HbA1c <7.0%) and sustained weight loss (≥5%) compared to placebo, semaglutide 1 mg, and insulin therapies. This suggests that tirzepatide may provide more durable disease management with fewer hypoglycaemic events than insulin.

A combined high-protein (25% energy) and low-glycemic-index (LGI) diet is superior to low-protein/high-GI diets for maintaining weight loss and improving insulin resistance (measured by TyG index) after an initial energy-restricted weight loss.

If you have recently lost weight, switch to a maintenance diet that is high in protein (around 25% of calories) and low in glycemic index (low-GI carbs). This specific combination helps you keep the weight off longer and improves insulin sensitivity better than diets low in protein or high in glycemic index. You do not need to count calories strictly; focus on the quality of your protein and carbohydrate sources.

Adopting a low-carbohydrate (LC) or very low-carbohydrate ketogenic (VLCK) diet (defined as <50g, 50-100g, or 101-150g carbohydrates per day) improves glycemic control and facilitates the deprescribing of antihyperglycemic medications in patients with Type 2 Diabetes Mellitus (T2DM).

If you have Type 2 Diabetes, reducing your daily carbohydrate intake to under 150 grams (and potentially under 50 grams for ketosis) can significantly improve your blood sugar levels and allow you to reduce or stop diabetes medications. Work with your doctor to adjust your insulin and other drugs to prevent low blood sugar, and ensure you are drinking enough water and getting electrolytes to avoid initial side effects like fatigue or cramps.

Type 2 Diabetes Mellitus can be put into remission (defined as HbA1c < 6.5% for ≥ 3 months without T2DM medications) through the use of therapeutic carbohydrate reduction and subsequent medication deprescription.

If you have Type 2 Diabetes, remission is possible. This means getting your blood sugar (HbA1c) below 6.5% for at least 3 months without taking diabetes medications. This is achieved by strictly limiting carbohydrates and working with your doctor to safely stop or reduce your diabetes drugs. It requires commitment to the diet and close monitoring.

A 12-week dietitian-led telehealth intervention using web-based applications reduces 24-hour systolic blood pressure by approximately 6.7 mmHg, achieving efficacy comparable to a self-directed approach using the same digital tools.

To lower your blood pressure, you can use a structured digital program. If you add weekly check-ins with a dietitian who helps you set goals and stay motivated, you may get an extra benefit in nighttime blood pressure and physical activity, but the core digital tools alone will still significantly lower your daytime blood pressure.

A dietitian-led telehealth intervention significantly reduces sleep (nocturnal) systolic and diastolic blood pressure more effectively than a self-directed digital approach.

If you want to improve your nighttime blood pressure, adding professional coaching to a digital health program is more effective than using the app alone. The dietitian support helps drive the lifestyle changes that specifically lower blood pressure during sleep.

Resistance exercise followed immediately by protein feeding significantly increases phosphorylation of Akt Ser473, p70S6K1 Thr412, and rpS6 Ser235/236 in human skeletal muscle, with the combined stimulus producing greater or more sustained signaling than feeding alone.

To maximize the cellular signaling for muscle growth, combine resistance exercise with protein intake. This study shows that doing both together triggers a stronger and more sustained activation of key muscle-building pathways (mTORC1) than eating protein alone. Specifically, performing resistance training followed by a protein-containing meal leads to higher levels of signaling molecules like Akt and p70S6K1, which are critical for muscle protein synthesis.

Distributing a fixed weekly volume of resistance training across four sessions per week yields greater maximal strength gains than performing the same volume in a single session.

If you are an experienced lifter aiming to maximize your squat strength, split your weekly leg volume across four separate sessions (e.g., one heavy compound lift per day) rather than doing it all in one day. This allows you to handle heavier loads with better technique and less fatigue, resulting in significantly greater strength gains over 8 weeks compared to a single weekly session.

High-frequency (4x/week) and low-frequency (1x/week) resistance training produce equivalent improvements in muscle hypertrophy (muscle thickness) and jump height when weekly volume is equated.

If your primary goal is building muscle size (hypertrophy) or improving jump height, you do not need to train your legs 4 times a week. You can achieve similar muscle growth and power improvements by performing the same total volume of exercises in just one session per week. Focus on hitting your total weekly volume and intensity, regardless of how you split the sessions.