Browse the evidence

Intensive lifestyle intervention in adults with type 2 diabetes and overweight/obesity produces moderate, sustained weight loss and cardiovascular risk factor control, with significant cardiovascular benefits observed specifically in patients achieving >10% weight loss or >2 MET fitness increase in the first year.

For adults with type 2 diabetes, simply 'trying' lifestyle changes may not be enough to protect your heart. You need to aim for a significant result: losing at least 10% of your body weight or significantly increasing your physical fitness (measured in metabolic equivalents) within the first year. If you achieve this threshold, you are much more likely to see a reduction in cardiovascular outcomes compared to those who maintain their weight or fitness levels.

Metabolic surgery (bariatric surgery) is recommended for patients with type 2 diabetes and BMI ≥40 kg/m2, or BMI 35.0-39.9 kg/m2 without durable weight loss, and should be considered for BMI 30.0-34.9 kg/m2 without similar improvements, offering superior glycemic control and cardiovascular risk factor reduction compared to lifestyle/medical interventions.

If you have type 2 diabetes and a BMI of 30 or higher, metabolic surgery is a highly effective option, especially if other weight loss methods have failed. It offers superior glycemic control and significant reductions in cardiovascular risk factors. While there are short-term risks, perioperative mortality is low (0.03-0.20%), and the long-term benefits for health and mortality are substantial.

Frequent behavioral weight maintenance sessions (every-other-week) are significantly more effective for long-term weight loss maintenance than less frequent sessions (monthly or no maintenance).

To maintain weight loss, schedule regular check-ins (every 2 weeks) with a support system, whether a professional, a group, or a self-monitoring routine. Do not stop behavioral interventions after initial loss; consistent self-monitoring and problem-solving are key to preventing regain.

Consumption of specific whole fruits, particularly blueberries, grapes, and apples, is associated with a significantly lower risk of type 2 diabetes, whereas fruit juice consumption is associated with a higher risk.

Focus on whole fruits, specifically blueberries, grapes, and apples, to help lower your risk of type 2 diabetes. Limit fruit juice, as it is associated with higher risk. The type of fruit matters more than the total amount or glycemic index.

Adhering to a 'prudent' dietary pattern (high in fruits, vegetables, whole grains, legumes, poultry, and fish) significantly lowers the risk of coronary heart disease in women compared to a 'Western' pattern (high in red/processed meats, refined grains, sweets, and high-fat dairy).

To lower your risk of heart disease, structure your diet around a 'prudent' pattern: eat more fruits, vegetables, whole grains, legumes, fish, and poultry. Simultaneously, reduce your intake of red and processed meats, refined grains, sweets, and french fries. This combined approach is more effective for heart health than focusing on single nutrients.

Consuming 1 to 2 servings of seafood per week reduces the risk of sudden cardiac death, coronary heart disease, ischemic stroke, and congestive heart failure, particularly when seafood replaces less healthy foods.

Eat 1 to 2 servings of fish per week, focusing on oily fish like salmon, sardines, or canned tuna. Avoid frying the fish. This simple change can significantly lower your risk of heart attack, stroke, and sudden cardiac death, especially if you swap out less healthy proteins like processed meats.

Weight loss of 5–10% through diet and exercise substantially lowers all components of metabolic syndrome and reduces the risk of type 2 diabetes and cardiovascular disease.

Focus on achieving a 5-10% reduction in your current body weight through sustainable dietary changes and regular physical activity. You do not need to reach an 'ideal' weight to see substantial improvements in your blood pressure, lipids, and blood sugar. This modest loss is sufficient to significantly lower your risk of heart disease and type 2 diabetes.

Bariatric surgery is an effective treatment for individuals with BMI ≥ 40 or 35–40 kg/m² with significant comorbidity, offering greater weight loss and risk factor improvement than diet or drugs alone.

If you have a BMI over 40 (or 35-40 with serious health issues) and have tried diet and exercise without lasting success, bariatric surgery is a medically recognized option. It provides the most significant weight loss and improvement in conditions like diabetes and hypertension. However, it requires long-term commitment to follow-up and nutritional management.

Athletes should consume 1.3–1.8 g of protein per kg of body weight per day, distributed across 3–4 meals, to maximize muscle protein synthesis and adaptation.

Eat 1.3 to 1.8 grams of protein for every kilogram of your body weight each day. Split this total into 3 or 4 separate meals throughout the day rather than eating it all in one or two large doses. This strategy ensures your body has a steady supply of amino acids to build muscle after training.

During energy restriction (weight loss), athletes should increase protein intake to 1.8–2.0 g · kg−1 · day−1 to prevent the loss of lean muscle mass.

If you are cutting calories to lose fat, increase your protein intake to 1.8–2.0 grams per kilogram of body weight daily. This higher intake helps protect your muscle mass while you lose fat, especially if you are also resistance training.

Post-exercise protein intake of 20–25 g of high-quality protein maximally stimulates muscle protein synthesis in resistance-trained individuals.

After your resistance training session, consume 20–25 grams of high-quality protein (like whey, eggs, or meat). This amount is enough to maximally stimulate muscle growth, and eating more than this does not provide additional muscle-building benefits.

Adherence to a 'Prudent' dietary pattern, characterized by high intake of fruits, vegetables, legumes, fish, poultry, and whole grains, is associated with a reduced risk of type 2 diabetes.

Increase your consumption of fruits, vegetables, legumes, whole grains, fish, and poultry. This 'Prudent' dietary pattern is associated with a lower risk of type 2 diabetes, independent of body weight.

Post-diagnosis engagement in moderate-intensity recreational physical activity (≥2.8 MET-h/wk) significantly reduces the risk of breast cancer-specific mortality and all-cause mortality in women with invasive breast cancer.

After a breast cancer diagnosis, engaging in moderate-intensity recreational physical activity (like brisk walking) for at least 2.8 MET-hours per week is associated with a significantly lower risk of dying from breast cancer. You do not need to perform vigorous exercise to gain these survival benefits; consistent, moderate movement is effective.

Extended care interventions (face-to-face, telephone, or internet-based) significantly improve long-term adherence and weight maintenance compared to standard care with no follow-up.

If you are starting a weight loss program, insist on a plan that includes regular check-ins (monthly or biweekly) for at least a year after you reach your goal. This 'extended care' is the most effective way to keep the weight off, whether through phone calls, internet tools, or in-person visits. Do not assume that reaching your goal means you are 'done'; maintenance requires active support.

Skills training, specifically relapse prevention and problem-solving skills, combined with extended care, significantly improves long-term weight maintenance compared to extended care alone or no further contact.

Don't just learn about weight maintenance; practice it with support. Combine skills like problem-solving and relapse prevention with regular check-ins (extended care). This combination is far more effective than just learning the skills or just having check-ins alone.

Ingesting 20 g of whey protein every 3 hours (4 times daily) maximizes myofibrillar protein synthesis (MPS) over a 12-hour post-exercise recovery period, outperforming both larger boluses (40 g every 6 h) and smaller, more frequent doses (10 g every 1.5 h).

If you want to maximize muscle growth after a heavy leg workout, don't just eat your total daily protein in 2-3 big meals. Instead, consume 20 grams of high-quality protein (like whey) every 3 hours for the next 12 hours. This means eating 4 times post-workout. This strategy triggers more muscle building than eating larger amounts less frequently or grazing on tiny amounts constantly.

Health and wellness coaching is an effective behavioral intervention for improving health behaviors and outcomes when defined as a patient-centered process involving self-determined goals, self-discovery, and accountability, delivered by trained professionals.

To use health coaching effectively, ensure the process is patient-centered, meaning you set your own goals and the coach helps you discover solutions rather than just giving you a list of instructions. Look for a coach who fosters accountability and self-discovery, not just one who provides educational content. This approach is particularly useful for managing chronic conditions like diabetes or obesity.

Combining adherence to the 'fertility diet' with maintaining a healthy BMI (20-24.9) and engaging in vigorous physical activity (≥30 min/day) is associated with a 69% lower risk of ovulatory disorder infertility.

To maximize your chances of conceiving without ovulatory issues, aim for a healthy weight (BMI 20-24.9), engage in at least 30 minutes of vigorous exercise daily, and follow a diet rich in monounsaturated fats, vegetable proteins, high-fat dairy, iron, and multivitamins, while limiting trans fats, animal proteins, and high-glycemic carbohydrates.

GLP-1 receptor agonists (liraglutide, semaglutide) and dual GIP/GLP-1 agonists (tirzepatide) produce significant weight loss in adults with obesity by acting centrally to reduce appetite and peripherally to delay gastric emptying.

Semaglutide 2.4mg weekly, combined with a 500 kcal daily deficit and 150 minutes of weekly activity, produces an average 14.8% body weight loss over 68 weeks. Expect gastrointestinal side effects like nausea, which are common but often manageable.

Among women with type 2 diabetes, engaging in 4 or more hours per week of moderate-to-vigorous physical activity is associated with a substantially reduced risk of cardiovascular events compared to less than 1 hour per week.

If you have type 2 diabetes, aim for at least 4 hours of moderate-to-vigorous exercise per week, such as brisk walking, jogging, or gardening. This level of activity is associated with roughly a 40-50% lower risk of heart disease and stroke compared to being sedentary. You do not need to do intense gym workouts; consistent, moderate effort like brisk walking is highly effective and safe if you plan for it.

Adherence to a 'prudent' dietary pattern, characterized by high intake of fruits and vegetables, is inversely associated with the risk of acute myocardial infarction (AMI) globally.

To lower your risk of heart attack, adopt a 'prudent' diet: eat more fruits and vegetables and fewer fried foods, salty snacks, and meats. This pattern is protective globally, regardless of your specific country or region.

An unhealthy dietary intake, quantified by a Dietary Risk Score (DRS) emphasizing meat, salty snacks, and fried foods while de-emphasizing fruits and vegetables, increases the risk of AMI globally and accounts for approximately 30% of the population-attributable risk.

Use a simple rule: eat more fruits and vegetables, and less meat, salty snacks, and fried foods. This simple dietary shift can significantly lower your risk of heart attack.

Engaging in vigorous physical activity (e.g., running, jogging) reduces the relative risk of ovulatory disorder infertility, with each additional hour per week of vigorous activity associated with a 7% reduction in risk.

If you are trying to conceive, do not stop exercising. Aim for about an hour a week of vigorous activity, such as running, jogging, or racquet sports. This level of activity is associated with a lower risk of ovulatory infertility. You do not need to do moderate exercise like brisk walking to see this benefit, but vigorous activity helps.

Two weeks of progressive resistance exercise significantly increases the fractional rate of quadriceps muscle protein synthesis in both young and elderly adults, effectively eliminating the age-related deficit in synthesis rate without increasing whole-body or myofibrillar protein breakdown.

Start resistance training immediately, regardless of age. Your muscles are just as capable of building protein as a young person's when you lift weights at a challenging intensity (60-90% of your max). You don't need supplements to trigger this early response; the mechanical load itself is the signal.