Browse the evidence

A Mediterranean eating plan supplemented with extra-virgin olive oil (EVOO) significantly delays the initiation of new glucose-lowering medications in patients with type 2 diabetes compared to a low-fat control diet, without requiring caloric restriction or weight loss goals.

If you have type 2 diabetes, incorporating a Mediterranean-style diet rich in extra-virgin olive oil (aiming for about 4 tablespoons daily) may help delay the need to start new diabetes medications. This approach focuses on food quality rather than strict calorie counting or weight loss, and it involves regular dietary support sessions to maintain adherence.

High intake of fructose and high-glycemic carbohydrates promotes obesity and insulin resistance through de novo lipogenesis, ectopic lipid deposition, and inflammatory pathways, whereas high fiber intake improves metabolic health via short-chain fatty acid production and microbiome modulation.

Prioritize whole, fiber-rich carbohydrates (vegetables, whole grains, legumes) and minimize added sugars, especially fructose and high-fructose corn syrup found in processed foods and beverages. The type of carbohydrate matters more than the total amount for metabolic health.

Higher consumption of sugar-sweetened beverages (SSBs), refined grains, red/processed meats, and white rice is associated with an increased risk of type 2 diabetes, while higher consumption of whole grains, fruits, vegetables, legumes, and nuts is associated with a decreased risk, independent of body mass index (BMI).

Focus on the quality of your diet. Reduce sugar-sweetened beverages, refined grains, and processed meats. Increase whole grains, fruits, vegetables, legumes, and nuts to lower your risk of type 2 diabetes, even if your weight remains stable.

Higher baseline habitual physical activity, measured objectively as daily step count, is associated with a significantly lower risk of progression to type 2 diabetes in individuals with impaired glucose tolerance.

If you have prediabetes, aim to increase your daily step count. The study shows that every additional 2,000 steps per day (roughly 20 minutes of walking) lowers your risk of developing type 2 diabetes by about 5.5%. You don't need to reach 10,000 steps immediately; start by adding small amounts of walking to your day. Use a simple pedometer to track your progress objectively.

Ingesting 23 g of protein with 5 g of leucine following endurance exercise achieves near-maximal myofibrillar protein fractional synthetic rate (FSR), providing bioequivalent stimulation to a three-fold higher dose (70 g protein / 15 g leucine).

After intense endurance exercise, consume 23 grams of protein combined with 5 grams of leucine (spread over 4 servings in the first 90 minutes) along with carbohydrates and fat. This specific dose maximizes your muscle's ability to synthesize new protein. Consuming significantly more protein (e.g., 70g) provides no additional benefit for muscle synthesis and is less nutritionally efficient.

Restricting dietary carbohydrate to less than 130 grams per day improves metabolic health markers (insulin sensitivity, lipid profile, blood pressure) in individuals with insulin resistance, type 2 diabetes, or metabolic syndrome, often superior to low-fat diets.

To improve metabolic health, especially if you have insulin resistance or type 2 diabetes, reduce your daily carbohydrate intake to under 130 grams (or under 50 grams for a ketogenic effect). Ensure you eat adequate protein (1.2-2.0 g/kg of adjusted body weight) and replace lost electrolytes (sodium, potassium) to avoid side effects. This approach is more effective for metabolic markers than traditional low-fat diets.

Supplementation with plant sterols or plant stanols significantly reduces total cholesterol and LDL cholesterol in individuals with familial hypercholesterolemia.

If you have Familial Hypercholesterolemia, adding 2-3 grams of plant sterols or stanols daily to a standard cholesterol-lowering diet can significantly lower your total and LDL cholesterol. These are often found in fortified spreads or yogurts. This is an effective dietary adjunct, but it does not replace the need for medical management if prescribed.

Track and field athletes aiming for weight maintenance or gain should consume 1.3–1.7 g/kg body mass per day of protein, distributed in 0.3–0.4 g/kg servings, to optimize muscle protein synthesis and training adaptation.

If you are a track and field athlete trying to build or maintain muscle, aim for 1.3 to 1.7 grams of protein per kilogram of your body weight each day. Spread this out over 3 to 4 meals, aiming for about 0.3 to 0.4 grams per kilogram per meal (roughly 20-30 grams per serving for most athletes). Combine this with your regular training.

Track and field athletes undergoing energy restriction (weight loss) should consume 1.6–2.4 g/kg body mass per day of protein, combined with resistance training, to preserve or increase lean body mass.

If you are cutting weight for competition, increase your protein intake to 1.6–2.4 grams per kilogram of body weight daily. Spread this across 3-5 meals. Crucially, you must also perform resistance training to signal your body to keep muscle while losing fat. This approach helps you lose fat without losing strength or muscle mass.

Implementing subjective autoregulation methods (such as Reps in Reserve or flexible daily undulation) and objective autoregulation methods (such as velocity targets or velocity loss) into resistance training programs effectively enhances maximal strength.

To maximize strength gains, stop using rigid percentage-based plans that ignore how you feel or perform on any given day. Instead, adjust your weights and volume based on your daily readiness. You can do this subjectively by tracking how many reps you have left in reserve (RIR) or using Rating of Perceived Exertion (RPE). Alternatively, use objective tools like velocity-based training (VBT) to set velocity targets or limit velocity loss per set. Both approaches allow you to account for daily fluctuations in fatigue and fitness, leading to better strength outcomes than fixed programming.

GLP-1 receptor agonists (GLP-1 RAs) promote weight loss and improve glycemic control through multiple mechanisms including increased satiety, slowed gastric emptying, and enhanced insulin secretion, with semaglutide 2.4 mg showing the highest efficacy.

GLP-1 receptor agonists like semaglutide are highly effective for weight loss and blood sugar control. Semaglutide 2.4 mg taken once weekly (either orally or by injection) resulted in an average loss of 15.3 kg over 68 weeks in clinical trials. This is significantly more effective than placebo. These drugs work by increasing satiety, slowing digestion, and improving insulin function. They are suitable for adults with obesity or type 2 diabetes.

Resistance training increases the integrated rate of myofibrillar protein synthesis (MyoPS) and the synthesis rates of individual skeletal muscle proteins in older men during energy restriction, regardless of whether dietary protein is distributed evenly or skewed.

If you are an older adult trying to lose weight, focus on resistance training. The timing of your protein intake (whether you spread it out or eat it all at once) does not significantly impact your muscle protein synthesis rates as long as you are training. Prioritize the training stimulus over complex nutritional timing.

Resistance exercise combined with protein-carbohydrate feeding induces a sustained translocation of mTORC1 to the cell periphery (sarcolemma) in human skeletal muscle, which is associated with prolonged S6K1 kinase activity compared to feeding alone.

To maximize the duration of muscle-building signals, combine resistance training with protein intake. While eating protein alone triggers some signals, adding resistance exercise keeps the key growth machinery (mTORC1) active at the muscle cell membrane for longer (up to 3 hours post-workout), potentially supporting better muscle growth over time.

Higher cardiorespiratory fitness (CRF) is inversely and dose-dependently associated with a reduced risk of type 2 diabetes in the general population, with a 1-MET increase in CRF reducing risk by 10%.

To lower your risk of type 2 diabetes, focus on improving your cardiorespiratory fitness (CRF). You don't need to run marathons; even small increases in fitness (measured in METs) provide a 10% risk reduction per unit. Aim for activities that challenge your heart and lungs, like brisk walking, jogging, or cycling, and consider getting an objective fitness assessment if possible to track progress accurately.

For type 2 diabetes prevention, reducing body weight (BMI) is more effective than improving cardiorespiratory fitness (CRF) alone.

To prevent type 2 diabetes, losing weight is more impactful than just getting fit. If you are overweight, focus on weight loss first, as it reduces diabetes risk more significantly than improving fitness alone. However, maintaining fitness is still beneficial and should be part of your overall strategy.

Tirzepatide 15 mg provides superior HbA1c reduction and bodyweight loss compared to other GLP-1RA-based therapies, including high-dose GLP-1RA and GLP-1RA plus basal insulin fixed-ratio combinations, without increasing the risk of hypoglycemia.

For patients with type 2 diabetes seeking maximum glycemic control and weight loss, tirzepatide 15 mg is the most effective GLP-1RA-based therapy available, outperforming high-dose GLP-1RAs and insulin combinations without increasing hypoglycemia risk.

Adopting three or four healthy behaviors (increased physical activity, reduced alcohol, improved diet) within the first year of type 2 diabetes diagnosis significantly reduces the risk of cardiovascular disease events over five years.

Within the first year of your type 2 diabetes diagnosis, focus on making three key lifestyle changes: move more (aim for about an hour of brisk walking daily), cut back on alcohol, and improve your diet by eating more fiber and fruits/vegetables while reducing total fat and calories. Doing these three or four things together can significantly lower your risk of heart attacks and strokes over the next five years, even if you are taking medication.

Internet-delivered personalized nutrition interventions produce larger and more sustained improvements in dietary behavior compared to standard 'one-size-fits-all' healthy eating advice.

Use a personalized nutrition service delivered online rather than generic diet advice. The Food4Me study showed that tailoring advice to your specific diet and health data leads to better, longer-lasting changes in eating habits than standard guidelines. Ensure the service is internet-based for scalability.

Lifestyle interventions achieving 7-10% body weight loss are effective in resolving nonalcoholic steatohepatitis (NASH) and regressing fibrosis in patients with metabolic-associated fatty liver disease (MAFLD).

To reverse liver inflammation and fibrosis, you need to lose 7-10% of your body weight through diet and exercise. Losing more than 10% can even reverse scarring (fibrosis). The hardest part is sticking with it, as most people fail to reach these targets. Combine a calorie-restricted diet (like the Mediterranean diet) with 150-300 minutes of moderate exercise per week.

Post-exercise branched-chain amino acid (BCAA) supplementation significantly reduces delayed onset muscle soreness (DOMS) compared to placebo in untrained or recreationally active adults.

If you are new to exercise or train recreationally, taking a BCAA supplement (typically 5-10g) after your workout may help reduce muscle soreness the next day. This might help you stick to your routine. However, if you are an advanced athlete, you likely won't see much benefit, and you should prioritize getting enough total protein from food rather than relying on BCAAs.

Obesity (BMI > 30-35) in kidney transplant candidates increases the risk of delayed graft function, acute rejection, and graft loss, making weight reduction a recommended pre-transplant intervention.

If you are waiting for a kidney transplant and have a BMI over 30, you need to lose weight to improve your chances of success and reduce complications. Work with your medical team on a weight loss plan, which may include bariatric surgery, to get your BMI below 35 before your transplant.

Long-term intensive lifestyle intervention (caloric restriction and increased physical activity) improves mobility function (gait speed and lower extremity performance) in overweight/obese middle-aged and older adults with type 2 diabetes, primarily mediated by achieved weight loss.

For older adults with type 2 diabetes and obesity, a long-term lifestyle program focusing on modest weight loss (around 7%) and regular moderate physical activity (like brisk walking) can significantly improve walking speed and lower body function. This benefit persists for years and is not negated by potential muscle loss, as strength levels remain comparable to those who do not undergo such intensive lifestyle changes.

Health coaching utilizing motivational interviewing and mindfulness improves sustained weight loss and physical activity in patients with cardiovascular risk factors or chronic conditions.

If you struggle with weight or activity, consider a health coach who uses motivational interviewing. Look for programs with multiple sessions (over 10) and remote options. This approach helps you set your own goals and monitor progress, leading to better long-term results than trying to do it alone.

Higher objectively assessed moderate-to-vigorous intensity physical activity (MVPA) at year 4 is significantly associated with greater long-term weight loss (4-year WL) in individuals with type 2 diabetes, independent of initial weight loss.

For long-term weight loss maintenance in type 2 diabetes, consistent moderate-to-vigorous physical activity (MVPA) matters more than how much you lost in the first year. Aim for higher weekly minutes (ideally >= 250 min/wk) as this is linked to greater long-term weight loss. However, if you cannot sustain high volumes, know that maintaining weight with lower activity (< 150 min/wk) is possible, likely supported by strict dietary adherence. Do not let the inability to hit 'expert' exercise targets discourage you from maintaining your weight.