Browse the evidence

Individualized nutritional interventions significantly improve nutritional knowledge and reduce eating disorder risk behaviors (EDE-Q) in competitive female athletes.

To improve your nutritional knowledge and reduce risky eating behaviors, seek a structured educational program that is part of a larger individualized plan. This should include 6 sessions covering energy availability, carbohydrates, and recovery, tailored to your specific sport and needs.

Incretin receptor agonists (GLP-1RA, dual/triple agonists) and SGLT2 inhibitors reduce the risk of progression to type 2 diabetes and improve cardiovascular outcomes in patients with prediabetes, primarily through weight loss and reduction of visceral ectopic fat.

If you have prediabetes along with obesity, heart failure, or kidney disease, your doctor may consider newer medications like GLP-1 agonists (e.g., semaglutide) or SGLT2 inhibitors. These drugs help with weight loss and reduce cardiovascular risk. They are not yet first-line for all prediabetes patients due to cost and lack of formal indications, but they can be very effective for high-risk individuals.

Intensive lifestyle interventions (ILIs) targeting fat reduction (specifically visceral and body fat mass) significantly improve complete remission rates in overweight patients undergoing fertility-sparing treatment for endometrial cancer and intraepithelial neoplasia.

For overweight patients undergoing fertility-sparing treatment for endometrial precancer, intensive lifestyle changes focusing on fat loss (not just scale weight) significantly improve remission rates. This involves a caloric deficit, daily moderate aerobic exercise, and resistance training to protect muscle mass. Aim for a modest ~3% weight loss, as excessive loss may reduce efficacy by depleting muscle.

Lifestyle interventions during OMM treatment should shift focus from caloric deficit for weight loss to optimizing health, specifically by mitigating lean mass loss through high protein intake and resistance training.

While taking OMMs, prioritize consuming 1.5g of protein per kg of fat-free mass (or 80-120g daily) and engage in resistance training 2-3 times per week. This helps preserve muscle mass and strength, which can be lost during rapid weight loss, and supports overall physical function.

A very low carbohydrate-low protein (VLCLP) diet is the most effective macronutrient ratio for weight loss compared to a moderate fat-low protein (MFLP) control diet, achieving a mean weight loss of 4.10 kg.

If your primary goal is weight loss, a diet very low in carbohydrates (≤30% of calories) and low in protein (≤30% of calories) appears more effective than high-protein low-carb diets. This approach outperforms standard moderate-fat diets. Ensure you are overweight or obese, as results in normal-weight individuals are not well-established.

Fluid ingestion during high-intensity cycling in the heat prevents performance impairment caused by low-level dehydration (<2% body mass loss), primarily by reducing ratings of perceived exertion (RPE) and plasma vasopressin (ADH) rather than by altering core temperature or plasma volume.

If you are cycling hard (near race pace) in the heat, do not wait until you are thirsty or feel dehydrated. Even a small loss of body weight (under 2%) will increase how hard the exercise feels (RPE) and cut your performance short. Drink a sodium-containing solution (20 mmol/l) in small, frequent amounts (e.g., 120ml every 10 minutes) during your warm-up or moderate-intensity phase to ensure you have fluid available for the high-intensity finish. This prevents the mental and hormonal strain of dehydration, allowing you to sustain power longer.

Upper and lower body muscle power, measured via the Wingate Anaerobic Test (WAT) and Maximal Sustained Power Output (MPO) tests, significantly predicts freestyle swimming performance in sprint (50m) and middle-distance (400m) events.

If you are a sprint or middle-distance swimmer, focus on developing specific muscle power (both upper and lower body) rather than just increasing your aerobic volume. Use tests like the Wingate Anaerobic Test to measure your power output, as this is a strong predictor of your race speed. While technique (distance per stroke) is also critical, improving your power output through targeted training can lead to measurable performance improvements.

Treatment-resistant type 2 diabetes, defined as failure to achieve HbA1c targets despite triple oral therapy (metformin, sulfonylurea, and a third agent), can be effectively managed by adding a DPP-4 inhibitor and an SGLT2 inhibitor to metformin, or by combining basal insulin with a GLP-1 receptor agonist or SGLT2 inhibitor.

If your blood sugar remains high despite taking three oral diabetes medications (metformin, a sulfonylurea, and another), ask your doctor about adding a DPP-4 inhibitor and an SGLT2 inhibitor. These oral drugs work together to lower blood sugar effectively. If you are already on insulin, adding a GLP-1 receptor agonist or an SGLT2 inhibitor can improve control, reduce insulin dosage, and help with weight loss without increasing hypoglycemia risk.

Adding herbs and spices to reduced-fat meals restores consumer liking to levels comparable to full-fat meals, effectively mitigating the palatability loss associated with fat reduction.

If you are cutting fat from your meals, do not skip the seasoning. Use herbs and spices generously to replace the flavor lost by removing fat. This study shows that reduced-fat meals with spices are liked just as much as full-fat versions, making it easier to stick to a lower-fat diet without feeling deprived.

Intensive lifestyle intervention (ILI) focused on weight loss and frequent goal-based pharmacological monitoring both significantly improve systolic blood pressure control in overweight/obese adults with type 2 diabetes compared to standard education and support.

If you have type 2 diabetes and high blood pressure, both intensive lifestyle changes (focusing on weight loss and exercise) and frequent monitoring with medication are effective strategies. Standard education alone is less effective. You should discuss these options with your doctor to find the best fit for your lifestyle and health goals.

Replacing sugar-sweetened beverages (SSBs) with water or non-nutritive sweeteners (NNS) reduces long-term weight gain and obesity risk in children and adults.

To manage weight, replace sugary drinks (soda, juice, sports drinks) with water or unsweetened beverages. This substitution is associated with reduced long-term weight gain. If you miss the sweetness, non-nutritive sweeteners (like stevia or aspartame) are a viable, low-calorie alternative that does not appear to negatively impact metabolism or appetite in the short term. Focus on reducing total caloric intake from beverages.

Replacing saturated fatty acids (SFAs) with polyunsaturated fatty acids (PUFAs) reduces the risk of coronary events and mortality, whereas replacing SFAs with carbohydrates increases risk.

Don't just cut fat; swap the right kind. Replace saturated fats (found in palm, coconut, dairy) with polyunsaturated fats (found in fish, flax, sunflower oils). Avoid replacing them with refined carbs, as that increases heart disease risk.

Low-carbohydrate diets can induce remission of type 2 diabetes, with clinical trials showing >50% remission rates in some studies.

If you have type 2 diabetes, a ketogenic diet (20-50g carbs/day) can potentially lead to remission. Work with your doctor to monitor blood sugar and adjust medications, as many patients reduce or stop medications within weeks.

Obesity causes secondary hormonal changes (elevated TSH, insulin/leptin resistance) that mimic hypothyroidism; weight loss alone can normalize these hormone levels without thyroid medication.

If you are obese and have slightly high TSH, it might be because of your weight, not a broken thyroid. Losing weight can often fix these hormone levels without medication. Ask your doctor if your thyroid issue is 'secondary' to obesity.

GLP-1 receptor agonists (e.g., tirzepatide) and bariatric surgery are highly effective for weight loss in patients with thyroid disease and should be considered when behavioral therapy fails, as they do not increase thyroid cancer risk in non-MTC patients.

If diet and exercise aren't enough, GLP-1 drugs or surgery are safe and effective options even if you have thyroid disease (unless you have a specific family history of thyroid cancer). These treatments cause significant weight loss (5-20%+) and improve cardiovascular health.

Bariatric surgery, specifically Roux-en-Y gastric bypass, resolves non-alcoholic steatohepatitis (NASH) in approximately 85% of patients and regresses liver fibrosis, outperforming conservative lifestyle interventions.

For obese patients with fatty liver disease who have not achieved results with diet and exercise, Roux-en-Y gastric bypass is a highly effective treatment that can resolve NASH in the majority of cases and reverse fibrosis. It should be considered before liver damage becomes irreversible (cirrhosis).

Weight loss of 7-10% through lifestyle interventions (diet and exercise) leads to histological improvement in MAFLD, including reduced steatosis, ballooning, and inflammation.

Lose 7-10% of your body weight through a Mediterranean diet and regular exercise. This amount of weight loss is enough to improve liver health histologically. Even 5% loss helps.

Replacing saturated fat with polyunsaturated fat reduces cardiovascular disease risk, whereas replacing it with carbohydrate does not.

To lower your heart disease risk, focus on swapping saturated fats (like those in some meats or butter) with polyunsaturated fats (like those in nuts, seeds, and vegetable oils). Simply cutting fat without replacing it with healthy fats, or replacing it with refined carbs, will not improve your heart health.

Adherence to the DASH diet lowers systolic blood pressure by 5.5 mmHg and diastolic blood pressure by 3 mmHg.

If you have high blood pressure, follow the DASH diet by eating more fruits, vegetables, and low-fat dairy. This can lower your systolic blood pressure by about 5.5 mmHg and diastolic by 3 mmHg.

Physician-delivered nutrition counseling utilizing the 5A model (Assess, Advise, Agree, Assist, Arrange) significantly improves patient retention of advice and leads to measurable improvements in dietary intake, weight, and blood lipid levels.

If you have a chronic condition like diabetes or high blood pressure, ask your doctor for a structured nutrition counseling session using the '5A' method. Ensure your doctor is trained in this specific approach. Be prepared to discuss your readiness to change on a scale of 1-10. If you are not ready, focus on building motivation. If you are ready, work with your doctor to set small, specific goals and schedule follow-ups. Do not rely solely on a referral to a dietitian; your primary doctor's ongoing involvement is critical for success.

Integrating an online weight management program with population health management (PHM) support from nonclinical staff significantly improves patient engagement and weight loss outcomes compared to the online program alone.

If you are using a digital weight loss program, do not rely on it alone. Seek out programs that include human support, such as a coach or health manager, who can check in on your progress, answer questions, and provide accountability. This human element is critical for staying engaged and achieving better weight loss results.

For chronic nonspecific low-back pain, exercise programs incorporating supervision, high dose (>20h), and individualized design provide larger effect sizes on pain and function.

For chronic back pain, choose supervised, individualized programs with high dose (>20h).

Once-weekly subcutaneous semaglutide 2.4 mg significantly reduces ad libitum energy intake, suppresses appetite, and improves control of eating in adults with obesity, leading to clinically meaningful weight loss, without evidence of delayed gastric emptying at steady state.

Take 2.4 mg of subcutaneous semaglutide once weekly. Start with the lowest dose (0.25 mg) and escalate every 4 weeks as directed to minimize side effects. Expect a significant reduction in hunger, food cravings, and overall calorie intake, leading to weight loss without needing to manually restrict calories.

A Very Low-Calorie Ketogenic Diet (VLCKD) protocol, defined as <800 kcal/day with <50g carbohydrates, 1-1.5g protein/kg ideal body weight, and 15-30g fat, produces significant short- and long-term weight loss and superior fat mass reduction compared to standard low-calorie diets.

To use this protocol, you must follow a strict daily limit of under 800 calories with less than 50g of carbs, 15-30g of fat, and 1-1.5g of protein per kg of your ideal body weight. This is typically done for 8-12 weeks using meal replacements and supervised by a doctor. Expect significant weight and fat loss, superior to standard diets, but be prepared for mild, manageable side effects initially.