Browse the evidence

Pharmacological activation of G protein-coupled receptors (GPCRs) in thermogenic brown and beige adipocytes can increase energy expenditure and improve metabolic health, but current adrenergic agonists have a narrow safety window due to cardiovascular side effects.

While cold exposure is a natural way to activate brown fat, scientists are developing drugs that target specific receptors (GPCRs) to do the same thing. Current drugs like mirabegron show promise for boosting metabolism by ~200 kcal/day, but they can affect heart rate. Future treatments aim to target these receptors more selectively to avoid side effects while still improving metabolic health.

Non-adrenergic Gs-coupled receptors (e.g., secretin, glucagon, adenosine) can stimulate brown adipose tissue thermogenesis independently of the sympathetic nervous system, offering a potential pathway to avoid cardiovascular side effects associated with adrenergic agonists.

Scientists are exploring hormones other than adrenaline (like secretin or glucagon) to activate fat-burning cells. These hormones can boost glucose uptake in brown fat by 57%, but they break down quickly. Future drugs may modify these hormones to last longer, potentially offering a way to boost metabolism without the heart risks of current adrenaline-targeting drugs.

Resmetirom, a selective thyroid hormone receptor beta (THR-β) agonist, significantly reduces hepatic fat content and improves fibrosis markers in patients with non-cirrhotic MASH.

If you have MASH (formerly NASH) with significant liver fat, ask your doctor about resmetirom. It is an FDA-approved medication that targets the liver specifically to reduce fat and improve fibrosis. The standard dose is 80mg or 100mg taken once daily. It is not a supplement but a prescription drug with specific eligibility criteria (non-cirrhotic MASH).

Postprandial plasma leucine concentration and ingested leucine dose are poor predictors of muscle protein synthesis (MPS) rates when protein is consumed as whole foods or mixed meals, indicating that leucine is not the sole or primary driver of the anabolic response in complex nutritional contexts.

Stop obsessing over hitting specific leucine targets with isolated powders. When you eat whole protein sources like eggs, meat, or dairy, your body handles the anabolic signaling effectively regardless of minor variations in leucine content. The food matrix and other nutrients play a crucial role that isolated leucine metrics miss.

Supplementation with Beta-Hydroxy-Beta-Methylbutyrate (HMB) in either free acid or calcium salt form does not enhance strength or hypertrophic adaptations to resistance training in resistance-trained men consuming adequate protein.

If you are already lifting weights regularly and eating enough protein (at least 1.7g per kg of body weight), taking HMB supplements (whether free acid or calcium salt) will not help you build more muscle or get stronger than you would from training alone. Save your money.

GLP-1 receptor agonists provide cardiovascular protection through peripheral anti-inflammatory effects, independent of their weight-loss or glucose-lowering actions.

Beyond helping you lose weight, GLP-1 medications like semaglutide have been shown to protect your heart. This protection comes from reducing inflammation in your body's peripheral tissues, offering a dual benefit for metabolic and cardiovascular health.

Pegozafermin (BIO89-100), an FGF-21 analog, demonstrates improvement in liver fibrosis in patients with MASH, as shown in Phase 2b trials, and has entered Phase 3 clinical trials.

Pegozafermin is an experimental drug for MASH that works by mimicking FGF-21. It is given as a subcutaneous injection every two weeks. It is currently in Phase 3 trials and not yet approved.

Pioglitazone, a PPAR-gamma agonist, improves steatosis, inflammation, and liver biomarkers in patients with MAFLD, but its effect on liver fibrosis is not clear.

Pioglitazone is an older diabetes drug that can improve liver fat and inflammation in MAFLD patients. However, it may cause weight gain and other side effects, and its ability to reverse liver scarring is unclear. It is sometimes used in patients with T2DM and MASH.

Chronic administration of GIP receptor agonists (specifically GIP108) causes functional desensitization of the GIP receptor in pancreatic islets, reducing the efficacy of subsequent glucose-lowering challenges.

Long-term use of GIP-based therapies (like tirzepatide) triggers a biological adaptation where the pancreas becomes less responsive to the drug's glucose-lowering signal. This is a known mechanism called desensitization. However, the drug still promotes weight loss, suggesting the benefit comes from multiple pathways, not just pancreatic sensitivity. If glycemic control wanes, dose adjustments may be necessary.

While a protein-polyphenol beverage accelerates early functional adaptations and increases type II fiber hypertrophy, it does not further increase peak isometric torque, overall muscle function, or total quadriceps muscle volume compared to placebo in the later stages of resistance training (sessions 10-30).

Don't expect this specific supplement to make you bigger or stronger than standard protein in the long run. The early boost in function and fiber size is nice, but for overall muscle volume and peak strength after the first month, it offers no advantage over a placebo or standard protein. You can likely stop the specialized polyphenol supplements after the initial adaptation phase.

Consumers exhibit significantly higher skepticism toward food advertisements than toward food labels, yet remain generally skeptical of both, including the Nutrition Facts Panel (NFP).

Do not assume that seeing a Nutrition Facts Panel or a government-regulated label automatically means a consumer will trust or use it. Consumers are skeptical of both ads and labels, though they trust labels slightly more. To improve adherence, labels must be designed to overcome this inherent skepticism, perhaps by being clearer and less misleading, rather than relying on the assumption that regulation alone builds trust.

Iso-caloric substitution of poly-unsaturated fat for saturated fat is associated with an increased risk of cancer-related mortality.

If you are replacing saturated fats (e.g., from butter, cheese, or red meat) with poly-unsaturated fats (e.g., from vegetable oils, nuts, or fish), this study suggests your risk of dying from cancer may increase by 12%. Consider balancing your fat intake and not relying solely on PUFA-rich oils as a health strategy.

Moderate-intensity lifestyle counseling delivered by primary care clinicians and lifestyle coaches yields negligible net weight loss (~1.3 kg) over 24 months, primarily due to significant weight rebound after the initial 12 months when coaching frequency is tapered.

If you are relying on a primary care weight loss program that involves seeing a coach monthly for a year and then less frequently, do not expect significant long-term weight loss. This study shows that such moderate-intensity interventions result in negligible weight change (~1.3 kg) and often a rebound after the first year. To achieve meaningful weight loss, you likely need more intensive, frequent, or specialized interventions than standard primary care counseling provides.

Polygenic scores derived from 59 SNPs associated with central adiposity predict a smaller reduction in waist circumference after one year of lifestyle intervention, though the effect size is too small to be clinically significant.

Your genes might make it slightly harder to lose belly fat compared to someone else with different genetics, but the difference is less than a centimeter. This is too small to matter for your health goals. Focus on the lifestyle intervention (diet and exercise) as it provides a much larger benefit than any genetic disadvantage.

When adipose tissue storage capacity is exceeded, lipids are redirected to the pancreas causing lipotoxicity, beta-cell dysfunction, and type 2 diabetes.

If you have obesity but do not have diabetes, your body may still be successfully storing fat in your adipose tissue. If you have obesity and diabetes, your body may have reached its limit for storing fat safely, causing fat to leak into your pancreas and damage insulin-producing cells. Focus on improving adipose tissue function rather than just weight loss.

Saturated fatty acids induce beta-cell apoptosis and dysfunction through ceramide accumulation and ER stress, whereas minimal levels of fatty acids are required for normal insulin secretion.

Your body needs some fatty acids to function properly, but too much, especially saturated fat, can poison your insulin-producing cells. This happens when your fat storage cells are full, forcing fat into your pancreas. Managing saturated fat intake and supporting fat storage health are key.

Pea protein supplementation (25 g/day for 13 days) does not attenuate exercise-induced muscle damage in older adults following prolonged walking, performing similarly to a placebo.

If you are over 60 and walk long distances, switching to pea protein instead of whey may not help reduce muscle soreness or damage markers. You might need to stick with whey or increase the dose of plant protein.

Short-term (2-week) crossover metabolic ward trials without washout periods are invalid for determining chronic macronutrient effects on energy intake and body fat due to massive, differential carry-over effects from physiologic adaptation.

Do not rely on short-term (under 4-6 weeks) diet studies to predict long-term weight loss outcomes. The body's metabolic adaptation to macronutrient changes (like ketosis or insulin shifts) takes weeks to months. Short trials often measure transient adaptation rather than chronic effects, leading to misleading conclusions about which diet is superior for fat loss.

In older adults, the muscle protein synthesis response to protein ingestion is blunted (anabolic resistance), and simply increasing protein intake does not overcome this resistance.

As you age, your muscles become less responsive to protein. Simply eating more protein won't build muscle. You must combine adequate protein intake with resistance exercise to overcome this 'anabolic resistance' and stimulate muscle growth.

Accelerometer-derived summary metrics (MIMS-unit, AAI, MAD, ENMO) derived from raw data provide greater comparability across different device manufacturers and models than traditional proprietary activity counts.

If you are a researcher, stop relying on proprietary 'counts' to compare studies. Use open-source raw data algorithms (like MIMS-unit or AAI) to ensure your findings are comparable across different device brands. If you are a consumer, understand that 'steps' or 'activity scores' from different brands are not mathematically equivalent, even if they look similar.

Food industry donations to academic programs create conflicts of interest by influencing research design, minimizing criticism of harmful products, and shaping public policy, often without transparent disclosure of the donation's purpose.

When evaluating health or nutrition research funded by food companies, check for disclosed conflicts of interest. If a study is funded by an industry with a vested interest in the outcome (e.g., sugary drinks funding obesity research), scrutinize the study design and conclusions more heavily, as industry funding is correlated with outcomes favorable to the sponsor.

Equating total load lifted (volume) during acute resistance training renders exercise intensity (35% vs 70% 1RM) irrelevant for acute neurotrophic factor (BDNF, NGF) responses.

If you want to stimulate brain-derived neurotrophic factors (BDNF) through resistance training, you do not need to lift heavy weights. As long as you lift the same total amount of weight (volume) as someone lifting heavy, your brain gets the same acute signal. This allows for joint-friendly training using lighter loads (e.g., 35% 1RM) to achieve similar neurotrophic outcomes to heavier loads (70% 1RM).

Prolonged use of Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for 3 years or more can enhance beta-cell function.

For those who cannot or will not undergo surgery or strict dieting, long-term GLP-1 agonist therapy (3+ years) may help preserve your pancreas's insulin-producing capacity. This is a disease-modifying effect, not just glucose lowering.

Cardiac diastolic function, specifically the E/e' ratio and Left Atrial Volume Index (LAVI), significantly moderates the reduction in relative peak oxygen uptake in Type 2 Diabetes patients.

For T2D patients, standard cardiac checks might miss the root cause of exercise intolerance. If you struggle with exercise despite normal ejection fraction, ask about diastolic function (E/e' ratio). Addressing this through specific training (like high-intensity interval training, as suggested by the authors) may be more effective than generic advice.