Browse the evidence

The multiple-pass 24-hour recall is the recommended method for estimating energy intake during obesity treatment because it minimizes underreporting compared to other traditional methods.

Ask your clinician to use a 'multiple-pass' 24-hour recall method for at least 3 days (including a weekend). This involves a structured interview where they probe for forgotten foods (snacks, drinks) in multiple steps. This is more accurate than simple food diaries or questionnaires.

The fixed-dose combination of phentermine and extended-release topiramate (Qsymia) produces synergistic, robust, and sustained weight loss in obese adults, with a significant proportion achieving ≥10% weight loss.

For adults with obesity (BMI ≥35, or ≥27 with comorbidities), the combination of phentermine and extended-release topiramate is a clinically approved option that can produce significant, sustained weight loss (often >10% of body weight) when combined with a caloric deficit. It is designed to be taken once daily, starting at a low dose and titrating up to maximize tolerance. This approach addresses the limitation of short-term monotherapies by offering a long-term management strategy with a favorable risk-benefit profile for many patients, though it requires monitoring for specific side effects like paresthesia or cognitive changes.

Habitual sleep duration of less than 6 hours or greater than 9 hours is associated with a significantly increased risk of cardiovascular disease (CVD) and all-cause mortality compared to 7-8 hours of sleep.

Aim for 7-8 hours of sleep per night to minimize cardiovascular risk. Both sleeping less than 6 hours and more than 9 hours is associated with higher risks of heart disease and death. Prioritize consistent, adequate sleep duration as a key modifiable health factor.

Management of sarcopenia in cirrhosis requires a multi-pronged approach including specific nutritional targets (35 kcal/kg, 1.2-1.5 g/kg protein) and exercise (150-200 mins/week), with late-evening snacks recommended.

To fight muscle loss, you need to eat enough calories (at least 35 per kg of body weight) and protein (1.2-1.5 grams per kg) every day. Don't restrict protein even if you have liver confusion. Also, eat a snack before bed to stop your body from breaking down muscle overnight. Combine this with moderate exercise for 150-200 minutes a week.

Weight-bearing exercise during childhood and adolescence maximizes peak bone mass, which delays the onset of osteoporosis by approximately 13 years and reduces fracture risk by up to 50% in post-menopausal women.

Prioritize weight-bearing physical activities (like jumping, running, or resistance training) during childhood and teenage years. This is the most effective window to build maximum bone density, which acts as a buffer against bone loss later in life. Even if you were less active as a child, starting exercise in adulthood still helps preserve existing bone strength.

Aerobic exercise training significantly improves body composition, cardiovascular health, and metabolic profiles in patients with metabolic syndrome, with isolated aerobic exercise appearing optimal for reducing fat mass and body mass.

If you have metabolic syndrome, engaging in aerobic exercise for at least 12 weeks is a highly effective strategy to improve your health. You can expect improvements in your weight, waist size, blood pressure, blood sugar, and cholesterol levels. You do not necessarily need to combine this with resistance training to see these benefits, as aerobic exercise alone is sufficient and optimal for many of these outcomes. Aim for moderate to high intensity aerobic activity, but consistency over 12+ weeks is key.

Whey protein supplementation combined with resistance training produces greater skeletal muscle hypertrophy and lean body mass gains compared to soy protein or carbohydrate placebo.

If you are lifting weights to build muscle, choose whey protein (isolate or hydrolysate) over soy or carbohydrate supplements. Take 15-25g of whey immediately before or after your workout. This strategy leverages whey's fast absorption and high leucine content to maximize muscle growth more effectively than other protein sources.

Weight loss of 5% to 10% of initial body weight produces clinically meaningful health benefits and is considered a success.

Aim for a 5-10% reduction in your starting weight. This amount is enough to improve your health markers and is considered a successful outcome by medical professionals.

Increasing physical activity to at least 30 minutes per day on 5 days a week, preferably combining cardiorespiratory endurance and resistance training, improves glucose homeostasis and insulin sensitivity.

Aim for 30 minutes of moderate activity, like brisk walking, on at least 5 days a week. If you can, add some strength exercises twice a week. If you can't do 30 minutes at once, break it into smaller chunks throughout the day; any movement counts.

Dietary modifications focusing on high fiber (≥25-35g/day), low saturated/trans fat (≤10% energy), and controlled sugar intake (≤50g/day) reduce diabetes risk and improve cardiovascular risk factors.

Eat more vegetables, whole grains, and legumes. Limit saturated fats (like butter) and sugars. Aim for 25-35 grams of fiber daily. This helps manage weight and lowers diabetes and heart disease risk.

Participation in running is associated with a significantly lower risk of all-cause, cardiovascular, and cancer mortality compared to non-running, regardless of the specific dose or volume of running.

Start running, even if it's just once a week for less than 50 minutes. You do not need to run fast, long, or frequently to gain significant protection against all-cause, cardiovascular, and cancer mortality. The key is participation, not perfection or high volume.

Weight reduction interventions consistently lower systolic and diastolic blood pressure in overweight or hypertensive individuals, with the magnitude of blood pressure reduction being directly proportional to the amount of weight loss achieved.

If you are overweight or have high blood pressure, losing weight is one of the most effective non-pharmacological ways to lower your blood pressure. You do not need to reach an 'ideal' weight; the reduction in blood pressure is directly proportional to how much weight you lose. Aim for a sustained weight loss of around 9 kg (approx. 20 lbs) through dietary changes, ideally with professional support, which can result in a clinically significant drop in both systolic and diastolic blood pressure.

Sugar-sweetened beverage (SSB) consumption causes significant health harms, specifically weight gain, type 2 diabetes, and cardiovascular disease, through mechanisms involving liquid calorie non-satiety, high glycemic load, and insulin resistance.

Limit sugar-sweetened beverages to reduce your risk of type 2 diabetes and heart disease. Liquid sugar is processed differently than solid sugar, leading to less fullness and higher blood sugar spikes. Even modest reductions in consumption can lower your long-term health risks.

Ingestion of milk (both fat-free and whole) following resistance exercise stimulates net muscle protein synthesis, shifting muscle protein balance from negative to positive.

Drink milk immediately after your resistance training. Both fat-free and whole milk work to build muscle by shifting your body into an anabolic state. Whole milk may offer a slight edge in utilizing specific amino acids like threonine compared to fat-free milk, but both are effective strategies for post-workout recovery.

Maximal fat oxidation (MFO) occurs at exercise intensities between 45% and 65% of VO2max, with rates ranging from 0.17 to 1.27 g/min in trained individuals, and can exceed 1.5 g/min in ketogenic-adapted individuals.

To maximize the amount of fat your body burns per minute, exercise at a moderate intensity, specifically between 45% and 65% of your maximum heart rate capacity (VO2max). If you are adapted to a ketogenic diet, you may achieve even higher fat oxidation rates, but for most people, staying in this moderate zone is key for maximizing fat burning efficiency.

Regular vigorous exercise is associated with a significantly lower risk of mortality before age 90 and better late-life physical function in men.

To maximize your chances of living to 90 with good health, engage in vigorous exercise that makes you sweat at least 2-4 times a week. This habit, combined with not smoking, maintaining a healthy weight, and controlling blood pressure, significantly lowers your risk of dying before 90 and improves your physical function in old age.

Athletes should consume high-quality protein distributed across 4-5 daily meals, targeting 0.3-0.4 g/kg per meal, to optimize muscle protein synthesis and adaptation to training.

Eat 4-5 meals a day, each containing about 0.3-0.4 grams of high-quality protein per kilogram of your body weight. For a 70kg athlete, this is roughly 21-28g of protein per meal. If you are trying to lose weight, aim for the higher end (0.4-0.5 g/kg) to protect muscle mass.

For events lasting longer than 90 minutes, consuming 30-90 g/hour of carbohydrates during the event improves performance by maintaining exogenous fuel supply as endogenous stores dwindle.

For races longer than 90 minutes, consume 30-60 grams of carbohydrates per hour. For races longer than 2 hours, aim for up to 90 grams per hour using a mix of carbohydrate sources (e.g., glucose and fructose). Practice this during training to avoid stomach issues.

Consuming sugar-sweetened beverages (SSBs) increases total energy intake and body weight because humans fail to compensate for liquid calories by reducing solid food intake, unlike when consuming solid foods.

Stop drinking your calories. Replacing sugar-sweetened beverages with water or non-caloric drinks is one of the most effective ways to reduce overall energy intake because your body doesn't naturally compensate by eating less food later. This shift directly addresses the 'liquid energy' problem driving global obesity.

Multicomponent exercise training (aerobic, strength, and balance) is the most effective intervention for improving mobility, increasing muscle mass and strength, and decreasing falls in older adults with physical frailty and sarcopenia.

If you are an older adult experiencing weakness or slowness, do not avoid movement. Engage in a structured program that combines walking (aerobic), resistance training (strength), and balance exercises. This combination is proven to preserve independence, reduce falls, and maintain muscle mass better than any single type of exercise.

Adults should perform at least 30 minutes of daily moderate-to-vigorous physical activity to maintain health, with 60 minutes recommended for weight gain prevention.

Aim for 30 minutes of moderate-to-vigorous activity every day. If you are trying to prevent weight gain, increase this to 60 minutes. You do not need to do it all at once; breaking it into 10-minute chunks throughout the day is effective.

Saturated and trans fatty acid intake should be limited to approximately 10% of total energy intake to reduce LDL-cholesterol and coronary heart disease risk.

Limit your intake of saturated and trans fats to about 10% of your daily calories. Focus on reducing foods high in these fats, such as fatty meats and processed foods, and replace them with healthier fats like those found in fish and plants.

Refined sugar intake should not exceed 10% of total energy intake to prevent obesity and caries.

Keep your refined sugar intake to 10% or less of your daily calories. This means limiting sugary drinks and processed sweets. Focus on getting your carbohydrates from whole foods like fruits, vegetables, and whole grains.

High levels of physical activity can blunt the effect of obesity-predisposing genetic variants (specifically FTO) on BMI and obesity risk, reducing the genetic predisposition by approximately 40%.

If you have a family history of obesity, prioritize regular, high-level physical activity. Studies show this can reduce your genetic risk for obesity by up to 40%, effectively neutralizing much of the genetic predisposition.