Browse the evidence

Thiazolidinediones (specifically Pioglitazone) reduce the incidence of type 2 diabetes in individuals with impaired glucose tolerance, but their use is limited by adverse effects such as weight gain, fluid retention, and increased fracture risk.

Pioglitazone can prevent diabetes, but it often causes weight gain and other side effects. It is usually not the first choice; Metformin or GLP-1 medications are typically preferred unless Pioglitazone is specifically indicated for your case.

Higher physical activity levels significantly attenuate the genetic predisposition to obesity associated with the FTO rs1421085 risk allele, reducing its effect on BMI and body adiposity by 36–75%.

If you carry the FTO obesity risk gene, regular physical activity is your most effective tool to counteract that genetic predisposition. The study shows that being active can reduce the genetic impact on your body fat by up to 75%. Focus on consistent movement to mitigate your genetic risk.

Skeletal muscle hypertrophy can occur in an energy deficit, particularly in resistance training-naive, overweight, or obese individuals, challenging the textbook requirement for an energy surplus.

If you are new to resistance training or have higher body fat, you do not need to eat in a caloric surplus to build muscle. You can build muscle while losing fat by focusing on high protein intake and consistent resistance training. If you are already highly trained and lean, a small surplus may be more beneficial, but it is not strictly required for all populations.

Self-tracking of physical activity using wearable devices increases daily step count in people with type 2 diabetes, but does not significantly improve glycated hemoglobin (HbA1c) levels unless the individual achieves a specific threshold of activity increase (≥1000 steps/day).

Use a wearable tracker to monitor your daily steps, but don't expect your blood sugar to improve automatically. Focus on increasing your daily steps by at least 1,000 over your current baseline. If you achieve this increase, you are likely to see a meaningful improvement in your HbA1c. If you don't reach this threshold, your HbA1c may not change significantly, even if you are more active than before.

Resistance training protocols must report within-exercise variables beyond load and repetitions—including failure status, range of motion, time under tension, and attentional focus—to accurately determine the training stimulus.

When designing or documenting a resistance training program, do not just list the weight and number of reps. You must also specify whether sets were taken to failure, the range of motion used (full or partial), the speed/tempo of each phase, and whether the athlete used an internal or external focus. This level of detail is required to replicate the stimulus and ensure the training is effective.

Training to failure produces greater hypertrophic adaptations than training not to failure, but only when total volume is not equated; when volume is equated, the two methods yield equivalent results.

You do not need to train to failure on every set to maximize muscle growth. If you train close to failure but stop before, you can achieve similar hypertrophy as long as you match the total volume (sets x reps x load) of a failure-based program. Training to failure increases recovery time and may not be comfortable for beginners.

GLP-1/glucagon co-agonists achieve superior weight loss and metabolic improvements compared to GLP-1 mono-agonists by combining central appetite suppression with glucagon-mediated increases in energy expenditure and hepatic lipid oxidation.

GLP-1/glucagon co-agonists (like cotadutide and efinopegdutide) are emerging treatments that target both appetite and energy expenditure. They appear to offer greater weight loss than current GLP-1-only drugs (like semaglutide or liraglutide) and may also improve liver health. However, they carry a higher risk of gastrointestinal side effects like nausea and vomiting. Patients should expect a careful dose-titration process to manage these effects.

Skeletal muscle-derived VEGF, induced by endurance exercise via PGC-1α, mediates training-induced capillarization, enhancing oxygen and substrate delivery to muscle tissue.

Endurance training triggers your muscles to release VEGF locally, which builds new capillaries to improve oxygen delivery. You don't need to monitor blood VEGF levels to know this is happening; it is a standard, autonomous response to the stress of endurance exercise. Consistent training volume is the key driver.

High systolic blood pressure (SBP) and suboptimal diet (specifically low fruit/whole grain intake and high sodium) are the primary drivers of cardiometabolic mortality in Brazil, accounting for the majority of premature deaths before age 70.

To reduce your risk of heart disease or diabetes, focus on lowering your blood pressure and improving your diet. Specifically, increase your intake of fruits and whole grains, and reduce sodium consumption. These are the most impactful changes you can make based on population data.

High body mass index (BMI) is a significant contributor to premature cardiometabolic mortality, particularly in adults aged 45-69, largely mediated through its effects on blood pressure and glucose.

Maintaining a healthy weight is crucial for preventing early death from heart disease or diabetes, especially if you are middle-aged. This risk is often linked to blood pressure and blood sugar levels, so managing weight helps manage those metrics.

Exenatide once weekly improves glycemic control (A1C and FPG) and cardiovascular risk markers (SBP, LDL-C, triglycerides) independently of weight loss, although the magnitude of improvement is greater in patients with higher weight loss.

If you have Type 2 Diabetes, Exenatide once weekly will lower your blood sugar (A1C) and improve heart health markers even if you don't lose weight. However, you will get the biggest benefits if you do lose weight. Be aware that those who lose the most weight are more likely to experience nausea or hypoglycemia, especially if you are also taking sulfonylureas. Most people tolerate the injection well.

Obesity contributes to metabolic derangements, poorer lung and kidney function, vascular health issues, low-grade inflammation, and thrombotic potential, which collectively reduce the body's capacity to cope with the systemic effects of the hyperimmune response in COVID-19.

Obesity affects multiple body systems, making it harder to fight off severe infections like COVID-19. Managing weight can help improve these underlying health issues, potentially reducing the risk of severe illness. Focus on sustainable lifestyle changes to improve overall health.

Tirzepatide improves liver fat content and shows potential efficacy in treating nonalcoholic steatohepatitis (NASH) in patients with type 2 diabetes.

For patients with type 2 diabetes and fatty liver, tirzepatide significantly reduces liver fat content more than insulin therapy, potentially helping manage NASH.

Higher maternal pregnancy weight gain is independently associated with increased childhood BMI and a higher risk of overweight/obesity in offspring, even after controlling for shared genetic and environmental factors.

For expectant mothers, aiming for weight gain within recommended guidelines (typically 11-16 kg for normal BMI) is a prudent step for long-term child health. While the direct impact on any single child's weight is modest, avoiding excessive gain reduces the statistical risk of childhood overweight. This is best achieved through balanced nutrition and appropriate physical activity, rather than extreme restriction.

Implementing a 10% tax on sugar-sweetened beverages and subsidies on healthy foods (fruits, vegetables, whole grains, nuts/seeds) reduces cardiometabolic disease mortality by altering dietary intake patterns.

For policymakers, this evidence supports enacting a 10% tax on sugar-sweetened beverages and processed/red meats, while using the revenue to subsidize fruits, vegetables, whole grains, and nuts. This dual approach shifts consumer behavior toward healthier options, resulting in a measurable reduction in heart disease and diabetes deaths, particularly benefiting lower-income populations who are more price-sensitive.

Fiscal interventions on diet reduce health disparities between socioeconomic groups, with greater mortality reductions observed in lower education groups compared to college graduates.

Policymakers should design fiscal policies to explicitly account for higher price sensitivity in low-income populations. By combining taxes on sugary drinks and red meats with subsidies for fruits and vegetables, the policy can close the health gap between socioeconomic groups, as lower-income individuals are more likely to change their behavior in response to price changes.

Semaglutide significantly reduces high-sensitivity C-reactive protein (hsCRP) levels in patients with type 2 diabetes compared to placebo and active comparators, indicating an anti-inflammatory effect.

If you have type 2 diabetes, semaglutide (whether injected weekly or taken as a daily pill) significantly lowers hsCRP, a key marker of inflammation linked to heart disease risk. This reduction is greater than with placebo or other common diabetes drugs like exenatide or empagliflozin. While part of this benefit comes from losing weight and lowering blood sugar, there appears to be a direct anti-inflammatory effect. For patients with chronic kidney disease, the trend is positive but not statistically significant compared to placebo in this specific analysis, so discuss risks/benefits with your doctor.

Offering explicit swaps to lower-saturated-fat alternatives reduces the percentage energy from saturated fat in the shopping basket, but is less effective than altering the default product order.

If you are designing an online grocery platform, offer explicit swaps to lower-SFA alternatives when a user selects a high-SFA product. Ensure the swap matches the brand, weight, and price as closely as possible to increase acceptance. Note that this method is less effective than simply sorting products by health metrics.

Combining default order alteration and explicit swaps does not significantly increase the reduction in saturated fat compared to altering the default order alone.

If you are designing an online grocery platform, you do not need to implement both default ordering and explicit swaps. Implementing default ordering (sorting by SFA) is sufficient to achieve the maximum reduction in saturated fat. Adding explicit swaps provides no significant additional benefit and may increase complexity.

High consumption of ultra-processed foods (UPF) displaces unprocessed and minimally processed foods, leading to a diet with significantly higher free sugars, saturated fats, and energy density, and lower protein, fiber, and potassium, thereby increasing the prevalence of nutrient inadequacy associated with non-communicable diseases (NCD).

To improve your diet quality and reduce NCD risk, prioritize unprocessed or minimally processed foods (fruits, vegetables, whole grains, lean meats) and limit ultra-processed foods (soft drinks, packaged snacks, processed meats, industrial breads). As UPF consumption rises, your intake of harmful sugars and fats increases while beneficial fiber and protein decrease, significantly raising your risk of nutrient inadequacy.

Following 16 weeks of resistance training, the acute activation of muscle satellite cells (SC) in response to a single bout of exercise is augmented (increased Pax7+/MyoD+ cells and MyoD mRNA expression at 24h), which is accompanied by increased muscle fiber capillarization.

If you have been resistance training consistently for a few months, your muscles become more efficient at repairing themselves after a workout. Specifically, your muscle stem cells activate faster (within 24 hours) and express more growth-related genes (MyoD) after a single intense session compared to when you were a beginner. This suggests that long-term training enhances the muscle's ability to adapt to acute stress, likely supported by improved blood flow (capillarization) in the muscle.

Implementing the US FDA's voluntary sodium reformulation targets for processed foods reduces population sodium intake, lowers systolic blood pressure, and significantly decreases cardiovascular disease incidence and mortality, resulting in substantial net cost savings for society.

Supporting the FDA's voluntary sodium reduction goals for processed foods is a highly effective public health strategy. Even if compliance is not 100%, reducing sodium intake in processed foods lowers blood pressure and prevents hundreds of thousands of cardiovascular events, saving billions in healthcare costs. Focus on choosing lower-sodium processed options and advocating for industry reformulation.

Global mean potassium intake (2.25 g/day) is significantly below the World Health Organization's recommended target of >3.5 g/day, with only 14% of the global population achieving this level.

Most people globally do not eat enough potassium. To improve cardiovascular health, aim to increase potassium intake towards the WHO recommendation of >3.5 g/day, focusing on affordable sources like beans, potatoes, and leafy greens, especially if your sodium intake is high.

Polygenic risk scores (PRS) derived from South Asian-specific genetic data provide significantly better prediction of Type 2 Diabetes (T2D) risk than PRS derived from European data, identifying individuals with ~4-fold higher risk in the top quartile.

If you are of South Asian descent, standard genetic risk models based on European data may underestimate your specific risk for Type 2 Diabetes. To get an accurate assessment, seek out or advocate for polygenic risk scores (PRS) that are specifically calibrated using South Asian genetic data. This can identify if you are in the top quartile of genetic risk, which correlates with a 4-fold higher likelihood of developing T2D compared to the bottom quartile. Knowing this allows for earlier, more aggressive lifestyle interventions (diet, exercise, regular screening) to mitigate that risk.