Browse the evidence

Resmetirom, a selective thyroid hormone receptor beta (THRβ) agonist, significantly reduces hepatic steatosis, liver fibrosis, and serum lipid levels (LDL, TG, ApoB) in patients with MASLD, particularly those with fibrosis.

For patients with fatty liver disease who have developed early scarring (fibrosis), Resmetirom is a new medication that targets the liver specifically to burn fat and reduce scarring. It also lowers bad cholesterol (LDL) and triglycerides. Clinical trials show it significantly improves liver health markers.

Reducing insulin resistance, rather than strictly lowering blood glucose, is the primary mechanism for reducing cardiovascular risk in type 2 diabetes.

For patients with Type 2 Diabetes, focusing solely on lowering blood sugar may not be enough to protect your heart. The key to reducing cardiovascular risk is improving your body's sensitivity to insulin. This can be achieved through lifestyle changes (weight loss, diet, exercise), specific medications like Metformin or Pioglitazone, or newer drugs like GLP-1 agonists (e.g., Liraglutide) and SGLT2 inhibitors (e.g., Empagliflozin), which offer cardiovascular benefits beyond glucose control.

Bariatric surgery (specifically Roux-en-Y gastric bypass and sleeve gastrectomy) induces greater magnitude of weight reduction and T2D remission than intensive medical therapy, though non-surgical interventions may offer better quality-of-life improvements.

If lifestyle changes fail after 6 months and you have Class 2/3 obesity, discuss bariatric surgery (RYGB or Sleeve) with a specialist. It offers the best chance for significant weight loss and T2D remission, but be aware of surgical risks and potential QoL trade-offs compared to medical management.

Acute resistance exercise increases the colocalization of IGF-1 with muscle satellite cells (SC) in humans, peaking at 72 hours post-exercise, indicating a localized role for IGF-1 in SC function and proliferation.

To maximize muscle repair and growth potential, perform resistance training. This triggers a local increase in IGF-1 at your muscle stem cells, peaking around 72 hours after the workout. This local signal is crucial for activating satellite cells, which are necessary for muscle repair and hypertrophy. Consistency in training ensures this mechanism is repeatedly engaged.

Rating of Perceived Exertion (RPE) correlates with blood lactate levels in high repetition resistance training protocols, suggesting RPE can be used as a non-invasive proxy for metabolic stress.

You can use how hard a set feels (RPE) to estimate your metabolic stress. In high-rep sets, if it feels very hard (high RPE), your lactate levels are likely elevated, indicating significant metabolic stress.

Contrave (naltrexone/bupropion) promotes weight loss (~6% TBWL) and may improve fertility by mitigating PCOS and endometriosis effects, though it is less effective than GLP-1 RAs.

Contrave is an oral option for weight loss that targets food cravings and reward pathways. It typically results in about 6% weight loss. It is less potent than GLP-1 injections but may help with emotional eating. You must stop taking it before trying to conceive.

GLP-1 receptor agonists (e.g., semaglutide, liraglutide) and dual/triple incretin agonists (e.g., tirzepatide, retatrutide) significantly reduce hepatic steatosis and liver enzymes in patients with MASLD, primarily through indirect mechanisms of weight loss and improved insulin resistance, though they may not consistently resolve fibrosis.

If you have MASLD, especially with diabetes or obesity, GLP-1 based therapies (like semaglutide or tirzepatide) are highly effective at reducing liver fat and inflammation. However, do not expect them to reverse advanced scarring (fibrosis) on their own. The benefit comes largely from the weight loss and metabolic control they provide, so they work best when combined with lifestyle changes.

Ketogenic diets produce superior short-term glycemic control (HbA1c reduction) compared to low-carbohydrate diets, but are not superior to other dietary patterns for long-term weight loss or metabolic outcomes.

If you have Type 2 Diabetes, a strict ketogenic diet (20-50g carbs/day) can lower your HbA1c faster than standard low-carb diets in the short term. However, do not expect it to help you lose more weight in the long run compared to other healthy diets. It is a tool for glycemic control, not a magic bullet for weight loss.

A higher variety score of dietary protein sources (consuming appropriate quantities from more of the eight major sources: grains, meat, poultry, fish, egg, legumes) is inversely associated with the risk of new-onset diabetes.

To lower your risk of type 2 diabetes, aim to include a variety of protein sources in your diet rather than relying on just one or two. The study suggests that consuming appropriate amounts from a mix of grains, legumes, fish, poultry, and eggs is associated with a significantly lower risk of developing diabetes compared to a diet with fewer protein sources. You do not need to eliminate any specific source, but rather ensure your diet includes a broad spectrum of these foods.

Total protein intake has a U-shaped association with diabetes risk, where both very low (<10.6% of energy) and very high (≥14.0% of energy) intakes are associated with higher risk compared to moderate intake (10.6-14.0% of energy).

Avoid both very low and very high total protein intakes. The study suggests that getting 10.6% to 14.0% of your daily calories from protein is associated with the lowest risk of developing diabetes. This means you should neither severely restrict protein nor consume excessive amounts, but rather aim for a moderate level.

Specific protein sources have non-linear associations with diabetes risk: fish and legumes show inverse J/L-shaped associations (lower risk with higher intake), while red meat and poultry show J/U-shaped associations (increased risk at high intakes).

Choose your protein sources wisely. Fish and legumes are associated with lower diabetes risk, especially at higher intakes. Red meat and poultry should be consumed in moderation, as high intakes are associated with increased risk. Eggs and whole grains are also beneficial when consumed in appropriate amounts.

Chronic resistance exercise training increases skeletal muscle LAT1 protein content, but this increase is significantly blunted by concurrent leucine or whey protein supplementation compared to a placebo.

If you are doing resistance training, you will build muscle regardless of whether you take leucine or whey protein supplements. Interestingly, your body's expression of the LAT1 transporter (which moves leucine into cells) increased significantly more when you took a placebo compared to when you took leucine or whey. This suggests that supplementing with these specific compounds might blunt this specific molecular adaptation, even though it doesn't stop muscle growth. You don't need to avoid them, but don't expect them to maximize every single molecular marker.

High intake of starch (primarily from rice) is inversely associated with total, cardiovascular, and non-cancer/non-cardiovascular mortality in Japanese men, whereas high intake of total sugars (including glucose, fructose, and sucrose) is positively associated with these mortality risks.

For Japanese men, prioritizing starch (like rice) over sugars (including glucose, fructose, and sucrose) is associated with lower mortality risk. High sugar intake, regardless of source (free or natural), is linked to higher mortality. Women showed no significant association for starch, but free sugar intake was positively associated with mortality. Focus on reducing total sugar intake rather than just free sugars, and maintain starch intake as a primary energy source.

In Japanese women, high starch intake is not significantly associated with mortality, but high free sugar intake is positively associated with total and non-cancer/non-cardiovascular mortality.

For Japanese women, reducing free sugar intake is associated with lower mortality risk, while starch intake (like rice) does not appear to increase mortality risk. Focus on minimizing free sugars rather than restricting starch.

High-volume resistance training increases non-myofibrillar protein synthesis rates more than high-load resistance training, suggesting a mechanism for sarcoplasmic hypertrophy.

High-volume training may promote muscle growth through increased non-myofibrillar protein synthesis, which contributes to sarcoplasmic hypertrophy. This suggests that volume-based protocols can drive muscle growth through mechanisms beyond just contractile protein accretion.

In young and middle-aged adults (18-55 years), the combination of obesity, diabetes, and hypertension increases the risk of COVID-19-related mortality to levels comparable to those observed in older adults (56-75 years) without these conditions.

If you are under 55, your age alone does not protect you from severe COVID-19 outcomes if you have obesity, diabetes, or high blood pressure. These conditions combine to elevate your mortality risk to that of an older adult. Prioritize managing these metabolic factors through lifestyle changes and medical care, and ensure you are prioritized for preventive measures like vaccination.

Large-sized fast-food bundled meals (cheeseburger, fries, cola) provide 65-80% of daily energy and 63-91% of daily sodium, making portion-size labeling alone insufficient for managing intake.

When eating fast food, do not rely on 'small' or 'regular' labels to control intake. A single large meal can provide most of your daily calories and sodium. To manage intake, choose smaller items, skip sugary drinks, and be aware that sodium and calories remain high even in 'healthy' options like grilled chicken.

Targeting specific inflammatory pathways (e.g., IL-1, TNFα, IL-6) with pharmacological antagonists can improve insulin sensitivity and glycemic control in patients with obesity and related inflammatory conditions.

In clinical settings, reducing inflammation through targeted medications can help manage blood sugar and insulin resistance in obese patients, especially those with co-existing inflammatory diseases. This supports the broader goal of reducing metabolic risk.

In females with type 2 diabetes, the combination of low fat mass and low muscle mass is synergistically associated with higher glycated hemoglobin (A1C) levels compared to other body composition phenotypes.

If you are a woman with type 2 diabetes, do not assume that being thin means your blood sugar is well-managed. This research shows that having low body fat AND low muscle mass is a specific risk factor for higher blood sugar levels. To improve your A1C, focus on building muscle mass through resistance training, rather than just trying to lose weight or stay thin.

In males with type 2 diabetes, high fat mass is significantly associated with higher A1C, but muscle mass does not significantly influence A1C levels.

If you are a man with type 2 diabetes, your blood sugar levels are more closely linked to your body fat than your muscle mass. While building muscle is healthy, prioritizing fat loss through diet and exercise is likely to have a more direct impact on lowering your A1C levels.

High consumption of ultra-processed foods (UPF) in young adult women is associated with a long-term increase in fat mass and a decrease in lean mass by early middle age.

For women, consistently high intake of ultra-processed foods (over 35% of daily grams) in your 20s predicts higher fat mass and lower muscle mass in your late 30s. To mitigate this, prioritize whole foods and minimize UPFs, as they are linked to unfavorable body composition changes over time.

White common bean extract (WCBE) rich in alpha-amylase inhibitor, taken 1.5g before meals, significantly improves glycemic control (HbA1c) and ameliorates diabetic peripheral neuropathy in type 2 diabetes patients over 4 months by remodeling gut microbiota to enrich SCFA-producing bacteria.

If you have Type 2 Diabetes, taking 1.5 grams of white common bean extract half an hour before each meal may help lower your HbA1c and improve nerve health. This supplement works by blocking starch digestion and feeding beneficial gut bacteria that produce short-chain fatty acids, which help regulate blood sugar. It should be used alongside your prescribed medication and dietary guidance, not as a replacement.

Resistance training in hypoxia (RTH) yields similar muscle hypertrophy and strength gains compared to normoxia when protocols are not optimized for specific covariates.

If you are training in hypoxia, do not expect automatic superior gains in muscle size or strength compared to training in normal air. The overall benefit is negligible unless you specifically optimize your rest intervals and load.

Resistance training in hypoxia enhances strength development (1RM) when using long inter-set rest intervals (≥ 120s) and moderate loads.

To gain strength in hypoxia, use moderate weights and rest for at least 2 minutes between sets. This allows you to maintain the intensity needed for strength adaptations, which hypoxia may support better than normoxia under these specific conditions.