Browse the evidence

Elevated liver disease activity, measured by MRI-derived iron-corrected T1 (cT1), is independently associated with a higher risk of major cardiovascular events, atrial fibrillation, heart failure, CVD hospitalization, and all-cause mortality.

If you have elevated liver disease activity (measured by MRI cT1), your risk for heart failure, atrial fibrillation, and other cardiovascular events is significantly higher, independent of your liver fat or standard blood tests. This suggests that assessing liver health via advanced imaging may be crucial for cardiovascular risk stratification, even in those without metabolic syndrome.

Combining 3g/day calcium HMB with high protein intake (60g on training days, 30g on non-training days) during 12 weeks of resistance training significantly increases leg fat-free mass compared to protein supplementation alone, though it does not significantly increase whole-body fat-free mass.

If you are doing resistance training and already eating enough protein, adding 3g of Calcium HMB daily (split into 6 doses of 0.5g) can significantly boost your leg muscle growth compared to protein alone. However, do not expect this to change your total body weight or scale readings significantly. The benefit is localized to the legs, likely due to the specific training stimulus and metabolic response in large muscle groups.

Diabetes remission, rather than weight loss itself, is the primary driver for reducing the risk of new-onset microvascular complications.

While weight loss is important, achieving diabetes remission (normal blood sugar without medication) is what actually protects against microvascular complications like kidney and eye damage. Weight loss without remission may not provide this specific protection.

Dulaglutide 1.5 mg reduces systolic blood pressure (SBP) and pulse pressure in patients with type 2 diabetes, with the majority of this reduction (64% for SBP, 86% for pulse pressure) being independent of weight loss.

If you have Type 2 Diabetes, taking dulaglutide (1.5 mg weekly) can lower your systolic blood pressure by about 2.6 mmHg after 6 months. Crucially, most of this benefit comes from the drug's direct effect on your blood vessels and nervous system, not just from losing weight. This means you may see blood pressure improvements even if your weight remains stable.

Higher doses of dulaglutide (4.5 mg) provide additional blood pressure reduction compared to 1.5 mg, but this additional benefit is primarily driven by greater weight loss rather than enhanced weight-independent mechanisms.

Increasing your dulaglutide dose from 1.5 mg to 4.5 mg may lower your blood pressure a bit more, but this extra benefit comes mostly from losing more weight, not from a stronger direct effect on your blood vessels. If you are not losing enough weight on 1.5 mg, the higher dose might help your BP by helping you lose more weight.

The packaged food supply in New Zealand supermarkets is dominated by a small number of companies and is predominantly unhealthy, with 59% of products classified as having a Health Star Rating (HSR) below 3.5, 53% as discretionary, and 69% as ultra-processed.

The current supermarket environment in NZ is heavily skewed towards unhealthy, ultra-processed foods controlled by a few large companies. Individual choice is limited by this market structure. Systemic policy changes, such as mandatory reformulation targets and front-of-pack labeling, are required to improve the healthiness of available products.

Products that voluntarily display the Health Star Rating (HSR) label on the front of pack have significantly higher health scores (mean 3.2) compared to those that do not display the label (mean 2.5).

Voluntary labeling is not enough; companies that display the Health Star Rating tend to have healthier products. Mandating this label for all products would help consumers easily identify healthier options and encourage manufacturers to reformulate.

Core food groups such as bread, breakfast cereals, cheese, canned baked beans, and yoghurt have significant potential for reformulation to meet Heart Foundation targets, yet many dominant companies fail to meet these sodium and sugar targets.

Major food companies have the ability to reduce sodium and sugar in staple foods like bread and yogurt, but many are not doing so. Government-mandated reformulation targets for these core categories are necessary to improve population health.

Progressive overload in cardiac rehabilitation is achieved primarily through increasing exercise duration rather than intensity, resulting in suboptimal cardiorespiratory fitness improvements.

For cardiac rehab, simply doing more minutes of exercise isn't enough if the intensity stays the same. To improve fitness, you must increase the effort (heart rate/resistance) as you get fitter, not just the time spent. Relying solely on duration leads to minimal fitness gains.

Obesity significantly increases the risk of cardiovascular disease, heart failure, and cerebrovascular disease, even in individuals classified as 'metabolically healthy'.

If you have obesity, your risk for heart disease and heart failure is significantly higher than someone with a normal weight, even if your blood pressure and cholesterol are currently normal. You should prioritize cardiovascular health monitoring and weight management strategies to mitigate this elevated risk.

Tirzepatide improves hepatic steatosis and renal outcomes in patients with type 2 diabetes, independent of or additive to weight loss.

Tirzepatide not only helps with blood sugar and weight but also significantly reduces liver fat and protects kidney function in people with type 2 diabetes. This makes it a valuable option for those at risk of liver or kidney complications.

Women with obesity exhibit distinct physiological and psychological responses to weight management compared to men, including greater neural sensitivity to food rewards, higher baseline leptin levels, and a tendency toward peripheral (gluteo-femoral) fat distribution which offers metabolic protection until menopause.

If you are a woman with obesity, your body may respond differently to food and stress than a man's due to hormonal and neural factors. This is not a failure of willpower. Post-menopause, your fat distribution may shift to the abdomen, increasing health risks. Work with providers who assess your specific hormonal status and mental relationship with food, rather than just applying a generic 'calories in, calories out' model.

Post-menopausal women face a significantly increased risk of cardiovascular disease and metabolic complications due to the shift from protective gluteo-femoral fat to visceral, perivascular, and epicardial fat accumulation following estrogen decline.

After menopause, your body stores fat differently, often around organs (visceral/epicardial fat), which increases heart disease risk even if your BMI stays the same. Focus on maintaining muscle mass and reducing visceral fat through exercise and diet, as standard BMI checks may not capture this new risk.

In strength-trained individuals, resistance training frequency (1x vs 3x per week) produces equivalent maximal strength (1RM) and muscle hypertrophy (CSA) gains when total training volume is equalized.

If you are an experienced lifter, you do not need to train a muscle group three times a week to get bigger or stronger. You can train it once a week, provided you perform the same total amount of work (volume) and intensity. Focus on getting your sets in during that single session rather than spreading them out for frequency's sake.

In patients with type 2 diabetes and recent acute coronary syndrome, a body weight gain of 5% or more is independently associated with an increased risk of cardiovascular mortality or heart failure hospitalization.

If you have diabetes and heart disease, gaining more than 5% of your body weight is a warning sign of heart failure. It likely means your body is holding onto fluid. Monitor your weight daily and seek medical attention if you see a rapid increase, as this may require medication adjustment for your heart.

Long-term intentional weight loss via intensive lifestyle intervention causes greater bone mineral density loss at the hip in men with type 2 diabetes compared to control, increasing frailty fracture risk.

If you have type 2 diabetes and are planning to lose weight, be aware that men may experience greater bone loss at the hip over the long term. To mitigate this, ensure your weight loss plan includes bone-preserving strategies such as resistance training, adequate calcium and vitamin D intake, and regular monitoring of bone density, rather than relying solely on caloric restriction and walking.

High adherence to a Mediterranean diet attenuates the risk of type 2 diabetes associated with obesity, independent of weight loss.

If you are overweight or obese, adopting a Mediterranean diet pattern (rich in vegetables, fruits, nuts, legumes, whole grains, and olive oil) can significantly lower your risk of developing type 2 diabetes, even if you do not lose weight. Focus on food quality and composition rather than just calorie counting.

High cardiorespiratory fitness combined with low saturated fat intake attenuates the negative impact of high waist circumference on early-phase insulin secretion (DI30) in women.

If you have a higher waist circumference, focus on building cardiorespiratory fitness and reducing saturated fat intake. This combination can significantly protect your body's ability to secrete insulin in response to glucose, especially if you are a woman. It is not just about weight loss; fitness and diet quality matter independently.

Higher dietary fiber intake is positively associated with whole-body insulin sensitivity (Matsuda-IS) independent of cardiorespiratory fitness and waist circumference.

Increase your intake of dietary fiber, particularly from whole-grain bread and vegetables. This improves insulin sensitivity regardless of your current fitness level or waist size. Aim for higher fiber consumption as a standalone strategy to support metabolic health.

In women with high waist circumference, low saturated fat intake combined with high fitness significantly preserves early-phase insulin secretion (DI30) compared to those with suboptimal lifestyle profiles.

For women with higher body weight, combining a diet lower in saturated fats with regular cardio exercise can significantly help maintain healthy insulin secretion. This protective effect is less pronounced in men, highlighting the importance of sex-specific lifestyle strategies.

Training to muscular failure elongates recovery time courses and increases fatigue perception compared to non-failure training, potentially impairing subsequent performance if insufficient recovery time is allowed between sessions.

Avoid training to failure on exercises scheduled before high-priority sessions (like heavy singles or technical lifts). Reserve failure training for isolation movements, the last set of a session, or when you have ample recovery time (48+ hours) before training the same muscle group again. This preserves performance for important lifts.

Exercise selection significantly impacts recovery time, with lower body, multi-joint, eccentric-heavy, and lengthened-position exercises requiring longer recovery periods (48-72 hours) compared to upper body or isolation movements.

Schedule lower body, multi-joint, or eccentric-heavy exercises (like squats, deadlifts, or lengthened partials) with at least 48 hours of rest before training the same muscle groups again. Use upper body or isolation exercises for more frequent training sessions.

Home-based training (HBT) is an effective alternative to supervised exercise training when SET is not feasible, provided it is monitored.

If you can't go to a supervised clinic, do home-based walking exercises. Start with 20 minutes and build up to 60 minutes, 3 times a week. Use a pedometer, smartwatch, or logbook to track your activity. This is a valid alternative to supervised training.

High-intensity interval training (HIIT) engages a unique subset of skeletal muscle signaling networks compared to work-matched moderate-intensity continuous training (MICT), specifically involving kinases and pathways associated with plasma lactate levels.

If you are healthy and untrained, HIIT can trigger unique muscle signaling pathways linked to metabolic health (like lactate response) that moderate continuous training does not, even when the total work done is the same. This suggests HIIT is a potent tool for metabolic adaptation.