Browse the evidence

Early and intensive glycemic control, particularly within the first two years of diagnosis, is associated with a lower risk of long-term diabetes-related complications and can lead to diabetes remission in some patients.

If you are newly diagnosed with type 2 diabetes, starting treatment early is crucial. It can help prevent long-term complications and even lead to remission in some cases. Don't delay seeking medical advice or starting prescribed therapies.

During single-joint resistance training, non-recruited muscles undergo significant volume loss (atrophy), particularly when energy and protein intake are low, suggesting a localized reallocation of muscle mass from untrained to trained tissues.

If you are doing targeted resistance training (like arm curls or leg extensions) and not eating enough calories or protein, your untrained muscles may actually shrink. To maximize net muscle gain, ensure your energy and protein intake are sufficient to support the metabolic cost of building new tissue in your trained muscles, preventing your body from cannibalizing untrained muscles for energy.

Advanced resistance training systems (Rest-Pause and Sarcoplasmic Stimulating Training) induce significantly higher perceived exertion, pain, and displeasure compared to traditional multi-set training, despite producing lower post-exercise lactate concentrations.

If you are an experienced lifter, advanced techniques like Rest-Pause or Sarcoplasmic Stimulating Training can increase your total training load and volume, which are key for muscle growth. However, be aware that these methods will feel significantly more painful and unpleasant than standard training, even if they produce less lactate. Because of this high discomfort, these systems are best reserved for experienced athletes who can tolerate the psychological burden, rather than beginners.

Replacing saturated fatty acids with monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA) improves glycemic control and reduces cardiovascular risk in type 2 diabetes patients.

Focus on the quality of fats you eat. Replace butter, lard, and fatty meats with olive oil, nuts, seeds, and fish. This substitution helps your body use insulin better and protects your heart.

Monounsaturated fatty acids (MUFA) preserve insulin signaling and activate AMPK, while polyunsaturated fatty acids (PUFA) increase GLUT4 expression and mitochondrial function.

Include sources of both MUFAs (like olive oil) and PUFAs (like fish oil or walnuts) in your diet to support different aspects of insulin sensitivity.

GLP-1 receptor agonists and SGLT2 inhibitors are underutilized in specialist diabetes clinics for patients with BMI ≥ 35 kg/m2, despite guidelines recommending their use for weight-lowering effects.

Ask your doctor about GLP-1 agonists or SGLT2 inhibitors if you have Type 2 Diabetes and are overweight. These drugs help with weight loss and blood sugar control, unlike older medications that can cause weight gain.

Biliopancreatic diversion (BPD) and its modifications (BPD-DS, SADI) induce rapid remission of type 2 diabetes (T2D) and normalize lipid profiles, largely through hormonal mechanisms (increased GLP-1, decreased ghrelin) that occur independently of significant weight loss.

For patients with severe obesity and Type 2 Diabetes, surgical options like BPD-DS or SADI are highly effective at inducing diabetes remission (often >90%), frequently independent of immediate weight loss. This is driven by hormonal shifts (increased GLP-1, decreased ghrelin) caused by bypassing parts of the small intestine. While effective, these procedures require lifelong medical monitoring and vitamin supplementation to manage malabsorption risks.

A higher proportion of saturated fatty acids relative to total fat intake (SFA/TFAT) is associated with a 23% increased risk of all-cause mortality, whereas a higher proportion of polyunsaturated fatty acids relative to total fat (PUFA/TFAT) is associated with a 14% reduced risk, mediated partially by the neutrophil percentage-to-albumin ratio (NPAR).

To support longevity, focus on the ratio of fats in your diet rather than just cutting total fat. Ensure that polyunsaturated fats (found in fish, nuts, seeds, vegetable oils) make up a larger proportion of your total fat intake, while saturated fats (found in red meat, butter, cheese) make up a smaller proportion. This shift is associated with lower mortality risk, potentially by reducing systemic inflammation.

Higher dietary resistant starch (RS) intake is associated with significantly lower all-cause and cancer mortality, but not cardiovascular disease (CVD) mortality.

To potentially lower your risk of cancer and all-cause mortality, aim to increase your intake of resistant starch. The best sources are whole grains and legumes. A key strategy is to cook starchy foods (like potatoes, rice, or pasta) and then cool them before eating, as this process increases resistant starch content. Aim for the highest intake levels seen in the study (approx. 4.7 g per 1,000 kcal of energy), but do not do this by simply eating more total carbohydrates; instead, swap digestible carbs for RS-rich foods to avoid increasing total energy intake.

High starch intake (top quartile, >28.8 E%) is associated with a significantly higher risk of cardiovascular disease and all-cause mortality compared to moderate intake (22.8-25.3 E%), creating a U-shaped risk curve.

Aim for moderate starch intake, roughly 20-30% of your total daily energy, rather than very low or very high levels. This range is associated with the lowest risk of cardiovascular disease and death in this population. Focus on the source of starch (e.g., bread, potatoes) as the study notes specific protein associations.

In adult females aged 19-50, higher pasta consumption (tertiles) is associated with reduced body weight, waist circumference, and BMI compared to non-consumption, whereas no such weight-related benefits are observed in males or older adults.

If you are a woman between 19 and 50, including pasta in your diet is associated with lower body weight and BMI compared to not eating it. You can enjoy pasta as part of a weight-conscious diet.

Pasta consumption is associated with reduced intake of added sugars and saturated fats in adults, and reduced saturated fat in children, compared to non-consumption, while energy intake remains similar.

Eating pasta is linked to eating less added sugar and saturated fat than people who don't eat it. You can include pasta in your diet without worrying about increasing your sugar or fat intake.

For non-resistance trained women, distributing resistance training volume across four weekly split-body sessions yields equivalent maximal strength, muscle mass, and explosive power gains compared to two weekly full-body sessions, provided total weekly volume is equated.

If you are new to resistance training, you do not need to commit to four gym days a week to get strong or build muscle. You can achieve the same results with just two full-body sessions per week, as long as you perform the same total amount of work (sets and reps). Choose the schedule that fits your life best, as forcing four sessions may lead to dropping out.

For untrained individuals, training muscle groups four times per week (Full-Body) yields equivalent strength and hypertrophy gains as training them twice per week (Split), provided total weekly set volume is equal.

If you are new to lifting, you do not need to follow a complex split routine to maximize gains. You can train your entire body 4 times a week with fewer sets per session, or split your body into 2 groups and train each twice a week with more sets per session. As long as you do the same total number of sets per week and push close to failure, your results will be the same. Choose the schedule that fits your life best.

Competition preparation in physique athletes, characterized by severe energy restriction and intense training, causes significant reductions in IGF-1, IGFBP-3, and testosterone, along with increased cortisol and SHBG, leading to decreased muscle strength and mood disturbances, all of which are reversible upon recovery.

If you are preparing for a physique competition, expect significant drops in IGF-1, testosterone, and strength, along with increased fatigue and mood disturbances. These are normal, adaptive responses to severe energy restriction and intense training. Do not panic about temporary hormonal suppression; they will fully recover during the post-competition refeeding phase. Monitor your energy availability, but understand that some performance and hormonal decline is inevitable during the peak week.

Performing one long resistance training session results in higher perceived effort and discomfort, but also higher session pleasure and preference compared to splitting the same workout into two shorter sessions.

If you enjoy feeling like you've worked hard, do one long session. If you prefer to feel less uncomfortable during the workout, split it. Both approaches are valid; choose based on your psychological preference.

GLP-1 receptor agonists (GLP-1RA) and dual/triple incretin agonists significantly improve metabolic dysfunction-associated steatohepatitis (MASH) resolution without worsening fibrosis in patients with MASLD, primarily through indirect mechanisms involving weight loss, improved insulin sensitivity, and reduced hepatic lipogenesis.

If you have fatty liver disease (MASLD/MASH), especially with type 2 diabetes or obesity, GLP-1 based medications (like semaglutide or tirzepatide) are currently the most promising pharmacological treatment. They work by reducing liver fat, inflammation, and improving insulin sensitivity. While they may cause temporary stomach issues, they significantly increase the chance of resolving liver inflammation (MASH). The goal is to stop liver damage progression; fibrosis reversal is still being studied in larger trials. Consult a hepatologist or diabetologist for eligibility.

Long-term stable use of GLP-1 receptor agonists results in attenuated gastric emptying effects (tachyphylaxis) compared to recent initiation, reducing perioperative risk.

If you have been on your GLP-1 shot for months, your body has likely adapted, and your stomach empties more normally than when you first started. This makes surgery safer for you than for someone who just started the drug two weeks ago.

GLP-1 receptor agonists (semaglutide, liraglutide) suppress food intake and induce weight loss by targeting distinct neural pathways in the brainstem (NTS, AP, LC, VTA) and hypothalamus, rather than solely relying on peripheral vagal signaling.

GLP-1 medications like semaglutide work by directly acting on specific areas of the brain (brainstem and hypothalamus) to reduce hunger and food intake, rather than just sending signals from the gut. This central action is key to their effectiveness in treating obesity.

Tirzepatide, a dual GIP and GLP-1 receptor agonist, produces superior weight loss (up to -20.9% at 15mg) compared to placebo and established GLP-1 agonists, though it is not yet fully approved for obesity treatment in all contexts.

Tirzepatide (5-15 mg weekly) is a powerful dual-action drug that can help you lose up to 21% of your body weight. It is more effective than current GLP-1 drugs like semaglutide. However, it may not be fully approved for obesity treatment in your region yet, so discuss with your doctor if it's an option for you.

Older anti-obesity medications (Orlistat, Phentermine/Topiramate, Naltrexone/Bupropion) provide modest weight loss (3-10%) but are limited by side effects and lower efficacy compared to newer GLP-1 based therapies.

Older medications like Orlistat, Phentermine/Topiramate, and Naltrexone/Bupropion can help with weight loss (3-10%), but they are less effective than newer GLP-1 drugs. They also have specific side effects like oily stools (Orlistat) or potential mood/cognitive changes (Topiramate/Bupropion). They remain options if newer drugs are inaccessible or unaffordable.

A high-protein breakfast (34g) significantly increases subjective satiety and reduces hunger compared to a low-protein breakfast (6g) in young women with overweight, but this does not translate to reduced daily energy intake.

If you switch to a high-protein breakfast, you will likely feel fuller and less hungry in the hours after eating. However, be aware that this feeling of fullness may not automatically lead to eating less food throughout the rest of the day, as this study showed no difference in total daily energy intake.

Resistance training under hypoxic conditions (RTH) provides a trivial but statistically significant benefit for strength development (1RM) compared to normoxic training (RTN) when specific methodological variables are optimized.

If you have access to hypoxic training, you can gain a small advantage in strength over normal air training, but only if you structure your workout correctly. Focus on multi-joint exercises, do at least 9 sets per muscle group per week, and stop short of muscle failure (non-failure). Do not train to failure in hypoxia, as it may increase fatigue without adding benefit.

Optimizing resistance training prescription variables in hypoxia—specifically using non-full-body routines, multi-joint exercises, 9+ sets/week, and training to non-failure—yields a small but significant strength benefit over normoxic training.

To get the most out of hypoxic training, structure your week to train specific muscle groups separately (non-full-body). Use compound movements (squats, presses), aim for at least 9 sets per muscle group weekly, and crucially, stop 1-2 reps before failure. This specific combination yields better strength results than standard hypoxic training.