Browse the evidence

Loss-of-function mutations in the myostatin (MSTN) gene cause excessive skeletal muscle growth (hypertrophy) and increased strength by removing the natural inhibition on muscle development.

This paper describes a rare genetic condition (myostatin deficiency) that causes massive muscle growth. For the average person, this is not a viable or safe intervention. However, understanding that myostatin limits growth suggests that therapies blocking it (under medical supervision) might help those with muscle-wasting diseases, but it is not a recommendation for healthy individuals seeking hypertrophy.

Perivascular Fat Attenuation Index (FAI) measured via cardiac CT serves as a biomarker for coronary inflammation and predicts cardiac mortality, with values above -70.1 HU indicating a 6- to 9-fold higher adjusted risk of future cardiac mortality.

If you are getting a heart scan for chest pain, ask your doctor about the Fat Attenuation Index (FAI). This AI-enhanced measurement looks at the fat around your heart arteries to detect hidden inflammation. A high FAI score means your risk of a heart event is much higher, even if your arteries don't look blocked yet. This helps doctors treat you before a major problem occurs.

Semaglutide does not significantly impact renal outcomes, including nephrolithiasis, acute kidney injury, or chronic kidney disease, in patients with overweight or obesity.

If you are using semaglutide for weight management or cardiovascular risk reduction, do not expect it to protect your kidneys. This meta-analysis found no significant impact on renal outcomes like kidney stones or acute kidney injury in overweight or obese patients.

Pharmacological inhibition of Complement C3 using AMY-101 improves healthspan, metabolic fitness, and reduces inflammaging in aged mice.

In aged mice, weekly injections of a C3 inhibitor (AMY-101) improved metabolic health and physical function. This suggests that targeting the complement system could be a viable strategy to combat age-related decline, potentially mimicking the benefits of caloric restriction.

Age-associated elevation of C3a in visceral adipose tissue (VAT) is primarily driven by adipose tissue macrophages (ATMs) via an autocrine ERK-dependent signaling loop.

In aging, fat tissue (specifically visceral fat) becomes a source of inflammation due to immune cells (macrophages) producing complement proteins like C3a. This process is driven by specific signaling pathways within these cells.

Obesity heritability is estimated at 40-70%, driven by over 1000 genetic variants and complex interactions with environmental and epigenetic factors, with early-onset severe obesity strongly linked to specific genetic mutations.

Recognize that obesity has a strong biological basis, with heritability estimates up to 70%. For those with early-onset severe obesity, genetic factors play a major role. This understanding supports the use of targeted therapies and early screening rather than relying solely on lifestyle advice.

Chronic hyperglycemia and oxidative stress induce beta-cell dedifferentiation by altering the balance of PAX4 and ARX gene expression, causing beta-cells to lose insulin-secreting identity and adopt alpha-cell features.

In Type 2 Diabetes, high blood sugar and stress can cause insulin-producing beta-cells to 'forget' their job and turn into glucagon-producing alpha-like cells. This is driven by epigenetic changes to genes like PAX4 and ARX. This loss of identity contributes to worsening blood sugar control, suggesting that therapies aiming to restore beta-cell identity or function could be beneficial.

Tirzepatide attenuates alcohol-induced dopamine release in the nucleus accumbens and induces sustained synaptic depression in the lateral septum.

Tirzepatide's effect on alcohol reward involves reducing dopamine release in the nucleus accumbens and altering synaptic plasticity in the lateral septum.

Finerenone, a nonsteroidal mineralocorticoid receptor antagonist, reduces the risk of heart failure and kidney disease progression in patients with chronic kidney disease and type 2 diabetes.

If you have type 2 diabetes and kidney disease, ask your doctor about finerenone. It helps protect your kidneys and heart from further damage.

Bariatric surgery in older adults (≥65 years) is associated with significantly higher rates of in-hospital mortality and complications compared to younger adults, and should be reserved for refractory cases.

Surgery is the most effective weight loss method but carries higher risks for those over 65. It should only be considered if you have severe obesity and have failed all other treatments, after a thorough risk-benefit discussion with specialists.

Cardiovascular disease (CVD) is the leading cause of death in China, accounting for 36% of deaths.

Healthcare strategies in China should prioritize addressing CVD to reduce mortality.

There has been little attention paid to designs, methods, and analytic techniques for early phase trials in behavioral intervention research.

More focus is needed on innovative designs for early phase trials in behavioral interventions.

No significant associations were found between LCD scores and mortality risk in other racial and ethnic groups.

Practitioners should be aware that LCD scores may not be relevant for mortality risk in non-Hispanic populations.

Despite extensive research, many unknowns remain in the field of nutrition due to the difficulty of studying lifestyle factors in isolation.

Practitioners should remain aware of the complexities and uncertainties in nutrition research.

Mechanistic studies may explain the cardiovascular benefits of SGLT2 inhibition in T2DM patients.

Practitioners should consider the underlying mechanisms when evaluating the cardiovascular benefits of SGLT2 inhibitors.

Genetically predicted higher childhood obesity, adult obesity, and increased fat-free mass are causally associated with a reduced risk of Brugada syndrome.

If you have Brugada syndrome, maintaining a BMI in the upper-normal range and increasing fat-free mass through resistance training may help reduce your risk. This contrasts with general population advice to lose weight, so consult your cardiologist about personalized weight management.

Pharmacological activation of brown adipose tissue using beta-3-adrenoreceptor agonists increases cardiovascular risk (heart rate and blood pressure) without providing weight loss benefits.

Avoid beta-3-adrenoreceptor agonists for weight loss. They increase heart rate and blood pressure and have failed in clinical trials due to side effects.

Acquired hypothalamic obesity (HO) is driven by structural damage to medial hypothalamic nuclei (ARC, PVN), leading to hyperphagia, central insulin/leptin resistance, and reduced sympathetic energy expenditure, resulting in rapid, treatment-resistant weight gain.

If you have hypothalamic obesity due to brain tumor or surgery, standard diet and exercise will likely fail because the brain's 'thermostat' is broken. You need medical interventions that target the specific hormonal pathways (like GLP-1 agonists or MC4R agonists) rather than relying on willpower alone.

In a universal healthcare system, socioeconomic status does not significantly influence access to bariatric surgery for individuals with severe obesity (BMI > 40 kg/m²), indicating equal access regardless of income or education.

If you have a BMI over 40, your income or education level should not stop you from getting bariatric surgery in a universal healthcare system. The medical eligibility criteria (BMI > 40) override socioeconomic barriers, ensuring equal access to publicly funded care.

SGLT2 inhibitors provide cardioprotection through hemodynamic improvements, specifically by reducing preload and afterload via osmotic diuresis and natriuresis, which decreases ventricular wall tension and myocardial oxygen consumption.

If you have Type 2 Diabetes and heart issues, SGLT2 inhibitors (like empagliflozin or dapagliflozin) are recommended not just for blood sugar, but to physically reduce the workload on your heart by helping your kidneys remove excess fluid and sodium, protecting your heart function.

SGLT2 inhibitors protect kidney function by restoring tubuloglomerular feedback, which reduces glomerular hyperfiltration and intraglomerular pressure, thereby indirectly reducing cardiovascular disease risk.

SGLT2 inhibitors protect your kidneys by reducing pressure inside the kidney filters, which also helps protect your heart, as kidney health is closely linked to heart health.

Continuous postoperative pulse oximetry (CPOX) monitoring without preoperative obstructive sleep apnea (OSA) screening is a safe and effective perioperative strategy for bariatric patients.

For bariatric patients, skipping preoperative sleep testing and relying on continuous pulse oximetry monitoring after surgery is a safe alternative. This approach avoids the cost and time of preoperative screening while maintaining low complication rates, provided patients receive supplemental oxygen and monitoring during the first postoperative night.

Menopausal hormone therapy (MHT) containing estrogen does not reduce cardiovascular disease risk and may increase stroke risk in women with type 2 diabetes, making it unsuitable for primary prevention.

Do not use estrogen patches or pills to protect your heart if you have diabetes. While they help with hot flashes, they do not prevent heart attacks and may increase stroke risk. Focus on blood pressure, lipids, and blood sugar control instead.

Intensive lifestyle coaching combined with care coordination does not reduce 10-year cardiovascular disease risk or improve secondary health outcomes in people with schizophrenia spectrum disorders and abdominal obesity compared to treatment as usual.

For individuals with severe mental illness and obesity, intensive lifestyle coaching and care coordination do not appear to offer additional cardiovascular benefits over standard medical care alone. While the intervention was well-intentioned and assertive, it did not lead to significant improvements in weight, fitness, or cardiovascular risk factors over two years. Clinicians should manage expectations and focus on standard medical management of risk factors, as behavioral interventions alone may not be sufficient for this population.