Browse the evidence

A diagnosis of Type 2 diabetes triggers a statistically significant but small reduction in household calorie purchases (approx. 2%), resulting in an estimated 4.3 to 8.3 pounds of weight loss in the first year, which is only about 10% of the reduction suggested by medical guidelines.

If you are diagnosed with diabetes, expect your diet to improve slightly, but do not expect it to fix itself. You will likely lose a small amount of weight (4-8 lbs) initially, but this is far less than doctors suggest. To get better results, do not try to eat 'healthier' in general; instead, identify your top 1-2 unhealthy food categories and focus exclusively on reducing them.

Changes in insulin resistance (measured by HOMA-IR) can be accurately predicted and monitored using serial measurements of body weight and fat mass via the Weight-Fat-Energy (WFE) calculation framework, eliminating the need for direct insulin or glucose testing.

To monitor your metabolic health without blood tests, track your body weight and fat mass daily using a reliable scale (bioimpedance or DXA). Use a mobile app that applies the Weight-Fat-Energy (WFE) model to these serial measurements. The app calculates your 'Rw-ratio' and predicts changes in insulin resistance based on the strong correlation between your body composition changes and metabolic health. This allows you to see the impact of your diet and exercise on your metabolic health indirectly but accurately.

Fat-restricted (RF) diets lead to greater overall fat mass loss and greater reduction in insulin resistance compared to carbohydrate-restricted (RC) diets, despite both diets being isocaloric.

If you are trying to lose fat, both low-carb and low-fat diets work if you eat the same number of calories. However, a fat-restricted diet might lead to slightly more fat loss because your body burns extra energy trying to turn excess carbs into fat. Don't obsess over cutting carbs; focus on the total energy balance and the energy cost of processing nutrients.

In emerging economies like Vietnam, the rapid expansion of modern retail and increased availability of ultra-processed foods (UPFs) drives a shift toward unhealthy dietary patterns, contributing to rising obesity and diabetes rates.

For policymakers in emerging economies: Simply having traditional markets is not enough. You must actively regulate the expanding modern retail sector (supermarkets/convenience stores) through labeling, marketing restrictions, and fiscal incentives to ensure healthy food remains affordable and accessible compared to ultra-processed options.

Experts prioritize communication, education, and voluntary standards over strict regulatory constraints (like taxes or advertising bans) when designing food environment policies.

Policymakers should not rely solely on education and voluntary standards. To effectively combat the rise of UPFs, they must implement stricter regulatory measures like taxes and marketing restrictions, despite perceived feasibility challenges, as these are proven to be effective in other contexts.

Long-term adherence to a Low-Carb High-Fat (LCHF) diet is difficult for most patients, leading to decreased efficacy over time compared to low-fat diets, although it may offer short-term benefits for diabetes management.

If you choose a low-carb diet, be aware that sticking to it strictly (e.g., <30g carbs) for more than a year is very difficult for most people and may lead to weight regain or increased LDL cholesterol. Focus on finding a carbohydrate level you can maintain socially and psychologically for years, rather than aiming for extreme ketosis if it causes you to quit.

Performing static hamstring stretching immediately before sets of the barbell back squat acutely increases biceps femoris muscle thickness without impairing total training volume or exercise performance.

If you want to target your hamstrings during squats, add a 40-second static hamstring stretch right before each squat set. Sit with legs extended, hinge forward until you feel a strong stretch (pain rating >7/10), hold for 40 seconds, then immediately perform your squat set. This will increase blood flow and muscle thickness in the hamstrings without hurting your performance or total volume.

Electromagnetic resistance devices (including variable resistance and eccentric overload settings) produce myoelectric activity (sEMG) amplitudes that are statistically similar to traditional dumbbell resistance training, with observed differences being modest (~5-10%) and of minimal practical significance for muscle excitation.

If you are using or considering an electromagnetic resistance device (like Tonal) with variable or eccentric overload settings, you can expect muscle activation levels that are largely comparable to using dumbbells. While there may be slight differences in shoulder (deltoid) or forearm (brachioradialis) activation, the primary arm muscle (biceps) receives similar stimulation from both. You do not need to switch to dumbbells to get results, nor do you need to buy expensive tech to get better results than dumbbells offer for this movement.

Replacing saturated fats with polyunsaturated fats (omega-3 and omega-6) reduces cardiovascular risk, whereas restricting total fat or saturated fat without replacement does not improve cardiovascular outcomes.

Stop fearing dietary fat. Instead of just cutting back on saturated fats (like those in red meat and full-fat dairy), actively replace them with polyunsaturated fats. Eat fatty fish at least twice a week, use olive oil, and include nuts and seeds. This substitution, rather than simple restriction, is what lowers your cardiovascular risk.

A one-week complete cessation from resistance training (detraining) at the midpoint of a 9-week program does not enhance hypertrophy, power, or endurance compared to continuous training, and significantly reduces strength gains.

If your goal is maximizing strength and size, do not take a full week off from training. This study shows that one week of complete rest during a training block blunts strength gains without improving muscle size. If you are fatigued, consider a 'deload' with reduced volume or intensity rather than complete cessation.

A poly-metabolite score derived from serum and urine metabolomics can accurately predict and discriminate between high (80% energy) and low/zero (0% energy) ultra-processed food (UPF) intake in free-living populations.

Current dietary self-reporting methods for ultra-processed foods are prone to error and misclassification. This research identifies specific blood and urine metabolite patterns that serve as objective biomarkers for UPF intake. For researchers, these scores improve the accuracy of studying UPF's health impacts. For individuals, it underscores that 'ultra-processed' is a biological reality detectable in the body, not just a label on a package, highlighting the metabolic complexity introduced by industrial food processing.

Urolithin A supplementation (1000 mg/day for 4 weeks) significantly reduces indirect markers of muscle damage (creatine kinase) and ratings of perceived exertion following intense exercise in highly trained male distance runners, facilitating recovery without enhancing actual running performance.

If you are a highly trained male distance runner, taking 1000 mg of Urolithin A daily for 4 weeks may help you recover faster from hard workouts by reducing muscle damage markers and perceived exertion. However, do not expect this supplement to make you run faster in races. It supports recovery, not performance output.

Higher consumption of sugar-sweetened beverages (SSBs) is associated with a greater increase in type 2 diabetes risk compared to artificially sweetened beverages (ASBs).

If you must choose between sugary and artificially sweetened drinks, sugary drinks pose a much higher risk for type 2 diabetes. However, both are associated with increased risk compared to not drinking them. The best choice for diabetes prevention is water or unsweetened beverages.

Educational documentaries can significantly increase intentions to reduce meat consumption, but these intentions do not predict actual consumption.

While watching a documentary might make you *want* to eat less meat, it won't necessarily make you *do* it. The study shows a significant increase in intentions, but no change in actual consumption. To make real changes, focus on practical, small-scale adjustments to your environment and habits rather than relying on informational interventions.

Obesity should be managed as a chronic, relapsing disease with long-term structured medical interventions (pharmacotherapy, surgery, behavioral therapy) rather than relying on short-term lifestyle changes, mirroring the established management model for Type 2 Diabetes Mellitus (T2DM).

Stop treating obesity as a short-term lifestyle issue. Seek a healthcare provider who recognizes it as a chronic disease. This means expecting long-term management with evidence-based tools like GLP-1 receptor agonists (e.g., semaglutide, tirzepatide), behavioral therapy, and potentially surgery, rather than just being told to 'eat less and move more.'

Combining multiple receptor pathways (e.g., GLP-1/GIP, GLP-1/Amylin, or GLP-1/Glucagon) produces synergistic and superior weight loss compared to monotherapy, representing a historical inflection point in obesity pharmacotherapy.

Obesity is a chronic biological disease requiring physiological treatment, not just willpower. Modern combination therapies (targeting GLP-1, GIP, Amylin, or Glucagon receptors) are significantly more effective than older drugs or lifestyle changes alone, achieving 15-24% weight loss in trials. While access and cost are current barriers, these medications are designed to be used alongside lifestyle modifications to overcome biological forces promoting weight gain. Consult a provider about whether combination receptor agonists are appropriate for your health profile.

In patients with type 2 diabetes, initiating tirzepatide (a dual GIP/GLP-1 receptor agonist) results in significantly greater reductions in HbA1c and body weight compared to initiating injectable semaglutide (a GLP-1 receptor agonist) over a 12-month period, regardless of prior GLP-1 RA exposure.

If you have Type 2 Diabetes and are starting a GLP-1 based therapy, choosing tirzepatide over semaglutide is likely to result in better blood sugar control and more significant weight loss over the first year. This benefit holds true whether you have never used these drugs before or have tried semaglutide previously. The trade-off is managing the weekly injection schedule and potential side effects, but the metabolic gains are statistically superior.

Retatrutide increases the rate of gastrointestinal adverse events (nausea, vomiting, constipation) and hypersensitivity reactions compared to placebo, but does not significantly increase serious adverse events.

Be aware that retatrutide is more likely to cause nausea, vomiting, and constipation than a placebo. However, these are typically not 'serious' adverse events, and the drug does not appear to increase the risk of serious health complications or death compared to no treatment. Monitor your symptoms and communicate with your doctor.

Intermittent Energy Restriction (IER) paradigms, including Intermittent Fasting (IMF) and Time-Restricted Feeding (TRF), produce equivalent weight loss compared to Continuous Energy Restriction (CER) when total caloric intake is matched.

If you are overweight or obese, you can lose weight using Intermittent Fasting (fasting 2-3 days a week or restricting eating to 8-10 hours a day) just as effectively as eating less every single day. The key is that you don't need to restrict calories on your 'fed' days, and most people naturally eat less overall. Focus on consistency with your chosen window rather than perfection, as the total energy deficit matters most.

Time-restricted eating (TRE) with a 10-hour window, when combined with caloric restriction, leads to greater lean mass loss compared to caloric restriction alone.

If you use a 10-hour eating window to lose weight, be aware that you might lose more muscle than if you just counted calories without a time limit. To counter this, ensure you are eating enough protein within your 10-hour window, perhaps spreading it out evenly.

Healthy low-carbohydrate diet (HLCD) reduces fecal branched-chain amino acids (BCAAs) and increases unsaturated fatty acids, which are positively associated with fat mass.

HLCD changes your gut environment by lowering BCAAs and increasing unsaturated fats, which are linked to lower fat mass. This suggests that what you eat changes how your gut processes nutrients, aiding fat loss.

Higher acculturation levels moderate the effectiveness of the MyPlate intervention, with the most acculturated participants showing the greatest reductions in waist circumference.

If you are recently immigrated or less acculturated to US food systems, standard MyPlate advice might be less effective for reducing belly fat. You may need more personalized guidance that integrates your traditional healthy foods with US dietary guidelines.

Obesity is primarily caused by a sustained positive energy balance where caloric intake exceeds energy expenditure, driven by biological, behavioral, and environmental factors.

Focus on creating a sustainable energy deficit through modest dietary changes and increased physical activity, while recognizing that biological and environmental factors may make this challenging. Addressing these factors (e.g., sleep, stress, food environment) is crucial for long-term success.

In adults with prediabetes, a high-carbohydrate (50% energy) diet reduces fasting glucose more effectively than a reduced-carbohydrate (35% energy) diet when both are calorie-restricted, despite similar weight loss.

If you have prediabetes, you do not need to severely restrict carbohydrates to improve your fasting blood sugar. A diet providing about 50% of your calories from carbohydrates, focusing on high-fiber foods like whole grains and vegetables, can lower fasting glucose better than a lower-carb diet, provided you are in a calorie deficit. Focus on the quality of carbs (fiber) rather than just cutting them out.