Browse the evidence

Low-carbohydrate/high-fat diets (e.g., Atkins) primarily result in weight loss through caloric restriction and water loss, not superior metabolic advantages, and may increase long-term mortality risk if animal proteins and fats are used.

If you choose a low-carb diet, be aware that weight loss is likely due to eating fewer calories and losing water weight, not magic metabolism. Also, be cautious of long-term risks associated with high animal protein/fat intake.

Low-carbohydrate diets (<40% energy) are at least as effective as low-fat diets for short-term weight loss and improve triglyceride and HDL cholesterol profiles, but they increase total and LDL cholesterol levels.

If you choose a low-carb diet for weight loss, expect better triglyceride and HDL improvements than a low-fat diet, but monitor your LDL cholesterol closely as it may rise. The weight loss benefit is real in the short term (under 1 year).

In Korean populations, high carbohydrate intake (50-80% of energy) is associated with an increased risk of metabolic syndrome, elevated triglycerides, and lower HDL cholesterol, but a reduced risk of elevated total and LDL cholesterol.

If you eat a traditional Korean high-carb diet, be aware that high carb intake correlates with higher triglycerides and lower HDL. However, it may keep LDL lower. Focus on improving the quality of your carbohydrates (whole grains) rather than just cutting them.

Moderate carbohydrate intake (50-60% of energy) is associated with the lowest all-cause mortality risk, forming a U-shaped relationship where both very low (<40%) and very high (>70%) intakes increase mortality risk.

Aim for 50-60% of your calories from carbohydrates for optimal longevity. Both very low and very high carbohydrate intakes are associated with higher mortality risks.

Amateur bodybuilders in the pre-contest period experience significantly increased oxidative stress, inflammation, and upper respiratory tract infection severity due to severe caloric restriction and macronutrient deficits.

If you are cutting calories drastically for a competition, expect your immune system and recovery to suffer. This study shows that severe energy restriction (45% deficit) combined with high training volume leads to increased oxidative stress and inflammation, even if you eat enough protein. To mitigate this, ensure you are getting enough micronutrients (especially Vitamins A and E) and healthy fats, as their deficiency was linked to higher oxidative damage. Be aware that using anabolic steroids, common in this population, may mask some symptoms but does not eliminate the underlying oxidative stress.

Severe caloric restriction in bodybuilders leads to micronutrient deficiencies (specifically Vitamins A and E) which correlate with increased oxidative stress and reduced antioxidant enzyme activity.

When cutting calories, do not neglect micronutrients. This study found that 75% of bodybuilders failed to meet the Recommended Daily Allowance for Vitamin E during their cut. This deficiency was strongly correlated with higher oxidative stress. Ensure your diet includes sufficient sources of Vitamins A and E, and adequate dietary fats to aid absorption, as fat intake was also severely restricted.

Pre-contest bodybuilding preparation is associated with worsened psychological status, including increased fatigue, mood disturbance, and perceived stress, alongside reduced recovery.

Be prepared for mental fatigue and mood swings during your cut. This study shows that total mood disturbance increases by 35% and fatigue by 23% during the pre-contest phase. This is likely due to the combination of low energy availability and high training stress. Prioritize sleep and stress management strategies, as perceived recovery drops significantly.

In Type 2 Diabetes, the adoption of newer glucose-lowering medications (GLP-1 agonists and SGLT2 inhibitors) is associated with a significant decline in fracture incidence rates, particularly in men and women under 50 and over 70.

If you have Type 2 Diabetes, discuss with your doctor whether your current medication increases your fracture risk. The data suggests that switching to newer classes of drugs, specifically GLP-1 agonists or SGLT2 inhibitors, is associated with a significant reduction in fracture rates compared to older medications like sulfonylureas.

The isoflow method, which measures inspiratory muscle endurance by maintaining a constant flow while subjects perform repeated maximum voluntary inspirations, provides a reproducible and accurate assessment of inspiratory muscle fatigue in healthy humans.

This paper describes a specialized laboratory method for testing breathing muscle endurance, not a home exercise. It shows that breathing muscles fatigue in a predictable, exponential manner when pushed to maximum effort at a constant airflow. For athletes or patients with lung issues, this test can accurately measure how well their diaphragm and accessory muscles hold up over time, identifying fatigue earlier than standard tests.

Organized sports contribute disproportionately to moderate-to-vigorous energy expenditure (MVEE) compared to total daily energy expenditure (TDEE) in adolescents.

If your goal is to increase the intensity of your child's physical activity, organized sports are highly effective, contributing over a third of their moderate-to-vigorous energy expenditure. However, do not rely on sport alone for total calorie burn.

Specific subgroups of ultra-processed foods, namely fats/condiments/sauces and ice cream/sherbet, are associated with increased cardiovascular and colorectal cancer-specific mortality, respectively, in CRC survivors.

CRC survivors should pay attention to specific UPF categories. High intake of fats/condiments/sauces is linked to higher heart disease death risk, while ice cream/sherbet is linked to higher cancer death risk. Reducing these specific items may offer targeted benefits.

GLP-1 receptor agonists (specifically liraglutide and semaglutide) improve histological features of NASH and achieve resolution of NASH without worsening fibrosis in adults with or without type 2 diabetes.

If you have NASH, GLP-1 agonists like semaglutide or liraglutide are proven to improve liver health, potentially resolving the disease without worsening scarring. They are taken as injections (daily or weekly). While they can cause nausea, the liver benefits are substantial, especially if you have type 2 diabetes or obesity. Consult your doctor for dosing.

SGLT2 inhibitors (empagliflozin, dapagliflozin) reduce liver fat content in patients with NAFLD, as assessed by MRI-based techniques.

SGLT2 inhibitors like empagliflozin or dapagliflozin reduce liver fat in people with type 2 diabetes and fatty liver. They are oral medications taken daily. They can increase the risk of genital infections, so good hygiene is important. They also help with weight and blood sugar.

Physical exercise provides cardiovascular and mental health benefits independent of weight loss, justifying its inclusion in obesity treatment even when pharmacological weight loss is significant.

Even if your medication helps you lose weight, keep exercising. It protects your heart and mood in ways that weight loss alone might not. Focus on brisk walking and basic strength exercises rather than intense workouts.

The current food environment in Dutch supermarkets and out-of-home chains predominantly promotes energy-dense, nutrient-poor products, with 79% of supermarket assortment and 90% of out-of-home assortment falling outside healthy dietary guidelines (Schijf van Vijf).

Recognize that the default food environment is engineered to promote unhealthy eating. 79% of supermarket items and 90% of out-of-home items do not meet basic healthy dietary guidelines. To eat healthily, you must actively seek out specific healthy items rather than assuming they are the norm, as they are often less promoted and less accessible than unhealthy alternatives.

Promotional strategies in supermarkets, including folder offers and in-store placements (end-caps, impulse displays), heavily favor unhealthy products, with 81% of promoted items falling outside healthy dietary guidelines.

Be cautious of promotions and in-store placements, as they are designed to sell unhealthy products. 81% of promoted items do not meet healthy dietary guidelines. To eat healthily, avoid impulse buys and promotions, and stick to a shopping list of healthy items.

Industrial trans fats are harmful and should be avoided, while natural trans fats (from ruminants) are beneficial and may protect against heart disease.

Avoid processed foods with 'partially hydrogenated oils' (industrial trans fats). However, do not avoid natural trans fats found in butter and meat from grass-fed animals, as they may actually protect your heart.

Gastric bypass results in large and long-lasting weight loss (25-27% total body weight loss at 12-15 years) and remission of obesity-related conditions, making it suitable for patients with BMI 35-50 kg/m2, especially with type 2 diabetes or reflux.

Gastric bypass is a highly effective surgical option for patients with BMI 35-50, especially those with type 2 diabetes or reflux. It leads to large, long-lasting weight loss (25-27% at 12-15 years) and remission of obesity-related conditions.

Poly-metabolite scores derived from blood and urine metabolomics can objectively quantify ultra-processed food (UPF) intake, serving as a valid alternative to self-reported dietary assessments.

If you want to accurately track your ultra-processed food intake without relying on memory or self-reporting bias, emerging metabolomic scores offer a precise biological alternative. While currently a research tool, these scores objectively reflect your actual UPF consumption by analyzing specific metabolites in blood and urine, bypassing the common errors of dietary surveys.

Moderate carbohydrate restriction (30% energy) inducing weight loss does not negatively affect global cognition or health-related quality of life in patients with type 2 diabetes compared to a conventional diabetes diet.

If you have Type 2 Diabetes, switching to a moderate low-carb diet (around 30% of calories from carbs) for 6 weeks to lose weight will not harm your thinking abilities or how you feel about your health. It performs similarly to standard diabetic diets regarding mental well-being and cognitive function, though you may see a slight, non-significant boost in mental health scores.

Moderate carbohydrate restriction (30% energy) selectively worsens psychomotor speed (measured by SDMT) compared to a conventional diabetes diet, despite no effect on global cognition.

Be aware that switching to a moderate low-carb diet might make you feel slightly slower at processing information or performing quick mental tasks (like the Symbol Digit Test) in the first few weeks. However, this does not appear to affect your overall memory or general thinking ability, and this specific slowdown may improve with longer-term adherence.

Tirzepatide (15 mg) produces a greater improvement in insulin sensitivity per unit of weight loss compared to semaglutide (1 mg) in patients with type 2 diabetes, suggesting mechanisms beyond simple adiposity reduction.

If you are treating type 2 diabetes with GLP-1 based therapies, tirzepatide (15 mg) appears to offer superior improvements in how your body uses insulin for every pound lost, compared to semaglutide (1 mg). This suggests tirzepatide works through additional hormonal pathways (GIP/GLP-1) beyond just reducing fat mass. For patients prioritizing metabolic health improvements alongside weight loss, this distinction may be clinically relevant.

Regulation and food product reformulation to cut salt intake are cost-effective interventions that generate significant health gains and offset implementation costs.

Advocate for food product reformulation to reduce salt content. The evidence indicates this is a cost-effective strategy that saves lives and reduces healthcare costs.

Limiting children's exposure to advertising of foods high in salt, sugar, and fat is a cost-effective intervention that gains thousands of years of life in good health annually.

Support policies that restrict advertising of unhealthy foods to children. The evidence shows this is a low-cost, high-impact way to improve population health.