Browse the evidence

Home-based resistance exercise is an effective and feasible intervention to maintain or improve muscle mass, strength, and functionality in older adults during periods of social isolation.

Prescribe home-based resistance exercises for all older adults during isolation. Focus on maintaining muscle mass and strength. If equipment is limited, focus on bodyweight movements and light activity. Clinicians should prescribe this 'as medicine'.

Adherence to a plant-based diet significantly improves glycemic control (HbA1c), psychological well-being, and quality of life in adults with type 2 diabetes compared to standard diabetic guidelines.

For adults with Type 2 Diabetes, switching to a plant-based diet (focusing on whole plant foods and minimizing animal products) for at least 3 weeks can significantly improve blood sugar control (HbA1c), reduce depression, and improve quality of life compared to standard dietary advice. Adherence is often higher because the diet feels less restrictive than standard diabetic guidelines.

Personalized nutrition (PN) approaches using individual-specific information can drive measurable health benefits and behavior change more effectively than conventional population-based dietary guidelines.

To get the best dietary results, look for programs that use your specific data (like blood work, genetics, or lifestyle) rather than just following general guidelines. This personalized approach is more likely to lead to lasting health improvements.

Vitamin D supplementation in vitamin D-deficient athletes improves muscle strength, power, and recovery, and reduces injury rates.

If you are an athlete, get your Vitamin D levels tested, especially if you train indoors or live in northern latitudes. If you are deficient, supplementation has been shown to improve muscle strength and reduce injuries. Do not assume you have enough just because you are healthy.

Bariatric surgical procedures (Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, and biliopancreatic diversion/duodenal switch) provide substantial and durable weight loss (>45% excess weight loss) that persists for 10 to 20 years, significantly outperforming non-surgical medical therapy.

If you are considering bariatric surgery, understand that modern procedures like gastric bypass and banding are not short-term fixes. They provide substantial, durable weight loss (often 45-75% of excess weight) that lasts for 10-20 years. While reoperation rates exist, they have decreased with better techniques. Compared to lifestyle changes alone, which rarely maintain significant weight loss beyond a few years, surgery offers a significantly more effective long-term solution for obesity.

Laparoscopic Adjustable Gastric Banding (LAGB) provides durable weight loss (~49% EWL) over 20 years, but is associated with high reoperation rates that have decreased with improved band design and surgical technique.

If you choose LAGB, be prepared for long-term commitment to aftercare and potential adjustments. While the initial reoperation rates were high, modern techniques have significantly improved safety and reduced complications. The weight loss is durable, lasting up to 20 years, making it a viable option if you are willing to manage the device and follow-up.

Younger individuals (≤50 years) experience more significant weight and waist circumference reductions from Survodutide compared to older individuals (>50 years).

If you are 50 years or younger, you may experience greater weight loss from Survodutide than those over 50. This is likely due to metabolic differences and fewer comorbidities in younger patients, but the drug remains effective across age groups.

Expanding access to GLP-1 and GIP/GLP-1 receptor agonists (e.g., semaglutide, tirzepatide) for eligible populations in the US could avert approximately 43,719 deaths annually by reducing obesity-related mortality.

If you have a BMI of 30 or higher (or 27+ with conditions like diabetes), you are likely eligible for GLP-1 medications like semaglutide or tirzepatide. These drugs are highly effective for weight loss and can significantly reduce your risk of early death from obesity-related causes. The main barrier is not efficacy, but cost and insurance coverage. Discuss these options with your doctor and explore insurance coverage options or patient assistance programs, as expanded access policies may soon make these treatments more available and affordable.

Tirzepatide is the only obesity management medication shown to significantly reduce the Apnea-Hypopnea Index (AHI) and achieve remission of Obstructive Sleep Apnea Syndrome (OSAS) in patients with obesity.

If you have obesity and sleep apnea, Tirzepatide has been shown to significantly reduce the severity of your sleep apnea (AHI) and can lead to remission of the condition. This is a unique benefit not clearly demonstrated by other weight loss drugs in this review.

Combining semaglutide with lifestyle interventions (diet and exercise) reduces the risk of hypoglycemia and improves triglyceride levels compared to semaglutide alone, despite potentially lower absolute weight loss goal achievement in the short term.

If you are taking semaglutide, do not skip lifestyle changes. Combining the medication with diet and exercise significantly reduces your risk of hypoglycemia and improves your triglyceride levels. While you might see quick weight loss without lifestyle changes, the long-term health benefits and safety profile are superior when you combine the drug with healthy habits.

A personalized low-glycemic index (Low-GI) diet informed by nutrigenetic testing yields superior long-term weight loss and cardiometabolic improvements compared to a standard ketogenic diet, primarily through enhanced dietary adherence rather than immediate metabolic advantage.

If you are struggling to keep weight off after losing it, consider that 'one-size-fits-all' diets like Keto may not be sustainable for you long-term. A personalized approach that adjusts your carbohydrate and fat intake based on your genetic profile (specifically genes related to metabolism and sensitivity) can help you maintain weight loss and improve cholesterol and blood sugar levels. This works best when the diet is tailored to your biology, making it easier to stick to over the long haul.

Bariatric surgery induces a significant decrease in Total Daily Energy Expenditure (TDEE) and metabolic adaptation at 8 weeks post-intervention, but this metabolic suppression is reversed by 52 weeks, coinciding with a sustained increase in free-living physical activity.

If you have had bariatric surgery, expect your energy expenditure to drop significantly in the first two months as your body adjusts to its new size. This 'metabolic adaptation' is normal but not necessarily permanent. The key to long-term success appears to be increasing your daily physical activity, which may help counteract this drop in energy expenditure and allow your metabolism to normalize over the course of a year.

Weight loss efficacy from primary care interventions attenuates over time, with an average regain of 0.53 kg per 6 months, even when the intervention continues.

Don't expect your weight loss to stay perfectly static. Even with ongoing treatment, you may regain about 0.5 kg every 6 months. This is normal. To maintain your loss, you likely need to stay on your treatment plan (including medication if used) long-term, rather than treating it as a short-term fix.

Anti-obesity medication (AOM) administered in primary care settings produces approximately double the weight loss (-2.94 kg) compared to non-pharmacologic interventions, but efficacy attenuates over time at a rate of 0.44 kg per six months.

If you are seeking weight loss in primary care, expect that adding medication to lifestyle changes will roughly double your weight loss compared to lifestyle changes alone. However, be prepared for this to be a long-term commitment; stopping the medication often leads to regaining the weight because your body fights to maintain the lower weight. Consistency and long-term use are key to maintaining results.

Consuming carbohydrates above 65% of total energy intake reduces the odds of having a high Triglyceride-Glucose (TyG) index, while consuming lipids below 25% of total energy also reduces the odds of a high TyG index.

For patients with heart disease, dietary composition matters for metabolic health. This study suggests that consuming more than 65% of calories from carbohydrates and less than 25% from lipids is associated with a lower Triglyceride-Glucose index. However, be cautious: the quality of these carbohydrates (e.g., whole grains vs. refined sugars) and fats (e.g., unsaturated vs. saturated) was not fully analyzed here, so prioritize nutrient-dense sources.

Low-Carbohydrate diets are more effective in reducing HbA1c in the short term (<12 months), in smaller studies, and in patients aged 60 years or older.

If you are over 60 years old with Type 2 Diabetes, a Low-Carbohydrate diet may offer superior HbA1c reduction compared to other diets, especially if you can maintain it for less than a year. This subgroup benefit was not as pronounced in younger or longer-term studies.

Omega-3 fatty acid supplementation attenuates muscle loss and accelerates recovery during periods of muscle disuse (immobilization) in young women.

If you are a young woman facing temporary immobilization (e.g., injury/surgery), taking ~3g EPA and ~2g DHA daily before and during the immobilization period may help preserve muscle volume and speed up recovery compared to not taking omega-3s.

Adherence to a ketogenic diet for 6-12 months produces transient improvements in weight loss, blood pressure, triglycerides, and HbA1c, but these benefits typically diminish and lose statistical significance after 12 months.

If you start a ketogenic diet, expect to see improvements in weight, blood pressure, and blood sugar within the first year. However, do not expect these benefits to persist indefinitely if you cannot maintain the diet strictly. After 12 months, the weight loss advantage over other diets disappears, and you may regain weight. To mitigate this, consider focusing on plant-based fats and proteins rather than animal-derived ones, as this may improve long-term sustainability and cardiovascular risk profiles.

Low physical activity (defined as ≤600 MET min/week) is highly prevalent (69.4%) in the Saudi adult population and is a primary driver of elevated cardiovascular disease risk, particularly when combined with obesity and unhealthy diet.

In this population, nearly 7 out of 10 adults do not meet basic physical activity guidelines. This is a major contributor to heart disease risk. Prioritize increasing daily movement, even if it starts with small steps like walking, to counteract the high prevalence of inactivity.

Obesity (BMI ≥30) affects nearly half (49.6%) of the Saudi adult population, with women having significantly higher rates of obesity (BMI >35) and central obesity compared to men.

Obesity is a major health issue in Saudi Arabia, affecting nearly half of adults. Women are disproportionately affected by severe obesity and central adiposity. Addressing environmental barriers to exercise and promoting safe spaces for physical activity can help mitigate this risk.

High consumption of ultra-processed foods is associated with increased risk of obesity, metabolic syndrome, and all-cause mortality in adults.

Limit ultra-processed foods to reduce your long-term risk of obesity, metabolic syndrome, and early mortality. Focus on whole foods for better health outcomes.

Implementing a 30% financial incentive for fruits and vegetables (F&V) within the US Supplemental Nutrition Assistance Program (SNAP) increases F&V intake and prevents cardiovascular disease events, resulting in net healthcare cost savings over a lifetime.

If you are a policy maker or advocate, push for a 30% discount on fruits and vegetables for SNAP recipients. This specific financial incentive has been modeled to significantly reduce heart disease and save money on healthcare costs over the long term.

Restricting the purchase of sugar-sweetened beverages (SSBs) using SNAP funds, when combined with fruit and vegetable incentives, significantly amplifies cardiovascular disease prevention and healthcare cost savings compared to fruit and vegetable incentives alone.

Advocate for policies that not only incentivize healthy food purchases but also restrict the use of SNAP benefits for sugar-sweetened beverages. This combination yields much larger health benefits and cost savings than incentives alone.

A personalized postprandial-targeting (PPT) diet, which uses machine learning to predict individual glycemic responses based on clinical and microbiome data, significantly improves glycemic control and metabolic health in newly diagnosed type 2 diabetes (T2DM) patients compared to a standard Mediterranean-style (MED) diet.

For newly diagnosed T2DM patients, a standard Mediterranean diet may not be sufficient. A personalized diet that predicts your specific blood sugar response to foods (using your microbiome and health data) is significantly more effective at lowering blood sugar and achieving remission than standard dietary advice. This approach requires technology (CGM and an app) but offers a path to diabetes remission (61% of participants in the long-term study) that standard diets do not guarantee.