Browse the evidence

Long-term adherence to low-carbohydrate diets, regardless of carbohydrate quality, is associated with a greater annual increase in waist circumference compared to higher-carbohydrate diets.

Be aware that long-term low-carbohydrate diets may be associated with increased waist circumference, even if other cardiometabolic markers improve. Monitor your waist circumference and consider adjusting your diet if you notice an increase.

High-carbohydrate diets (≥45% TDCI) are superior to low-carbohydrate diets for reducing LDL cholesterol in healthy adults under energy-matched conditions.

If your primary concern is lowering LDL cholesterol, and you are willing to eat more carbohydrates (at least 45% of your calories), this may be more effective than a low-carb diet, provided you keep your total calorie intake the same.

Low-carbohydrate diets provide short-term improvements in HbA1c and body weight but lack consistent long-term superiority over balanced diets.

Low-carb diets can be useful for short-term metabolic improvement in selected patients, but require clinical monitoring. They are not superior to balanced diets in the long term for everyone.

Dietary guidelines should prioritize the NOVA classification (degree of processing) over nutrient profiling to effectively reduce diet-related disease.

Advocate for or follow dietary guidelines that emphasize eating fresh meals and avoiding ultra-processed products, rather than focusing solely on macronutrient ratios or calorie counts.

Obesity is positively associated with increased susceptibility to COVID-19 infection, higher disease severity, and increased mortality.

If you have obesity, you are at a significantly higher risk for severe COVID-19, including hospitalization and death. This risk is particularly elevated in younger adults. You should take extra precautions, such as vaccination, masking, and avoiding crowded indoor spaces, and seek medical attention early if you show symptoms. Do not let fear of weight stigma prevent you from seeking care.

The association between obesity and severe COVID-19 outcomes is stronger in younger age groups compared to the elderly.

If you are young and have obesity, you might feel invincible, but your risk of severe COVID-19 is actually higher relative to your non-obese peers than it is for elderly obese individuals. Take the virus seriously, get vaccinated, and monitor your symptoms closely, as your body may mount a more severe inflammatory response.

Remote behavioral weight loss interventions yield superior weight loss outcomes for Black women compared to in-person interventions, whereas in-person interventions are more effective for white women.

If you are a Black woman seeking weight loss support, a remote program (phone/web) may be more effective for you than a traditional in-person group class. The study shows Black women lost more weight (-3.0%) with remote support compared to in-person (-2.0%), while white women did better in person. Remote options offer flexibility for busy schedules and may reduce the stress of group dynamics. If you are a white woman, in-person support might yield better results (-7.2% vs -4.4%).

Replacing saturated fatty acids (SFAs) with polyunsaturated fatty acids (PUFAs) significantly reduces the risk of coronary heart disease (CHD) and fatal CHD.

To lower your heart disease risk, swap some of the saturated fats in your diet (like butter or fatty meats) for polyunsaturated fats (like vegetable oils, nuts, or seeds). Aim to replace about 5% of your total calories from saturated fat with these healthier fats. This change is linked to a significant drop in heart disease risk.

Specific saturated fatty acids have different effects on lipid profiles: Lauric, myristic, and palmitic acids raise LDL-C, while stearic acid is biologically neutral.

Not all saturated fats affect your cholesterol the same way. Fats found in coconut oil and meat (lauric, myristic, palmitic) tend to raise LDL cholesterol. Stearic acid, found in some animal fats, does not. However, replacing saturated fats with unsaturated fats remains a beneficial strategy for heart health.

Emulsions containing liquid-state triacylglycerols that are stable against gastric acid result in slower gastric emptying, higher postprandial satiety hormones (PYY, GLP-1), lower hunger hormone (ghrelin), and greater subjective satiety compared to emulsions with crystalline droplets or acid-unstable emulsifiers.

If you consume a liquid fat emulsion that is stable in stomach acid (like certain commercial beverages or formulated foods), it may keep you fuller for longer and trigger better satiety hormones than fats that crystallize or break down quickly in the stomach. Focus on the structure and stability of the fat, not just the calorie count.

Low-carbohydrate diets (defined as <40% energy) improve short-term cardiovascular risk markers, specifically reducing triglycerides and increasing HDL, compared to low-fat diets, but these benefits diminish or become insignificant after 24 months.

If you switch to a low-carb diet (under 40% of calories), you will likely see improved cholesterol markers (lower triglycerides, higher HDL) and weight loss within the first 6 months. However, these specific lipid benefits tend to fade after 2 years, and LDL cholesterol might rise slightly. Because long-term adherence is difficult, consider focusing on high-quality carbohydrates (fiber, whole grains) if you cannot sustain strict low-carb intake.

High salt intake (from 2-3 sources) is significantly associated with higher odds of diabetes and overweight/obesity in older adults.

If you are over 40 and live in an urban area, reducing salt intake from multiple sources (cooking, table, snacks) can help lower your risk of diabetes and obesity. Try to limit added salt and choose less processed foods.

In women, higher intake of total protein, animal protein, polyunsaturated fatty acids (PUFA), and n-3 fatty acids is associated with decreased all-cause mortality, whereas higher carbohydrate intake is associated with increased all-cause mortality.

If you are a woman over 40, prioritizing adequate protein (especially animal sources like fish or lean meat), healthy fats (PUFA and n-3), and moderating carbohydrate intake may support longevity. If you are a man, ensuring sufficient fat intake (including saturated and monounsaturated fats) might be beneficial. These findings suggest that sex-specific dietary patterns, rather than one-size-fits-all macronutrient ratios, may be optimal for healthspan.

In men, higher intake of total fat, saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), and n-6 fatty acids is associated with decreased all-cause mortality.

If you are a man over 40, ensuring adequate intake of fats, including saturated and monounsaturated fats (from sources like meat, cheese, nuts), may support longevity. This does not mean overconsumption, but rather that fat restriction may not be necessary for men in the same way it is often recommended.

Substituting 3% of total energy intake from polyunsaturated fatty acids (PUFA) for carbohydrates (low or high glycemic index) or proteins (animal or vegetable) significantly reduces systolic blood pressure (SBP) in adults.

To potentially lower systolic blood pressure, try replacing 3% of your daily calories from saturated or monounsaturated fats with Polyunsaturated Fats (PUFA). This can be done by swapping some animal proteins or refined carbohydrates for PUFA-rich foods like fatty fish, walnuts, or sunflower oil. This swap should be done while keeping your total calorie intake the same. Note that this benefit was observed in men for SBP reduction and in women for hypertension risk reduction in this specific population.

Substituting Polyunsaturated Fatty Acids (PUFA) for carbohydrates (LGI or HGI) significantly reduces the odds of developing hypertension.

To potentially lower your risk of developing hypertension, consider replacing 3% of your daily calories from carbohydrates (both low and high glycemic index) with Polyunsaturated Fats (PUFA). This is particularly beneficial for women in this study. Ensure you keep your total calorie intake the same by reducing carbs rather than adding extra fat. Good sources of PUFA include fatty fish, walnuts, and sunflower oil.

Adherence to a nutrient pattern rich in folate, carotene, fiber, vitamin C, potassium, iron, and retinol is associated with significantly lower all-cause, cardiovascular disease, and cerebrovascular disease mortality.

To support longevity, prioritize a diet rich in vegetables, fruits, and legumes. This specific combination of nutrients (folate, fiber, vitamins C and E, potassium, iron, retinol) is linked to lower risks of heart disease, stroke, and early death. You do not need to supplement these individually; obtaining them through whole food sources like leafy greens, carrots, and beans is the recommended approach.

Moderate adherence to a nutrient pattern rich in unsaturated fatty acids and vitamin E is associated with lower all-cause and cancer mortality, whereas high adherence is associated with increased cerebrovascular disease mortality.

Include unsaturated fats (like those in fish and vegetable oils) and vitamin E sources in your diet, but avoid excessive consumption. The study suggests that moderate intake lowers cancer and all-cause mortality, while very high intake might increase stroke risk, possibly due to how these fats are prepared (e.g., deep-frying) or paired with other high-fat foods.

Smoking, overweight (BMI ≥24), and physical inactivity are independent risk factors for stroke, increasing risk by 1.18-1.22 fold and 1.75 fold respectively compared to non-smokers, normal weight, and active individuals.

Avoid smoking, maintain a healthy weight (BMI <24), and engage in regular physical activity (moderate or vigorous exercise ≥30 minutes, ≥3 times/week). These three factors are independently associated with a significantly lower risk of stroke. Focus on quitting smoking, managing weight, and staying active to protect your cardiovascular health.

Higher scores on the Dietary Index for Gut Microbiota (DI-GM), specifically driven by beneficial components, are associated with significantly reduced all-cause and cardiovascular mortality in individuals with Cardiovascular-Kidney-Metabolic (CKM) syndrome stages 0-3.

For individuals with early-stage metabolic or kidney risks, prioritizing foods known to support gut health—such as fiber, fermented dairy, whole grains, and specific fruits/vegetables—may lower the risk of death from heart or other causes. This benefit appears distinct from just general dietary quality, suggesting specific gut-microbiome interactions are key.

The protective effect of beneficial dietary components on all-cause mortality is partially mediated by a reduction in systemic inflammation, as measured by the Systemic Inflammation Index (SII).

While reducing inflammation is part of the benefit, it is not the whole story. The dietary components likely work through multiple pathways, including direct gut microbiome effects, not just lowering blood inflammation markers.

High unfavorable dietary components (processed meats, red meats, refined grains, high-fat patterns) are associated with increased all-cause mortality but show no significant association with cardiovascular mortality after full adjustment.

Avoiding processed meats, refined grains, and high-fat patterns is important for overall survival, even if it doesn't directly predict heart disease death in this specific population. It contributes to general longevity.

Adherence to high dietary risk patterns (high DII score, high saturated fat/sodium, low fiber/omega-3) is significantly associated with increased odds of Major Adverse Cardiovascular Events (MACE), stroke, and cardiovascular mortality in patients with angiocardiopathy.

For patients with angiocardiopathy, adopting a low-inflammatory diet (low DII score) is strongly associated with reduced risk of major cardiovascular events, stroke, and death. This involves increasing intake of fruits, vegetables, fiber, and omega-3s, while reducing saturated fats, sodium, and added sugars. While this study is observational, the strong associations suggest that dietary optimization is a key component of managing cardiovascular risk in this population.

Voluntary muscle forces are the primary determinant of bone mass and structural adaptation, dominating over gravitational forces from body weight.

To build or maintain bone density, focus on exercises that generate high muscle forces (like resistance training) rather than just weight-bearing activities. Muscle contraction is the primary signal for bone strengthening, not just gravity.