Browse the evidence

Long-term dietary interventions (≥12 months) involving moderate macronutrients, low-fat/high-carbohydrate, or high-fat/low-carbohydrate diets all produce significant and comparable weight loss, BMI reduction, and waist circumference reduction compared to a usual diet, with no clinically significant difference between the specific diet types.

If you are overweight or obese, any structured diet that involves active counseling and reduces calories will help you lose weight over the long term (12+ months). Whether you choose high-fat, low-fat, or moderate macronutrients, the amount of weight lost is roughly the same (around 5 kg). Do not waste energy trying to find the 'magic' macronutrient ratio; instead, choose the dietary pattern that fits your lifestyle and preferences so you can stick with it.

High-fat/low-carbohydrate (HFLC) diets may result in a statistically significant but clinically minimal additional weight loss (approx. 0.8 kg) and BMI reduction (approx. 0.4 kg/m2) compared to moderate macronutrient (MM) diets over the long term.

If you prefer a high-fat, low-carb diet, you might lose slightly more weight (less than 1 kg) than someone on a moderate diet, but the difference is negligible for health goals. Do not switch diets expecting a dramatic result; consistency and caloric deficit are the main drivers.

The same 12-week program significantly improves metabolic health markers, including insulin resistance (HOMA index), lipid profiles (triglycerides, VLDL), and inflammatory markers (CRP, PINI), independent of the magnitude of weight loss.

Obesity management should target metabolic health, not just weight. This program improves insulin sensitivity, lowers bad fats (triglycerides/VLDL), and reduces inflammation, which are key risk factors for cardiovascular disease and diabetes.

Time-restricted eating (TRE) improves metabolic markers (insulin sensitivity, blood pressure) and aids weight loss, but its long-term efficacy is not yet fully established.

Try eating within an 8-hour window each day (e.g., 12 PM to 8 PM). This may improve your blood pressure and insulin sensitivity. Be cautious if you have diabetes or are pregnant. Adjust the window to fit your social life.

Vitamin D3 supplementation at high doses (10,000 IU/day loading, then 5,000 IU/day maintenance) raises serum 25(OH)D to 40-60 ng/mL, which is associated with a reduced risk of respiratory tract infections including influenza and COVID-19.

If you are at risk for respiratory infections, consider taking 10,000 IU of Vitamin D3 daily for about a month to boost your levels, then switch to 5,000 IU daily. Aim for a blood test showing 40-60 ng/mL of 25(OH)D. Ensure you are also getting enough magnesium, and do not take high-dose calcium supplements simultaneously to avoid toxicity.

An 8-week stress management program comprising diaphragmatic breathing, progressive muscle relaxation, and guided visualization significantly enhances weight loss (BMI reduction) and improves mental health outcomes in adults with obesity compared to standard lifestyle instructions alone.

If you are struggling with obesity, adding a structured stress management routine to your standard diet and exercise plan may yield better weight loss results than diet and exercise alone. The study used an 8-week program involving breathing exercises, muscle relaxation, and visualization, practiced weekly with home reinforcement. This approach targets the hormonal and behavioral links between stress and weight gain, such as cortisol-driven abdominal fat storage and emotional eating.

High-glycemic load carbohydrates promote obesity by stimulating insulin secretion, which partitions calories into adipose tissue, thereby reducing circulating fuel availability, increasing hunger, and lowering energy expenditure.

To manage weight, prioritize the quality of carbohydrates over strict calorie counting. Reduce intake of high-glycemic foods like refined grains, potatoes, and added sugars. Instead, emphasize low-glycemic carbohydrates such as non-starchy vegetables, legumes, and whole fruits. This approach aims to lower insulin levels, reduce fat storage, and decrease hunger, making it easier to maintain a healthy weight without severe restriction.

High-glycemic load diets lower energy expenditure and increase hunger compared to low-glycemic load or low-carbohydrate diets, even when calorie intake is controlled.

If you feel constantly hungry or have low energy, consider that your diet might be slowing your metabolism. Switching from high-glycemic foods to lower-glycemic options or reducing total carbohydrates may help normalize your energy expenditure and reduce hunger.

Individuals with high insulin secretion in response to carbohydrates are more likely to gain weight on high-glycemic load diets and benefit more from low-glycemic or low-carbohydrate diets.

If you struggle with weight loss despite following a low-fat diet, you might have a high insulin response to carbohydrates. Trying a low-glycemic or low-carbohydrate diet may be more effective for you.

People with severe insulin resistance or diabetes may benefit from reducing total carbohydrate intake.

If you have diabetes or severe insulin resistance, talk to your doctor about reducing your total carbohydrate intake. This may help improve your metabolic health, but long-term data is still being gathered.

Polyunsaturated fatty acid (PUFA) intake has a cardio-protective effect in studies with follow-up durations of more than 10 years.

In long-term studies (>10 years), higher PUFA intake is associated with a 5% reduction in CVD risk. This suggests PUFA may be protective over time, although overall meta-analysis results were not significant.

Adherence to a healthful plant-based diet pattern is associated with a statistically significant reduction in both the risk of contracting COVID-19 and the severity of the disease.

Adopting a diet rich in fruits, vegetables, and whole grains (high healthful plant-based diet score) is associated with a lower risk of getting COVID-19 and a significantly reduced risk of severe outcomes. This benefit appears to be especially important for individuals in areas with higher socioeconomic deprivation, suggesting that improving access to healthy foods is a key public health strategy.

Administration of 4 g daily of omega-3 carboxylic acids (Epanova) to statin-treated high-risk patients with hypertriglyceridemia and low HDL-C reduces triglycerides by 26-31% and non-HDL-C, but its impact on reducing cardiovascular events is currently unknown and being tested in the STRENGTH trial.

If you are on a statin and still have high triglycerides and low HDL, your cardiovascular risk remains elevated. This trial investigates whether adding 4 grams of a specific prescription omega-3 (Epanova) daily, on top of your statin, can lower those lipids and prevent heart events. While it reliably lowers triglycerides, whether this translates to fewer heart attacks or strokes is still being determined by the STRENGTH trial results.

Manipulating carbohydrate availability during training (e.g., 'train low') to create metabolic stress can upregulate cellular signaling and adaptive responses, potentially leading to superior performance when carefully integrated into an endurance training program.

Do not train low all the time. Use low-carbohydrate strategies only for specific, lower-intensity or shorter-duration sessions where performance outcome is less critical. This triggers metabolic adaptations. For high-intensity workouts, races, or long sessions, ensure high carbohydrate availability to support performance and recovery. Personalize based on your weekly workload.

Patients taking GLP-1 receptor agonists or dual GIP/GLP-1 agonists should continue these medications through the peri-operative period rather than withholding them, as evidence suggests withholding is insufficient to reduce aspiration risk.

If you take a GLP-1 or GIP/GLP-1 drug (like Ozempic, Wegovy, Mounjaro, Trulicity) for your upcoming elective surgery, do NOT stop taking it. Stopping it for a week or even three weeks does not guarantee your stomach is empty and may not reduce aspiration risk. Instead, tell your anesthesia team you are taking it so they can use specific techniques (like ultrasound or specific intubation methods) to keep you safe.

Patients taking SGLT2 inhibitors should omit these medications the day before and the day of surgery to prevent euglycemic diabetic ketoacidosis (DKA).

If you take an SGLT2 inhibitor (like Jardiance, Farxiga, or Invokana) for your upcoming elective surgery, stop taking it the day before your surgery and do not take it on the day of surgery. This is critical to prevent a rare but serious condition called euglycemic DKA. Your medical team will monitor your blood sugar closely during your stay and manage it with insulin if necessary, which is the safest approach.

Combined adherence to healthy lifestyle factors (Mediterranean diet, physical activity, non-smoking, moderate alcohol, ideal weight) significantly reduces the risk of developing periodontitis and tooth loss.

Your gum health depends on more than just brushing. Combining a healthy diet (like Mediterranean), regular exercise, not smoking, and maintaining a healthy weight significantly lowers your risk of gum disease and tooth loss, even if your brushing habits are average.

Pre-operative administration of carbohydrate-rich fluids (12.5% solution, 400-800 mL) attenuates post-operative insulin resistance and endogenous glucose release, potentially reducing hospital stay and inflammatory markers in THR/TKR patients.

If you are having hip or knee replacement surgery, ask your surgical team about drinking a specific carbohydrate-rich solution (like a clear maltodextrin drink) the night before and/or 2 hours before your procedure. This is not regular food or water; it is a specific medical protocol designed to reduce surgical stress and speed up recovery. Do not do this unless your medical team approves it, as they will provide the specific type and timing.

A combination of Beta-Hydroxy Beta-Methylbutyrate (HMB), L-Arginine, and L-Glutamine suppresses the loss of quadriceps muscle strength following Total Knee Replacement (TKR).

Ask your surgeon if a specific combination of HMB, L-Arginine, and L-Glutamine is appropriate for your knee replacement. The study used a high dose (totaling 30.4g of amino acids/acids) daily for 5 days before and 4 weeks after surgery. This may help you maintain your leg strength better than standard care.

Administration of a novel amino acid formulation (AXA2678) containing essential and non-essential amino acids, including N-acetylcysteine, attenuates skeletal muscle atrophy and prevents intramuscular fat accumulation during short-term (7-day) limb immobilization in healthy young men.

If you are facing a period of forced inactivity (like a cast or bed rest), standard protein or leucine supplements may not be enough to stop muscle loss. A specific blend of essential and non-essential amino acids, including antioxidants like NAC, appears to protect muscle mass and prevent fat infiltration in the muscle during short-term immobilization. This is not a substitute for movement, but a mitigation strategy.

Combining a ketogenic diet with resistance training promotes fat mass reduction in strength-trained individuals, but it does not support muscle mass accretion and may impair absolute strength and power gains compared to conventional diets.

If your goal is to lose fat while maintaining your current strength, a ketogenic diet combined with resistance training is a viable short-term strategy (up to 12 weeks). However, do not expect to build significant new muscle mass or maximize absolute strength/power gains; conventional diets with adequate carbohydrates are superior for those specific hypertrophy and power goals. Monitor protein intake closely (1.6-2.0 g/kg/day) to mitigate potential muscle loss.

Low-bar back-squats (LBBS) allow for greater load lifting compared to high-bar back-squats (HBBS) due to increased hip flexion and posterior hip displacement, which shifts emphasis to stronger hip musculature and decreases the trunk lever arm.

If your goal is to lift the maximum possible weight in a squat, switch to a low-bar back-squat position. Place the bar lower on your traps (over the posterior deltoids) rather than high on your neck. This position allows you to lean your torso forward slightly, which shifts the workload to your stronger hip muscles (glutes/hamstrings) and allows you to handle heavier loads than a high-bar squat. If your goal is to mimic Olympic weightlifting movements (snatch/clean) or emphasize knee-dominant muscles, stick with high-bar.

High-bar back-squats (HBBS) are biomechanically superior to low-bar back-squats (LBBS) for replicating Olympic weightlifting catch positions and emphasizing knee-dominant musculature.

If you are an Olympic weightlifter or want to improve your snatch and clean technique, use the high-bar back-squat. Place the bar high on your traps (below the C7 vertebra) to maintain an upright torso. This position closely mimics the 'catch' phase of Olympic lifts and places more emphasis on your quadriceps (knee musculature). Do not use this variation if your primary goal is to move the maximum possible weight; use low-bar for that.

GLP-1 receptor ligands improve bone health and reduce fracture risk in type 2 diabetes, with clinical outcomes varying by specific agent.

If you have type 2 diabetes, some GLP-1 drugs like liraglutide and lixisenatide may help protect your bones and reduce fracture risk. However, not all GLP-1 drugs have this effect (e.g., exenatide shows no impact). Discuss your bone health history with your doctor to choose the right medication.