Browse the evidence

A reduction in the FibroScan-aspartate aminotransferase (FAST) score of at least 0.22 points after 72 weeks of semaglutide treatment is associated with achieving the primary histological endpoint of NASH resolution without worsening of fibrosis.

If you are being treated for NASH with semaglutide, a reduction in your FAST score of 0.22 points or more after 72 weeks is a strong indicator that your liver is improving histologically (NASH resolution without worsening fibrosis). This non-invasive metric may help doctors monitor your progress without requiring repeated liver biopsies, although further validation is needed.

Preoperative administration of GLP-1 receptor agonists (OMMs) serves as an effective bridging therapy for super-obese patients, facilitating technical operability and reducing perioperative complications compared to non-pharmacological methods.

If you are waiting for bariatric surgery and have a very high BMI, ask your doctor about using GLP-1 medications (like liraglutide) beforehand. This can help you lose weight faster and reduce surgical risks, potentially making you eligible for surgery sooner than if you waited without medication.

During COVID-19 lockdown restrictions, rugby union players experienced a significant reduction in training volume and access to equipment, leading to a mismatch between energy intake and expenditure, with 36% reporting increased total food intake despite reduced physical activity.

If you are an athlete facing a period of reduced training (like lockdown or injury), do not assume your appetite or intake will automatically decrease. The study shows a significant portion of players increased their food intake despite training less. To maintain body composition, you must actively monitor your total food intake and adjust it to match your reduced energy expenditure, focusing on maintaining protein intake to preserve lean mass.

Rugby union players during lockdown consumed high-biological-value protein sources less than twice daily, with 43.9% reporting consumption of such sources more than twice daily, which may be suboptimal for retaining lean mass during reduced training.

To help maintain muscle mass during periods of reduced training, aim to consume high-quality protein sources (like meat, fish, eggs, dairy) at least 3-4 times per day, rather than concentrating all your protein in one or two meals. This helps stimulate muscle protein synthesis more consistently throughout the day.

Following the relaxation of COVID-19 lockdown restrictions, rugby union players showed increased self-reliance in food purchasing and preparation, with 67% purchasing and 71% preparing their own food, and reported higher motivation to train compared to during lockdown.

When returning to normal training after a disruption, expect your motivation to increase and your ability to manage your own nutrition to improve. Take advantage of this by taking full responsibility for purchasing and preparing your own meals to ensure they align with your performance goals.

Exercise stimulates the release of 'exerkines' (signaling molecules like IL-6, 12,13-diHOME, and musclin) that mediate systemic health benefits, including improved cardiac function and metabolic flexibility.

Engaging in regular exercise triggers the release of beneficial signaling molecules (exerkines) from your muscles, fat, and liver that protect your heart and metabolism. You don't need to manage these molecules directly; consistent physical activity is the key to activating them.

Lower baseline circulating cysteine concentrations are significantly associated with a positive weight loss response to exenatide treatment.

Current research suggests that women with lower baseline levels of the amino acid cysteine may be more likely to respond to exenatide. This is an emerging biomarker finding and not yet a standard clinical test for predicting response.

Resistance-trained men habitually consuming high protein intakes (>2.2 g/kg/day) experience attenuated post-exercise whole-body net protein balance when their intake is acutely reduced to moderate levels (1.2 g/kg/day), and this metabolic state requires 3-5 days to fully adapt.

If you are a regular weightlifter who eats a lot of protein (over 2.2g/kg), you cannot simply drop your intake to moderate levels (1.2g/kg) and expect your body to use that protein efficiently for muscle building right away. Your body has adapted to burning off excess protein, and it takes 3 to 5 days to slow down that burning process. During this week, your muscle building efficiency is lower. If you must reduce protein, give your body time to adjust, or maintain higher intake during the transition.

Among dietary factors, vitamin or mineral supplement use is associated with decreased cardiovascular disease risk, whereas caffeine intake is associated with increased risk, and alcohol consumption exhibits a U-shaped association with risk.

This study suggests that among Canadian adults, those who take vitamin or mineral supplements tend to have a lower predicted risk of cardiovascular disease, while high caffeine intake is linked to higher risk. Alcohol consumption shows a complex U-shaped pattern, with moderate frequency (1-3 times per week) associated with lower risk than both heavy drinking and abstinence. These are observational associations, not proof of causation, and should not replace standard medical advice.

Very-low-calorie diets (VLCDs) can induce remission of type 2 diabetes and favorable metabolic profiles in the short term, but long-term sustainability and safety data are lacking.

VLCDs can help some people with type 2 diabetes achieve remission in the short term, but they are not a long-term solution. They require medical supervision and supplementation. Long-term success depends on transitioning to sustainable habits.

Integrating passive stretch into the inter-set rest period of resistance training enhances muscle hypertrophy compared to standard passive rest, particularly in type I muscle fibers, without compromising strength gains.

To potentially maximize muscle growth without extending your workout time, hold a passive stretch for 20-30 seconds immediately after your last rep of each set, during your rest period. Aim for a discomfort level of 8 out of 10. This strategy appears most beneficial for slower-twitch (Type I) muscle fibers and does not appear to negatively impact long-term strength gains.

Older athletes have higher demands for specific nutrients, including adequate energy, protein, vitamin D, and probiotics, to prevent low bone and muscle mass and reduce infection burden.

Older athletes should prioritize adequate protein intake to support muscle mass and consider specific supplements like vitamin D and probiotics to support bone health and immune function, as their needs may differ from younger athletes or sedentary individuals.

Social interactions between sedentary individuals and moderately active individuals are the primary driver for transitioning sedentary populations to physically active habits.

To build a lasting exercise habit, do not rely on willpower alone. Actively seek out social environments where moderate physical activity is the standard. Join groups or classes where you interact with moderately active peers, as their influence is the strongest predictor of your own persistence.

Social interactions that draw moderately active individuals into sedentary behaviors are the primary cause of exercise persistence failure (recidivism).

Protect your exercise gains by managing your social environment. If your social circle is predominantly sedentary, you are at high risk of dropping out. Limit social activities that reinforce sedentary behavior and seek interactions that support active lifestyles.

Telemedicine (video visits) delivers clinically significant weight loss outcomes equivalent to in-person care for patients with overweight or obesity receiving medically managed treatment with anti-obesity medications.

If you are using weight loss medication, seeing your doctor via video is just as effective for losing weight as seeing them in person. In fact, video visits might allow you to see your provider more often (median 5 times vs 4) because it is easier to schedule, which supports better adherence to your treatment plan.

GLP-1 receptor agonists (GLP-1RAs) induce weight loss and improve metabolic function in patients with hypothalamic obesity (HO), with efficacy potentially independent of the extent of hypothalamic damage.

If you have hypothalamic obesity, standard diets and exercise often fail because the brain's 'thermostat' is broken. GLP-1 medications (like semaglutide or liraglutide) work by targeting brain areas outside the damaged hypothalamus to signal fullness. While results vary, many patients experience significant weight loss and metabolic improvement, especially if the medication is started at a low dose and increased slowly to manage side effects.

GLP-1 receptor agonists accelerate preoperative weight loss in obese patients undergoing elective hernia repair, significantly reducing time to surgery compared to lifestyle modifications alone, without increasing postoperative complication rates.

If you are obese and need hernia surgery, using GLP-1 medications (like semaglutide) alongside diet and exercise can help you reach your weight loss goal much faster than diet and exercise alone. This means you can get your surgery sooner without increasing your risk of complications. Talk to your surgeon about whether this is an option for you, keeping in mind that insurance coverage and cost may be barriers.

A national produce prescription program for patients with diabetes and food insecurity is projected to improve diet, BMI, and HbA1c, thereby reducing long-term cardiovascular disease outcomes, improving quality-adjusted life-years, and generating health care cost savings.

If you have diabetes and struggle with food insecurity, a produce prescription program can help you eat more fresh fruits and vegetables. This change in diet can lower your risk of heart disease and diabetes complications, improve your daily quality of life, and potentially save money on healthcare costs over time. Talk to your healthcare provider about accessing such programs.

Targeting the Ghrelin Receptor (GHSR1a) with inverse agonists or antagonists like LEAP2 reduces food intake and postprandial glucose, offering a potential treatment for type-2 diabetes and obesity.

A new approach to blocking hunger involves a natural peptide called LEAP2. In a small study, giving LEAP2 intravenously reduced how much people ate and lowered their blood sugar after meals. This suggests it might help people with type-2 diabetes or obesity, but more research is needed to see if these benefits last long-term.

Ten weeks of high-intensity interval training (HIIT) partially restores muscle proteostasis in obese, insulin-resistant men by increasing the turnover rates of specific proteins, although it does not fully mitigate indicators of poor proteome health.

If you have obesity and insulin resistance, 10 weeks of HIIT (3x/week, cycling at max effort for 1-minute intervals) can significantly improve the turnover and abundance of key muscle proteins. While this doesn't erase all metabolic risks or fully normalize your muscle proteome, it does partially restore a critical aspect of muscle health (proteostasis) that is typically compromised in obesity.

Older adults transitioning to vegetarian or vegan diets may face greater challenges in maintaining protein adequacy compared to younger adults.

If you are an older adult switching to a plant-based diet, pay closer attention to your protein intake. You may need to be more deliberate about including high-quality plant proteins like legumes and soy products to ensure you are meeting your increased requirements, as the margin for error is smaller than in younger adults.

Children following vegetarian or vegan diets do not have specific concerns regarding protein adequacy due to their high energy requirements relative to protein needs.

If you are raising a child on a vegetarian or vegan diet, you generally do not need to worry about protein deficiency. As long as the child is eating enough calories from a variety of plant foods, they will likely get enough protein.

Very-low carbohydrate ketogenic diets (<10% carbs) promote weight loss and improve lipid profiles (lower triglycerides, higher HDL) primarily through energy restriction and ketone body production, rather than macronutrient partitioning alone.

If you choose a ketogenic diet, expect short-term weight loss and improved triglycerides/HDL. However, note that these benefits are largely due to eating fewer calories, not just the lack of carbs. Be aware that this diet excludes many healthy foods like whole grains and fruits, and long-term adherence is difficult.

Ketogenic diets positively affect the gut microbiome by increasing the ratio of Bacteroidetes to Firmicutes and increasing beneficial bacteria like Bifidobacteria and butyrate-producing species.

You can support your gut health on a KD by eating low-carb vegetables, nuts, and berries. This can increase beneficial bacteria like Bacteroidetes.