Browse the evidence

Allostatic load (AL) represents the cumulative physiological stress and cost of adaptation, and can be measured using an Allostatic Load Index (ALindex) to guide nutrition and exercise interventions.

For elite athletes, consider monitoring allostatic load using biomarkers (like CRP, resting heart rate, HDL, waist-to-height ratio, and HbA1c) to assess cumulative stress. This can help adjust training and nutrition to prevent overtraining and injury.

Insurer-based telephonic health coaching achieves modest weight loss (mean -2.1% to -5.9%) in adults with obesity, but significant weight loss requires completing at least 6 coaching sessions.

If you join a health coaching program, aim to complete at least 6 sessions. The study shows that stopping before 6 sessions yields no significant weight loss benefit, whereas completing 6+ sessions leads to modest but significant weight loss (approx. 3.5%).

Higher intake of whole grains and fruits is associated with lower total cholesterol, LDL-C, and HDL-C levels in long-term plant-based eaters.

Prioritize whole grains and fruits daily. While the cholesterol-lowering effect is modest, it is a consistent benefit. Do not fear small amounts of less-healthy plant foods (like pasta) if they fit your overall healthy pattern, but be aware they may impact other markers like uric acid.

Higher intake of plant-based fast food and white flour pasta is associated with higher uric acid levels, even in a plant-based diet.

Limit plant-based fast food and white flour pasta. While they are plant-based, they can raise uric acid levels. Choose whole-food alternatives like whole-grain pasta and unprocessed foods to minimize this risk.

Higher intake of polyunsaturated fatty acids (PUFAs) is uniquely and negatively associated with LDL-C levels in a plant-based diet.

Include sources of PUFAs (nuts, seeds, flax) in your diet. They may help lower LDL-C levels, even if the effect is modest.

Multivitamin supplementation is recommended for individuals using GLP-1 receptor agonists to address micronutrient insufficiencies resulting from reduced caloric intake and gastrointestinal side effects.

Take a daily multivitamin while on GLP-1RA medication. Because you are eating less, you might not get enough vitamins from food alone. This helps protect your long-term health and prevents deficiencies.

Fiber and Probiotic supplementation can improve bowel regularity and mitigate gastrointestinal side effects (constipation, diarrhea) associated with GLP-1RA treatment.

If you experience constipation or diarrhea from GLP-1RA medication, try taking more than 10 grams of fiber daily and a probiotic supplement. This can help regulate your bowel movements.

The cardiometabolic benefits of exercise, particularly on glucose regulation and inflammation, may be attenuated or dependent on weight loss in individuals with obesity.

Be aware that while exercise is beneficial, achieving weight loss may be necessary to fully improve glucose regulation and inflammation in obesity. However, do not stop exercising if weight loss is difficult; other benefits remain.

Proactive, personalized lifestyle coaching significantly increases patient engagement (messaging frequency and app usage) in semaglutide-supported digital obesity programs, but does not significantly improve short-term (16-week) weight loss compared to reactive, standardized coaching.

If you are using semaglutide with a digital coaching program, expect that a proactive coaching style will make you feel more supported and engaged (more messages, more app opens). However, do not assume this increased engagement will automatically lead to more weight loss in the first 4 months. The medication and basic lifestyle changes drive the weight loss, while the coaching style drives the feeling of support. Stick to the program regardless of engagement levels, as the weight loss outcomes are similar between high and low engagement groups in the short term.

High-calorie, high-protein nutritional supplementation and specific supplements (L-alanyl-L-glutamine + PUFAs) can counteract lean mass loss and improve quality of life in heart failure patients, potentially mitigating GLP-1RA-induced sarcopenia.

If you are losing muscle on heart failure medication, ask your doctor about high-protein nutritional supplements. Specific combinations like glutamine and fish oil (PUFAs) have been shown to help increase lean body mass and improve how you feel.

Intentional weight loss, particularly through bariatric surgery, is associated with improvements in New York Heart Association (NYHA) classification, diastolic function, and reductions in left ventricular (LV) mass index and left atrial size.

Intentional weight loss improves heart function, including diastolic function and reducing left ventricular mass and left atrial size.

A salutogenic, peer-group-based healthy eating program for type 2 diabetes improves glycemic control and psychosocial well-being by fostering active learning, social belonging, and stress management rather than strict dietary prescription.

For someone with Type 2 Diabetes, try joining a supportive peer group focused on holistic health rather than just strict dieting. Focus on building social connections, managing stress, and experimenting with small, sustainable food changes (like swapping ingredients) instead of extreme restrictions. Use tools like glucose monitoring to get feedback on how these small changes affect your body, and involve your partner for support.

Very Low Calorie Diets (VLCD) produce substantial short-term weight loss (10-17 kg) but suffer from gradual attenuation and weight regain over time unless supported by behavioral interventions.

VLCDs are powerful for rapid short-term loss but require medical supervision and a structured reintroduction phase. Without behavioral support, the weight loss is likely to be partially regained over time.

Intermittent Energy Restriction (IER) strategies (TRE, PF, ADF) produce short-term weight loss comparable to Continuous Energy Restriction (CR), with no significant long-term difference between the two approaches.

Choose an IER method (like Time-Restricted Eating) if it helps you adhere to your calorie goals, but do not expect it to be more effective than continuous calorie restriction in the long run. The key is consistency and adherence.

Low-carbohydrate, high-fat (LCHF) nutrition education programs can be successfully implemented in under-resourced South African communities, provided interventions address socioeconomic barriers, family dynamics, and safety concerns.

If you are designing a nutrition program for low-income communities, do not assume LCHF is too expensive; instead, offer tiered food options. Engage the whole family, especially men who control budgets, in the education process. Address safety concerns by offering home-based exercises and secure meeting spaces. Recognize that participants may fear high fat intake due to medical advice; provide clear education on metabolic benefits.

Longer-muscle length resistance training (LML-RT) produces greater muscle hypertrophy than shorter-muscle length resistance training (SML-RT).

To maximize muscle growth, prioritize exercises that allow you to train at longer muscle lengths (e.g., deep squats, overhead presses, or lengthened partials). While you can still grow with partial ROM, the evidence suggests that loading the muscle in its stretched position yields superior hypertrophy, particularly in the distal regions of the muscle.

Carbohydrate-modified diets (low glycemic load, high fiber, or reduced-CHO) are more effective for weight loss or weight regain prevention in individuals with impaired glucose metabolism (prediabetes, IFG, or IGT) compared to those with normal glucose tolerance, supporting the hypothesis of precision nutrition based on glycemic status.

If you have prediabetes or impaired glucose tolerance, you may lose more weight or prevent weight regain by choosing a carbohydrate-modified diet (such as low glycemic load, high fiber, or reduced carbohydrate) compared to a standard high-carbohydrate diet. While the evidence is not yet definitive, this approach aligns with your body's likely insulin resistance. Consult a healthcare provider for testing and personalized guidance.

Women with type 2 diabetes treated with GLP-1 receptor agonists achieve significantly greater weight loss than men after 12 months, despite similar glycemic control improvements.

If you are a woman with Type 2 Diabetes on a GLP-1 agonist, you are statistically more likely to achieve significant weight loss (over 5% or 10%) than a man on the same medication class, particularly after 6-12 months. This does not mean men won't lose weight, but the magnitude of benefit tends to be greater in women. Glycemic control (HbA1c) improves similarly for both sexes.

Obesity significantly impairs work productivity and daily activities, with over 25% of work time impaired due to obesity status, and this impairment is greater in patients with obesity-related complications.

If you feel like obesity is affecting your work or daily activities, it is likely having a measurable impact. This impairment is a recognized part of the disease burden. Effective treatment of obesity may help reduce this impairment and improve your quality of life and productivity.

Glucagon receptor (GCGR) agonism increases energy expenditure and promotes weight loss, particularly when combined with GLP-1R and/or GIPR agonism in dual or triple receptor agonists.

Current obesity treatments often lead to weight regain because they don't significantly increase energy expenditure. New drugs that activate the glucagon receptor (GCGR), either alone or combined with GLP-1/GIP drugs, are designed to boost energy expenditure and prevent this metabolic slowdown. While early results show significant weight loss (up to 24% in some trials), long-term clinical data is still emerging, and these are prescription medications requiring medical supervision.

In a mixed population of diabetic and non-diabetic patients, liraglutide (up to 3 mg) and semaglutide (up to 1 mg) produce statistically equivalent weight loss, contradicting findings from trials using higher doses or specific diabetic cohorts.

If you are using liraglutide or semaglutide at lower, standard starting-to-maintenance doses (up to 3mg and 1mg respectively), expect similar weight loss results. The perceived superiority of semaglutide in marketing often relies on higher doses (2.4mg) not used in this study. Focus on adherence and titration rather than switching solely for weight loss efficacy at these doses.

Concomitant use of SGLT2 inhibitors significantly enhances weight loss in patients taking GLP-1 receptor agonists, independent of the specific GLP-1 RA used.

If weight loss stalls on a GLP-1 RA, discuss adding an SGLT2 inhibitor. This study found that using both together significantly improved weight loss outcomes compared to using GLP-1 RAs alone, likely due to complementary mechanisms.

Higher baseline BMI and the presence of symptomatic comorbidities (specifically knee osteoarthritis or obstructive sleep apnoea) are associated with greater improvements in health utility scores following semaglutide 2.4 mg treatment.

If you have a higher BMI (over 35 or 40) and suffer from knee osteoarthritis or sleep apnea, semaglutide 2.4 mg once weekly may offer even greater improvements in your daily health quality of life than it would for someone with a lower BMI or fewer comorbidities.

Digital weight-loss services utilizing GLP-1 receptor agonists exhibit a prescribing error rate of 4.4%, with the most prevalent errors being insufficient safety counseling (49.15%) and inadequate investigation of contraindications (30.29%).

If you are using a digital service for GLP-1 RAs, expect a thorough intake process. The most common errors are not about the drug dose, but about skipping safety checks. Ensure you answer all health questions accurately, especially regarding family history and other medications, as this protects you from serious side effects. The 4.4% error rate in this large study is relatively low, indicating that digital services can be safe when they enforce multidisciplinary oversight.