Browse the evidence

Denosumab is the most promising pharmacological treatment for osteosarcopenia because it inhibits RANKL in both muscle and bone, leading to increased lean mass, bone mass, grip strength, and reduced fall risk.

Denosumab is currently the most promising drug for treating osteosarcopenia, showing benefits for both muscle and bone. However, it is still under further clinical investigation. It should be considered alongside, not instead of, resistance training and proper nutrition.

Protein or amino acid supplementation combined with resistance exercise training in older adults produces a positive but minor effect on whole-body lean mass growth, while having minimal and inconsistent effects on muscle mass, strength, or functional capacity.

If you are an older adult doing resistance training, adding protein or amino acid supplements will likely help you gain a small amount of lean body mass (roughly 0.2-0.8 kg more than exercise alone). However, do not expect significant increases in strength, muscle size, or physical function from the supplement alone; the exercise is doing the heavy lifting. This benefit is most noticeable in frail or sarcopenic individuals, whereas those who are obese may see little to no benefit.

Nutritional interventions (protein, leucine, HMB, creatine) preserve or modestly increase lean mass in sarcopenia but fail to consistently restore muscle strength or physical function when applied in isolation.

Eat enough protein (at least 1.2g per kg of body weight daily) and consider creatine or HMB, but do not expect these supplements to fix your strength or balance on their own. You must combine them with resistance exercise to see functional benefits. Nutrition primes the muscle, but exercise builds the function.

During COVID-19 stay-at-home mandates, older adults with type 2 diabetes experienced significant weight loss (average 2.1%) rather than the weight gain often reported in younger populations.

If you are an older adult with type 2 diabetes, do not assume the pandemic shutdown will automatically cause weight gain. This study found that the majority of participants actually lost weight. However, those who did gain weight reported more negative impacts on their health and access to food, so monitoring your weight and mental well-being is still important.

Among older adults with type 2 diabetes, those who gained weight during the pandemic reported significantly more negative psychosocial and behavioral impacts than those who lost weight.

If you gained weight during the pandemic, you are not alone, but you may be experiencing more stress, sleep issues, or access problems than those who lost weight. Focus on addressing these specific barriers (food access, sleep) rather than just the scale number. If you lost weight, it was likely intentional and not associated with the negative mental health impacts seen in gainers.

Metabolic surgery (VSG/RYGB) alters gut hormone profiles by increasing GLP-1 and PYY while decreasing ghrelin, leading to reduced hunger and improved satiety, which aids in sustained weight loss and glucose control.

Surgery biologically reduces your hunger drive (ghrelin) and increases fullness signals (GLP-1/PYY), making it easier to maintain weight loss compared to dieting alone, which often triggers intense hunger.

Older adults (>30 years) significantly increase their energy intake from ultra-processed foods (UPFs) on weekends compared to weekdays, whereas younger adults (18-30 years) maintain consistent UPF consumption levels regardless of the day of the week.

If you are over 30, your weekend meals are likely driving your high ultra-processed food intake, whereas your weekday habits are stable. To improve your diet, focus your planning efforts specifically on Friday through Sunday. You do not need to change your weekday routine, as your data shows consistency there. Targeting the weekend window is the highest-yield intervention for this demographic.

Younger adults (18-30 years) consume ultra-processed foods (UPFs) in a continuous 'grazing' pattern throughout the day, with distinct peaks at 8 pm and 1 pm, whereas older adults follow conventional three-meal patterns with an additional morning peak.

If you are under 30, you likely snack on ultra-processed foods throughout the day rather than just at meals. Your intake peaks at 1 pm and 8 pm. To reduce UPF intake, focus on eliminating snacks during these specific hours, particularly the late evening peak, rather than just trying to eat 'less' overall.

Resistance, sprint, and power training induce a shift from fast-twitch IIx fibers to the fast-twitch IIa phenotype, with minimal change in pure type I fibers.

If you engage in heavy resistance training, expect your muscle fibers to become more efficient at generating power (shifting from IIx to IIa), but do not worry about losing your slow-twitch endurance fibers. This adaptation supports better performance in power activities without compromising your base endurance.

Endurance training induces a shift toward a more oxidative phenotype, characterized by an increase in Type I fibers and a decrease in Type IIa fibers.

High-volume endurance training will make your muscles more efficient at using oxygen by increasing Type I fibers. If you are an endurance athlete, expect this shift. If you are a strength athlete, be aware that excessive endurance work might reduce your peak power, but you can mitigate this with proper tapering.

Higher total and dietary zinc intake is associated with a modestly lower risk of type 2 diabetes in women, with the effect being most pronounced when dietary zinc is high and supplemental zinc is low.

Focus on getting zinc from food sources like meats, dairy, and whole grains rather than relying solely on supplements. This prospective study suggests that higher dietary zinc is linked to a slightly lower risk of type 2 diabetes in women, but this benefit appears to diminish if you are already getting enough zinc from your diet. Supplements may help those with low dietary intake, but they do not offer extra protection for those who already eat a zinc-rich diet.

A higher dietary zinc-to-heme iron ratio is significantly associated with a lower risk of type 2 diabetes, suggesting that the balance between these minerals matters more than zinc intake alone.

Pay attention to the balance of zinc and iron in your diet. This study found that a higher ratio of dietary zinc to heme iron is linked to a significantly lower risk of type 2 diabetes. This suggests that ensuring adequate zinc intake while managing heme iron consumption (found in red meat) may be more important for diabetes prevention than zinc intake alone.

High levels of vigorous physical activity significantly reduce the risk of symptomatic diverticular disease in men, whereas non-vigorous activity does not.

To lower your risk of symptomatic diverticular disease, focus on vigorous exercise rather than just walking. Aim for activities that raise your heart rate significantly, such as running, jogging, bicycling, or swimming, for at least 47 hours per week (based on the highest quintile in the study). While walking is healthy, it does not appear to offer the same protective benefit against this specific condition.

The combination of low dietary fiber intake and low physical activity significantly increases the risk of symptomatic diverticular disease compared to high levels of both.

If you have a diet low in fiber and you are not physically active, your risk of developing symptomatic diverticular disease is more than 2.5 times higher than someone with high fiber and high activity. To minimize this risk, you should aim to increase both your dietary fiber intake and your level of physical activity, particularly vigorous exercise.

The Stanford Seven-Day Physical Activity Recall (7D-PAR) provides a reasonable estimate of mean total daily energy expenditure (TDEE) and physical activity energy expenditure (PAEE) for group-level epidemiological studies, but exhibits high individual variability that limits its validity for assessing individual energy expenditure.

If you are using a 7-day physical activity recall or similar self-report tool to track your own daily calorie burn for weight loss, do not rely on the specific number. The tool is designed for group averages in research, not individual precision. The error margin is so large that the specific value is likely misleading for your personal diet or exercise adjustments.

Reporting error in self-reported physical activity energy expenditure is significantly predicted by gender, percent body fat, peak oxygen uptake, and the level of physical activity itself, with higher activity levels leading to greater underestimation.

Your fitness level and body composition affect how accurately you can estimate your activity. Highly fit individuals or those with higher body fat may systematically over- or underestimate their activity. If you are trying to self-report activity, be aware that your specific physiological profile may bias your recall.

Shifting US protein intake by reducing total volume by 25% and changing the animal-to-plant ratio from 85:15 to 60:40 aligns consumption with dietary recommendations while significantly reducing environmental impact.

To improve both your health alignment and environmental impact, reduce your total daily protein intake by about a quarter and shift your sources. Instead of 85% of your protein coming from animal sources (meat, dairy, eggs), aim for 60% animal and 40% plant (beans, lentils, nuts, grains). This shift aligns with official dietary guidelines and significantly lowers your carbon and water footprint without compromising nutritional adequacy for the average adult.

Optimal BMI and waist circumference thresholds for identifying cardiometabolic risk are higher in African-American women compared to white women, whereas thresholds are similar between white and African-American men.

If you are an African-American woman, standard BMI and waist circumference cutoffs for obesity and high risk may underestimate your actual cardiometabolic risk. This study suggests your optimal thresholds for identifying risk are approximately 3 kg/m2 higher for BMI and 5 cm higher for waist circumference compared to white women. For men, regardless of ethnicity, standard thresholds appear adequate. Consult a healthcare provider to determine if ethnic-specific thresholds should be used for your screening.

Obesity in Type 1 Diabetes is associated with increased cardiometabolic risk, higher insulin requirements, and an enhanced risk of chronic complications compared to normal-weight T1D patients.

Obesity in T1D is not just about weight; it significantly increases the risk of heart disease, kidney issues, and eye problems due to insulin resistance. Managing weight is critical for long-term complication prevention.

A Low FODMAP diet significantly improves functional gastrointestinal symptoms (pain, bloating, diarrhea) in IBD patients, but does not reduce underlying inflammatory disease activity.

If you have IBD and suffer from bloating, pain, or diarrhea, a Low FODMAP diet can significantly improve these functional symptoms and your quality of life. However, it does not treat the underlying inflammation of IBD, so it should be used alongside standard medical care and ideally under guidance to ensure nutritional adequacy.

After adjusting for fat-free mass, fat mass, visceral fat, age, and physical activity, African-American young adults have a significantly lower resting metabolic rate (RMR) than white young adults, with a mean difference of approximately 80 kcal/day.

This research indicates that African-American individuals may have a slightly lower resting metabolic rate than their White counterparts, even when accounting for body size and composition. However, this difference (approx. 80 kcal/day) is small and does not appear to be the main driver of obesity disparities, especially since African-American men in the study did not have higher obesity rates despite having lower RMR. Focus on consistent physical activity and balanced nutrition rather than assuming metabolic inevitability.

Increasing fish consumption to at least 2 servings per week in mid- or later life reduces the risk of coronary heart disease in women but has no significant effect in men.

If you are a woman, aiming for 2 or more servings of fish per week starting in midlife may help lower your risk of heart disease. If you are a man, this specific dietary change did not show a significant reduction in heart disease risk in this study, so you should focus on other proven heart-healthy strategies rather than relying on fish alone.

Six months of calorie restriction (10-30%) significantly enhances T-cell-mediated immune function in overweight adults, evidenced by increased delayed-type hypersensitivity and lymphocyte proliferation.

If you are overweight, restricting your calories by 10-30% for six months can boost your immune system's ability to fight off threats. This is achieved by improving T-cell function and reducing inflammatory markers like PGE2. This benefit is most pronounced with a 30% restriction.

Familiarity with the exercise modality significantly reduces the magnitude of biomarker elevation and the severity of Delayed Onset Muscle Soreness (DOMS) due to physiological adaptations.

When starting a new running routine or increasing intensity, expect significant muscle soreness and elevated biomarkers. This is normal. As you repeat the activity, your body adapts, reducing soreness and biomarker spikes, which is a sign of improved resilience.