Browse the evidence

Post-bariatric surgery weight regain (affecting 15-20% of patients) can be managed with endoscopic interventions or OMM, but optimal dosing and scheduling for these combination therapies remain undefined.

If you regain weight after surgery (affecting 15-20% of patients), you are not out of options. Endoscopic procedures or adding back medications like GLP-1s can help, but doctors currently lack clear guidelines on the best doses and schedules for this specific scenario.

In obese individuals, a combined metabolic index of insulin (INS) and free fatty acids (FFAs) effectively predicts the presence of subclinical left ventricular hypertrophy (LVH), serving as a practical prescreen for early cardiac remodeling risk.

If you are obese, standard blood work might miss early heart strain. Ask your doctor about checking insulin and free fatty acids alongside standard lipids. This combination can flag heart thickening (LVH) before your heart's pumping ability drops, allowing for earlier lifestyle or medical intervention.

Triglycerides (TG) are the most robust independent predictor of the continuous burden of left ventricular mass (LVM) in obesity, whereas insulin and FFAs predict the threshold transition to hypertrophy.

High triglycerides are a strong indicator of increasing heart muscle mass in obesity. Monitoring TG levels can help track the gradual structural load on the heart, even if blood pressure and pumping function seem normal.

Moderate-intensity and high-intensity interval exercise training provide equal cardioprotection against diabetic cardiomyopathy in rats by preventing left ventricular fibrosis and collagen cross-linking.

If you have diabetes or are at risk, both moderate-intensity and high-intensity interval exercise can protect your heart. You do not need to choose high intensity if moderate is more sustainable; both approaches prevent heart damage and fibrosis in this model.

Pyridoxamine supplementation alleviates cardiac fibrosis and oxidative stress in prediabetic rats, preventing left ventricular collagen deposition.

Pyridoxamine may help reduce heart scarring and oxidative stress in prediabetes, but this is based on animal studies. It should not replace lifestyle changes like exercise and diet.

Age is a significant factor in T2DM risk, with subjects aged 60 years and above having a substantially higher odds ratio (OR=178.29) for diabetes compared to those aged 30-39.

As you age, your risk for type 2 diabetes increases significantly. By age 60, your odds of having diabetes are much higher than in your 30s. This is due to natural changes in how your body handles insulin and blood sugar. Regular screening and maintaining a healthy weight become increasingly important as you get older.

In rural Indian populations, coronary artery disease risk is not significantly associated with total carbohydrate or fat intake, but is linked to poor intake of fruits and vegetables.

If you are concerned about heart health, do not obsess over total fat or carbohydrate grams. Instead, prioritize increasing your intake of fruits and vegetables, as low intake of these foods is associated with higher CAD risk in rural populations.

Higher carbohydrate intake is significantly associated with single vessel disease (SVD) compared to normal coronaries, but not with double or triple vessel disease.

For individuals with early-stage heart disease (single vessel), monitoring carbohydrate intake may be relevant, whereas it may be less critical for advanced disease stages in this population.

In vitro digestion of jatobá-do-cerrado flour extracts significantly inhibits alpha-amylase and alpha-glycosidase activity, thereby reducing carbohydrate digestion.

This research suggests that jatobá flour contains phenolic compounds that survive digestion and can inhibit key digestive enzymes (amylase/glycosidase) in a lab setting. While promising for glucose management, this is an in vitro finding and does not confirm clinical efficacy in humans.

High daily consumption of carbohydrates (>60% of total energy) and simple sugars (>10% of total energy) is associated with a statistically significant increase in breast cancer risk.

To potentially lower breast cancer risk, aim to keep carbohydrate intake below 60% of your total daily energy and ensure simple sugars (added sugars) do not exceed 10% of your total energy. Focus on reducing refined sugars and high-glycemic carbohydrates, as high intake of these is linked to a significantly higher risk of developing breast cancer in this study.

Ketogenic dietary therapies (KDTs) may improve cerebrovascular health and neuroprotection by shifting brain energy metabolism from glucose to ketone bodies (specifically β-hydroxybutyrate), reducing oxidative stress, and modulating inflammatory signaling, though current human evidence is limited and heterogeneous.

If you have cognitive concerns or are aging, a ketogenic diet might offer neuroprotective benefits by shifting your brain's fuel source to ketones, which may reduce inflammation and oxidative stress. However, current human evidence is not strong enough to recommend it broadly. If you try it, consider less restrictive versions like the Modified Atkins Diet for better long-term adherence, and be aware that benefits may take weeks to manifest as your body adapts (keto-adaptation).

Lower Body Mass Index (BMI) is inversely associated with arterial stiffness in Japanese patients with Type 2 Diabetes, contradicting findings in non-Asian populations.

If you are Asian and have Type 2 Diabetes, do not rely solely on BMI to assess your cardiovascular risk. Even if your BMI is 'normal', you may have high visceral fat which increases arterial stiffness. Focus on body composition and metabolic health markers rather than just weight.

Serum uric acid levels are positively associated with arterial stiffness in Type 2 Diabetes patients, independent of other cardiovascular risk factors.

High uric acid is linked to stiffer arteries in diabetes. While lowering it is not yet a standard primary treatment for stiffness, keeping uric acid levels within a healthy range through diet and hydration may support vascular health.

Sustained ad libitum consumption of an ultra-processed diet for two weeks does not significantly alter sweet or salty taste detection thresholds or preferences compared to an unprocessed diet.

Eating ultra-processed foods for two weeks does not change your basic ability to taste salt or sugar, nor does it change what you prefer. If you are overeating on these foods, look at factors like eating speed or energy density rather than assuming your taste buds have adapted.

Higher salt taste preference is positively correlated with systolic blood pressure, body weight, and BMI following consumption of an ultra-processed diet.

If you prefer salty foods and eat an ultra-processed diet, you may have higher blood pressure and body weight. Monitoring your salt preference and overall diet quality might be beneficial.

Swearing improves physical performance in short, intense tasks by increasing pain tolerance, state disinhibition, and physiological arousal.

If you are about to perform a short, intense physical task like a heavy lift or a sprint, using a swear word (either aloud or internally) may help you push harder. The effect comes from increased pain tolerance and mental focus. However, be mindful of social contexts where swearing might be inappropriate.

Dermal white adipose tissue (dWAT) loss and fibrotic transformation due to aging and photodamage reduce adiponectin production, leading to compromised skin health, fine lines, and atrophy.

Prioritize skin health by maintaining healthy dermal fat. Avoid aggressive fat-destroying procedures if possible, as loss of dermal white adipose tissue (dWAT) leads to fibrosis, reduced adiponectin, and faster skin aging. Focus on treatments that support or regenerate small, healthy fat cells rather than just removing volume.

GLP-1 receptor agonists (GLP-1RAs) cause facial fat atrophy, sagging, and wrinkling ("Ozempic face") by inhibiting adipocyte differentiation and promoting fibrotic transformation of dWAT.

If using GLP-1RAs, be aware that facial fat loss and skin aging ('Ozempic face') are common side effects. Consider proactive skin care or aesthetic interventions (like fat grafting or regenerative fillers) to counteract fat loss and fibrosis. Monitor facial changes and discuss mitigation strategies with your provider.

Hypertrophic (large) adipocytes promote skin aging by secreting proinflammatory cytokines, downregulating collagen/elastin, and upregulating MMPs, whereas small healthy adipocytes promote skin health via adiponectin.

Maintain a healthy weight to avoid hypertrophic (large) fat cells, which promote skin aging through inflammation and collagen breakdown. Focus on strategies that promote small, healthy fat cells, which support skin structure via adiponectin.

Seasonal variations in glycemic control (HbA1c) and body mass index (BMI) in older adults with type 2 diabetes are preserved and not disrupted by lifestyle modifications associated with the COVID-19 pandemic.

For older adults with type 2 diabetes, do not assume that pandemic-related lifestyle changes (like staying home more) will necessarily disrupt your seasonal blood sugar patterns. The body's seasonal metabolic rhythm (typically better control in autumn, higher in spring) appears robust and may persist even when daily habits change. Focus on managing these known seasonal fluctuations in your treatment plan rather than expecting lifestyle changes to reset your baseline metabolic rhythm.

Chronic psychological or physiological stress contributes to severe disease susceptibility by increasing cortisol, which suppresses immune function (specifically secretory IgA) and promotes dysbiosis, thereby increasing vulnerability to infection.

Manage chronic stress through mind-body interventions like diaphragmatic breathing or other relaxation techniques, as high stress levels can suppress your immune system and disrupt your gut health, making you more vulnerable to infections.

Long-term adherence to low-carbohydrate diets may attenuate weight loss benefits and potentially increase LDL cholesterol in some individuals, raising cardiovascular risk concerns.

While LCDs work well for short-term weight loss, be aware that benefits may diminish after a year, and some people see their bad cholesterol (LDL) rise. Regular monitoring of lipids and liver health is essential if you stay on this diet long-term.

The weight loss benefit of tirzepatide over semaglutide is significantly attenuated or absent in patients with type 2 diabetes compared to those without diabetes.

For patients with diabetes, the weight loss advantage of tirzepatide over semaglutide seen in non-diabetics may not be present. Consult your doctor to manage expectations regarding weight loss if you have diabetes.

The efficacy of low carbohydrate diets for diabetes remission is markedly reduced in patients who are using insulin.

If you are using insulin for type 2 diabetes, a low carbohydrate diet can still help, but the chances of achieving full remission are lower than for those not using insulin. You may need to work more closely with your healthcare provider to adjust your insulin dosage as your blood sugar improves.