Browse the evidence

Current statistical estimates of protein consumption in Africa likely overestimate actual intake due to post-harvest and cooking losses, meaning the severity of protein deficiency is greater than reported disappearance data suggests.

Do not rely solely on national average protein statistics to assess your personal risk. If you live in an area with poor storage or frequent power outages, actual protein intake is likely lower than official reports suggest. Prioritize accessible, shelf-stable protein sources or frequent small meals.

Dietary fiber (specifically fermentable fibers like pectin) reduces the production of indole, a precursor to the uremic toxin indoxyl sulfate, by triggering catabolite repression of the tnaA gene in indole-producing gut bacteria (e.g., E. coli).

To support gut health and potentially reduce the production of harmful metabolites like indole, incorporate fermentable fibers (such as pectin found in apples) into your diet. This encourages beneficial bacteria to produce protective metabolites (ILA, IPA) and suppresses the production of indole, which is linked to chronic kidney disease risk.

During pandemic lockdowns, adults and adolescents globally shifted toward modified eating behaviors characterized by increased snack frequency, higher consumption of sweets and ultra-processed foods, and decreased adherence to healthy diets (fruits/vegetables).

Pandemic lockdowns and restrictive measures led to a global shift in eating behaviors, with people consuming more snacks, sweets, and ultra-processed foods while eating fewer fruits and vegetables. This resulted in decreased adherence to healthy diets and increased alcohol consumption across various demographics.

Vulnerable populations, including those with diabetes, obesity, and low socioeconomic status, experienced more acute declines in nutritional quality and health during lockdowns compared to the general population.

If you have diabetes, obesity, or live in a high-deprivation area, lockdowns can severely impact your diet. You may experience more acute changes in eating behavior, such as increased consumption of unhealthy foods and decreased adherence to healthy diets. It is crucial to have targeted support and strategies to maintain nutrition during such times.

Pandemic lockdowns led to increased alcohol consumption and a shift in dietary patterns towards higher intake of snacks, sweets, and ultra-processed foods, while decreasing consumption of fresh foods like fruits and vegetables.

Lockdowns led to increased alcohol consumption and a shift towards snacks, sweets, and ultra-processed foods, while decreasing fresh food intake. This resulted in decreased adherence to healthy diets.

Pre-emptive switching from thymidine analogues (stavudine and zidovudine) is recommended to prevent lipoatrophy, as these drugs are strongly associated with subcutaneous fat loss.

If you are taking stavudine or zidovudine, discuss switching to tenofovir or abacavir with your doctor. These older drugs are linked to facial and limb fat loss (lipoatrophy). Switching can help restore some fat, though it happens slowly. Ensure your doctor checks for potential side effects like kidney issues (tenofovir) or allergic reactions (abacavir).

Statins are the first-line pharmacological therapy for lowering LDL-cholesterol in HIV patients, but require careful dose adjustment and monitoring due to drug-drug interactions with protease inhibitors (PIs) and NNRTIs.

If lifestyle changes aren't enough, statins are the first drug choice for high cholesterol. However, some statins interact dangerously with certain HIV drugs (like ritonavir-boosted PIs). Your doctor will choose a safe statin (like atorvastatin or rosuvastatin) and adjust the dose to avoid side effects while lowering your cholesterol.

Daily physical activity counts decrease by approximately 1.3% per year of age in older adults, with a significant drop in afternoon and evening activity intensity.

If you are over 60, expect your daily activity to naturally drop by about 1.3% each year. This drop is most noticeable in the afternoon and evening. To counter this, focus on maintaining morning activity levels and consider how employment or structured routines might help sustain activity later in the day.

Combined endurance and resistance exercise training significantly improves baroreflex sensitivity (BRS) in patients with type 2 diabetes, independent of changes in central hemodynamics.

If you have Type 2 Diabetes, engaging in a structured exercise program that includes both aerobic activity (like walking or jogging) and strength training, performed four times a week for a year, can significantly improve your body's ability to regulate blood pressure (baroreflex sensitivity). This improvement is linked to better blood sugar control rather than changes in artery stiffness. This suggests that consistent, combined exercise is a powerful tool for reducing cardiovascular risk in diabetes, even if it doesn't change the physical stiffness of your arteries.

Central obesity, measured by waist circumference (WC) or waist-to-hip ratio (WHR), is independently associated with an increased risk of nonalcoholic fatty liver disease (NAFLD), even after adjusting for general obesity (BMI).

Monitor your waist circumference, not just your weight. If your waist is large, your risk for fatty liver disease is elevated, even if your BMI is normal. Prioritize reducing abdominal fat through diet and physical activity to mitigate this risk.

General obesity, measured by BMI, is independently associated with an increased risk of NAFLD, even after adjusting for central obesity (WC).

Higher BMI is associated with a higher risk of fatty liver, even if you don't have a large waist. Maintaining a healthy weight is important for liver health.

Gut microbiota composition directly influences host glycemic control and insulin sensitivity through mechanisms including incretin secretion, short-chain fatty acid (SCFA) production, and bile acid metabolism.

Your gut bacteria play a key role in how your body handles sugar. Eating non-digestible carbohydrates (like inulin and oligofructose) can feed beneficial bacteria that produce short-chain fatty acids and stimulate hormones (GLP-1) that improve insulin response. This suggests that dietary fiber is not just for digestion but is a metabolic tool for glycemic control.

Prebiotic supplementation with non-digestible carbohydrates (e.g., oligofructose, inulin) improves glucose tolerance and insulin response by increasing GLP-1 secretion and SCFA production.

Incorporate prebiotic fibers like inulin or oligofructose into your diet. These are found in foods like chicory root, garlic, and onions, or taken as supplements. They feed gut bacteria that produce beneficial compounds (SCFAs) and stimulate hormones (GLP-1) that help lower blood sugar and reduce appetite.

Sugar-sweetened beverages (SSBs) are associated with increased risk of obesity and cardiometabolic disease, but this association is largely mediated by excess caloric intake and confounding lifestyle factors, rather than a unique property of the beverage itself.

Reducing sugar-sweetened beverages is a prudent strategy for weight management and metabolic health, primarily because it reduces excess calories and is associated with healthier lifestyle choices. However, do not expect SSB reduction to solve all health issues if your overall diet and lifestyle remain poor. Moderate SSB intake has negligible risk.

Long-term shift work, particularly involving night shifts, is strongly associated with increased risks of cardiovascular disease, metabolic disorders (type 2 diabetes, metabolic syndrome), and gastrointestinal issues, largely mediated by circadian misalignment, sleep restriction, and adverse lifestyle behaviors.

If you work nights or rotating shifts, prioritize protecting your sleep environment (dark, cool, quiet) and manage light exposure (bright light during shift, dark glasses on commute home). Be mindful of meal timing; eating late at night can worsen metabolic risk. Recognize that fatigue and digestive issues are common physiological responses to circadian disruption, not just personal failings, and consider strategies to align your schedule with your body's clock where possible.

HIIT improves glycaemic control (HbA1c, 2h glucose) and reduces visceral fat in type 2 diabetes, but does not significantly change fasting glucose or insulin sensitivity (HOMA-IR) within the study period.

HIIT helps lower your average blood sugar (HbA1c) and improves how your body handles sugar after meals, even if your fasting blood sugar doesn't change immediately. It also reduces visceral fat. Stick to the 12-week protocol; the benefits on liver fat and overall glucose control are significant, even if fasting numbers remain stable.

A 12-week combined endurance and resistance exercise training program increases mitochondrial content and intrinsic mitochondrial function in patients with type 2 diabetes to a similar extent as in healthy control individuals, paralleled by improved insulin sensitivity.

If you have type 2 diabetes, a 12-week program of combined cardio (cycling) and strength training can boost your muscle's energy-producing mitochondria just as much as it does for healthy people. You don't need to do more than a healthy person to get this benefit; your body is capable of the same adaptation. Stick to a consistent routine, and your insulin sensitivity will likely improve alongside your mitochondrial health.

In individuals with chronic kidney disease (CKD), the presence of sarcopenia (defined by low muscle strength, mass, or performance) significantly increases the risk of all-cause mortality and progression to end-stage renal disease (ESRD).

If you have chronic kidney disease, having low muscle strength or mass is a serious warning sign that increases your risk of death and needing dialysis. You should get your muscle strength checked (e.g., handgrip test) and prioritize physical activity, as it is one of the most effective ways to counteract muscle loss and improve your prognosis.

Blocking myostatin/activin signaling (via ActRIIB blockade) promotes muscle hypertrophy and can reverse cancer cachexia by inhibiting SMAD2/3 signaling and stimulating SMAD1/5/8 pathways.

For those struggling with severe muscle loss, such as in cancer cachexia, therapies that block myostatin/activin signaling show promise in preserving and even increasing muscle mass. This approach targets the root cause of excessive muscle breakdown rather than just stimulating synthesis.

Nudging interventions that combine altering both the properties and the placement of fruit and vegetables yield a significant, medium effect size on increasing selection.

For maximum impact, combine strategic placement (e.g., eye-level, front-of-counter) with property alterations (e.g., attractive presentation, priming, or sizing cues). This dual approach significantly boosts fruit and vegetable selection compared to control conditions.

A eucaloric low-carbohydrate/high-fat diet reverses metabolic syndrome in obese individuals independent of weight loss, primarily by improving atherogenic dyslipidemia (triglycerides, HDL, LDL particle size) and reducing circulating saturated fatty acids and de novo lipogenesis markers.

If you have metabolic syndrome, switching to a low-carbohydrate, high-fat diet can improve your blood lipids and metabolic markers within 4 weeks, even if you do not lose weight. Focus on reducing carbohydrates (to ~6% of calories) and increasing fat, while keeping total calories stable. This approach improves triglycerides, HDL, and LDL particle size more effectively than high-carbohydrate diets, regardless of changes in body weight.

Consuming a high-fat lunch rich in monounsaturated fatty acids (MUFA, specifically oleic acid) stimulates appetite and increases subsequent energy intake compared to consuming lunches rich in polyunsaturated (PUFA) or saturated fatty acids (SFA).

If you are trying to control your appetite, the type of fat in your meal matters. A lunch high in monounsaturated fats (like olive oil) may leave you feeling less full and cause you to eat more later compared to a lunch high in polyunsaturated (like sunflower oil) or saturated fats (like shea butter), assuming the total fat content and calories are the same. To maximize satiety from a high-fat meal, consider using polyunsaturated fats.

Dietary intake of fermentable carbohydrates and fibers drives the gut microbiota to produce short-chain fatty acids (SCFAs) like butyrate and propionate, which exert anti-inflammatory, anti-cancer, and metabolic regulatory effects on the host.

Prioritize whole plant foods rich in diverse fibers (grains, legumes, fruits, vegetables) to feed your gut bacteria. These bacteria convert fiber into short-chain fatty acids (SCFAs) like butyrate, which reduce inflammation, protect against colon cancer, and support metabolic health. Avoid highly processed high-carb foods that lack fiber, as they do not provide these microbial benefits.

Animal-based diets high in saturated fats and proteins promote the growth of bile-tolerant and proteolytic bacteria, leading to the production of potentially harmful metabolites like TMAO, ammonia, and hydrogen sulfide, which are linked to inflammation and cardiovascular disease.

If you consume animal products, be aware that high intake of red meat and saturated fats can promote gut bacteria that produce harmful metabolites like TMAO and hydrogen sulfide, linked to heart disease and inflammation. Balance animal proteins with high-fiber plant foods to encourage beneficial SCFA production and mitigate these risks.