Browse the evidence

Recovery of adverse lipid profiles (HDL, Apo-A1, Lp(a)) after stopping AAS use is prolonged and depends on the duration of prior AAS use, with 14 weeks of use leading to slower normalization than 8 weeks.

If you stop using AAS, your cholesterol levels do not immediately return to normal. If you used steroids for 14 weeks, your 'bad' cholesterol markers may remain elevated for months, keeping your cardiovascular risk high long after you stop injecting.

Weight loss achieved through exercise and weight loss achieved through calorie restriction produce comparable improvements in LDL particle size and VLDL mass, but exercise yields a significantly greater increase in HDL2 mass than diet when adjusted for equivalent weight loss.

If you are losing weight, combining exercise with calorie restriction is superior to dieting alone for improving your HDL (good) cholesterol profile. While both methods improve LDL particle size and VLDL levels equally for the same amount of weight lost, only exercise significantly boosts HDL2 mass beyond what weight loss alone achieves. Prioritize aerobic exercise (like running) alongside your dietary changes to maximize cardiovascular benefits.

The improvements in LDL particle size and VLDL mass resulting from weight loss are primarily driven by the reduction in body mass index (adiposity) rather than the method of weight loss (exercise vs. diet).

For improving LDL particle size and reducing VLDL, the method of weight loss (exercise vs. diet) matters less than achieving the weight loss itself. Both approaches yield similar benefits for these specific markers when the amount of weight lost is the same. However, you should still exercise because it provides additional HDL2 benefits that diet alone does not.

Consumption of polyphenol-rich foods (e.g., fruits, vegetables, tea, cocoa) alters gut microbiota composition by promoting beneficial bacteria (Lactobacillus, Bifidobacterium) and inhibiting harmful pathogens, thereby reducing inflammation and improving metabolic health.

Increase your intake of polyphenol-rich foods such as berries, dark chocolate, green tea, and olive oil. These compounds feed beneficial gut bacteria like Lactobacillus and Bifidobacterium while inhibiting harmful ones. This process reduces inflammation and supports metabolic health, even if the polyphenols themselves are processed by gut bacteria rather than directly absorbed.

The Western diet, high in refined carbohydrates, saturated fats, and low in fiber, disrupts gut microbiota diversity and increases the risk of obesity, cardiovascular disease, and metabolic syndrome.

Avoid the Western diet pattern, which is high in refined carbs, saturated fats, and low in fiber. This diet is linked to obesity, cardiovascular disease, and metabolic syndrome. Instead, focus on whole foods, high fiber, and healthy fats to support gut health and reduce disease risk.

n-3 LC-PUFA reduce liver steatosis and hepatic glucose output by activating PPAR-alpha to stimulate fatty acid oxidation and suppressing SREBP-1c to inhibit lipogenesis enzymes.

For individuals with fatty liver, n-3 fatty acids may help reduce liver fat by shifting the liver's metabolism to burn fat (via PPAR-alpha) and stop making new fat (via SREBP-1c suppression).

High-Intensity Interval Training (HIIT) is an essential component for enhancing endurance performance in athletes, though the optimal intensity distribution and specific prescription remain unclear.

For endurance athletes, HIIT is non-negotiable for performance gains, but you must balance it with moderate volume. Do not prescribe HIIT in isolation; integrate it into a broader program (pyramidal or polarized) to avoid overtraining. The exact type of HIIT (short vs. long intervals) should be periodized based on the specific sport and competition phase.

Recent experiences of weight-based stigmatization are significantly associated with increased psychological distress (depression, anxiety, lower self-esteem) and a higher likelihood of binge eating disorder diagnosis in obese individuals seeking weight loss surgery.

If you are overweight or obese, negative comments or discriminatory treatment from others (including doctors) can significantly increase your risk of depression, anxiety, and binge eating. It is crucial to seek supportive healthcare environments where providers use respectful language and focus on health rather than weight bias.

Vitamin E improves steatohepatitis in nondiabetic patients but is not recommended for diabetic patients due to cardiovascular risks.

If you have fatty liver but do not have diabetes, Vitamin E supplementation may improve your liver inflammation. However, if you have diabetes, do not take Vitamin E for this purpose, as it may increase your risk of heart problems. Consult your doctor to determine if this is appropriate for your specific health profile.

Occupational physical activity, particularly light-intensity activity (LPA) and sedentary time (ST), does not confer the same cardiometabolic health benefits as leisure-time moderate-to-vigorous physical activity (MVPA), and high occupational ST is associated with adverse health outcomes regardless of leisure-time activity.

If you have a sedentary job, your health risk is driven by prolonged sitting, not just lack of exercise. If you have a physically demanding job, your health risk is driven by the lack of cardiovascular intensity and recovery time, not just 'activity.' To mitigate risk, office workers should prioritize leisure-time MVPA and reduce sitting time. Manual laborers should prioritize cardiovascular exercise and recovery, as their job activity may not provide sufficient health benefits and may even increase risk if not managed.

Taxes on sugar-sweetened beverages (SSBs) increase retail prices by 43-100% of the tax amount, leading to a significant decrease in SSB sales and overall consumption among adults.

Implementing a tax on sugary drinks raises their price, which effectively reduces consumption among adults. Policymakers should design taxes to maximize pass-through to consumers and consider broader tax scopes to minimize unhealthy substitutions.

Nonexercise activity thermogenesis (NEAT) serves as a primary biological regulator of body weight by modulating energy expenditure in response to positive or negative energy balance, thereby counterbalancing fat gain or loss.

Focus on increasing your daily non-exercise movement. This includes standing, walking to work, fidgeting, and doing chores. These activities collectively burn significantly more calories than structured exercise for most people. To manage weight, ensure your daily environment encourages movement rather than sedentary convenience.

Environmental factors, particularly occupation and urbanization, are the primary determinants of NEAT levels, with mechanization and sedentary environments drastically reducing energy expenditure.

Recognize that your environment dictates your baseline movement. If you have a sedentary job, you must consciously introduce movement (standing, walking) to counteract the environment. Urbanization and mechanization reduce NEAT, so intentional activity is required to maintain energy expenditure.

Dysbiosis, characterized by an altered gut microbiota composition, contributes to the development of diabetes and obesity by disturbing energy balance and promoting inflammation.

Your gut health is a key player in your metabolic health. A diverse and balanced microbiome helps regulate energy, inflammation, and insulin sensitivity. Focus on a diet rich in fiber and diverse plant foods to support a healthy gut ecosystem.

Incretin stimulation via GLP-1 receptor agonists (e.g., liraglutide, exenatide) and DPP-4 inhibitors reduces visceral and epicardial adipose tissue volume and thickness while promoting the browning of white adipocytes, thereby alleviating insulin resistance and associated cardiovascular pathologies in obese and type-2 diabetic patients.

For patients with obesity and Type-2 Diabetes, GLP-1 receptor agonists (like liraglutide) and DPP-4 inhibitors are effective pharmacological tools to specifically target dangerous visceral and epicardial fat. Unlike Metformin, these drugs significantly shrink epicardial fat thickness, which is linked to cardiovascular risk. This reduction in fat volume, combined with improved insulin sensitivity, offers a targeted approach to preventing heart disease in this population.

Front-of-package Warning Labels (WLs) are significantly more effective than Traffic-Light Labels (TLLs) at improving consumer understanding of nutrient content, identifying healthier products, and shifting purchase intentions toward healthier options or abstinence.

For policymakers and food manufacturers, implementing Front-of-Package Warning Labels (like the 'High in' octagonal signs) is a more effective strategy for improving public health literacy and encouraging healthier purchasing decisions than Traffic-Light Labels. The explicit warning format significantly reduces the ability of consumers to overlook high levels of sugar, sodium, and saturated fat, leading to better product identification and healthier purchase intentions.

Postoperative sleep disturbances, characterized by fragmentation and loss of deep/REM sleep, significantly increase the risk of postoperative delirium, cardiovascular events, and delayed recovery.

Recognize that poor sleep after surgery is not just 'being tired' but a clinical risk factor for confusion (delirium) and heart issues. Advocate for sleep-promoting measures like minimizing night interruptions, using earplugs/eye masks, and discussing sleep aids with the medical team.

Pharmacological interventions including zolpidem, melatonin, and dexmedetomidine can improve postoperative sleep quality and reduce complications like delirium.

Ask your care team about sleep-promoting medications like dexmedetomidine or melatonin, especially if you are elderly or in the ICU, as they may help prevent confusion and improve recovery.

Nonpharmacological interventions such as regional anesthesia, noise reduction, and use of earplugs/eye masks improve postoperative sleep quality.

Request earplugs and eye masks from nursing staff to block out hospital noise and light, which are major disruptors of sleep architecture.

Objective measures of physical capability (grip strength, walking speed, chair rise, standing balance) are robust indicators of healthy biological ageing and predict lower mortality and morbidity rates.

Focus on maintaining objective physical capabilities like grip strength, walking speed, and balance. These are not just measures of current fitness but strong predictors of your long-term survival and risk of chronic disease. Regularly assessing these metrics provides a clearer picture of your health trajectory than self-reported feelings of ability.

Bariatric surgeries, specifically Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG), reduce fasting plasma LEAP2 levels in humans with obesity, correlating with weight loss and improved metabolic markers.

Bariatric surgeries like RYGB and VSG lower levels of the hormone LEAP2, which is typically high in obesity. This hormonal shift, along with weight loss, may help maintain the weight loss by altering hunger signaling. This suggests that surgery works partly by resetting hormonal balances.

Sarcopenic obesity (SO) is a significant predictor of increased all-cause mortality in adults, with a pooled hazard ratio of 1.21 compared to non-sarcopenic non-obese individuals.

Maintaining muscle mass while managing body fat is critical for longevity. If you are older or have a sedentary lifestyle, prioritize resistance training and adequate protein intake to prevent sarcopenic obesity, as this condition significantly increases your risk of death regardless of your weight.

Sarcopenic obesity defined by visceral fat area confers the highest risk of all-cause mortality (HR = 2.54) compared to other obesity definitions like BMI or waist circumference.

If you have sarcopenic obesity, knowing your visceral fat level is crucial. Visceral fat combined with low muscle mass nearly doubles your mortality risk compared to other forms of SO. Prioritize exercises and diets that reduce visceral fat and build muscle, rather than just focusing on total weight loss.

Sarcopenic obesity poses a significantly higher mortality risk for hospitalized patients (HR = 1.65) compared to community-dwelling adults (HR = 1.14).

If you are hospitalized, ask about sarcopenic obesity. The risk of death is significantly higher for hospitalized patients with SO than for those in the community. Early intervention to preserve muscle and manage fat is crucial for your prognosis.