Browse the evidence

Pre-operative administration of carbohydrate-rich fluids (12.5% solution, 400-800 mL) attenuates post-operative insulin resistance and endogenous glucose release, potentially reducing hospital stay and inflammatory markers in THR/TKR patients.

If you are having hip or knee replacement surgery, ask your surgical team about drinking a specific carbohydrate-rich solution (like a clear maltodextrin drink) the night before and/or 2 hours before your procedure. This is not regular food or water; it is a specific medical protocol designed to reduce surgical stress and speed up recovery. Do not do this unless your medical team approves it, as they will provide the specific type and timing.

A combination of Beta-Hydroxy Beta-Methylbutyrate (HMB), L-Arginine, and L-Glutamine suppresses the loss of quadriceps muscle strength following Total Knee Replacement (TKR).

Ask your surgeon if a specific combination of HMB, L-Arginine, and L-Glutamine is appropriate for your knee replacement. The study used a high dose (totaling 30.4g of amino acids/acids) daily for 5 days before and 4 weeks after surgery. This may help you maintain your leg strength better than standard care.

Administration of a novel amino acid formulation (AXA2678) containing essential and non-essential amino acids, including N-acetylcysteine, attenuates skeletal muscle atrophy and prevents intramuscular fat accumulation during short-term (7-day) limb immobilization in healthy young men.

If you are facing a period of forced inactivity (like a cast or bed rest), standard protein or leucine supplements may not be enough to stop muscle loss. A specific blend of essential and non-essential amino acids, including antioxidants like NAC, appears to protect muscle mass and prevent fat infiltration in the muscle during short-term immobilization. This is not a substitute for movement, but a mitigation strategy.

Combining a ketogenic diet with resistance training promotes fat mass reduction in strength-trained individuals, but it does not support muscle mass accretion and may impair absolute strength and power gains compared to conventional diets.

If your goal is to lose fat while maintaining your current strength, a ketogenic diet combined with resistance training is a viable short-term strategy (up to 12 weeks). However, do not expect to build significant new muscle mass or maximize absolute strength/power gains; conventional diets with adequate carbohydrates are superior for those specific hypertrophy and power goals. Monitor protein intake closely (1.6-2.0 g/kg/day) to mitigate potential muscle loss.

Low-bar back-squats (LBBS) allow for greater load lifting compared to high-bar back-squats (HBBS) due to increased hip flexion and posterior hip displacement, which shifts emphasis to stronger hip musculature and decreases the trunk lever arm.

If your goal is to lift the maximum possible weight in a squat, switch to a low-bar back-squat position. Place the bar lower on your traps (over the posterior deltoids) rather than high on your neck. This position allows you to lean your torso forward slightly, which shifts the workload to your stronger hip muscles (glutes/hamstrings) and allows you to handle heavier loads than a high-bar squat. If your goal is to mimic Olympic weightlifting movements (snatch/clean) or emphasize knee-dominant muscles, stick with high-bar.

High-bar back-squats (HBBS) are biomechanically superior to low-bar back-squats (LBBS) for replicating Olympic weightlifting catch positions and emphasizing knee-dominant musculature.

If you are an Olympic weightlifter or want to improve your snatch and clean technique, use the high-bar back-squat. Place the bar high on your traps (below the C7 vertebra) to maintain an upright torso. This position closely mimics the 'catch' phase of Olympic lifts and places more emphasis on your quadriceps (knee musculature). Do not use this variation if your primary goal is to move the maximum possible weight; use low-bar for that.

GLP-1 receptor ligands improve bone health and reduce fracture risk in type 2 diabetes, with clinical outcomes varying by specific agent.

If you have type 2 diabetes, some GLP-1 drugs like liraglutide and lixisenatide may help protect your bones and reduce fracture risk. However, not all GLP-1 drugs have this effect (e.g., exenatide shows no impact). Discuss your bone health history with your doctor to choose the right medication.

A reduction in the FibroScan-aspartate aminotransferase (FAST) score of at least 0.22 points after 72 weeks of semaglutide treatment is associated with achieving the primary histological endpoint of NASH resolution without worsening of fibrosis.

If you are being treated for NASH with semaglutide, a reduction in your FAST score of 0.22 points or more after 72 weeks is a strong indicator that your liver is improving histologically (NASH resolution without worsening fibrosis). This non-invasive metric may help doctors monitor your progress without requiring repeated liver biopsies, although further validation is needed.

Preoperative administration of GLP-1 receptor agonists (OMMs) serves as an effective bridging therapy for super-obese patients, facilitating technical operability and reducing perioperative complications compared to non-pharmacological methods.

If you are waiting for bariatric surgery and have a very high BMI, ask your doctor about using GLP-1 medications (like liraglutide) beforehand. This can help you lose weight faster and reduce surgical risks, potentially making you eligible for surgery sooner than if you waited without medication.

During COVID-19 lockdown restrictions, rugby union players experienced a significant reduction in training volume and access to equipment, leading to a mismatch between energy intake and expenditure, with 36% reporting increased total food intake despite reduced physical activity.

If you are an athlete facing a period of reduced training (like lockdown or injury), do not assume your appetite or intake will automatically decrease. The study shows a significant portion of players increased their food intake despite training less. To maintain body composition, you must actively monitor your total food intake and adjust it to match your reduced energy expenditure, focusing on maintaining protein intake to preserve lean mass.

Rugby union players during lockdown consumed high-biological-value protein sources less than twice daily, with 43.9% reporting consumption of such sources more than twice daily, which may be suboptimal for retaining lean mass during reduced training.

To help maintain muscle mass during periods of reduced training, aim to consume high-quality protein sources (like meat, fish, eggs, dairy) at least 3-4 times per day, rather than concentrating all your protein in one or two meals. This helps stimulate muscle protein synthesis more consistently throughout the day.

Following the relaxation of COVID-19 lockdown restrictions, rugby union players showed increased self-reliance in food purchasing and preparation, with 67% purchasing and 71% preparing their own food, and reported higher motivation to train compared to during lockdown.

When returning to normal training after a disruption, expect your motivation to increase and your ability to manage your own nutrition to improve. Take advantage of this by taking full responsibility for purchasing and preparing your own meals to ensure they align with your performance goals.

Exercise stimulates the release of 'exerkines' (signaling molecules like IL-6, 12,13-diHOME, and musclin) that mediate systemic health benefits, including improved cardiac function and metabolic flexibility.

Engaging in regular exercise triggers the release of beneficial signaling molecules (exerkines) from your muscles, fat, and liver that protect your heart and metabolism. You don't need to manage these molecules directly; consistent physical activity is the key to activating them.

Lower baseline circulating cysteine concentrations are significantly associated with a positive weight loss response to exenatide treatment.

Current research suggests that women with lower baseline levels of the amino acid cysteine may be more likely to respond to exenatide. This is an emerging biomarker finding and not yet a standard clinical test for predicting response.

Resistance-trained men habitually consuming high protein intakes (>2.2 g/kg/day) experience attenuated post-exercise whole-body net protein balance when their intake is acutely reduced to moderate levels (1.2 g/kg/day), and this metabolic state requires 3-5 days to fully adapt.

If you are a regular weightlifter who eats a lot of protein (over 2.2g/kg), you cannot simply drop your intake to moderate levels (1.2g/kg) and expect your body to use that protein efficiently for muscle building right away. Your body has adapted to burning off excess protein, and it takes 3 to 5 days to slow down that burning process. During this week, your muscle building efficiency is lower. If you must reduce protein, give your body time to adjust, or maintain higher intake during the transition.

Among dietary factors, vitamin or mineral supplement use is associated with decreased cardiovascular disease risk, whereas caffeine intake is associated with increased risk, and alcohol consumption exhibits a U-shaped association with risk.

This study suggests that among Canadian adults, those who take vitamin or mineral supplements tend to have a lower predicted risk of cardiovascular disease, while high caffeine intake is linked to higher risk. Alcohol consumption shows a complex U-shaped pattern, with moderate frequency (1-3 times per week) associated with lower risk than both heavy drinking and abstinence. These are observational associations, not proof of causation, and should not replace standard medical advice.

Very-low-calorie diets (VLCDs) can induce remission of type 2 diabetes and favorable metabolic profiles in the short term, but long-term sustainability and safety data are lacking.

VLCDs can help some people with type 2 diabetes achieve remission in the short term, but they are not a long-term solution. They require medical supervision and supplementation. Long-term success depends on transitioning to sustainable habits.

Integrating passive stretch into the inter-set rest period of resistance training enhances muscle hypertrophy compared to standard passive rest, particularly in type I muscle fibers, without compromising strength gains.

To potentially maximize muscle growth without extending your workout time, hold a passive stretch for 20-30 seconds immediately after your last rep of each set, during your rest period. Aim for a discomfort level of 8 out of 10. This strategy appears most beneficial for slower-twitch (Type I) muscle fibers and does not appear to negatively impact long-term strength gains.

Older athletes have higher demands for specific nutrients, including adequate energy, protein, vitamin D, and probiotics, to prevent low bone and muscle mass and reduce infection burden.

Older athletes should prioritize adequate protein intake to support muscle mass and consider specific supplements like vitamin D and probiotics to support bone health and immune function, as their needs may differ from younger athletes or sedentary individuals.

Social interactions between sedentary individuals and moderately active individuals are the primary driver for transitioning sedentary populations to physically active habits.

To build a lasting exercise habit, do not rely on willpower alone. Actively seek out social environments where moderate physical activity is the standard. Join groups or classes where you interact with moderately active peers, as their influence is the strongest predictor of your own persistence.

Social interactions that draw moderately active individuals into sedentary behaviors are the primary cause of exercise persistence failure (recidivism).

Protect your exercise gains by managing your social environment. If your social circle is predominantly sedentary, you are at high risk of dropping out. Limit social activities that reinforce sedentary behavior and seek interactions that support active lifestyles.

Telemedicine (video visits) delivers clinically significant weight loss outcomes equivalent to in-person care for patients with overweight or obesity receiving medically managed treatment with anti-obesity medications.

If you are using weight loss medication, seeing your doctor via video is just as effective for losing weight as seeing them in person. In fact, video visits might allow you to see your provider more often (median 5 times vs 4) because it is easier to schedule, which supports better adherence to your treatment plan.

GLP-1 receptor agonists (GLP-1RAs) induce weight loss and improve metabolic function in patients with hypothalamic obesity (HO), with efficacy potentially independent of the extent of hypothalamic damage.

If you have hypothalamic obesity, standard diets and exercise often fail because the brain's 'thermostat' is broken. GLP-1 medications (like semaglutide or liraglutide) work by targeting brain areas outside the damaged hypothalamus to signal fullness. While results vary, many patients experience significant weight loss and metabolic improvement, especially if the medication is started at a low dose and increased slowly to manage side effects.

GLP-1 receptor agonists accelerate preoperative weight loss in obese patients undergoing elective hernia repair, significantly reducing time to surgery compared to lifestyle modifications alone, without increasing postoperative complication rates.

If you are obese and need hernia surgery, using GLP-1 medications (like semaglutide) alongside diet and exercise can help you reach your weight loss goal much faster than diet and exercise alone. This means you can get your surgery sooner without increasing your risk of complications. Talk to your surgeon about whether this is an option for you, keeping in mind that insurance coverage and cost may be barriers.