Browse the evidence

Metabolic and bariatric surgery (MBS) shows a trend toward reducing MACE risk compared to both medical weight management and usual care in patients with obesity and type 2 diabetes, potentially due to metabolic changes independent of weight loss.

Bariatric surgery showed a trend toward reducing heart events compared to usual care or medical weight management in this study. This benefit might come from metabolic changes, not just weight loss. If you are considering surgery, discuss these potential cardiovascular benefits with your healthcare provider, especially if you have type 2 diabetes.

Participation in a citizen-led, unsupervised online peer coaching community for type 2 diabetes leads to substantial, sustained improvements in weight, waist circumference, fasting glucose, and HbA1c.

Join a supportive, peer-led community focused on lifestyle changes like low-carb diets and fasting. Track your metrics (weight, waist, glucose) regularly and share them. The social support and accountability from others with similar struggles can drive significant, sustained metabolic improvements without needing direct medical supervision.

High baseline Weight Bias Internalization (WBI) is associated with reduced likelihood of achieving clinically meaningful weight loss in lifestyle modification programs.

If you struggle with negative thoughts about your weight, know that this can make weight loss harder. Consider asking your care team about strategies to address these feelings, such as self-compassion exercises or counseling. Addressing these psychological barriers can help you stay engaged and improve your chances of reaching your health goals.

Formula diet-based lifestyle interventions may lead to greater weight loss compared to modern antidiabetic drugs, while maintaining comparable long-term glycemic control in obese type 2 diabetes patients.

If you have type 2 diabetes and are obese, consider a formula diet-based lifestyle intervention. It may help you lose more weight than antidiabetic drugs while keeping your blood sugar under control, at least in the short term.

A 12-week canteen-based intervention marginally improves lipid metabolism (decreased TG, LDL-C, ApoB; increased HDL-C) but does not significantly affect blood pressure, glucose, or insulin resistance in middle-aged adults.

While this intervention improves lipid profiles, it may not significantly impact blood pressure or blood glucose in the short term. Focus on lipid management through dietary changes if you have mild dyslipidemia.

Medium-chain triglycerides (MCTs) increase ketonaemia and accelerate the time to achieve nutritional ketosis compared to long-chain triglycerides (LCTs) during keto-induction.

If you are starting a ketogenic diet and want to ensure you enter ketosis quickly, using MCT oil as part of your fat intake is more effective than using standard long-chain fats. While it may not eliminate all side effects, it biochemically accelerates ketone production.

Greater carbohydrate restriction (VLCKD) provides the greatest improvements in cardiometabolic markers (HDL-c, TG) and anthropometrics for individuals with poorer baseline health, although between-group differences were not statistically significant.

If you have poor baseline metabolic health (e.g., high triglycerides, low HDL), a very low-carbohydrate diet (5% of calories from carbs) is likely to yield the best improvements in cholesterol and weight over 12 weeks. However, adherence is harder, so a moderate low-carb approach (15-25%) is a viable alternative with similar trends.

Adherence to the DASH diet is inversely associated with a lower risk of developing NAFLD and reduced liver fat content.

Incorporate more fruits, vegetables, whole grains, and low-fat dairy into your diet while reducing red meat, sweets, and sugary drinks. High adherence to this pattern is linked to a significantly lower risk of developing NAFLD.

Low-carbohydrate diets reduce insulin resistance primarily through weight loss and ketosis, though evidence is mixed and long-term safety is debated.

If you try a low-carb diet, expect weight loss to be the main driver of improved insulin sensitivity. Ensure you are getting enough fiber and nutrients, as strict low-carb diets can lack certain vitamins and minerals. Monitor your progress, but don't assume low-carb is inherently superior to other balanced diets if weight loss is similar.

High-protein diets improve insulin sensitivity primarily through weight loss and increased satiety, but may have negative effects if protein quality is poor.

Increasing protein can help you feel full and preserve muscle, which supports weight loss. However, don't obsess over hitting extreme protein targets. Focus on high-quality protein sources and ensure you are getting enough fiber and nutrients. If you are not losing weight, high protein alone may not improve your insulin sensitivity.

Low-sodium diets are significantly associated with hypertension and dyslipidaemia management, but not significantly associated with diabetes in this population.

If you have high blood pressure or high cholesterol, reducing your sodium intake to under 2000mg per day is associated with better health outcomes. However, this specific restriction may not help manage diabetes.

Ketogenic and low-carbohydrate diets improve glycemic control and can induce remission, primarily through weight loss, though some benefits may occur independently of weight loss via reduced glycemic load.

A ketogenic or low-carbohydrate diet can significantly lower blood sugar and HbA1c, sometimes even without major weight loss. This is achieved by drastically reducing carbs and eating healthy fats. While weight loss often accompanies this and aids remission, the direct reduction in glycemic load is also beneficial. Monitor your lipid levels and ensure you are getting enough fiber and micronutrients.

Uniform dietary interventions fail to deliver consistent metabolic benefits in individuals with metabolic syndrome due to biological heterogeneity, whereas food-based dietary patterns emphasizing whole foods and limiting ultra-processed foods provide relatively consistent metabolic benefits across diverse phenotypes.

Stop looking for a single 'best' diet for metabolic syndrome. Instead, focus on the quality of your food: eat more whole foods (vegetables, fruits, legumes, whole grains) and minimize ultra-processed foods. This approach is more likely to benefit you regardless of your specific metabolic profile.

Adopting a low-carbohydrate, high-fat dietary pattern (defined as carbohydrate energy ≤40-49% and fat energy ≥34-40%) is associated with a significantly lower triglyceride-glucose (TyG) index, a surrogate marker for insulin resistance, primarily through the reduction of fasting triglyceride levels.

To potentially improve your insulin resistance markers, consider shifting your energy intake to include fewer carbohydrates (around 40-49% of calories) and more fat (around 34-40% of calories). This shift is linked to lower triglyceride levels, which is a key component of insulin resistance. Focus on whole food sources for these macronutrients.

Government-mandated lockdowns and quarantine measures contribute to weight gain and the development of obesity through reduced physical activity and increased consumption of hyperpalatable foods.

Lockdowns can lead to weight gain due to stress eating and less activity. To counter this, try to maintain a routine, find non-food ways to cope with stress, and limit access to hyperpalatable, calorie-dense foods. Even small increases in physical activity can help mitigate these effects.

Higher consumption of ultra-processed foods (UPF), specifically beverages and snacks, is significantly associated with food addiction (FA) in young adults, independent of BMI and other demographic factors.

If you struggle with compulsive eating or 'food addiction,' focus on reducing ultra-processed beverages and snacks. These specific categories showed the strongest link to addictive behaviors in young adults, regardless of your weight. Prioritize whole foods to potentially reduce the reinforcing power of your diet.

Consuming whole dairy milk provides superior nutrient bioavailability and fewer adverse metabolic effects compared to isolated dairy nutrients or high-dose supplements due to the protective food matrix.

Prioritize drinking plain cow's milk over calcium supplements or isolated whey powders when possible. The natural structure of milk helps your body absorb nutrients better and avoids potential side effects linked to high-dose isolated supplements.

Fermented dairy products offer enhanced health benefits compared to unfermented milk due to bioactive compounds produced during fermentation and reduced lactose content.

If you experience bloating or discomfort from milk, try fermented options like yogurt or kefir. The fermentation process breaks down lactose and creates beneficial compounds that support gut health.

Engaging in 'planning talk' during Motivational Interviewing (MI) sessions is associated with better weight loss maintenance outcomes, specifically greater weight and BMI reduction compared to low planning.

When using Motivational Interviewing for weight loss, encourage clients to engage in 'planning talk'. However, be aware that vague or 'medium' level goal setting might actually lead to weight gain. Instead, focus on helping clients create highly specific, high-commitment plans. Therapists should use questions to help clients refine their plans to be more specific, as this specificity is linked to better outcomes.

General Practitioner-delivered weight management programs are feasible and acceptable in primary care settings, with strong therapeutic alliance correlating with better patient retention and improved GP self-efficacy.

If you are a GP, consider delivering weight management directly using a structured, person-centered approach. Focus on building a strong therapeutic alliance with your patients, as this improves retention and outcomes. If you are a patient, ask your GP if they offer weight management programs, as they can be effective and may reduce the need for referrals.

Psychological factors, including anxiety, depression, and low self-esteem, are significant barriers to weight loss, often leading to emotional eating and avoidance of exercise.

Address mental health first. If you are anxious or depressed, seek support (therapy, counseling) to manage emotions without food. This reduces the psychological barrier to exercise and improves adherence to dietary changes.

High fruit, vegetable, and legume (VFL) intake is associated with lower noncardiovascular and total mortality, with maximum benefits at 3-4 servings per day.

Aim to eat 3-4 servings of fruits, vegetables, and legumes every day. This habit is linked to living longer and reducing the risk of non-heart-related diseases. Try to include a variety of plant foods in your meals.

Adolescents in South-Eastern Serbia exhibit inadequate intake of dietary fiber, sodium, calcium, vitamins A, C, D, and B9 (folate), necessitating targeted public health interventions.

For parents in South-Eastern Serbia, ensure adolescents are not just eating enough calories, but are getting enough fiber, calcium, and vitamins. Traditional high-fat, high-sodium diets may leave gaps in essential nutrients like Vitamin D, Calcium, and Folate. Consider increasing intake of fruits, vegetables, and fortified foods, or consult a healthcare provider for supplementation strategies tailored to adolescent needs.

Adults in South-Eastern Serbia consume a low-carbohydrate, high-fat dietary pattern with excessive sodium intake, which may not be inherently hazardous if complex carbohydrates are prioritized.

Adults in this region are eating less carbohydrates and more fats than recommended. This isn't necessarily bad if the fats are unsaturated and the carbohydrates are complex (whole grains, vegetables). However, sodium intake is excessively high, which is a clear risk factor for blood pressure. Prioritize reducing salt and processed meats while maintaining a balanced intake of fiber-rich carbohydrates.