Browse the evidence

Very low carbohydrate (VLC) diets offer short-term advantages in reducing medication use and lowering HbA1c in people with type 2 diabetes, but long-term evidence is limited to 12 months.

If you have type 2 diabetes, a very low carbohydrate diet can help lower your blood sugar and reduce medication needs in the short term (up to 12 months). However, long-term data is scarce, so consider this a short-term tool rather than a lifelong guarantee.

Weight loss achieved through GLP-1 agonists or lifestyle interventions improves the severity and treatment response of immune-mediated skin diseases like psoriasis and hidradenitis suppurativa.

If you have psoriasis or hidradenitis suppurativa, losing weight can directly reduce the severity of your skin lesions and improve how well your treatments work. This is because excess fat tissue drives inflammation. Managing your weight helps calm the underlying immune response.

Adding DPP4 inhibitors (e.g., sitagliptin) to metformin significantly improves glycemic profiles (fasting blood sugar and HOMA-IR) in women with PCOS compared to metformin alone.

If metformin alone isn't controlling your blood sugar or insulin resistance, adding a DPP4 inhibitor (like sitagliptin) is a clinically supported next step. This combination targets glucose metabolism more effectively than metformin alone in PCOS patients.

Adding Thiazolidinediones (TZDs) to metformin has the most significant influence on lipid levels (specifically lowering LDL and improving lipid profiles) in women with PCOS.

If lipid management is a primary concern in your PCOS treatment, adding a TZD (like pioglitazone) to metformin is the most effective strategy among the reviewed drugs for improving your lipid profile.

Exercise prescriptions for clients taking anti-obesity medications (AOMs) should be reframed from caloric expenditure to focus on health, well-being, and functional targets (strength, aerobic fitness, body awareness) rather than enhancing weight loss.

Stop telling your client on Ozempic or Wegovy that they need to run 5 miles to 'earn' their food. The drug handles the weight loss. Instead, ask them how they feel. Do they have energy? Are they strong? Program for those feelings. If they feel weak, lift weights to improve strength. If they feel tired, do light cardio to boost energy. This builds trust and keeps them coming back, which is what matters for long-term health.

Efpeglenatide, a long-acting GLP-1 receptor agonist administered once weekly or every two weeks, significantly reduces body weight and improves glycemic control (reverting pre-diabetes to normoglycemia) in patients with obesity or overweight without type 2 diabetes, regardless of baseline BMI, age, or pre-diabetes status.

If you have obesity or are overweight with health issues but no diabetes, efpeglenatide is a once-weekly (or bi-weekly) injection that can help you lose weight and improve your blood sugar control. It works regardless of your age or how much you weigh. You should also try to eat about 500 fewer calories a day and be more physically active. Common side effects are stomach-related, like nausea, but these often get better over time.

Vitamin D3 supplementation (800 IU/day) is the most cost-effective management strategy for sarcopenia in Iran, whereas combination therapies (Protein + Vitamin D3) are not cost-effective despite higher clinical effectiveness.

For managing sarcopenia cost-effectively, Vitamin D3 supplementation (800 IU/day) is the recommended single intervention. While combining it with protein and exercise improves muscle metrics, the added cost makes it economically inefficient for public health systems compared to Vitamin D alone.

Post-acute COVID-19 patients exhibit high rates of malnutrition risk (48%) and suboptimal protein intake, with gastrointestinal symptoms significantly correlating with reduced caloric consumption.

If you are recovering from COVID-19 and experiencing lingering symptoms like loss of taste, smell, or stomach issues, you are at high risk for malnutrition. Prioritize nutrient-dense foods and consider small, frequent meals if large portions are difficult. Monitor your protein intake, as many patients fail to meet recovery needs.

Protein distribution is skewed in post-acute COVID-19 patients, with less than 4% meeting the per-meal threshold of 0.4 g/kg, limiting muscle protein synthesis stimulation.

Do not concentrate all your protein at dinner. Post-acute COVID-19 patients often fail to meet the 0.4 g/kg per-meal threshold at breakfast and lunch. Add protein sources to morning and midday meals to support muscle recovery.

In severely obese nondiabetic males, a decrease in the serum cortisol-to-cortisone (F/E) ratio following significant weight loss is independently associated with a reduction in systolic blood pressure.

For severely obese men, losing significant weight (15% or more) through a structured program not only lowers blood pressure but also shifts how the body processes cortisol. This shift, measured by the cortisol-to-cortisone ratio, is a key driver of that blood pressure improvement. Monitoring this metabolic change might help predict who benefits most from weight loss interventions for hypertension.

Financial incentives structured around achieving intermediate behavioral goals (goal-directed) are theoretically more sustainable for long-term weight management than incentives contingent solely on weight loss outcomes (outcome-based), as they build self-efficacy and intrinsic motivation.

If you are trying to lose weight, focus on rewarding yourself for doing the right things (going to the gym, tracking food) rather than just the scale number. This paper suggests that paying for the *behavior* helps you build the habits and confidence to keep the weight off long-term, whereas paying only for the result might not sustain the effort once the money stops.

Statewide public education campaigns using non-stigmatizing, mass-media advertising can significantly improve the public's ability to accurately identify overweight and obesity based on height and weight, and increase awareness of obesity as a personal health issue.

If you are a health educator or policymaker, use mass media campaigns that focus on factual, non-shaming information about weight status. Encourage people to check their own BMI and health risks objectively. This increases awareness and accuracy in identifying obesity, which is a necessary first step before expecting behavior change.

Consuming a high-fat dinner (60% fat) results in significant positive fat balance and metabolic inflexibility, whereas a low-fat dinner (20% fat) results in fat balance near zero, indicating metabolic flexibility.

If you eat a high-fat dinner, your body may store that fat rather than burning it, leading to a positive fat balance overnight. If you eat a lower-fat dinner, your body is more likely to burn the fat you eat, resulting in zero net fat storage. This suggests that meal composition timing matters for overnight fat balance, especially if you have metabolic inflexibility.

Combination incretin therapies (GLP-1/GIP, GLP-1/Glucagon, or GLP-1/GIP/Glucagon) produce superior weight loss and glycemic control compared to monotherapy GLP-1 receptor agonists by targeting multiple hormonal pathways simultaneously.

If standard GLP-1 drugs (like Ozempic or Saxenda) aren't delivering enough weight loss or metabolic improvement, combination therapies like Tirzepatide (Mounjaro/Zepbound) or Cotadutide target multiple hormones (GLP-1, GIP, Glucagon) to potentially achieve greater weight loss and better blood sugar control. These are typically weekly injections, though oral versions exist. Expect potential gastrointestinal side effects like nausea, which often improve over time. Consult a doctor to see if you qualify for these newer, more potent treatments.

Dual GLP-1/Glucagon receptor agonists (e.g., Cotadutide, Oxyntomodulin) promote weight loss by combining appetite suppression (GLP-1) with increased energy expenditure (Glucagon).

Drugs like Cotadutide combine two hormones: GLP-1 (which reduces appetite) and Glucagon (which increases energy expenditure). This dual action can lead to weight loss, potentially greater than GLP-1 alone. These are daily injections. Be aware of potential gastrointestinal side effects and monitor heart rate, as glucagon can increase heart rate. Discuss with your doctor if this mechanism is appropriate for your health profile.

Combining GLP-1 receptor agonists with SGLT2 inhibitors produces additive weight loss by reducing caloric intake (GLP-1) and increasing caloric excretion via glucosuria (SGLT2).

Combining a GLP-1 drug (like Byetta/Bydureon) with an SGLT2 inhibitor (like Farxiga/Jardiance) can lead to greater weight loss than either drug alone. The GLP-1 reduces hunger, while the SGLT2 causes you to excrete sugar in your urine, burning calories. This combination is often used for Type 2 Diabetes but can aid weight loss. Be mindful of potential genital yeast infections or UTIs, which are common side effects of SGLT2 inhibitors.

Bariatric surgery and incretin-based therapies (GLP-1 RAs, tirzepatide) reduce pancreatic disease burden and improve metabolic profiles relevant to pancreatic pathology.

If you are considering weight loss medications like GLP-1 agonists (e.g., semaglutide) or dual agonists (e.g., tirzepatide), current evidence suggests they do not increase the risk of pancreatitis or pancreatic cancer. They may actually help reduce pancreatic inflammation and disease burden by improving metabolic health.

A 6-month intensive, multidisciplinary lifestyle intervention significantly reduces 24-hour systolic and diastolic blood pressure in patients with resistant hypertension.

If you have resistant hypertension, standard advice to 'just exercise and eat better' often fails because the condition is complex. This study shows that a structured, supervised program involving diet, exercise, and sleep management can significantly lower blood pressure. Success requires commitment to regular visits and personalized guidance from a healthcare team.

HMB supplementation alone (3g/day) prevents the decline in muscle mass and grip strength in elderly sarcopenic patients after hip surgery, but does not significantly increase muscle mass or strength compared to baseline.

Take 3g of HMB daily after hip surgery. It won't build new muscle on its own, but it may help stop your muscles from shrinking as much as they otherwise would during recovery.

Repeated intensive lifestyle interventions result in a progressively less favorable ratio of fat mass loss to fat-free mass loss, indicating a shift towards preserving less lean mass relative to fat loss with each subsequent intervention.

Be aware that as you lose weight repeatedly, you might lose a higher proportion of muscle relative to fat. To mitigate this, ensure your protein intake is adequate (15-20% of calories as per the study) and incorporate resistance training if possible, although the study used mixed activities.

Dietary fats exert pro- or anti-inflammatory effects on atherosclerosis through specific immune-inflammatory pathways (e.g., TLR4 activation by saturated fats, SCFA-mediated anti-inflammation) that operate independently of, or in addition to, their metabolic effects on serum lipids.

Focus on the quality and type of fats, not just the quantity. Saturated fats may trigger inflammation via TLR4, while unsaturated fats and gut-derived short-chain fatty acids (from fiber) can reduce inflammation. Prioritize whole food sources of fats (nuts, fish) over processed fats to leverage beneficial immune interactions.

Post-exercise consumption of 20g whey protein (WP), casein (CAS), or 80:20 WP/CAS blends increases plasma branched-chain amino acid (BCAA) concentrations and reduces delayed onset muscle soreness (DOMS) compared to placebo, but combining WP and CAS does not enhance BCAA profiles or muscle recovery beyond consuming WP alone.

If you are looking to reduce muscle soreness after a heavy workout, taking 20g of whey protein, casein, or an 80:20 blend immediately after training will help more than a placebo. However, there is no need to buy expensive 'blend' supplements; pure whey protein provides the same amino acid spike and recovery benefits as the blend. Save your money and stick to whey protein.

Adherence to the Mediterranean Diet (MED) or Dietary Approaches to Stop Hypertension (DASH) improves cardiovascular disease risk biomarkers (total and LDL cholesterol, blood pressure) and reduces oxidative stress and inflammation in postmenopausal women.

Focus on whole-food dietary patterns like the Mediterranean or DASH diet, emphasizing fruits, vegetables, whole grains, and healthy fats. These patterns have been shown to improve cholesterol and blood pressure in postmenopausal women, addressing key cardiovascular risks associated with hormonal changes.

Replacing dietary fat with high-glycemic index (GI) carbohydrates increases the prevalence of hypertriglyceridemia and low HDL-cholesterol, particularly in non-obese individuals.

If you eat a high-carbohydrate diet, the quality of those carbohydrates matters significantly for your blood fats. Replacing fats with high-glycemic index carbs (like white rice or refined grains) is linked to higher triglycerides and lower 'good' HDL cholesterol. This effect is particularly strong if you are not overweight. Focus on low-GI carbohydrates and healthy fats rather than simply reducing fat intake.