TL;DR:

800–900 kcal/day diet (30% protein, 50% carbohydrate, 20% fat). Remission at 24 weeks occurred in 27/50 (54%) of intervention participants vs. 2/46 (4%) control participants.

Summary

Background: Low energy diets (LED) can induce type 2 diabetes remission but have not been studied in combination with structured supervised exercise. We aimed to determine if a combined intervention could induce remission in early-onset type 2 diabetes (EOT2D ≤ 45 years of age), a population with high lifetime risk of complications.

Methods: Across 3 centres in England and Canada, we conducted a randomised, open-label, blinded endpoint efficacy trial among adults 18–45 years of age with EOT2D and obesity, not on insulin therapy. The groups were usual care alone vs. an intervention combining 800–900 kcal/day LED, twice-weekly supervised (aerobic, resistance) and once-weekly independent exercise (weeks 1–12), followed by a weight-maintenance diet with independent exercise (weeks 13–24). An independent statistician generated web-based randomisation sequences (1:1, country- and sex-stratified, variable block size). The primary outcome was remission at 24 weeks (HbA1c< 6.5% [48 mmol/mol], without glucose-lowering medication ≥12 weeks). The primary efficacy and harms analysis was in all randomised individuals, assuming no remission when data were unavailable. Secondary endpoints included cardiorespiratory fitness, body composition, and cardiac structure. The trial is registered at ISRCTN (15487120) and is now closed.

Findings: We randomised 96 participants (mean age 38 years, BMI 35.2 kg/m2) between September 24, 2021 and June 6, 2025 (intervention group: 24 female, 26 male with 18 European, 17 South Asian, 15 Other ethnicity; control group: 21 female, 25 male with 19 European, 10 South Asian, 17 Other ethnicity). In total, 86 (90%) attended final assessments. Remission at 24 weeks occurred in 27/50 (54%) of intervention participants vs. 2/46 (4%) control participants (50% difference, 95% CI 33%–64%; adjOR 21.6, 95% CI 6.2 to 114.5), without serious adverse events. Most intervention group participants experienced at least one adverse event (43/50 vs. 6/46), mainly early LED effects (e.g., constipation, headache, dizziness, fatigue) that resolved.

Interpretation: High remission rates signal feasibility and efficacy of a combined LED and intensive exercise intervention in EOT2D, justifying examination of synergistic benefits beyond remission.

https://www.sciencedirect.com/science/article/pii/S2667193X26002942

To assess the effectiveness of the Pritikin program of diet and exercise for treating patients with non-insulin-dependent diabetes mellitus (NIDDM), data were obtained from 60 patients who completed the 26-day residential program. Of the 23 patients who were taking oral hypoglycemic agents upon entry, all but 2 were off medication by the end of the program. Of the 17 patients who were taking insulin, all but 4 were off medication at discharge. Two of the four had their insulin reduced by 50% while the remaining two had no major change in their insulin dosage. Fasting blood glucose was reduced from 194.9 ± 10.1 to 144.6 ± 7.1 mg/dl. Serum cholesterol was reduced from 225.4 ± 5.7 to 181.7 ± 4.9 mg/dl while triglycerides were reduced from 283.7 ± 28.8 to 186.2 ± 11.6 mg/dl. The group as a whole lost an average of 4.3 kg/body wt and achieved 40.5% of their desired weight loss. Maximum work capacity increased from 5.6 ± 0.3 to 7.9 ± 0.4 METs, while daily walking increased from 11.7 ± 2.4 to 102.8 ± 4-8 min/day. The decrease in fasting glucose was not correlated with weight loss (r = 0.24), increase in walking time (r = 0.00), or increase in MET capacity (r = 0.05). We conclude that the total program is an effective means for treating NIDDM patients. We also feel that the high-complexcarbohydrate, high-fiber, low-fat diet is of primary importance.

ABSTRACT

Purpose: Metabolic syndrome is a risk factor for several diseases. The relationship between metabolic syndrome and hypogonadism is well known. Our objetive is to assess whether a low carbohydrate diet can increase total serum testosterone and improve erectile function in hypogonadal men with metabolic syndrome.

Methods: An open label randomized clinical trial was conducted comparing a low carbohydrate diet and controls, during three months, in hypogonadal men with metabolic syndrome. Anthropometric measurements were evaluated as well as total serum testosterone levels, and symptoms of hypogonadism, using the ADAM and AMS scores, and sexual function using IIEF-5 score.

Results: Eighteen men were evaluated. Anthropometric measures were improved only in low carbohydrate diet group. The intervention group also had a statistically increase in IIEF-5 score and a significant reduction in AMS and ADAM scores (p < 0.001). The increase in serum total testosterone levels was statistically significant in the low carbohydrate group compared to the control group as well as calculated free testosterone (p < 0.001).

Conclusions: Low carbohydrate diet may increase serum levels of testosterone and improve erectile function in hypogonadal men with metabolic syndrome. However, larger studies are necessary to strongly prove the effectiveness of low carbohydrate diet in treating male hypogonadism.

https://pmc.ncbi.nlm.nih.gov/articles/PMC9892661/

TL;DR:

A study of 8,783 middle-aged Canadian adults found that higher ultra-processed food intake was associated with greater body fat and more signs of hidden vascular brain injury on MRI, but not with measurable cognitive decline.

Key Points

Question: Is higher consumption of ultraprocessed foods associated with adiposity, subclinical vascular brain injury, and cognitive performance among middle-aged adults in Canada?

Findings: In this cross-sectional study of 8783 adults, higher ultraprocessed food intake was associated with greater percentage of body fat and visceral adipose tissue and with higher odds of magnetic resonance imaging–defined vascular brain injury. Ultraprocessed food intake was not associated with cognitive performance.

Meaning: In this study, higher ultraprocessed food intake was associated with markers of adiposity and subclinical cerebrovascular injury that may precede detectable cognitive deficits, but longitudinal studies are needed to establish temporality.

Abstract

Importance: Ultraprocessed foods (UPFs) account for a substantial and increasing proportion of dietary intake in Canada. Although UPFs are consistently associated with adiposity and cardiometabolic disease, their associations with subclinical vascular brain injury (VBI) and cognitive performance in midlife are unclear.

Objective: To evaluate associations of UPF consumption with adiposity, magnetic resonance imaging (MRI)–defined VBI, and cognitive performance in middle-aged adults in Canada.

Design, Setting, and Participants: This cross-sectional study included 8783 adults aged 35 to 69 years without cardiovascular disease who were enrolled in the Canadian Alliance for Healthy Hearts and Healthy Minds (CAHHM) and Prospective Urban and Rural Epidemiology-MIND (PURE-MIND) studies. Participants from CAHHM were recruited from January 1, 2014, to December 31, 2018, and participants from PURE-MIND were recruited from January 1, 2010, to December 31, 2018. Data analyses were conducted between July 16, 2024, and August 16, 2026.

Exposures: UPF consumption assessed using previously validated semiquantitative food frequency questionnaires and expressed as servings per 2000 kcal/d.

Main Outcomes and Measures: The main outcomes were body fat (BF) percentage (bioelectrical impedance), visceral adipose tissue (VAT) volume, hepatic fat fraction (HFF), VBI defined as covert brain infarcts or high white matter hyperintensities (HWMHs) (measured by MRI), and cognitive performance measured by the Montreal Cognitive Assessment (MOCA) and the Digital Symbol Substitution Test (DSST).

Results: In this cross-sectional study of 8783 participants (mean [SD] age, 57.7 [8.7] years; 4917 females [56.6%]), those in the highest quartile of UPF intake had a BF percentage that was 1.7 (95% CI, 1.2-2.2) percentage points higher and a 5.7 (95% CI, 3.2-8.3) mL greater VAT volume compared with those in the lowest quartile, but no significant difference in HFF. Compared with the lowest quartile, the highest UPF quartile had higher odds of VBI (adjusted OR, 1.40; 95% CI, 1.10-1.77; P for trend = .009). No significant associations were observed between UPF intake and MOCA or DSST performance.

Conclusions and Relevance: In this cross-sectional study of middle-aged adults in Canada, higher UPF intake was associated with greater adiposity and higher odds of MRI-defined VBI but not cognitive performance. Associations with VBI were sensitive to UPF exposure definition. Longitudinal studies are needed to establish temporality.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2855351

Effects of dietary quality on type 2 diabetes risk and the mediating role of inflammatory markers

DOI: https://doi.org/10.1017/S0007114526108605

Diabetes mellitus is a significant global health concern, with a staggering rise in prevalence, particularly in China, where approximately 140.9 million individuals were diagnosed with diabetes in 2021. This study addresses a critical gap in understanding how dietary quality influences diabetes risk, especially in Asian populations, which have been underrepresented in existing research. The objective was to explore the associations between dietary quality indices—specifically the Healthy Eating Index (HEI), Diet Quality Index (DQI), and Diet Balance Index (DBI)—and diabetes risk, while also investigating the potential mediating role of systemic inflammatory markers. The study included 21,476 participants from the Fuqing Cohort Study, aged 35-75 years, who completed a food frequency questionnaire (FFQ) to assess their dietary habits.

The results demonstrated that higher dietary quality is inversely associated with diabetes risk across all indices. Specifically, participants in the highest dietary quality category had adjusted odds ratios (OR) of 0.863 (95% CI = 0.768–0.970) for HEI, 0.719 (95% CI = 0.640–0.807) for DQI, and 0.852 (95% CI = 0.754–0.961) for DBI compared to those in the lowest category. The mediation analyses revealed that the association between HEI and diabetes risk was partially mediated by systemic inflammatory markers. This means that some of the protective effect of a higher HEI on diabetes risk can be explained by its impact on inflammatory markers in the body. For instance, higher dietary quality was linked to lower levels of total white blood cell count, neutrophils, and monocytes—cells that are often elevated during inflammation.

The study quantified the mediation effects in terms of percentages, indicating how much each inflammatory marker contributes to the overall relationship between dietary quality and diabetes risk. For example, total white blood cell count accounted for 10.67% of the mediation effect. This means that when individuals improved their dietary quality, about 10.67% of the reduction in diabetes risk can be attributed to the resulting decrease in white blood cell levels, which are often elevated in inflammatory states. Neutrophils contributed 11.32% to the mediation effect, signifying that the influence of dietary quality on diabetes risk is similarly affected by changes in neutrophil levels. Monocytes contributed 4.05%, indicating a smaller but still significant role in this relationship.

When considering all inflammatory markers together, the cumulative mediated proportion was 8.83%. This figure suggests that nearly one-tenth of the beneficial effect of high dietary quality on diabetes risk is due to its ability to lower inflammation in the body. In simpler terms, if a person improves their diet, almost 9% of the positive impact on reducing diabetes risk can be explained by the associated decrease in inflammation. This highlights the significant role that inflammation plays in how dietary quality influences diabetes risk.

Study Design and Methodology

• Sample Size: 21,476 participants
• Duration: Data collected from July 2020 to December 2022
• Measurement Tools: Food Frequency Questionnaire (FFQ) assessing dietary intake; dietary quality indices (HEI, DQI, DBI)
• Controls Used: Adjustments for age, sex, education, occupation, smoking, alcohol consumption, tea drinking, hypertension, and hyperlipidaemia

Key Findings

• HEI:
  • Highest dietary quality category OR = 0.863 (95% CI = 0.768–0.970)
• DQI:
  • Highest dietary quality category OR = 0.719 (95% CI = 0.640–0.807)
• DBI:
  • Highest dietary quality category OR = 0.852 (95% CI = 0.754–0.961)
• Mediation Effects:
  • Total WBC: Mediated proportion 10.67%
  • Neutrophils: Mediated proportion 11.32%
  • Monocytes: Mediated proportion 4.05%
  • Overall mediated proportion: 8.83%

Limitations

• Cross-sectional design limits causal inference
• Potential reverse causation cannot be ruled out
• Self-reported dietary data may introduce bias
• Lack of measurement for salt intake may affect dietary index scoring
• Single-region study may limit generalizability

Discussion and Implications

This study significantly contributes to our understanding of dietary quality as a protective factor against type 2 diabetes, particularly in Southeast Asian populations. The findings indicate that improved dietary quality, as measured by HEI, DQI, and DBI, correlates with lower diabetes risk and reduced levels of systemic inflammatory markers. The study highlights that chronic systemic inflammation is a crucial pathway through which dietary quality influences diabetes risk. Inflammatory markers such as total white blood cell count, neutrophils, and the neutrophil-to-lymphocyte ratio were identified as mediators, suggesting that diets high in quality can mitigate inflammatory responses that contribute to diabetes development.

Furthermore, the study underscores the importance of dietary diversity and balance in dietary interventions, particularly in populations experiencing rapid dietary transitions. The results emphasize that focusing on plant-based foods, which are linked to lower inflammation levels, can be critical in diabetes prevention strategies. As dietary patterns evolve, promoting healthy eating indices that prioritize quality over quantity could lead to significant public health benefits in reducing diabetes prevalence.

Higher dietary quality is associated with a lower risk of type 2 diabetes, mediated in part by systemic inflammation. These findings underscore the need for dietary interventions that emphasize quality and diversity, particularly plant-based foods, to combat the growing diabetes epidemic. More research is needed to confirm these associations and explore their implications in diverse populations.

Abstract

Objective The aim of this study was to explore the effects of a low-fat plant-based diet on hepatocellular and intramyocellular lipids, advanced glycation end products (AGEs), insulin resistance, and beta-cell function in adults with type 2 diabetes.

Research design and methods Participants (n=25) were asked to follow a low-fat vegan diet for 16 weeks. Dual X-ray absorptiometry was used to measure body composition. Hepatocellular and intramyocellular lipids were quantified by ¹H magnetic resonance spectroscopy. Tissue accumulation of AGEs was measured using a skin fluorescence technique. Insulin resistance was assessed in a fasting state with the Homeostasis Model Assessment (HOMA-IR) index. Postprandial insulin sensitivity was assessed with the predicted insulin sensitivity index (PREDIM). Beta-cell function was calculated by a mathematical model after a standard meal, using C-peptide deconvolution.

Results Mean body weight decreased by 6.0 kg, a 6.6% decrease relative to baseline. This was largely due to the reduction in fat mass. Visceral fat volume decreased by 290 cm³. Hepatocellular lipids decreased by 33.0%. The AGE score decreased by 0.4. The HOMA-IR index, a measure of insulin resistance, fell 2.5, whereas PREDIM, a measure of insulin sensitivity, increased on the vegan diet +1.3 mg/min/kg. Several markers of beta-cell function improved on the vegan diet. Specifically, insulin secretion at 6 and 7 mmol/L glucose, beta-cell glucose sensitivity, rate sensitivity, and potentiation factor all increased.

Conclusions On an ad libitum low-fat plant-based (vegan) dietary intervention, the participants with type 2 diabetes experienced reductions in ectopic fat, particularly visceral and hepatocellular fat, improvements in insulin sensitivity, reductions in AGEs, and improvements in beta-cell function.

The Diabetes diet they put him on first:

• 8 meals a day

• 260 g of carbohydrates

• 74 g of protein

• 63 g of fat

The Carnivore diet:

• No carbohydrates

• 200 g of protein

• 135 g of fats

Abstract

Diabetes has been well established as one of the deadliest chronic diseases globally. Currently, India is known as the diabetes capital of the world although this disease had been documented in the country for centuries. Current treatment strategies center around oral hypoglycemic drugs, insulin, and the standard ‘diabetic diet.’ Nonetheless, millions continued to suffer from this chronic disease and its multiple complications. We herein present a case involving a male patient suffering from diabetes for 20 years despite being on medications and a diabetic diet who finally achieved remission of diabetes and hypertension by removing carbohydrates and following a carnivore diet.

https://pmc.ncbi.nlm.nih.gov/articles/PMC13007801/

Mankai (Wolffia globosa duckweed) shows promising potential for helping reduce visceral adipose tissue (VAT)—the deep abdominal fat around organs—based on human clinical trials.

Key Evidence from the DIRECT PLUS Trial

In the 18-month DIRECT PLUS randomized controlled trial (294 participants with abdominal obesity, similar age/profile to yours), the "green Mediterranean diet" enriched with daily Mankai (100g frozen cubes in a shake), walnuts (28g), and green tea (3-4 cups) led to:

• 14.1% reduction in visceral fat.
• Compared to ~6% on a standard Mediterranean diet and ~4% on healthy guidelines.
• Even after adjusting for overall weight loss, higher Mankai intake (≥3 times/week) was independently associated with greater VAT loss (up to 26% in high consumers).
• Benefits linked to Mankai's high polyphenols (which support fat metabolism and reduce inflammation), complete protein, fiber, and other nutrients.

This effect was stronger than diet alone, suggesting Mankai contributes specifically to targeting visceral fat (beyond just calorie control or general plant-based eating).

Practical Tips to Incorporate It

• Aim for 100g fresh/frozen Mankai daily (often as cubes blended into a green shake/smoothie—mild taste, easy to mask with berries or spinach).
• Combine with your low-carb, vegetarian-leaning preferences: e.g., in a protein shake replacing a meal or snack.
• Start gradually (e.g., 50g/day) to monitor digestion.
• Track waist circumference (a proxy for visceral fat) or get a DEXA/MRI if possible for better measurement.

The effect of high-polyphenol Mediterranean diet on visceral adiposity: the DIRECT PLUS randomized controlled trial
https://link.springer.com/article/10.1186/s12916-022-02525-8

(Full text is freely available there.)

For the trial registration and overview:
https://clinicaltrials.gov/study/NCT03020186

Limited Supply and Specialized Cultivation

Commercial food-grade Wolffia globosa grows primarily in controlled hydroponic systems (greenhouses or isolated aquatic setups) to ensure purity, consistent nutrition, and safety—no contaminants, heavy metals, or pesticides that could come from wild harvesting. This requires precise monitoring of water quality, nutrients, light, and temperature for optimal growth and nutrient profile (like high bioavailable B12, complete protein, and polyphenols backed by clinical studies).

The original branded Mankai (from Hinoman in Israel) involved years of R&D and patented strains, but the US arm shut down in 2022 due to investor decisions. Current suppliers (mostly from Thailand or smaller farms) operate on a smaller scale, so economies of scale aren't there yet—unlike cheap greens like spinach or kale powder.

Processing Costs

Most products are freeze-dried or carefully dried to preserve nutrients, which is more expensive than simple air-drying used for many greens. Harvesting the tiny plants (each frond is <1mm) and turning them into powder adds labor and tech costs.

Niche Market Premium

It's marketed as a premium plant-based protein/superfood with unique benefits (e.g., natural B12, high protein digestibility), so it commands higher prices similar to other trendy items like spirulina, chlorella, or matcha when they were new. Demand is growing (especially among vegans/vegetarians for lipids and visceral fat support), but supply hasn't caught up fully.

Prices should drop as cultivation scales up—research shows potential for efficient, sustainable growth with low water/land use, and more farms are coming online. For now, that 2oz jar (often 10–20 servings) works out to $1–2 per dose, which isn't bad compared to other superfood powders.

several accessible alternatives show strong evidence for targeting visceral adipose tissue (VAT) through similar mechanisms—like boosting polyphenols, fiber, plant proteins, and anti-inflammatory compounds.

Top Evidence-Based Alternatives

1. Walnuts (28g/~1 ounce daily) Part of the same trial as Mankai—walnuts provided key polyphenols (ellagitannins leading to urolithin A metabolites) independently linked to greater VAT loss. Studies show walnuts improve lipid profiles, reduce inflammation, and specifically target abdominal fat. Easy to snack on or add to shakes/salads.
2. Green Tea (3–4 cups daily, or EGCG supplements) Another core component of the "green" diet—rich in catechins (especially EGCG) that promote fat oxidation and visceral fat reduction in human trials. Meta-analyses confirm modest but significant VAT decreases, especially with consistent intake. Opt for brewed tea (unsweetened) for best polyphenol absorption.
3. Other Polyphenol-Rich Berries & Fruits
   • Blueberries, strawberries, or apples: High in anthocyanins and similar compounds; clinical reviews link them to reduced visceral fat via improved insulin sensitivity and gut microbiome changes.
   • Aim for 1–2 cups daily—fresh, frozen, or in smoothies. More affordable and versatile than Mankai.
4. Leafy Greens & High-Fiber Plants (e.g., spinach, kale, broccoli) The trial noted increased dietary fiber was strongly associated with VAT loss (even after adjusting for weight loss). These provide soluble fiber, polyphenols, and nitrates that support metabolic health and cholesterol management. Blend into green shakes as a direct Mankai substitute.
5. Legumes & Plant Proteins (e.g., lentils, chickpeas, peas) For the protein/fiber combo Mankai offers—human studies show high-plant-protein diets selectively reduce visceral fat.
6. Other Promising Options
   • Pistachios: Recent trials link them to visceral fat reduction via protein and healthy fats.
   • Rosehip extract: One RCT showed abdominal VAT decreases (though less studied).
   • Omega-3-rich plants (flaxseeds, chia): Support inflammation reduction and fat metabolism.

How to Implement (Similar to Mankai Shakes)

Replace or enhance your meals with a daily "green" routine:

• Morning/afternoon → 3–4 cups green tea.
• Snack → Handful of walnuts + berries.
• Evening shake/soup → Blend spinach/kale, berries, legumes (e.g., pea protein powder), and flaxseeds.

This mimics the polyphenol/fiber boost from the green Mediterranean diet (which doubled VAT loss vs. standard versions) without needing Mankai. Effects are best with calorie control, exercise, and low red/processed meat.

No single food matches Mankai exactly, but combining these (especially walnuts + green tea + greens) gets close based on the same trial data—and at a fraction of the cost. Track waist circumference for progress, and chat with your doctor about adding concentrated sources (e.g., EGCG supplements) if needed.

Latest position stand via the International Society of Sports Nutrition covers nutri for weight loss. Below are the essential points, reading the full text is highly recommended:

"International Society of Sports Nutrition position stand: diets for body weight reduction"

Volume 23, 2026

ABSTRACT

The International Society of Sports Nutrition (ISSN) has developed an official position on diets for body weight reduction. This critical analysis of the literature is intended to provide a scientific foundation for practitioners, coaches, and trainees regarding the effects of the major diet types in adults who are generally healthy, physically active, and/or athletic, while drawing from clinical research in those with overweight/obesity, when relevant. This position stand does not address acute dehydration-based weight cutting, pharmacotherapy (i.e. GLP-1RAs), or bariatric surgery. The following 15 points constitute the Position Statement of the Society; the Research Committee has approved them.

1) Diets for body weight reduction can be broadly categorized by the magnitude of the energy deficit, linearity of the deficit, and macronutrient composition. These factors need to be tailored to individual preferences, tolerances, and goals.

2) Very-low-energy diets (<800 kcal/day) and low-energy diets (800–1200 kcal/day) produce greater short-term weight loss but lack long-term advantages over less aggressive energy restrictions, such as calorie-controlled diets. These aggressive diets may increase lean mass loss, although adequate protein intake and resistance training may mitigate this risk. Caution is warranted about insufficiencies in vitamins, minerals, fiber, and other nutrients.

3) The evidence at-large shows a lack of differential effects between intermittent fasting variants (alternate-day fasting, time-restricted eating, and twice-weekly fasting) and continuous energy restriction on anthropometric outcomes, although macronutrient quality plays an independent role in optimizing body composition and metabolic health.

4) Intra-day meal frequency (as opposed to total daily nutrition) does not tend to crucially influence body weight and body fat reduction. Meal frequency may be individualized flexibly; no lower or upper limits can universally be prescribed to optimize outcomes. However, in physically active and athletic populations, distributing protein across at least three protein-rich meals (or eating occasions) per day may optimize lean mass retention and performance during sustained energy deficits.

5) Resistance training and sufficient protein intake are indispensable mitigators of lean mass loss in a sustained caloric deficit, regardless of the diet type or variant. Total daily protein is of primary importance; specific distribution of the constituent doses is a secondary concern.

6) For the general population, a daily protein intake of 1.2–1.6 g/kg BW is appropriate for supporting total body weight and fat loss, physical activity, and imparting benefits to musculoskeletal and cardiometabolic health.

7) Daily protein intakes ranging 1.6–2.2 g/kg BW combined with resistance training may optimize muscle anabolism, while higher intakes of 1.9–3.2 g/kg BW can maximize lean mass retention in lean, resistance-trained individuals sustaining hypocaloric conditions.

The dietary carbohydrate‒fat proportion can be individualized to personal preference for the goal of weight loss, since the range of ketogenic to low-fat diets performs similarly.

9) Ketogenic diets are effective at bodyweight and body fat reduction, but they also tend to decrease fat-free mass to a greater degree than higher-carbohydrate comparators, particularly in shorter trials where glycogen and total body water shifts can influence estimates.

10) Adaptations to weight loss can be physical, physiological, and/or behavioral, and converge toward reducing energy expenditure to fulfill the body’s drive toward neutralizing disruptions to homeostasis imposed by the caloric deficit.

11) Adaptive thermogenesis is a reduction in resting energy expenditure beyond that predicted by changes in body composition. It can occur in response to hypocaloric conditions and weight loss, but it is not an inevitable response, and it may attenuate substantially upon attainment of weight stability.

12) Metabolic adaptations that reduce energy expenditure, including adaptive thermogenesis, and impair gut microbial diversity, can often be attenuated by strategic dietary and exercise programming that foster nutrient-absorption and partitioning, and metabolic flexibility.

13) A multitude of tactics can be implemented to manage and overcome plateaus. However, plateaus are also opportunities/cues to practice maintaining progress made thus far (the ultimate goal is the maintenance of a plateau).

14) Guidance from an interdisciplinary team of health professionals while maintaining social support is recommended for successful weight management.

15) Learning how to prepare home-cooked meals (and plan meals ahead of time through the day) puts dieters in control of their nutritional fate – and in a better position to succeed in managing their body weight and body composition.

https://www.tandfonline.com/doi/full/10.1080/15502783.2026.2740266?scroll=top&needAccess=true#abstract