What the protein literature actually shows, and in whom it was shown
Where the familiar figures come from, what populations they were measured in, and how far the extrapolation reaches.
Bone density
Page 2 of 3 of this archive, newest first.
Sarcopenia is a diagnosis, not a synonym for losing lean mass
A tour of the source literatures, with an assessment of how far each legitimately reaches.
Load, not cardio: the distinction the general advice keeps losing
The recommendation survives scrutiny. The reasoning offered for it frequently does not.
The one-quarter rule, and the paper that took it apart
Grading six widely repeated claims against the studies actually behind them.
Two sessions a week, and the evidence behind the prescription
One randomised trial has combined a GLP-1 receptor agonist with supervised exercise. Its result is the single most useful piece of evidence in this area.
The advice is mostly reasonable. The certainty is not earned.
The gap between a defensible recommendation and a confident one is where most of the harm in this subject lives.
Two sessions a week, and the evidence behind the prescription
The older-adult diet-and-exercise trials are the closest analogue to rapid pharmacological weight loss, and they are twenty years old.
What the older diet-and-exercise trials found in the hip
A plausible mechanism, a measurable change, and no outcome data. This is what an open question looks like.
Sarcopenia is a diagnosis, not a synonym for losing lean mass
Almost every practical recommendation in circulation was established in a population that does not resemble the people now following it.
A few hundred participants carry the whole body-composition argument
A substudy powered to describe a mean is not a substudy powered to detect a clinically meaningful individual change.
Why "muscle-sparing" is a marketing term and not a measurement
Grading six widely repeated claims against the studies actually behind them.
Why "muscle-sparing" is a marketing term and not a measurement
Almost every practical recommendation in circulation was established in a population that does not resemble the people now following it.
The visceral fat result nobody quotes, from the substudy everybody cites
The trials measured mass. Nobody measured whether the participants got weaker.
Sarcopenia is a diagnosis, not a synonym for losing lean mass
The rule that a quarter of weight lost is lean tissue has been in textbooks for decades and does not survive close reading.
What we would need to randomise to answer this properly
The older-adult diet-and-exercise trials are the closest analogue to rapid pharmacological weight loss, and they are twenty years old.
The one randomised trial that combined an incretin with supervised exercise
One randomised trial has combined a GLP-1 receptor agonist with supervised exercise. Its result is the single most useful piece of evidence in this area.
Why the bone question is harder than the muscle question
What the Journal would want measured before treating this as settled in either direction.
The advice is mostly reasonable. The certainty is not earned.
A tour of the source literatures, with an assessment of how far each legitimately reaches.
The substudies, read properly: who was scanned, when, and with what
Both the reassuring reading and the alarming reading are supportable from the same tables. This piece sets out which is which.
Bone density during rapid weight loss: what is known, which is less than you would hope
Density is a proxy for strength and an imperfect one, particularly when soft-tissue thickness over the measurement site is changing.