Why "muscle-sparing" is a marketing term and not a measurement
A tour of the source literatures, with an assessment of how far each legitimately reaches.
Exercise
Page 2 of 4 of this archive, newest first.
Fat mass fell more than lean mass. That is the finding, and it is not the headline.
What was pre-specified, what was exploratory, and what was calculated afterwards by people who did not run the trial.
Eating enough protein on a suppressed appetite is an arithmetic problem before it is a nutritional one
A survey of what the meta-analyses support, with the populations named.
The one randomised trial that combined an incretin with supervised exercise
The recommendation survives scrutiny. The reasoning offered for it frequently does not.
The advice is mostly reasonable. The certainty is not earned.
Grading six widely repeated claims against the studies actually behind them.
Why "muscle-sparing" is a marketing term and not a measurement
A tour of the source literatures, with an assessment of how far each legitimately reaches.
Grams per kilogram of what? The denominator problem in protein guidance
A survey of what the meta-analyses support, with the populations named.
The imaging substudy is an afterthought in the protocol and the centrepiece of the debate
The trials measured mass. Nobody measured whether the participants got weaker.
Percentage of loss, absolute kilograms, and the sleight of hand between them
What was pre-specified, what was exploratory, and what was calculated afterwards by people who did not run the trial.
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.
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.
Why the bone question is harder than the muscle question
Density is a proxy for strength and an imperfect one, particularly when soft-tissue thickness over the measurement site is changing.
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.
The scale is not the measurement, and neither is the handheld device in the clinic
A body-composition report gives four decimal places and no confidence interval. That is the whole difficulty in one sentence.
The precision question nobody puts to a body-composition report
A body-composition report gives four decimal places and no confidence interval. That is the whole difficulty in one sentence.
What the protein literature actually shows, and in whom it was shown
The denominator matters more than the ratio: per kilogram of body weight, of ideal weight, or of lean mass gives three different targets.
Percentage of loss, absolute kilograms, and the sleight of hand between them
The trials measured mass. Nobody measured whether the participants got weaker.
Why "muscle-sparing" is a marketing term and not a measurement
Grading six widely repeated claims against the studies actually behind them.
Eating enough protein on a suppressed appetite is an arithmetic problem before it is a nutritional one
The resistance-training and energy-deficit literature supports a higher protein intake. None of it was conducted in people taking an incretin.
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.