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NADH and NAD+ act as electron donors and acceptors and NAD+ was shown to stimulate mitochondrial biogenesis and metabolic health. Here, the researchers developed and validated a non-invasive Phosphorous Magnetic Resonance Spectroscopy method to non-invasively quantify NAD+ and NADH in muscle on a clinical 3 T MRI scanner.

Cold acclimation has been shown to have beneficial metabolic effects, including improved insulin sensitivity in patients with type 2 diabetes. Here the authors show that a mild cold acclimation regiment during which overt shivering was prevented did not result in improved insulin sensitivity in a small group of patients with type 2 diabetes.

Creatine availability is known to affect creatine-driven thermogenesis in mice. Here Connell et al. report data from a clinical trial in which daily creatine supplementation, perhaps surprisingly, did not alter thermogenesis in adults with otherwise low dietary creatine intake.

Hepatic steatosis is associated with poor cardiometabolic health, with de novo lipogenesis (DNL) contributing to hepatic steatosis and subsequent insulin resistance. Here, the authors use ¹H-MRS methodology to show hepatic SFA fraction is a measure of DNL and specifically may hamper hepatic insulin sensitivity.

Evidence from preclinical models suggest that lowering levels of branched chain amino acids (BCAA) improves glucose metabolism. Here the authors report that NaPB, an accelerator of BCAA catabolism, improves peripheral insulin sensitivity in patients with type 2 diabetes in a randomized placebo-controlled crossover clinical trial.

A small clinical trial shows that short-term cold acclimation to moderately-cold temperature improves the glucose homeostasis of individuals with type 2 diabetes, without an appreciable activation of their brown adipose tissue.

Insulin resistance and type 2 diabetes mellitus are associated with mitochondrial dysfunction, and promoting healthy mitochondrial function could benefit patients. This Review discusses novel molecular targets for therapies that enhance mitochondrial function, with an emphasis on nonpharmacological regulation of factors such as nutrition, exercise, temperature and circadian rhythm.

In a two-part randomized phase 2a trial in men and women with overweight or obesity and type 2 diabetes mellitus, cotadutide promoted greater reductions in liver glycogen and fat than placebo and liraglutide.

Aging dynamics of complex lipids are incompletely understood. Here Janssens and colleagues describe lipids that change with age across ten tissues in mice. Notably, bis(monoacylglycerol)phosphate accumulated with age. This lipid also accumulated in muscle of older humans, and reduced upon a short bout of exercise.

β2-agonist treatment improves skeletal muscle glucose uptake and whole-body glucose homeostasis in rodents. Here the authors report that two-weeks of treatment with the β2-agonist clenbuterol improves insulin-stimulated glucose disposal in healthy young men in a double-blinded, randomized cross-over trial.

The authors compared muscle metabolomes of young and older adults with different muscle health and physical activity levels. They found that aging was characterized by lower levels of NAD⁺ that were correlated with activity levels and muscle function.

tRNAs are linked with their cognate amino acid by aminoacyl tRNA synthetases (ARS). Here, the authors report a developmental encephalopathy associated with biallelic VARS variants (valyl-tRNA synthetase) that lead to loss of function, as determined by several in vitro assays and a vars knockout zebrafish model.

Activation of brown adipose tissue can ameliorate obesity and diabetes. Here the authors show that chemical inhibition of hyaluronan synthesis by 4‐methylumbelliferone or genetic deletion of hyaluronan synthases 2 and 3 decreases body-weight gain and improves glucose homeostasis by inducing the thermogenic capacity of brown adipose tissue in mice.

Sellers, van Beek and colleagues show that intermittent cold exposure for 10 days, which induced 1 h of shivering per day, improves glucose homeostasis, lipid metabolism and blood pressure in adults with overweight or obesity.

Tobacco smoking and cold exposure are environmental modulators of human energy metabolism suppressing appetite and increasing energy expenditure, respectively. Here, the authors develop a novel pharmacological strategy in which they simultaneously mimic the metabolic benefits of both phenomena through small-molecule combination therapy, and show that this treatment improves metabolic health of obese mice.

Bart Staels and his colleagues show that the transcription factor Rev-erb-α is highly expressed in oxidative muscle and, via loss- and gain-of-function experiments, including pharmacological activation, that it plays a key partin regulating the oxidative capacity of the muscle and exercise endurance.

People with mutations in ATGL, a gene involved in lipid catabolism, suffer from neutral lipid storage disease and often from cardiomyopathy. Rudolf Zechner and his colleagues now show in mice that Atgl activity in cardiac muscle produces key lipid ligands for PPAR-α, a transcription factor that regulates proper lipid metabolism and fuel burning in this tissue. These results may explain the mechanisms responsible for the cardiomyopathy and offer a potential target for treatment.

Insulin resistance is a main determinant in the development of type 2 diabetes mellitus. Here, the authors review the physiological links between circadian clocks and insulin sensitivity and present current evidence for a relationship between circadian disruption and insulin resistance.