Browse the evidence

Obesity and post-diagnosis weight gain in breast cancer patients are associated with significantly increased risks of disease recurrence and mortality.

Maintaining a healthy weight or losing weight after a breast cancer diagnosis is clinically important. Evidence shows that being overweight or gaining weight after diagnosis increases the risk of the cancer returning and reduces survival. While specific weight loss protocols for breast cancer are still being finalized, managing weight through diet and activity is recommended to potentially improve outcomes.

Increasing dietary protein intake to 1.0–1.2 g/kg/day in elderly individuals maintains nitrogen balance and calcium metabolism without adverse renal effects, serving as a safe baseline compromise until higher-dose long-term trials are completed.

If you are over 65, aim for 1.0 to 1.2 grams of protein per kilogram of your body weight each day. This amount is safe for your kidneys and helps maintain muscle and bone health. This is a safe starting point, though some studies suggest higher amounts (up to 1.8 g/kg) might be better for building muscle, so consult your doctor if you have kidney issues.

Elderly individuals require higher protein intakes (1.6–1.8 g/kg/day) to achieve muscle anabolism due to an impaired anabolic response to mixed meals and reduced insulin sensitivity compared to younger adults.

To build or maintain muscle, elderly individuals may need 1.6 to 1.8 grams of protein per kilogram of body weight daily. This is higher than the standard recommendation because aging reduces the body's sensitivity to protein's muscle-building signals. Combining this intake with exercise can help restore the body's natural anabolic response.

High intake of rapidly digestible starches and sugars, particularly fructose, promotes obesity and metabolic disturbances through rapid glucose elevation, hyperinsulinemia, and increased energy intake, whereas resistant and slowly digestible starches improve satiety, insulin sensitivity, and weight management.

Focus on the quality of carbohydrates rather than just quantity. Prioritize whole grains, legumes, and vegetables which contain slowly digestible and resistant starches. These foods promote satiety, stabilize blood sugar, and improve insulin sensitivity. Minimize added sugars, especially fructose and sugar-sweetened beverages, which are linked to obesity and metabolic syndrome. Total energy intake remains the primary driver of weight loss, but carbohydrate quality influences adherence and metabolic health.

Caffeine improves 10-km cycling time by 4.8-6.8% in athletes with the CYP1A2 AA genotype (fast metabolizers), but impairs performance by 13.7% in those with the CC genotype (slow metabolizers).

If you use caffeine for endurance sports, your CYP1A2 genotype matters. Fast metabolizers (AA) benefit from 2-4 mg/kg, seeing 5-7% performance gains. Slow metabolizers (CC) should avoid high doses (4 mg/kg) as it can worsen performance by nearly 14%. If you suspect caffeine hurts your performance, genetic testing or a self-experiment comparing placebo vs. caffeine is recommended before committing to a regimen.

Hypocaloric dieting is the primary driver for improving insulin sensitivity and reducing hyperinsulinaemia in obese women with PCOS, whereas pharmacological interventions (metformin, flutamide) provide no significant additional benefit for these specific metabolic markers.

For obese women with PCOS, prioritizing a caloric deficit (approx. 1200-1400 kcal/day) is the most effective strategy to improve insulin sensitivity. Adding medications like metformin or flutamide does not provide additional metabolic benefits regarding insulin levels compared to diet alone. Medications may still be used for other symptoms (like hirsutism or menstrual regulation), but they should not replace dietary intervention for metabolic health.

Resistance training induces hypertrophy in older adults with magnitude and signaling responsiveness comparable to young adults, refuting the notion that aging inherently blunts the muscle protein synthesis machinery's ability to adapt to mechanical load.

If you are an older adult, do not assume resistance training is less effective for building muscle than it is for younger people. This study demonstrates that with a consistent progressive resistance training program (3 days/week, 16 weeks), older adults can achieve similar increases in muscle fiber size and strength as younger adults. The key is consistency and progressive overload, not age.

Central (visceral) obesity is a primary driver of hypertension through multiple mechanisms including sympathetic nervous system activation, renin-angiotensin-aldosterone system (RAAS) activation, and renal sodium retention, with weight loss serving as the cornerstone for management.

If you have high blood pressure and carry extra weight, especially around your waist, losing weight is the most effective way to lower it. This isn't just about looks; excess fat releases hormones that raise your blood pressure. You can achieve this through diet, exercise, or medications. Talk to your doctor about a plan that works for you.

Older adults require a daily protein intake of 1.0–1.2 g/kg (and up to 1.5 g/kg for those with acute or chronic disease) to preserve muscle mass, as the standard 0.8 g/kg RDA is insufficient due to age-related anabolic resistance.

If you are older, the standard protein recommendation of 0.8 grams per kilogram of body weight is likely not enough to stop muscle loss. Aim for 1.0 to 1.2 grams per kilogram daily. If you are sick or recovering, aim for 1.2 to 1.5 grams. Focus on high-quality sources like meat, dairy, or eggs at every meal to trigger muscle building.

Leucine-enriched protein sources (e.g., whey, meat) or HMB supplementation are more effective than plant-based proteins or low-dose amino acids for stimulating muscle protein synthesis in older adults due to their ability to overcome anabolic resistance.

To build muscle as you age, the type of protein matters. Choose sources high in leucine, such as meat, dairy (whey/casein), or eggs. If you eat plant-based, ensure you are eating larger portions or combining sources to get enough leucine (approx. 3g per meal). Supplements like HMB (2g/day) or leucine-enriched whey can also help.

Twelve weeks of creatine supplementation (6g/day) combined with heavy resistance training increases myosin heavy chain (MHC) mRNA and protein expression, leading to greater gains in muscle strength, fat-free mass, and myofibrillar protein compared to resistance training alone.

If you are new to resistance training, adding 6 grams of creatine monohydrate daily to your routine can help you build more muscle and strength than training alone. You do not need a loading phase; just take 6g every day for at least 12 weeks while training hard (85-90% of your max) 3 times a week.

Animal-derived proteins (dairy, meat) elicit a superior postprandial muscle protein synthesis response in older adults compared to plant-based proteins (soya, wheat) due to higher digestibility, superior essential amino acid profiles (specifically leucine, lysine, methionine), and faster amino acid absorption kinetics.

If you are older and rely on plant proteins, you likely need to eat more of them than you would animal protein to get the same muscle-building benefit. Try combining different plant sources (like rice and peas) to get a complete amino acid profile, or consider adding a small amount of dairy/whey if your diet allows, as it is more efficient at stimulating muscle growth in aging muscles.

Vigorous aerobic exercise improves body composition, cardiorespiratory fitness, and insulin resistance in women with PCOS, whereas resistance training and combined aerobic-resistance interventions show inconsistent or no significant benefits on these specific metabolic markers.

For PCOS management, prioritize vigorous aerobic exercise (like brisk walking, cycling, or swimming) for at least 75-150 minutes per week. This specific modality has the strongest evidence for improving insulin resistance and body composition. Resistance training alone may not provide the same metabolic benefits, so use it as a supplement, not a replacement, for aerobic activity.

Acute ingestion of 6 mg/kg caffeine potentiates skeletal muscle force output during low-frequency (20 Hz) stimulation, an effect mediated by enhanced calcium release from the sarcoplasmic reticulum, and this benefit occurs regardless of habitual caffeine consumption status.

If you consume caffeine regularly, you can still benefit from its performance-enhancing effects, specifically for endurance or submaximal efforts. Take 6 mg per kg of body weight about 1-2 hours before activity. This will help your muscles maintain force during prolonged, submaximal efforts by improving calcium release in the muscle cells, but it will not significantly boost your one-rep max or sprint power.

Acute ingestion of 6 mg/kg caffeine significantly enhances total sprint work and peak power during prolonged intermittent-sprint exercise in team-sport athletes without increasing the rate of fatigue development.

Take 6 mg of caffeine per kg of body weight about one hour before your game or high-intensity training. For a 80kg athlete, this is 480mg (roughly 3-4 cups of coffee or 2-3 standard caffeine pills). This dose has been shown to increase your total sprinting work and peak power by roughly 7-8% during a typical team sport match without making you tire out faster. Be aware that you might feel 'amped' or restless, but this does not appear to negatively impact performance in trained athletes.

A structured 3-month aerobic exercise training program significantly improves cardiopulmonary functional capacity (VO2max), insulin sensitivity, and reduces inflammatory markers (CRP) in young overweight women with Polycystic Ovary Syndrome (PCOS).

If you have PCOS and are overweight, a structured 3-month aerobic exercise program (like cycling) at 60-70% of your max effort, 3 times a week, can significantly improve your heart and lung capacity, insulin sensitivity, and reduce inflammation. You do not need a strict diet, just general healthy eating habits.

Curcumin supplementation significantly reduces fasting blood glucose, glycated hemoglobin (HbA1c), and body mass index in patients with Type 2 Diabetes Mellitus.

If you have Type 2 Diabetes, adding curcumin to your routine may help lower your blood sugar and HbA1c. Look for high-bioavailability forms like nano-curcumin or curcumin paired with piperine, taken daily for at least 8 weeks, while continuing your standard diabetes medications.

GLP-1 receptor agonists (specifically high-dose liraglutide 3.0 mg) produce clinically significant weight loss (5.9 kg/year) by enhancing satiety via hypothalamic stimulation and delaying gastric emptying.

If you have obesity (BMI ≥ 30, or ≥ 27 with health issues), a daily 3.0 mg injection of liraglutide can help you lose 5-6 kg per year by making you feel full faster and keeping you full longer. You must manage potential nausea, which is common, and this is prescribed for long-term use, not just a quick fix.

Combined oral contraceptive pills (COCPs) are recommended as first-line medical treatment for managing hyperandrogenism and regulating menstrual cycles in PCOS.

If lifestyle changes aren't enough to regulate your cycle or manage symptoms like excess hair growth, COCPs are the standard first medical treatment. They help by balancing hormones. Talk to your doctor about using the lowest effective dose to minimize side effects.

Ingestion of 6 mg/kg body mass of caffeine 60 minutes before simulated soccer activity significantly improves passing accuracy and functional leg power (jump height) without negatively affecting sprint performance or causing detrimental physiological effects.

If you are a soccer player, taking 6 mg of caffeine per kg of body weight about an hour before a match or training session can improve your passing accuracy and jumping ability. For example, a 70 kg player would take 420 mg of caffeine. This dose does not appear to cause dehydration or negatively impact sprint speed, and it helps maintain skill performance under fatigue. Ensure you tolerate caffeine well beforehand, as individual responses vary.

Consuming energy drinks containing approximately 2 mg/kg body mass of caffeine 10-60 minutes before exercise improves mental focus, alertness, anaerobic resistance exercise volume, and endurance performance.

If you are a healthy adult looking to boost performance, consume an energy drink 10-60 minutes before your workout. Aim for a dose providing roughly 2mg of caffeine per kg of body weight. This will likely improve your focus, alertness, and lifting volume or endurance time. Be aware that high-calorie versions can lead to weight gain if not managed within your daily calorie budget, and those with heart or metabolic conditions should consult a doctor first.

Targeted nutritional training (specifically high-carbohydrate or high-volume intake) adapts the gastrointestinal tract by upregulating SGLT1 transporters and accelerating gastric emptying, thereby increasing exogenous carbohydrate oxidation and reducing GI distress during endurance exercise.

Train your gut like you train your legs. If you plan to consume 60-90g of carbs per hour during races, practice this exact intake during long training sessions. Start with lower amounts and gradually increase over 2-3 weeks to upregulate your SGLT1 transporters. This reduces bloating and diarrhea risk while maximizing energy delivery. Do not restrict carbs on training days if you are an endurance athlete.

Twice-weekly resistance training (52 weeks) significantly reduces cortical white matter atrophy and improves executive function in older women compared to balance-and-toning training.

For older women, engaging in twice-weekly progressive resistance training for a year can help preserve brain white matter and improve executive function. Focus on compound movements like squats and lunges, progressively increasing weight as you get stronger.

GIP-GLP-1 co-agonists (e.g., tirzepatide) produce superior weight loss and glycemic control compared to GLP-1 receptor agonists alone in patients with type 2 diabetes and obesity.

For patients with T2DM and obesity, combining GIP and GLP-1 activity in a single weekly injection (like tirzepatide) is more effective for weight loss and blood sugar control than using GLP-1 agonists alone. This works despite GIP being ineffective on its own in diabetic patients, likely due to altered receptor signaling in the combined molecule.