Browse the evidence

Older adults require higher per-meal protein doses (0.40 g/kg) compared to younger adults (0.24 g/kg) to achieve maximal muscle protein synthesis due to anabolic resistance.

If you are over 60, you likely need more protein per meal than you think to build or keep muscle. Aim for about 0.4 grams of high-quality protein per kilogram of your body weight at each main meal (breakfast, lunch, dinner). This is roughly double the amount needed by a 20-year-old to trigger the same muscle-building response. Combine this with resistance exercise for best results.

Current Recommended Dietary Allowance (RDA) of 0.8 g/kg/day for protein is likely an underestimate for older adults and should be increased to 1.0-1.2 g/kg/day to support healthy muscle ageing.

If you are an older adult, aim for 1.0 to 1.2 grams of protein per kilogram of body weight every day. This is higher than the standard government recommendation of 0.8 g/kg. Spread this protein evenly across your meals (about 0.4 g/kg per meal) and combine it with strength training. This helps maintain muscle mass and function without harming healthy kidneys or bones.

Once-weekly subcutaneous semaglutide 2.4 mg injection is a cost-effective weight management therapy in the UK compared to diet and exercise alone, yielding an ICER of £14,827/QALY gained.

For patients in the UK with obesity and comorbidities, once-weekly semaglutide 2.4 mg combined with diet and exercise is a cost-effective treatment option approved by NICE. It offers significant health benefits over diet and exercise alone, with a stopping rule to ensure efficacy (5% weight loss at 6 months).

Supplementation with 15g of specific collagen peptides immediately following high-load resistance exercise significantly upregulates gene expression in the PI3K-Akt and MAPK anabolic signaling pathways in human skeletal muscle compared to placebo.

If you perform high-load resistance training, consuming 15g of specific collagen peptides immediately afterward may enhance the activation of key muscle-building signaling pathways (PI3K-Akt and MAPK) in your muscles compared to not taking them. This suggests collagen peptides can play a role in muscle adaptation when paired with exercise, even if they are not a complete protein source like whey.

Semaglutide 2.4 mg is the most cost-effective weight-management pharmacotherapy in Canada compared to standard of care (diet and exercise) and other approved drugs, primarily due to its superior ability to delay or prevent type 2 diabetes, sleep apnea, and cardiovascular events.

For adults in Canada with obesity (BMI ≥30 or ≥27 with comorbidities), Semaglutide 2.4 mg is currently the most cost-effective pharmacological treatment compared to diet/exercise alone or other drugs like Orlistat. It works by acting as a GLP-1 receptor agonist to promote weight loss and improve metabolic health. While it requires weekly injections and has a higher upfront cost, it significantly reduces the long-term risk of type 2 diabetes, cardiovascular events, and sleep apnea, making it a superior value for money in the Canadian healthcare system.

Weight loss interventions, including bariatric surgery, specific diets (Mediterranean, Low-Carbohydrate, VLCKD), and GLP-1 receptor agonists (Liraglutide, Semaglutide, Dulaglutide, Tirzepatide), improve renal outcomes by reducing albuminuria and improving eGFR.

If you have obesity and kidney concerns, weight loss is critical. Bariatric surgery, GLP-1 medications (like Semaglutide or Tirzepatide), and structured diets (Mediterranean or Low-Carb) can significantly reduce kidney damage risk. Consult a doctor before starting VLCKD if you have existing kidney disease.

Aggressive weight loss via lifestyle modifications or bariatric surgery is the key intervention to reverse adverse left ventricular remodeling and improve outcomes in the obese-diabetic phenotype of heart failure with preserved ejection fraction (HFpEF).

If you have HFpEF and are obese, losing weight is the most effective way to fix the heart's stiffness. This can be done through lifestyle changes or surgery. Standard heart failure drugs often don't fix the underlying structural changes in this specific group, so focusing on reducing fat mass is critical.

Combination therapy of semaglutide (2.4 mg) and cagrilintide (2.4 mg) (CagriSema) produces weight loss (~15.6%) and HbA1c reduction (~2.2%) comparable to the highest dose of tirzepatide (15 mg) in patients with Type 2 Diabetes.

For patients with Type 2 Diabetes and obesity, a new combination injection (CagriSema) containing semaglutide and cagrilintide (both 2.4 mg weekly) achieves significant weight loss (15.6%) and blood sugar control (HbA1c reduction 2.2%), comparable to the highest dose of tirzepatide. This offers a potent option for those who need both glucose and weight management.

Intensive lifestyle modifications, specifically combining calorie-reduced/low-sodium diets (e.g., DASH) with regular exercise, are the foundational first-line management strategy for obesity-related hypertension, aiming for 5-10% body weight loss.

Start with a DASH-style diet (low sodium, high fruits/veg) and regular exercise. Aim to lose 5-10% of your body weight over 6 months. This is the most effective non-drug way to lower blood pressure. Be prepared that maintaining this requires ongoing support because the 'yo-yo effect' is real.

Semaglutide (2.4 mg weekly) and Liraglutide (3 mg daily) are effective pharmacological interventions for obesity-related hypertension, with Semaglutide showing superior weight loss and blood pressure reduction compared to Liraglutide.

If lifestyle changes aren't enough, GLP-1 drugs like Semaglutide (Wegovy) are highly effective. You get a 14.9% weight loss and 6.2 mmHg BP drop on average. It's a once-weekly injection, which is more convenient than daily options.

Bariatric surgery (specifically gastric bypass) is a highly effective intervention for obesity-related hypertension, capable of inducing hypertension remission in over half of patients and significantly reducing antihypertensive medication use.

If you have severe obesity (BMI ≥35, or ≥30 with health issues), gastric bypass surgery is a powerful option. It can put hypertension into remission for 51% of patients and drastically cut the number of blood pressure meds you need.

Endurance athletes require a daily protein intake of approximately 1.8 g/kg body mass per day, which may increase to >2.0 g/kg/day during carbohydrate-restricted training or on rest days.

Aim for 1.8 grams of protein per kilogram of body weight every day. If you are doing low-carb training sessions or taking rest days, bump this up to over 2.0 grams per kilogram. This helps your body repair muscle and replace amino acids lost during exercise.

Dual GLP-1/GIP receptor agonists (e.g., tirzepatide) produce significantly greater weight loss and glycemic control than selective GLP-1 receptor agonists by synergistically targeting both incretin pathways.

If you have T2DM or obesity, dual GLP-1/GIP agonists like tirzepatide are currently the most effective pharmacological option for weight loss and blood sugar control, outperforming older GLP-1 drugs. They are taken as a once-weekly injection. Discuss with your doctor if this advanced therapy is appropriate for your specific health profile.

Reducing saturated fat intake significantly improves lipid profiles (Total Cholesterol and LDL-C) and body weight metrics in adults.

Lowering saturated fat intake not only helps your heart but also tends to lower your LDL ('bad') cholesterol and total cholesterol, and may help with modest weight loss. This is achieved by swapping high-saturated-fat foods for healthier unsaturated fat sources or plant-based alternatives.

Post-bariatric pharmacotherapy with GLP-1 receptor agonists (specifically liraglutide) effectively augments weight loss and prevents weight regain in patients who have undergone Roux-en-Y gastric bypass or sleeve gastrectomy.

If you have had bariatric surgery and are regaining weight, talk to your doctor about adding a GLP-1 medication like liraglutide. It is taken as a daily injection, starting at a low dose to minimize side effects like nausea, and can help you lose additional weight or stop regaining it. This is a standard, evidence-based next step when surgery alone is not enough.

In patients with type 2 diabetes, adopting any healthy dietary pattern (Mediterranean, low-carb, plant-based, etc.) significantly improves body weight and glycemic control (HbA1c) compared to usual diet within the first six months, though these benefits attenuate and lose statistical significance after 12 months.

If you have Type 2 Diabetes, changing your diet to a healthier pattern (like Mediterranean, low-carb, or plant-based) will help you lose weight and lower your blood sugar significantly within the first 6 months compared to doing nothing. However, these benefits tend to fade after a year if adherence drops. There is no single 'best' diet; choose the one you can stick to long-term, as consistency matters more than the specific macronutrient split.

Weight loss of 7-10% is required to improve histological disease activity and features of MASLD, while 3-5% weight loss stabilizes or improves fibrosis in normal-weight patients.

If you have MASLD, aim for a 7-10% reduction in body weight if you are overweight or obese, or 3-5% if you are normal weight. This is achieved by creating a daily calorie deficit of 500-1,000 kcal. Even if you cannot reach the higher target, losing just 5% of your body weight is highly likely to stabilize or improve liver fibrosis.

Adherence to a Mediterranean diet improves liver steatosis and metabolic parameters, and is the only diet pattern recommended as potential therapy for MASLD by major scientific societies.

Adopt a Mediterranean diet pattern: fill half your plate with vegetables, use olive oil as your primary fat, eat whole grains, and include fish and legumes regularly. Limit red meat and sweets. This pattern is the only one officially recommended for treating MASLD because it improves liver fat, blood sugar, and cholesterol simultaneously.

Moderate-to-vigorous physical activity (150-200 minutes/week) reduces intrahepatic lipid and improves MASLD outcomes, with vigorous exercise offering full benefits for steatohepatitis and fibrosis.

Aim for 150-200 minutes of moderate-to-vigorous physical activity per week, spread over 3-5 sessions. This can include brisk walking, cycling, or running. If you have joint issues, resistance training is also effective. Exercise reduces liver fat even if you don't lose weight, so start moving regardless of scale changes.

Excessive fructose consumption (e.g., >7 sugary drinks/week) is associated with hepatic fibrosis independent of calorie intake, and fructose-restricted diets decrease liver triglycerides.

Avoid sugary drinks and limit free sugars. High fructose intake causes liver fibrosis even if you don't gain weight. Switching to a fructose-restricted diet for just 6-8 weeks can reduce liver fat.

Initiating moderate-to-vigorous exercise after a new diagnosis of type 2 diabetes significantly reduces the risk of myocardial infarction, stroke, and all-cause mortality compared to remaining sedentary.

If you were just diagnosed with type 2 diabetes, start moving now. You do not need to be an athlete. Aim for at least 150 minutes of moderate activity (like brisk walking) per week. This single change can lower your risk of heart attack, stroke, and death by about 15-16% compared to staying sedentary.

The combination of smoking cessation and exercise initiation after a new diabetes diagnosis yields the greatest reduction in cardiovascular disease risk (46% reduction) and all-cause mortality (22% reduction) compared to continuing both bad habits.

For the best heart and life protection after a diabetes diagnosis, quit smoking and start exercising. Doing both together cuts your risk of heart disease by nearly half and death by over 20% compared to staying a smoker and sedentary. If you can only do one, start with exercise, but quitting smoking is also critical.

Older adults require protein intakes 50–100% higher than the standard RDA (~0.8 g/kg/day) to overcome anabolic resistance and preserve muscle mass.

If you are older, the standard protein recommendation is likely too low to stop muscle loss. Aim for roughly 1.2 to 1.6 grams of protein per kilogram of body weight every day, and combine this with regular resistance and aerobic exercise to effectively preserve your muscle mass.

Resistance exercise is the primary mechanical stimulus to prevent the decline in Type 2 muscle fiber cross-sectional area in older adults.

Engage in regular resistance training to maintain the size and function of your fast-twitch muscle fibers. This mechanical stimulus is crucial for keeping your muscles strong and functional as you age.