Browse the evidence

Creatine supplementation (3-5 g/day or loading phase) enhances power output and recovery in high-intensity weightlifting by increasing intramuscular phosphocreatine stores.

Take 3-5 grams of creatine daily. If you need faster results, take 20 grams daily for 5-7 days, then drop to 3-5 grams. This increases your muscle's energy stores for explosive lifts.

An intensive lifestyle intervention (ILI) comprising caloric restriction and increased physical activity significantly reduces the progression of kidney disease (decline in eGFR and need for kidney replacement therapy) in adults aged 60 years or older with type 2 diabetes, with benefits persisting after the active intervention ends.

If you are over 60 and have type 2 diabetes, a structured lifestyle program focusing on modest calorie reduction (1200-1800 kcal/day) and building up to 175 minutes of moderate exercise per week can significantly slow kidney damage. This benefit is specific to older adults and persists even after the formal program ends, making it a crucial strategy for renal protection in this demographic.

Improving alignment with the 2018 WCRF/AICR Cancer Prevention Recommendations (higher score) is associated with a significantly lower risk of developing type 2 diabetes in high-risk adults, particularly in those not taking metformin.

To lower your diabetes risk, aim to improve your overall lifestyle alignment. This means maintaining a healthy weight, being physically active (>=150 min/week), eating more plants/fiber, and limiting fast food, red/processed meat, sugary drinks, and alcohol. Even small improvements in these areas can significantly reduce your risk of developing type 2 diabetes, especially if you are not taking metformin.

GLP-1 receptor agonists (e.g., semaglutide, tirzepatide) produce clinically significant weight loss (approx. 10-22%) but are associated with high rates of gastrointestinal adverse events.

GLP-1 medications like semaglutide and tirzepatide are highly effective for significant weight loss (10-22%+), but they come with notable gastrointestinal side effects. They are most effective when combined with lifestyle changes and psychological support, rather than used in isolation.

Resistance exercise and adequate protein intake (1.4-2.4 g/kg body weight) are necessary to preserve lean muscle mass during GLP-1 induced weight loss, as 25-40% of weight lost with GLP-1s may be muscle.

To prevent losing muscle along with fat while on GLP-1s, eat 1.4-2.4 grams of protein per kilogram of body weight daily and engage in regular resistance training. This helps maintain strength and metabolic health, which might otherwise decline by 25-40% of the weight lost.

Adjunctive use of GLP-1 receptor agonists (specifically liraglutide, semaglutide, and tirzepatide) in adults with Type 1 Diabetes significantly improves glycemic control, reduces total daily insulin doses, and promotes weight loss compared to placebo, without increasing the risk of severe hypoglycemia.

If you have Type 1 Diabetes and struggle with weight or high insulin doses, ask your doctor about adding a GLP-1 medication like semaglutide or liraglutide. These drugs can help lower your blood sugar, reduce the amount of insulin you need, and help you lose weight. Be aware that you might experience stomach upset, but starting with a low dose and increasing slowly can help manage this. This is an off-label use for T1D, so discuss the risks and benefits with your healthcare provider.

Consuming 20–40g of whey protein immediately after resistance exercise significantly increases myofibrillar fractional synthetic rate (FSR) and activates the AKT/mTOR signaling pathway (AKT, mTOR, 4E-BP1, p70S6K, rpS6) in healthy adults, thereby extending the post-exercise anabolic window.

For healthy adults engaging in resistance training, consuming 20-40g of whey protein around your workout (either immediately after or up to 45 minutes before) significantly boosts muscle protein synthesis compared to placebo. This strategy activates the AKT/mTOR pathway, which drives muscle repair and growth. You do not need to consume excessive amounts (>40g) to see benefits, and pre-workout consumption may even offer a slight edge in FSR magnitude for some protocols.

Post-exercise carbohydrate intake of approximately 1.2 g/kg body mass per hour for up to 4 hours is essential for restoring glycogen reserves, supporting immune system energy needs, and facilitating tissue repair.

After your workout, eat about 1.2 grams of carbohydrates for every kilogram of your body weight each hour for the next 4 hours. For example, if you weigh 70kg, aim for 84g of carbs per hour. This helps refill your energy stores and supports your immune system. Don't fear carbs here; they are essential for recovery.

Post-exercise ingestion of high-quality protein (0.3–0.5 g/kg body mass) stimulates net muscle protein anabolism and contributes to faster tissue growth and repair.

After your workout, consume 0.3 to 0.5 grams of high-quality protein for every kilogram of your body weight. For a 70kg person, this is 21-35g of protein. This helps build and repair muscle tissue.

Pre-sleep nutrition, specifically casein- or protein-rich meals with slow digestion rates, has a restorative effect on the musculoskeletal, endocrine, immune, and nervous systems.

Eat a slow-digesting protein source, like casein or Greek yogurt, before bed. This helps your body recover and repair tissues while you sleep. Don't worry about fat gain if your total daily calories are on track.

Limited walking frequency (less than 1 day per week) significantly increases the odds of hypertension and diabetes, with the risk being more pronounced in socioeconomically vulnerable populations.

Walking less than once a week significantly increases your risk of high blood pressure and diabetes, especially if you have limited income. Aim to walk at least a few days a week to reduce these risks, as consistent walking is a powerful protective factor for older adults.

Substituting 5% of total energy intake from saturated fatty acids with polyunsaturated fatty acids lowers LDL cholesterol by approximately 10%.

To lower your bad cholesterol, replace about 5% of your daily calories from saturated fats (like butter, fatty meats, and full-fat dairy) with polyunsaturated fats (like olive oil, sunflower oil, and nuts). This single change can reduce your LDL cholesterol by 10% or more, offering a powerful, low-cost alternative to medication for many people.

Combining specific cholesterol-lowering foods (nuts, plant sterols, viscous fiber, soy protein) can lower LDL cholesterol by approximately 20%, comparable to low-dose statins.

You can lower your LDL cholesterol by about 20% by eating a 'dietary portfolio' daily: include plant sterols (found in fortified margarines/milks), soy protein, viscous fibers (oats/barley), and almonds. While effective, this requires significant dietary changes and strict adherence.

Patients treated with GLP-1 based therapies must increase protein intake to 1–1.5 g/kg bodyweight/day and engage in resistance training to mitigate the loss of lean body mass (LBM) and prevent sarcopenic obesity.

If you are taking a GLP-1 medication like Ozempic or Wegovy, you must eat more protein than the standard recommendation. Aim for 1 to 1.5 grams of protein per kilogram of your body weight every day. Additionally, you must lift weights or do resistance exercises at least twice a week. This combination is the only proven way to stop your body from eating its own muscle while you lose fat.

Whey protein supplementation (20-40 g/day) combined with resistance training preserves lean body mass and improves strength during GLP-1RA-induced weight loss.

Aim for 1.2-2.0 grams of protein per kilogram of body weight daily. Use whey protein shakes (20-40g) to help meet this goal, especially if you struggle to eat enough solid food. Combine this with resistance training to protect your muscles.

Omega-3 fatty acid supplementation (≥1 g/day) supports muscle quality, cardiovascular health, and reduces inflammation during GLP-1RA treatment.

Take at least 1 gram of Omega-3 fatty acids daily. This helps protect your heart, reduces inflammation, and may support muscle quality while you lose weight.

In patients with metabolic dysfunction-associated steatohepatitis (MASH) and fibrosis, achieving MASH resolution and fibrosis improvement is significantly associated with greater reductions in body weight, improved glycemic control (HbA1c), and normalization of liver fat.

If you have MASH with fibrosis, achieving significant weight loss, better blood sugar control, and normalizing liver fat are key steps toward resolving the disease. Tirzepatide, taken once weekly and titrated up from 2.5mg to 5-15mg over several months, has been shown to facilitate these metabolic changes, which in turn drive histological improvement in the liver.

Retatrutide (4-12 mg weekly) produces early, sustained changes in appetite and eating behaviors (reduced hunger, increased satiety, smaller portions) within 8 weeks, leading to significant weight loss and improved physical/emotional well-being in adults with obesity.

If you have obesity or overweight with health complications, retatrutide (4-12mg weekly) significantly reduces hunger and increases fullness within weeks, leading to substantial weight loss (up to 24%) and improved energy/mobility. It addresses the biological barriers to lifestyle changes that often cause failure with diet/exercise alone. Expect some frustration if results are slower than hoped or side effects occur, but the behavioral shift in eating is a key benefit.

Resistance training preserves or increases lean muscle mass and improves muscle quality in adults with obesity, even when combined with energy-restricted diets or obesity management medications that typically cause lean mass loss.

Incorporate resistance training into your routine to protect your muscle mass. This is especially important if you are dieting or taking weight-loss medications, as these can cause muscle loss. Focus on strength and function rather than just size.

GLP-1/GIP/Glucagon triple-agonists (e.g., Retatrutide) produce superior weight loss (up to 24.2%) compared to dual-agonists and GLP-1 monotherapies by simultaneously reducing food intake and increasing energy expenditure.

Retatrutide is a once-weekly injection that targets three hormones (GLP-1, GIP, Glucagon) to maximize weight loss. In clinical trials, doses up to 12mg resulted in an average 24.2% body weight loss over 48 weeks, outperforming single-hormone drugs. While it causes mild gastrointestinal side effects, the significant weight reduction makes it a highly effective option for obesity management.

Exercise training, particularly aerobic interval training and cardiac rehabilitation, is a Class I recommendation that counteracts skeletal muscle wasting and improves functional capacity in heart failure patients.

Engage in supervised exercise programs, such as cardiac rehabilitation or aerobic interval training. These are strongly recommended for heart failure patients to maintain muscle strength and improve how you feel.

Post-exercise supplementation with 40g of whey protein significantly enhances lower-body strength adaptations (leg 1-RM) in untrained adults performing low-volume intra-session concurrent training, compared to an isocaloric placebo.

If you are new to exercise and doing a mix of cardio and weights, drinking 40g of whey protein right after your workout can help you build more leg strength than if you drank a calorie-matched sugar drink. This is particularly useful if you struggle to eat a full meal immediately after training.

Bariatric surgery is recommended for eligible patients with noncirrhotic MASLD to achieve sustained weight reduction and remission of type 2 diabetes.

If you have severe obesity and MASLD, discuss bariatric surgery with your doctor. It can lead to significant weight loss and remission of type 2 diabetes, reducing your risk of liver and heart disease.

Prevention of GLP-1RA-induced muscle loss requires a multimodal strategy combining resistance exercise, high protein intake (1.2-1.6 g/kg/day), and potentially specific supplements (BCAA, Creatine, Vitamin D).

To keep your muscles while losing weight on GLP-1s, lift weights 2-3 times a week and eat 1.2-1.6 grams of protein per kg of your body weight every day. Spread this protein across 3 meals. Consider adding creatine or Vitamin D if your diet is lacking.