Browse the evidence

Combining protein supplementation (3-40g/day of amino acids/protein) with exercise training significantly increases muscle mass, muscle strength, and functional mobility while reducing pain in older adults with lower-extremity osteoarthritis, particularly those who have undergone total joint replacement.

If you are an older adult with knee or hip osteoarthritis, especially after joint replacement surgery, combining resistance or multicomponent exercise with protein supplementation (3-40g/day of amino acids or protein) is highly effective. This combination significantly increases muscle mass, improves strength, enhances mobility (walking, stair climbing), and reduces pain more than exercise alone. Aim for 2-7 weeks of consistent training with daily protein support to see these benefits.

Current U.S. Recommended Dietary Allowance (RDA) for protein (0.8 g/kg/day) is likely insufficient for older adults, athletes, and pregnant/lactating women, as newer methodologies (IAAO) and functional outcome studies suggest higher intakes (1.2–2.6 g/kg/day) are required for optimal health and physical function.

If you are over 65, an athlete, or pregnant, aim for more protein than the standard 0.8g/kg. Target 1.2-1.6g/kg for older adults to protect muscle, and up to 1.6-2.0g/kg for athletes. Distribute this protein evenly across meals to maximize muscle synthesis.

High-quality carbohydrates, defined by high dietary fiber and low added sugar content (e.g., whole grains, pulses, fruit), are associated with lower risks of cardiovascular disease, type 2 diabetes, and all-cause mortality, whereas refined carbohydrates and added sugars are linked to adverse cardiometabolic outcomes.

Prioritize carbohydrate sources that are high in fiber and low in added sugars. Choose whole grains, pulses, and fresh fruit over refined grains and sugary beverages. Use the 10:1 carbohydrate-to-fiber ratio as a practical guide: aim for products where there is at least 1 gram of fiber for every 10 grams of total carbohydrate. This approach naturally limits added sugars and improves overall diet quality, supporting better blood sugar control and cardiovascular health.

Higher overall diet quality, specifically defined by adherence to Swedish nutrition recommendations for saturated fat, polyunsaturated fat, fish, fiber, fruit/vegetables, and sucrose, is associated with a statistically significant reduction in the risk of incident atherosclerotic cardiovascular disease (ACVD).

Adopt a diet that prioritizes fish (at least 300g/week), high fiber (≥2.4g/MJ), and plenty of fruits and vegetables (≥400g/day), while limiting saturated fats to ≤14% of energy, polyunsaturated fats to 5-10%, and sucrose to ≤10%. This pattern, when maintained long-term, significantly lowers your risk of heart disease and stroke, independent of your blood pressure or cholesterol levels.

High leisure-time physical activity is associated with a reduced risk of incident atherosclerotic cardiovascular disease (ACVD), independent of other lifestyle factors.

Aim for high leisure-time physical activity, defined as >50 MET-hours per week. This can be achieved through various activities of different intensities. This level of activity significantly reduces your risk of heart disease and stroke, even when accounting for your diet and other risk factors.

Concurrent aerobic exercise and diet interventions significantly reduce total cholesterol, LDL cholesterol, triglycerides, and the TC:HDL ratio in overweight and obese adults, but do not significantly increase HDL cholesterol.

To improve your cholesterol and triglycerides, you need to do both: move your body aerobically (walking, jogging, cycling) 3 times a week for at least 30 minutes at a moderate intensity, AND adjust your diet to be lower in saturated fats and calories. While this combination significantly lowers 'bad' cholesterol and triglycerides, it may not raise 'good' HDL cholesterol, so consistent adherence is key.

Whey protein supplementation significantly increases appendicular skeletal muscle mass index and gait speed in older adults with sarcopenia compared to placebo or routine consultation.

If you are an older adult diagnosed with sarcopenia, adding whey protein supplements to your diet can help increase your muscle mass and improve your walking speed. You do not necessarily need to combine this with resistance training to see benefits in muscle mass and gait speed, though training may offer additional strength benefits. Aim for 9.6 to 40 grams of whey protein per serving, taken 1-3 times daily, over a period of at least 8 weeks.

Combining whey protein supplementation with resistance training significantly increases handgrip strength in older adults with sarcopenia compared to placebo or routine consultation.

For older adults with sarcopenia, combining whey protein supplements with resistance training is an effective strategy to improve handgrip strength. While resistance training alone is beneficial, adding whey protein ensures adequate protein intake to support muscle repair and growth. Aim for 9.6-40g of whey protein per serving, taken 1-3 times daily, alongside 2-5 sessions of resistance training per week for at least 8 weeks.

Whey protein supplementation significantly reduces interleukin-6 (IL-6) and increases insulin-like growth factor-1 (IGF-1) and albumin levels in older adults with sarcopenia.

Whey protein supplementation not only helps with muscle mass but also improves key biochemical markers in older adults with sarcopenia. It significantly reduces inflammation (IL-6) and increases beneficial hormones (IGF-1) and proteins (albumin). This suggests broader health benefits beyond just muscle size.

Post-exercise supplementation with whey protein (0.9 g/kg/day) significantly reduces serum creatine kinase and myoglobin levels compared to water in untrained males following intense eccentric exercise, whereas pea protein does not significantly reduce these biomarkers.

If you are untrained and do intense eccentric exercise (like a heavy leg day or downhill running), taking whey protein (about 0.9g per kg of body weight daily, split into 3 doses) for 5 days may help lower markers of muscle damage (like CK) compared to not taking protein. However, this did not reduce soreness or improve strength/power recovery in this study. Pea protein did not show the same biomarker benefits as whey in this specific trial.

Pedometer-based physical activity interventions produce modest but statistically significant reductions in BMI and body weight in overweight or obese adults with Type 2 diabetes compared to control groups.

If you have Type 2 diabetes and are overweight, using a pedometer to increase your daily walking can help you lose a small amount of weight and lower your BMI. You don't necessarily need to set strict step goals or combine it with diet changes to see some benefit, although adding dietary counseling might help. The key is consistency over several months.

Adopting a predominantly plant-based dietary pattern improves cardiovascular health markers, including LDL cholesterol, fasting insulin, and body weight, compared to an omnivorous diet.

Start by swapping one animal protein source per day with a plant-based alternative (like lentils or tofu). Focus on adding vegetables, fruits, whole grains, and legumes rather than just cutting out meat. If you experience bloating, increase your fiber intake slowly over weeks rather than all at once. Consider consulting a dietitian to ensure you are getting enough B12 and iron, especially if you are vegan.

Liraglutide 3.0 mg/day significantly reduces body weight in adults with obesity or overweight (BMI ≥30 or ≥27 with comorbidities) compared to placebo, with effects sustained over 56 weeks.

If you have obesity or are overweight with related health issues like high blood pressure, a daily 3.0 mg injection of liraglutide, combined with a modest calorie deficit and exercise, can help you lose significantly more weight than lifestyle changes alone. Start with a lower dose to let your body adjust to potential stomach side effects, then increase to the full dose over several weeks.

Liraglutide 1.8 mg/day improves glycemic control (HbA1c reduction) in patients with Type 2 Diabetes compared to placebo, rosiglitazone, glimepiride, insulin glargine, and exenatide.

For Type 2 Diabetes, a daily 1.8 mg injection of liraglutide effectively lowers blood sugar, often better than insulin or other common diabetes medications, while avoiding the weight gain often caused by insulin. It is typically added to existing medications like metformin.

Autoregulated resistance training using performance-based metrics (velocity, RIR, or RPE) optimizes adaptation by matching training stress to individual daily readiness and recovery, thereby reducing overtraining risk compared to fixed-load prescriptions.

Use tools like Reps in Reserve (RIR) or barbell velocity to decide your daily weights. If you feel fatigued or sluggish, lower the weight or reduce reps to maintain good form and velocity. If you feel great, push closer to failure or increase weight. This ensures you are training at the right intensity for your body on that specific day, rather than forcing a number that might be too hard or too easy.

GLP-1 receptor agonists (liraglutide, semaglutide, dulaglutide) produce significant weight loss in obese patients (BMI ≥30 or ≥27 with comorbidities) through mechanisms including delayed gastric emptying, increased satiety, and increased resting energy expenditure.

If you have obesity or overweight with related health issues, GLP-1 medications like liraglutide are a proven, effective treatment. They work by mimicking a hormone that signals fullness and increases energy use, not just by slowing digestion. You take a daily injection, but the significant weight loss and health improvements can be worth it. Always consult a doctor to see if you are a candidate, especially if you have a history of thyroid cancer.

The combination of phentermine and topiramate is highly effective for weight reduction, particularly in patients with compulsive overeating or bulimia nervosa, by reducing food intake through central mechanisms.

Phentermine/topiramate is a powerful combination for weight loss, especially for those with binge eating issues. It reduces food intake centrally. It is effective but has significant side effects and contraindications (e.g., glaucoma, hyperthyroidism). It is not approved in Europe due to safety concerns. Use only under strict medical supervision.

GLP-1 receptor agonists (specifically liraglutide and semaglutide) induce clinically significant, sustained body weight reduction in individuals with overweight or obesity, with histological resolution of NASH observed in approximately 40% to 60% of patients.

If you have obesity or type 2 diabetes, GLP-1 medications like semaglutide or liraglutide are highly effective for losing weight and improving liver health (NASH). They work by mimicking a gut hormone that reduces appetite and improves blood sugar control. While they require injections (or a daily pill for semaglutide) and may cause temporary stomach issues, the weight loss benefits are substantial and sustained when combined with lifestyle changes.

Consuming plant proteins in efficacious doses (typically larger than animal protein doses) over 8–12 weeks stimulates similar exercise training adaptations (strength, fat-free mass) as animal proteins.

You can build muscle and strength with plant protein just as well as animal protein. The key is dose: because plant proteins often have less leucine and lower digestibility, you need to eat more of them (e.g., 24-48g per serving) to get the same muscle-building signal as a smaller dose of whey. Ensure your total daily protein intake is high enough (around 1.6g/kg/day) and you will see similar results in strength and size.

Post-bariatric patients should restrict high-oxalate foods and maintain adequate calcium intake (1200-1500 mg/day) to bind intestinal oxalate and prevent enteric hyperoxaluria.

To prevent kidney stones after bariatric surgery, you must limit high-oxalate foods (like spinach and rhubarb) and ensure you are getting 1200-1500 mg of calcium daily, preferably from supplements like calcium citrate if you have dumping syndrome. This calcium binds oxalate in your gut so it doesn't reach your kidneys.

Bariatric patients should maintain a fluid intake of approximately 2.5 L/day to achieve a urinary volume of 2.5 L/day, mitigating the risk of stone formation caused by low urinary volume.

Drink 2.5 liters of water daily to prevent kidney stones. If your stomach is small, drink water between meals, not with them. Aim for 30 minutes before or 1 hour after eating. Avoid sugary drinks.

Bariatric patients should take calcium citrate supplements (1200-1500 mg/day) and Vitamin D (3000 IU/day) to ensure adequate absorption and prevent bone disease and kidney stones.

Take 1200-1500 mg of calcium citrate and 3000 IU of Vitamin D daily. Calcium citrate is required because your stomach acid is lower after surgery. Monitor your Vitamin D levels to ensure they stay above 30 ng/mL.

Weight loss, particularly >10% body weight reduction, significantly reduces atrial fibrillation burden and increases the probability of arrhythmia-free survival.

If you have atrial fibrillation and are obese, losing more than 10% of your body weight and keeping it off dramatically increases your chances of being free from AF. This benefit is seen even if you don't undergo ablation or take more anti-arrhythmic drugs.

Ultraprocessed foods contribute to weight regain and hinder weight loss maintenance by increasing caloric intake and body fat gain, independent of macronutrient composition, due to their palatability and marketing.

Focus on reducing ultraprocessed foods rather than obsessing over macronutrient ratios. Studies show that even when matched for fat, sugar, and fiber, ultraprocessed foods lead to greater calorie intake and fat gain. Prioritizing unprocessed foods supports weight maintenance by reducing the drive to overeat.