Browse the evidence

Users of unopposed estrogen were at increased risk of breast cancer after longer-term use.

Practitioners should consider the risks of long-term unopposed estrogen therapy in postmenopausal women.

The highest breast cancer risk was seen in cancers positive for estrogen receptor (ER+) and progesterone receptor (PR+).

Understanding receptor status may help in assessing breast cancer risk in patients using unopposed estrogen.

Mechanistic studies may explain the cardiovascular benefits of SGLT2 inhibition in T2DM patients.

Practitioners should consider the underlying mechanisms when evaluating the cardiovascular benefits of SGLT2 inhibitors.

No clear association existed between fiber or vegetable intake and risk of colon cancer.

Practitioners may consider that increasing fiber or vegetable intake may not significantly lower colon cancer risk.

No significant association was observed between dietary patterns and rectal cancer.

Dietary patterns may not influence the risk of rectal cancer in women.

No changes regarding the inflammatory state were observed after the cardiac rehabilitation program.

Cardiac rehabilitation may not affect inflammatory markers in patients with cardiovascular disease.

Genetically predicted higher childhood obesity, adult obesity, and increased fat-free mass are causally associated with a reduced risk of Brugada syndrome.

If you have Brugada syndrome, maintaining a BMI in the upper-normal range and increasing fat-free mass through resistance training may help reduce your risk. This contrasts with general population advice to lose weight, so consult your cardiologist about personalized weight management.

Pharmacological activation of brown adipose tissue using beta-3-adrenoreceptor agonists increases cardiovascular risk (heart rate and blood pressure) without providing weight loss benefits.

Avoid beta-3-adrenoreceptor agonists for weight loss. They increase heart rate and blood pressure and have failed in clinical trials due to side effects.

Acquired hypothalamic obesity (HO) is driven by structural damage to medial hypothalamic nuclei (ARC, PVN), leading to hyperphagia, central insulin/leptin resistance, and reduced sympathetic energy expenditure, resulting in rapid, treatment-resistant weight gain.

If you have hypothalamic obesity due to brain tumor or surgery, standard diet and exercise will likely fail because the brain's 'thermostat' is broken. You need medical interventions that target the specific hormonal pathways (like GLP-1 agonists or MC4R agonists) rather than relying on willpower alone.

In a universal healthcare system, socioeconomic status does not significantly influence access to bariatric surgery for individuals with severe obesity (BMI > 40 kg/m²), indicating equal access regardless of income or education.

If you have a BMI over 40, your income or education level should not stop you from getting bariatric surgery in a universal healthcare system. The medical eligibility criteria (BMI > 40) override socioeconomic barriers, ensuring equal access to publicly funded care.

SGLT2 inhibitors provide cardioprotection through hemodynamic improvements, specifically by reducing preload and afterload via osmotic diuresis and natriuresis, which decreases ventricular wall tension and myocardial oxygen consumption.

If you have Type 2 Diabetes and heart issues, SGLT2 inhibitors (like empagliflozin or dapagliflozin) are recommended not just for blood sugar, but to physically reduce the workload on your heart by helping your kidneys remove excess fluid and sodium, protecting your heart function.

SGLT2 inhibitors protect kidney function by restoring tubuloglomerular feedback, which reduces glomerular hyperfiltration and intraglomerular pressure, thereby indirectly reducing cardiovascular disease risk.

SGLT2 inhibitors protect your kidneys by reducing pressure inside the kidney filters, which also helps protect your heart, as kidney health is closely linked to heart health.

Continuous postoperative pulse oximetry (CPOX) monitoring without preoperative obstructive sleep apnea (OSA) screening is a safe and effective perioperative strategy for bariatric patients.

For bariatric patients, skipping preoperative sleep testing and relying on continuous pulse oximetry monitoring after surgery is a safe alternative. This approach avoids the cost and time of preoperative screening while maintaining low complication rates, provided patients receive supplemental oxygen and monitoring during the first postoperative night.

Menopausal hormone therapy (MHT) containing estrogen does not reduce cardiovascular disease risk and may increase stroke risk in women with type 2 diabetes, making it unsuitable for primary prevention.

Do not use estrogen patches or pills to protect your heart if you have diabetes. While they help with hot flashes, they do not prevent heart attacks and may increase stroke risk. Focus on blood pressure, lipids, and blood sugar control instead.

Intensive lifestyle coaching combined with care coordination does not reduce 10-year cardiovascular disease risk or improve secondary health outcomes in people with schizophrenia spectrum disorders and abdominal obesity compared to treatment as usual.

For individuals with severe mental illness and obesity, intensive lifestyle coaching and care coordination do not appear to offer additional cardiovascular benefits over standard medical care alone. While the intervention was well-intentioned and assertive, it did not lead to significant improvements in weight, fitness, or cardiovascular risk factors over two years. Clinicians should manage expectations and focus on standard medical management of risk factors, as behavioral interventions alone may not be sufficient for this population.

Large-scale community-based screening for type 2 diabetes using survey-based risk scores or random glucose testing in India generates a massive burden of false positives (ratios of 3.9 to 8.2 false positives per true positive), creating significant health system costs without proportional health benefits.

For policymakers and health system administrators in India: Do not implement large-scale community screening using current survey-based tools or random glucose tests without ensuring robust, affordable confirmatory testing infrastructure. The current approaches generate massive numbers of false positives, overwhelming the health system with costs ranging from $169 million to $567 million, with little gain in early detection compared to direct fasting glucose testing.

Among men, higher consumption of vitamin E supplements is not associated with a reduced risk of coronary heart disease.

If you are a man, taking high-dose vitamin E supplements (400 IU or more daily) will not lower your risk of heart disease. The study of health professionals showed no significant benefit. Do not rely on supplements for heart protection; instead, focus on a balanced diet rich in natural sources of vitamin E, such as vegetable oils, nuts, and seeds.

Microwave endometrial ablation (MEA) results in higher patient satisfaction and lower rates of subsequent hysterectomy compared to transcervical resection of the endometrium (TCRE) over a 5-year follow-up.

If you suffer from heavy menstrual bleeding and are considering surgical options, Microwave Endometrial Ablation (MEA) offers higher patient satisfaction and a lower chance of needing a hysterectomy within 5 years compared to Transcervical Resection (TCRE).

Postmenopausal hormone therapy (estrogen alone or combined with progestin) is not associated with a significant decrease in the risk of stroke, and may be associated with an increased risk of ischemic stroke.

For postmenopausal women, hormone therapy (estrogen alone or combined) does not reduce the risk of stroke. There is a suggestion of an increased risk of ischemic stroke among users, particularly with higher doses of estrogen.

Higher body mass index (BMI) at age 18 is associated with a lower risk of both premenopausal and postmenopausal breast cancer.

Maintaining a healthy weight in your late teens and early adulthood may offer long-term protection against breast cancer. While extreme leanness is not necessarily better, avoiding being underweight might be beneficial. Focus on overall health rather than extreme thinness.

Omega-3 PUFA supplementation does not reduce the risk of stroke (ischemic or hemorrhagic) in primary or secondary prevention settings.

Taking fish oil supplements will not prevent you from having a stroke, whether you have had one before or not. Do not take them for stroke prevention.

Restrictions on tobacco advertising and marketing, including bans on advertisements to children and near schools, effectively reduce tobacco use.

Support policies that ban tobacco advertising, especially near schools and to children. These are proven to reduce smoking rates.

GIP promotes triglyceride storage in white adipose tissue and may contribute to ectopic fat accumulation (fatty liver) in mice, acting as an obesogenic hormone in this context.

Endogenous GIP promotes fat storage in adipose tissue, particularly with high-sugar/high-fat diets. This 'obesogenic' effect is part of the biological puzzle that dual GIP/GLP-1 drugs must navigate to achieve net weight loss.

In overweight or obese patients with type 2 diabetes and severe insulin resistance, overriding insulin resistance with high-dose exogenous insulin therapy can induce insulin-mediated metabolic stress, leading to myocardial glucolipotoxicity and increased cardiovascular mortality.

If you have type 2 diabetes, are overweight, and struggle with high blood sugar despite lifestyle changes, aggressive insulin therapy might be doing more harm than good by stressing your heart. Instead of forcing glucose levels down with high insulin doses, focus on treatments that reduce the nutrient load (like weight loss or nutrient-offloading drugs) to respect your body's natural insulin resistance.