Browse the evidence

Administering Cognitive Behavioral Therapy for Insomnia (CBTi) prior to Continuous Positive Airway Pressure (CPAP) therapy significantly improves insomnia symptoms and increases long-term CPAP adherence in patients with Co-morbid Insomnia and Sleep Apnea (COMISA) compared to CPAP alone or no treatment.

If you have both sleep apnea and insomnia, treating them separately often fails. The most effective strategy is to start with Cognitive Behavioral Therapy for Insomnia (CBTi) delivered by a therapist before or alongside starting CPAP. This approach not only fixes your sleeplessness but also helps you stick with your CPAP machine longer, leading to better overall health outcomes than using CPAP alone.

The Cambridge Index, derived from a short self-report questionnaire, validly ranks individuals into distinct physical activity categories (inactive to active) based on their objectively measured energy expenditure and moderate-to-vigorous physical activity time.

Use a validated short questionnaire to track your general activity level. You don't need to count every step perfectly; the goal is to distinguish between being sedentary, moderately active, or very active. This method is reliable enough for large-scale health studies to rank people accurately.

The COVID-19 pandemic caused a significant overall decrease in physical activity and mobility, alongside a significant increase in sedentary behavior, across diverse global populations.

During periods of restricted mobility or facility closures, expect a significant drop in physical activity. To mitigate this, prioritize utilizing available outdoor spaces (parks, trails) or adapting home environments, as access to these resources is a key determinant of maintaining activity levels during crises.

High-intensity aquatic exercise programs can significantly reduce fall incidence and improve neuromuscular parameters in postmenopausal women, despite lacking the osteogenic impact of land-based exercises.

If you prefer water exercise or have joint pain, do not underestimate it. Engage in high-intensity aquatic exercises (like the HydrOS program) for 24 weeks. Focus on moving quickly and with resistance. This can significantly reduce your risk of falling and improve your balance and muscle strength, even if it doesn't build bone density as effectively as land-based impact exercise.

Vigorous or moderate exercise significantly reduces the risk of sleep disturbance in individuals with severe sedentary behavior, although this benefit is not mediated by the measured blood-cell-based inflammatory biomarkers.

If you sit for more than 8 hours a day, doing 150 minutes of moderate or 75 minutes of vigorous exercise per week significantly lowers your risk of sleep problems. However, this benefit is specific to those with high sitting times; for those who are already active, the added benefit on sleep risk was not statistically significant in this study.

Accumulating sleep debt (4 hours time-in-bed over 5 days) diminishes functional connectivity between the amygdala and the ventral anterior cingulate cortex (vACC), which downregulates the amygdala's functional suppression and enhances its response to negative emotional stimuli (fear), leading to increased anxiety and mood deterioration.

Consistently restricting your sleep to around 4 hours a night for several days will likely increase your anxiety and emotional reactivity to stress. This happens because your brain's ability to regulate fear responses (specifically the connection between the amygdala and the anterior cingulate cortex) is weakened. To maintain emotional stability, prioritize getting adequate sleep (around 8 hours) rather than just managing sleepiness.

Objective actigraphy reveals significantly lower physical activity and dampened circadian rhythms in individuals with current depressive or anxiety disorders compared to controls, whereas self-reported measures fail to capture these objective differences.

For individuals with depression or anxiety, relying on memory or self-reports of activity and sleep is often inaccurate. Objective monitoring via actigraphy reveals that these individuals are significantly less active and have more disrupted circadian rhythms than healthy controls. This objective data is crucial for accurate assessment and monitoring treatment response, as self-reports may miss these critical disturbances.

A short dietary screener (Multifactor Screener) using frequency questions and regression-based scoring algorithms can estimate usual intake of fruits, vegetables, percentage energy from fat, and fiber with correlations (0.5–0.8) comparable to full Food Frequency Questionnaires (FFQs), while exhibiting lower attenuation of relative risk estimates.

For large-scale health surveys or epidemiological studies, using a validated short dietary screener (like the Multifactor Screener) is a viable and efficient alternative to lengthy Food Frequency Questionnaires. It provides comparable accuracy in estimating fruit, vegetable, fat, and fiber intake while reducing respondent burden and minimizing the attenuation of observed health risks.

A literacy-sensitive, culturally tailored diabetes self-management intervention significantly improves glycemic control (HbA1c) and dietary quality in low-income Latino patients with type 2 diabetes over a 4-month period, though these glycemic benefits are not sustained at 12 months without ongoing support.

For low-income Latino patients with type 2 diabetes, a structured, culturally relevant program focusing on diabetes knowledge, self-efficacy, and hands-on skills (like cooking and glucose monitoring) can significantly improve blood sugar control and diet quality within 4 months. However, without ongoing support, these benefits tend to fade after a year. To maintain results, patients need strategies to sustain behavioral changes, such as regular follow-ups or booster sessions, rather than relying solely on an initial intensive course.

Personalized direct mail invitations significantly increase enrollment rates in internet-based weight loss programs compared to general newsletter announcements.

If you are designing a digital health program, do not rely on passive announcements like newsletters. Use personalized, direct mail from a trusted source (like a physician or prevention director) to significantly boost initial sign-ups, especially for high-risk groups.

Healthcare workers (nurses and physicians) treating COVID-19 patients exhibit significantly elevated prevalence of sleep disturbances (34.8% for nurses, 41.6% for physicians) driven by workplace stress, anxiety, and exposure to the virus.

If you are a healthcare worker treating infectious disease patients, your risk of sleep disturbance is high (approx. 35-42%). This is driven by stress and anxiety, not just workload. Prioritize stress-reduction interventions and sleep hygiene protocols to protect your health and patient safety.

Smoking is associated with lower cardiorespiratory fitness and respiratory function, and smoking cessation is associated with better maintenance of these functions over time.

Quitting smoking improves cardiorespiratory fitness over time, even if you were a smoker previously. Never smoking is associated with the best maintenance of fitness.

Continuous 3-shift work interacts with life-style factors to decrease the beneficial effects of leisure-time physical activity and increase the adverse effects of alcohol consumption on sleep quality and daytime sleepiness.

If you work 3-shift schedules, your sleep is highly sensitive to how you spend your free time. Regular exercise helps day workers, but may not help 3-shift workers due to schedule constraints. Alcohol consumption significantly worsens sleep for 3-shift workers but not day workers. Prioritize sleep hygiene and limit alcohol, especially if you are on a continuous rotating 3-shift system.

Simple, high-contrast front-of-package warning labels (specifically black-and-white stop signs with 'High in' text) significantly improve consumer visualization, understanding, and intention to modify purchase behavior compared to complex or positive-framing labels.

For policymakers and public health advocates: Implement mandatory, high-contrast front-of-package warning labels (e.g., black-and-white stop signs with 'High in [Nutrient]'). Avoid complex traffic-light systems or positive-only labels, as evidence shows they are less understood and less effective at modifying purchase behavior, especially among low-SES populations. Simplicity and visual salience are key to driving healthier food choices.

Step intensity (cadence) is positively correlated with step count and independently associated with lower risk of chronic diseases, though the relationship is less consistent than step count alone.

While total steps are the primary driver, walking faster (higher cadence) adds additional benefit. However, you do not need to obsess over speed; simply increasing your total daily steps will likely increase your average cadence and provide protection.

During pandemic lockdowns, adults and adolescents globally shifted toward modified eating behaviors characterized by increased snack frequency, higher consumption of sweets and ultra-processed foods, and decreased adherence to healthy diets (fruits/vegetables).

Pandemic lockdowns and restrictive measures led to a global shift in eating behaviors, with people consuming more snacks, sweets, and ultra-processed foods while eating fewer fruits and vegetables. This resulted in decreased adherence to healthy diets and increased alcohol consumption across various demographics.

Vulnerable populations, including those with diabetes, obesity, and low socioeconomic status, experienced more acute declines in nutritional quality and health during lockdowns compared to the general population.

If you have diabetes, obesity, or live in a high-deprivation area, lockdowns can severely impact your diet. You may experience more acute changes in eating behavior, such as increased consumption of unhealthy foods and decreased adherence to healthy diets. It is crucial to have targeted support and strategies to maintain nutrition during such times.

Pandemic lockdowns led to increased alcohol consumption and a shift in dietary patterns towards higher intake of snacks, sweets, and ultra-processed foods, while decreasing consumption of fresh foods like fruits and vegetables.

Lockdowns led to increased alcohol consumption and a shift towards snacks, sweets, and ultra-processed foods, while decreasing fresh food intake. This resulted in decreased adherence to healthy diets.

Daily physical activity counts decrease by approximately 1.3% per year of age in older adults, with a significant drop in afternoon and evening activity intensity.

If you are over 60, expect your daily activity to naturally drop by about 1.3% each year. This drop is most noticeable in the afternoon and evening. To counter this, focus on maintaining morning activity levels and consider how employment or structured routines might help sustain activity later in the day.

Nudging interventions that combine altering both the properties and the placement of fruit and vegetables yield a significant, medium effect size on increasing selection.

For maximum impact, combine strategic placement (e.g., eye-level, front-of-counter) with property alterations (e.g., attractive presentation, priming, or sizing cues). This dual approach significantly boosts fruit and vegetable selection compared to control conditions.

Health-related claims on food labels significantly increase the likelihood of purchasing and consuming the labeled product compared to identical products without such claims.

If you see a health or nutrition claim on a packaged food, expect that it will make you more likely to buy and eat it than if the package were blank. This is a powerful marketing tool that works in both lab settings and real-world sales data. Use this knowledge to be aware of your own biases when shopping.

Recent experiences of weight-based stigmatization are significantly associated with increased psychological distress (depression, anxiety, lower self-esteem) and a higher likelihood of binge eating disorder diagnosis in obese individuals seeking weight loss surgery.

If you are overweight or obese, negative comments or discriminatory treatment from others (including doctors) can significantly increase your risk of depression, anxiety, and binge eating. It is crucial to seek supportive healthcare environments where providers use respectful language and focus on health rather than weight bias.

Occupational physical activity, particularly light-intensity activity (LPA) and sedentary time (ST), does not confer the same cardiometabolic health benefits as leisure-time moderate-to-vigorous physical activity (MVPA), and high occupational ST is associated with adverse health outcomes regardless of leisure-time activity.

If you have a sedentary job, your health risk is driven by prolonged sitting, not just lack of exercise. If you have a physically demanding job, your health risk is driven by the lack of cardiovascular intensity and recovery time, not just 'activity.' To mitigate risk, office workers should prioritize leisure-time MVPA and reduce sitting time. Manual laborers should prioritize cardiovascular exercise and recovery, as their job activity may not provide sufficient health benefits and may even increase risk if not managed.

Taxes on sugar-sweetened beverages (SSBs) increase retail prices by 43-100% of the tax amount, leading to a significant decrease in SSB sales and overall consumption among adults.

Implementing a tax on sugary drinks raises their price, which effectively reduces consumption among adults. Policymakers should design taxes to maximize pass-through to consumers and consider broader tax scopes to minimize unhealthy substitutions.