Browse the evidence

Trans fats (industrial trans-fatty acids) are unequivocally harmful and should be completely avoided as they raise LDL-C, TGs, and Apo B while lowering HDL-C.

Completely avoid industrial trans fats. Check labels for 'partially hydrogenated oils' and avoid fried foods, baked goods, and processed snacks containing them. Opt for fresh, unprocessed foods and healthy cooking oils like olive or canola oil.

For menopausal women with osteoporosis, first-line pharmacologic therapies include alendronate, risedronate, zoledronic acid, and denosumab for the prevention of hip, nonvertebral, and vertebral fractures.

If you are a postmenopausal woman at high risk, these four drugs are the gold standard first-line treatments. They significantly reduce the chance of breaking a bone (by 30-70%). Discuss the specific dosing schedule (pill vs. injection) with your doctor, ensuring you also take 1200mg of calcium and 800-1000 IU of Vitamin D daily.

Folic acid fortification of flour prevents neural tube birth defects, and mandatory fortification is more effective than voluntary supplementation alone.

Women planning pregnancy should take folic acid supplements, but relying on fortified flour is a critical safety net for the broader population.

Preconception folic acid supplementation significantly reduces the risk of recurrent neural tube defects by approximately 69%.

If you are planning to conceive, start taking folic acid immediately. The neural tube closes very early, often before you know you are pregnant. This supplement is the most effective way to prevent serious birth defects like neural tube defects. If your pregnancy is unplanned, rely on food fortification as a backup, but do not wait to start supplements once you find out.

High consumption of trans-fats causes an increased risk of coronary heart disease (CHD).

Avoid trans-fats. They are linked to an increased risk of coronary heart disease. Check labels for 'partially hydrogenated oils' and choose foods with healthier fats like olive oil, nuts, and seeds.

Sodium bicarbonate supplementation (0.2–0.5 g/kg) improves performance in high-intensity exercise lasting 30 seconds to 12 minutes, including muscular endurance, combat sports, and high-intensity cycling, running, swimming, and rowing.

If you compete in high-intensity events lasting 30 seconds to 12 minutes (like a 400m run, boxing match, or rowing sprint), sodium bicarbonate can help. Start with 0.3 grams per kilogram of body weight, taken 60-180 minutes before your event. To avoid stomach issues, split the dose, take it with a high-carb meal, or use enteric-coated capsules. Do not exceed 0.3 g/kg for single doses as it increases side effects without adding benefit.

Sodium bicarbonate improves exercise performance in both men and women.

Women can benefit from sodium bicarbonate supplementation just as men do. Use the same dosing guidelines (0.3 g/kg) and timing (60-180 min pre-exercise).

Bariatric surgery leads to long-term nutrient deficiencies (anemia, neuropathies, osteoporosis) due to malabsorption and reduced gastric acid, requiring lifelong monitoring and supplementation.

After bariatric surgery, you must take lifelong vitamin and mineral supplements to prevent anemia, nerve damage, and bone loss. This is especially critical if you had a bypass procedure.

Replacing regular salt with a potassium-enriched salt substitute (75% NaCl, 25% KCl) significantly reduces cardiovascular events and mortality, particularly in populations with low baseline potassium and high sodium intake.

If you have high blood pressure or eat a lot of salty food, consider using a potassium-enriched salt substitute (like Low-Sodium Salt) instead of regular table salt. This can significantly lower your risk of heart disease and stroke, especially if you live in an area where most salt comes from home cooking.

Oral vitamin D supplementation at a dose of 700 to 800 IU per day significantly reduces the risk of hip and nonvertebral fractures in elderly persons, whereas a dose of 400 IU per day provides no significant benefit.

If you are over 60, standard 400 IU vitamin D is likely insufficient to prevent fractures. Aim for 700-800 IU daily (cholecalciferol). This dose reduces hip fracture risk by 26% and other fractures by 23%. While many trials included calcium, the high-dose vitamin D effect appears robust even without massive calcium supplementation.

Increasing potassium intake, particularly through salt substitution (25% KCl/75% NaCl) in populations with low potassium and high sodium intake, significantly reduces the risk of stroke and cardiovascular events.

If you live in a region where processed foods are common (high sodium) and fruit/vegetable intake is low, consider switching to a salt substitute containing 25% potassium chloride. This simple change has been shown in large trials to significantly reduce the risk of stroke and heart disease, especially if you have high blood pressure or a history of stroke. It is safe for most people, though those with advanced kidney disease should consult a doctor first.

Higher potassium intake is associated with lower blood pressure and reduced cardiovascular risk, independent of sodium intake levels, with benefits observed even when sodium reduction is modest.

Aim for a diet rich in potassium by eating more fruits, vegetables, legumes, and dairy. This helps lower blood pressure and reduces heart disease risk, even if you don't perfectly reduce your salt intake. If you use salt substitutes, choose ones with potassium chloride.

Restricting daily sodium intake to approximately 2 grams (5 grams of salt) reduces systolic blood pressure by approximately 7 mm Hg in hypertensive individuals.

Limit your daily sodium intake to about 2 grams (roughly one teaspoon of salt). Focus on avoiding processed and restaurant foods, which are the main sources of sodium, and use natural ingredients and herbs for flavoring. This single change can lower blood pressure by an amount comparable to taking a blood pressure medication.

Icosapent ethyl (pure EPA) reduces cardiovascular events in patients with Type 2 Diabetes and elevated triglycerides who are already on statin therapy.

If you have Type 2 Diabetes, high triglycerides, and are already taking a statin for cholesterol, ask your doctor about Icosapent Ethyl (Vascepa). This specific prescription omega-3 fatty acid has been shown to significantly reduce the risk of heart attack and stroke in patients like you. It is not the same as over-the-counter fish oil.

High-dose eicosapentaenoic acid (EPA) at 4g/day significantly reduces major cardiovascular events in high-risk patients already on statins, whereas general omega-3 supplementation shows mixed or null results for primary prevention.

If you are high-risk and on statins, ask your doctor about high-dose EPA (4g/day). Large studies show it significantly reduces heart attacks and strokes in this specific group. Standard over-the-counter fish oil doses may not offer this same protection.

Resistance training induces muscle hypertrophy primarily through increased muscle protein synthesis (MPS) mediated by mTORC1, resulting in a net gain of muscle protein when synthesis exceeds breakdown.

Muscle growth occurs when your body builds more protein than it breaks down. Resistance training triggers this process, and adequate protein intake ensures the raw materials are available to maximize this natural building process.

Bariatric surgery patients have extremely high rates of pre-existing micronutrient deficiencies, requiring comprehensive screening and aggressive post-operative supplementation.

If you are having bariatric surgery, get screened for nutrient deficiencies beforehand. Do not rely on standard multivitamins alone; you will likely need specific, higher-dose supplements tailored to your blood work to prevent long-term health issues.

Selenium deficiency can lead to specific diseases such as Keshan disease (cardiomyopathy) and myxedematous cretinism, which can be prevented or reversed by selenium supplementation, particularly when iodine levels are restored.

If you live in an area known for selenium-poor soil, be mindful of your selenium intake. Incorporate selenium-rich foods like Brazil nuts, fish, and eggs into your diet. For severe deficiency-related conditions like Keshan disease, medical supervision is essential, and treatment may require specific supplementation protocols.

A Mediterranean diet supplemented with mixed nuts (30 g/day) specifically improves memory function (episodic verbal memory) compared to a low-fat control diet in older adults at high cardiovascular risk.

Incorporate 30 grams of mixed nuts (walnuts, hazelnuts, and almonds) into your daily diet. This specific amount, when part of a Mediterranean dietary pattern, has been shown to improve memory function in older adults at high cardiovascular risk over a 4-year period.

Sodium reduction significantly lowers blood pressure in individuals with high-normal diastolic blood pressure, producing a net reduction of 0.9 mm Hg in diastolic and 1.7 mm Hg in systolic pressure over 18 months.

Reducing sodium intake can help lower blood pressure in people with high-normal levels. This study showed a small but significant drop in blood pressure (0.9 mm Hg diastolic) after 18 months of sodium reduction. While less effective than weight loss, it is a valid strategy. Focus on reducing sodium through food selection and cooking methods.

Orlistat reduces the absorption of fat-soluble vitamins (specifically D and E) and beta-carotene, necessitating daily multivitamin supplementation taken 2 hours before or after the drug.

Take a standard multivitamin every day while on Orlistat. Take it at least 2 hours before or 2 hours after your Orlistat dose to ensure your body can absorb the vitamins, as the drug blocks fat-soluble vitamin absorption.

Daily supplementation with 2000 mg calcium and 800 IU vitamin D reduces the incidence of stress fractures by 20% in female military recruits during basic training.

Female recruits in high-intensity training programs should consider taking 2000 mg of calcium and 800 IU of vitamin D daily to significantly lower their risk of stress fractures. This intervention is safe, does not interfere with training, and can prevent a substantial number of injuries.

Routine supplementation with omega-3 LC-PUFA (specifically DHA) during pregnancy reduces the risk of early preterm birth (<34 weeks) and low birth weight.

If you don't eat fish at least twice a week (including oily fish like salmon or mackerel), take a daily supplement providing at least 200 mg of DHA. This reduces the risk of early preterm birth and low birth weight. Avoid large predator fish like tuna and swordfish due to toxin risks.

Consuming 2-3 grams per day of plant sterols or plant stanols lowers LDL-cholesterol by 6-12% in a dose-dependent manner, with maximal benefit occurring around 3 grams per day.

To lower your LDL cholesterol, consume 2-3 grams of plant sterols or stanols daily, typically found in enriched margarines, yogurts, or juices. This dosage yields a 6-12% reduction in LDL. Do not exceed 3 grams daily, as benefits plateau and data on higher doses is unreliable. Ensure you consume these with meals containing fat to maximize absorption.