Browse the evidence

Adhering to the American Heart Association's 'Life's Essential 8' cardiovascular health metrics is associated with a significantly reduced risk of all-cause and cardiovascular disease-specific mortality in a linear dose-response manner.

To lower your risk of dying from heart disease or other causes, aim for high scores in eight key areas: healthy diet, physical activity, no nicotine, good sleep, healthy weight, normal blood lipids, normal blood glucose, and normal blood pressure. You do not need to be perfect in all areas; even small improvements in any single metric reduce your risk. Prioritize physical activity and quitting nicotine, as these had the largest impact on mortality in this study.

Adherence to a Mediterranean Diet style is associated with a lower degree of inflammation biomarkers and a protective role against cardiovascular and cerebrovascular events.

Focus on the overall pattern: prioritize vegetables, fruits, legumes, nuts, seeds, and olive oil as your primary fat source. Include moderate amounts of fish, poultry, and dairy, while limiting red meat and sweets. This pattern is linked to reduced inflammation and better heart health.

A high pre-treatment Prevotella-to-Bacteroides (P/B) ratio predicts significantly greater body weight and fat loss on energy-restricted diets, specifically when dietary fiber intake is high.

If you are struggling with weight loss on a standard calorie-restricted diet, your gut bacteria might be the missing variable. Specifically, if you have a high Prevotella-to-Bacteroides ratio, increasing your dietary fiber intake can significantly amplify your weight loss results. This suggests that personalized nutrition, based on gut microbiome testing, could be more effective than generic 'one-size-fits-all' diet advice.

High frequency of ultra-processed food consumption is associated with a significantly higher risk of all-cause mortality in US adults, independent of demographic, socioeconomic, and health behavior factors.

If you eat ultra-processed foods (like sugary drinks, processed meats, sweetened cereals, and packaged snacks) frequently (e.g., more than 5 times a day), your risk of dying from any cause is about 30% higher compared to those who eat them less often. This risk holds true even if you try to balance your diet with other healthy foods. To protect your longevity, try to reduce the frequency of these highly processed items and focus on whole or minimally processed foods.

Moderate intensity endurance exercise (<70% VO2max) improves gut microbial diversity and reduces systemic inflammation by decreasing intestinal permeability.

Engage in moderate endurance exercise (below 70% of your max oxygen uptake) to support gut health. This level of activity has been shown to increase microbial diversity and reduce systemic inflammation by strengthening the gut barrier, without the negative permeability effects seen in extreme exertion.

Elite athletes exhibit higher gut microbial diversity and a specific enrichment of bacteria involved in short-chain fatty acid (SCFA) production compared to sedentary controls.

Elite athletes tend to have gut microbiomes enriched in bacteria that produce beneficial short-chain fatty acids (SCFAs) like butyrate. This is linked to their high training volume and specific metabolic demands, suggesting that consistent endurance training may shape the microbiome toward more efficient energy metabolism.

Intense exercise (>70% VO2max) can increase intestinal permeability and endotoxemia, leading to temporary systemic inflammation and gastrointestinal distress.

High-intensity or prolonged endurance exercise can temporarily compromise your gut barrier, leading to inflammation and GI issues. This is common in ultrarunning or intense military training. While the long-term benefits of training outweigh these acute stresses, managing hydration, nutrition, and recovery is crucial to mitigate these temporary negative effects.

Sarcopenic obesity, defined as the concurrent presence of low muscle mass and high adiposity, has a compounding negative impact on health outcomes and is common in chronic disease populations.

For obese patients, especially those with chronic diseases, focusing solely on weight loss may be counterproductive. It is crucial to assess and preserve muscle mass through targeted interventions like resistance training and adequate protein intake, as sarcopenic obesity is associated with worse outcomes than obesity alone.

Muscle quality, assessed by muscle attenuation (fat infiltration) via CT or MRI, is an independent and emerging prognostic indicator for survival and outcomes, often more predictive than muscle mass alone.

For patients undergoing CT or MRI scans, muscle quality (attenuation) should be assessed alongside muscle mass, as it is a strong predictor of survival and outcomes. This is particularly relevant for cancer, critical illness, and liver disease patients. Future clinical practice should aim to make muscle quality assessment more routine.

Probiotic supplementation in overweight or obese adults produces a statistically significant but clinically small reduction in body weight, BMI, and fat percentage compared to placebo.

If you are overweight or obese, adding probiotics may help you lose a tiny amount of extra weight (about 0.6 kg) compared to not taking them. Do not rely on probiotics for weight loss; focus on diet and exercise first, as the probiotic effect is negligible in isolation.

Myosteatosis is associated with insulin resistance, type-2 diabetes, hypertension, and dyslipidemia independent of total body adiposity (BMI or DXA whole body fat).

Metabolic health is not guaranteed by a normal BMI. Fat infiltration into muscles (myosteatosis) is a specific risk factor for diabetes and heart disease, independent of overall body fat. For those with normal weight but metabolic issues, assessing muscle quality (via imaging or functional proxies) may be necessary.

Whole soy foods (e.g., soy nuts, tofu) significantly improve glycemic control and reduce blood pressure, whereas purified soy protein isolates or isolated isoflavone supplements often fail to produce these benefits.

To lower blood sugar and blood pressure using soy, prioritize whole soy foods like tofu, edamame, or soy nuts over protein powders or isolated isoflavone supplements. The fiber and other compounds in whole soy are necessary for the metabolic benefit; isolates often fail to deliver the same results.

The cardiovascular benefits of soy isoflavones, particularly regarding blood pressure and inflammation, are conditional on the individual's ability to metabolize daidzein into equol via gut microbiota.

If you eat soy and see no heart health benefits, you might be a 'non-producer' of equol. This is determined by your gut bacteria. While soy is still healthy, its specific blood-pressure-lowering power is mostly reserved for those who can convert it to equol.

Higher gut microbiome diversity is associated with lower levels of very-low-density lipoprotein (VLDL) particles, serum triglycerides, and total fatty acids, and higher levels of large/high-density lipoprotein (HDL) particles.

Focus on dietary patterns that support gut microbial diversity, such as high fiber intake and fermented foods, as this state is strongly linked to healthier lipid profiles (lower triglycerides, higher protective HDL).

Specific gut microbial taxa, particularly Christensenellaceae and Ruminococcaceae, are associated with favorable lipid profiles, including lower VLDL and triglycerides and higher large HDL particles.

Dietary diversity is key. Consuming a wide variety of plant fibers supports the growth of beneficial taxa like Christensenellaceae, which are linked to better lipid management.

Specific probiotic strains reduce the frequency, severity, and duration of upper respiratory tract infections (URTI) in athletes, particularly under conditions of high training load or environmental stress.

If you are an athlete prone to colds, look for a probiotic with a specific strain that has been studied for immune health (e.g., Lactobacillus rhamnosus GG). Do not buy generic 'probiotic' blends without strain identification. Ensure the product lists the specific genus, species, and strain on the label.

Athletes have distinct gut microbiota compositions compared to sedentary individuals, characterized by higher diversity and abundance of health-promoting bacteria, influenced by exercise and protein intake.

Regular exercise and a diet high in protein and fiber can positively shape your gut microbiota, increasing diversity and beneficial bacteria. This is a natural way to support gut health.

High sugar intake is associated with increased risk of dental caries, overweight, and cardio-metabolic risk factors, although the direct causal link to body adiposity may be mediated by total energy intake rather than sugar itself.

Reducing sugar intake is a valid strategy for improving health, particularly for dental health and metabolic markers like blood pressure and lipids. However, for weight management, the key factor is total energy intake. Replacing sugar with other carbohydrates without reducing overall calories will not lead to weight loss. Prioritize reducing high-calorie sweet products and beverages to lower total energy intake.

Heart-rate variability (HRV) serves as a valid biomarker for assessing the physiological and psychological health impacts of dietary interventions, with higher HRV indicating better autonomic regulation and resilience.

Use HRV as a key indicator of how your diet affects your overall health and stress resilience. Higher HRV is generally associated with better health outcomes, including lower risk of cardiovascular disease, diabetes, and psychiatric disorders. While more research is needed on specific foods, maintaining a diet that supports high HRV (e.g., Mediterranean diet, omega-3s) is a valid strategy for improving long-term physiological and psychological well-being.

Genetically predicted accelerometer-assessed physical activity causally decreases the risk of COVID-19 hospitalization.

Prioritize physical activity measured by devices (accelerometers) over self-reported estimates, as it is causally linked to reduced COVID-19 hospitalization risk. While the effect size is modest, combining this with reduced leisure sedentary time (like TV watching) may offer better protection.

Low dietary fiber intake leads to a reduction in gut microbiota diversity and promotes the degradation of host mucus, increasing susceptibility to inflammation and colitis.

Ensure adequate intake of diverse dietary fibers from whole plant sources to prevent the gut microbiota from degrading your intestinal mucus barrier, which protects against inflammation and disease.

Dual-energy X-ray absorptiometry (DXA) is the recommended clinical technique for assessing body composition (lean and fat mass) because it offers accuracy comparable to CT/MRI with significantly lower radiation exposure and cost.

Use DXA for accurate body composition tracking. It is safer and more accessible than CT/MRI for clinical purposes. Ensure standardized conditions (fasting, no exercise prior) for accurate results.

Urinary metabolic profiling using 1H-NMR spectroscopy can objectively classify dietary patterns into low or high non-communicable disease risk categories, providing a more accurate assessment than self-reported dietary data.

Instead of relying solely on food diaries or memory of what you ate, objective metabolic profiling of urine can accurately determine your dietary pattern and associated health risks. This method bypasses the common errors of self-reporting, such as forgetting snacks or misjudging portion sizes, offering a more reliable way to assess adherence to healthy eating guidelines.

Pre-intervention gut microbiota composition determines the efficacy of inulin supplementation for reducing BMI and adiposity in obese patients; specifically, higher baseline levels of Akkermansia and Butyricicoccus predict a positive response (BMI decrease), while higher baseline Anaerostipes predicts a non-response.

If you are obese and considering inulin supplementation, your current gut bacteria determine if it will help you lose weight. Specifically, having high levels of Akkermansia and Butyricicoccus and low Anaerostipes at the start predicts success. Without this profile, you may not see BMI benefits despite taking the supplement. This suggests microbiota testing could be valuable before starting such interventions.