Browse the evidence

Regular exercise induces adverse metabolic responses (worsening of cardiovascular or diabetes risk factors) in approximately 8-13% of individuals, affecting fasting insulin, systolic blood pressure, triglycerides, and HDL-cholesterol.

If you have been exercising regularly and your blood pressure, cholesterol, or blood sugar markers are getting worse instead of better, do not stop exercising. This is a known phenomenon affecting about 1 in 10 people. Consult a healthcare provider or exercise physiologist to identify if you are an 'adverse responder' and adjust your exercise type or intensity, as standard protocols may not be optimal for your specific metabolic profile.

Short-term aerobic exercise (12 weeks, 3 sessions/week) improves immediate and delayed memory, increases resting cerebral blood flow in the anterior cingulate and hippocampus, and enhances cardiovascular fitness in sedentary adults aged 57-75.

If you are a sedentary adult over 57, start with 3 one-hour aerobic sessions per week (walking or cycling) at a moderate intensity (50-75% of your max heart rate). You can expect improvements in memory and brain blood flow within 3 months, which may help counter age-related cognitive decline.

The Edmonton Obesity Staging System (EOSS) score is a stronger predictor of all-cause mortality than BMI classification alone, independently predicting increased mortality risk even after adjusting for metabolic syndrome and hypertriglyceridemic waist.

If you have overweight or obesity, your risk of death is better predicted by your overall health status (like blood pressure, diabetes, or mobility) than by your BMI alone. Doctors should use a comprehensive staging system (like EOSS) to assess your risk and prioritize treatments, rather than relying solely on weight metrics.

Longer duration of obesity is independently associated with increased all-cause and cause-specific mortality, with risk increasing significantly for every additional 2 years of obesity duration.

If you have been obese for a long time, your risk of dying from any cause, heart disease, or cancer is higher than someone who has never been obese, even if your current weight is normal. This risk accumulates over time. The best strategy is to achieve and maintain a healthy weight as early as possible to minimize the total years lived with obesity.

High baseline total cholesterol (TC) is significantly associated with an increased risk of myocardial infarction (MI) in men, whereas associations for LDL-C, triglycerides, and total CVD events disappear after adjusting for confounders like diet and BMI.

For middle-aged men, monitoring Total Cholesterol (TC) is crucial for predicting heart attack risk, potentially more so than LDL-C alone when other health factors are considered. Ensure your TC is managed through a balanced diet and lifestyle, as high levels are strongly linked to myocardial infarction in this demographic.

High baseline consumption of extra-virgin olive oil (EVOO) is associated with a significantly reduced risk of major cardiovascular events (myocardial infarction, stroke, or cardiovascular death) in individuals at high cardiovascular risk.

If you are at high risk for heart disease, incorporating extra-virgin olive oil into your daily diet (aiming for roughly 3-4 tablespoons or more per day if possible, as seen in the highest benefit group) is associated with a significantly lower risk of heart attacks and strokes. Ensure you are using extra-virgin quality to get the protective polyphenols, as refined olive oil did not show the same benefit.

High consumption of total olive oil is associated with a reduced risk of cardiovascular mortality, but not cancer or all-cause mortality.

Eating more olive oil (especially extra-virgin) can significantly lower your risk of dying from heart-related causes. However, do not expect it to prevent cancer or extend your overall lifespan beyond cardiovascular benefits. It is a specific, powerful tool for heart health, not a general 'life extension' pill.

High cardiorespiratory fitness does not completely eliminate the increased mortality risk associated with high body fatness (obesity).

Do not assume that being physically active cancels out the health risks of being overweight. While fitness is beneficial, maintaining a healthy body weight is also critical for minimizing mortality risk. Aim for both regular exercise and a healthy body composition.

Low cardiorespiratory fitness is a stronger predictor of mortality than high body fatness (obesity) when analyzed independently.

Focus on improving your cardiorespiratory fitness (e.g., through aerobic exercise) as it may be a more powerful predictor of longevity than body weight alone. However, maintaining a healthy weight is still important.

High levels of sedentary behavior (prolonged sitting or television viewing) are independently associated with an increased risk of developing colorectal, endometrial, ovarian, and prostate cancer, as well as increased cancer mortality in women.

If you have a desk job or spend significant time watching TV, try to break up long periods of sitting. Stand up, walk, or move frequently. This is important for cancer risk reduction regardless of whether you exercise regularly, as sitting triggers unique biological risks like metabolic dysfunction and inflammation.

A rapid shift in the Chinese diet toward higher fat and animal product intake, coupled with decreased physical activity, has caused a significant increase in obesity and diet-related non-communicable diseases (DR-NCDs).

As economies develop, diets tend to shift toward more fat and animal products, and physical activity often decreases. This combination leads to higher rates of obesity and chronic diseases. To maintain health, it is crucial to monitor dietary fat intake and maintain physical activity levels, especially as food availability increases.

Female skeletal muscle exhibits greater fatigue resistance than male skeletal muscle when subjected to equivalent high-intensity exercise dosages, primarily due to a higher proportion of type I muscle fibers and greater oxidative capacity.

When prescribing high-intensity exercise, recognize that women may sustain effort longer or recover faster from fatigue than men at the same relative intensity. This is due to their muscle composition favoring oxidative metabolism. Training programs should account for this by potentially adjusting recovery periods or intensity progression based on individual fatigue markers rather than assuming male-centric norms.

Females have a higher Critical Power (CP) relative to single-limb isometric exercise intensity compared to males, but CP is similar between sexes during whole-body exercise when normalized to maximum capacity.

For whole-body exercises like cycling or running, men and women have similar Critical Power relative to their maximum capacity. However, for single-limb tasks, women may have a higher threshold for fatigue. Use metabolic thresholds (like CP) to prescribe intensity rather than fixed percentages of maximums to ensure accurate comparison and training loads.

Consuming up to one egg per day is not associated with an increased risk of coronary heart disease or stroke in the general population.

You can safely eat up to one egg a day without increasing your risk of heart disease or stroke. This applies to the general population. If you have diabetes, the data suggests a potential increased risk for heart disease, so you should consult your doctor for personalized advice.

Obstructive Sleep Apnea (OSA) is highly prevalent in obese women with PCOS and contributes to insulin resistance; screening and treatment (e.g., CPAP) are recommended.

Obese women with PCOS should be screened annually for OSA, as it is common and worsens insulin resistance. Treatment with CPAP can help alleviate insulin resistance.

Bariatric surgery (specifically gastric bypass) significantly increases the likelihood of remission for hypertension and type 2 diabetes compared to specialized medical treatment, while simultaneously increasing the risk of new-onset depression, opioid use, and gastrointestinal complications.

If you have severe obesity (BMI ≥40 or ≥35 with health issues), bariatric surgery (specifically gastric bypass) is significantly more effective than lifestyle/medical treatment alone for reversing high blood pressure and type 2 diabetes. However, this benefit comes with a higher risk of mental health challenges (like new-onset depression), increased opioid prescriptions, and the need for future gastrointestinal surgeries. The decision requires a careful trade-off between metabolic remission and surgical/mental health risks.

Post-exercise blood lactate concentration decreases significantly with age, making fixed high-lactate thresholds (e.g., ≥ 8.0 mmol/L) inappropriate for older adults.

Do not judge an older adult's effort by the same lactate numbers used for young athletes. An 80-year-old reaching 6-7 mmol/L may have worked as hard as a 20-year-old reaching 12 mmol/L. Adjust your expectations for metabolic markers based on age.

Women exhibit significantly lower post-exercise blood lactate concentrations than men during maximal exercise, despite achieving similar relative exertion (Borg Scale) and RER.

When assessing women, do not use the same blood lactate threshold (e.g., 8.0 mmol/L) as men. Women naturally produce ~18% less lactate at max effort. Use sex-specific thresholds (e.g., ≥ 7.0 mmol/L for women <50, ≥ 5.0 for 50-64, ≥ 3.5 for ≥65) to accurately capture their VO2max.

Body composition assessment (quantifying fat mass and fat-free mass) is clinically superior to BMI for diagnosing and managing obesity, sarcopenia, and osteoporosis because BMI fails to distinguish between tissue compartments.

Stop relying solely on BMI or scale weight to judge health progress. Use body composition assessments (like DXA, BIA, or skinfolds) to distinguish between fat loss and muscle loss. This is critical for older adults at risk of sarcopenia or obesity, as BMI often hides dangerous muscle loss or high fat mass.

Strength gains from weight-lifting training in the elderly are specific to the trained movement and joint angle, with greater improvements in weight-lifting capacity and isokinetic torque than in isometric strength, despite similar hypertrophy.

To get stronger at specific tasks (like lifting groceries), train those specific movements. General machine exercises may not translate directly to the strength needed for those tasks, even if your muscles get bigger.

Adherence to a combination of low-risk lifestyle factors (physical activity, diet, smoking, alcohol, and adiposity) is associated with a markedly lower incidence of new-onset diabetes in older adults, with up to 90% of cases potentially attributable to nonadherence.

Focus on maintaining a healthy weight, eating a balanced diet rich in fiber and healthy fats, staying physically active, avoiding smoking, and drinking alcohol moderately. Doing these things together significantly lowers your risk of developing diabetes, even if you are older.

High levels of sedentary behavior, specifically television viewing time, are associated with a significantly increased risk of colon cancer compared to low levels of sedentary time.

If you watch a lot of television, be aware that this habit is linked to a higher risk of colon cancer. This risk is distinct from your exercise routine, meaning that even if you work out, spending many hours sitting and watching TV may still increase your risk. Try to limit continuous viewing time and take breaks to stand or move.

High levels of sedentary behavior, specifically television viewing time, are associated with a significantly increased risk of endometrial cancer compared to low levels of sedentary time.

If you watch a lot of television, be aware that this habit is linked to a higher risk of endometrial cancer. This risk is distinct from your exercise routine, meaning that even if you work out, spending many hours sitting and watching TV may still increase your risk. Try to limit continuous viewing time and take breaks to stand or move.

The Dreem Headband (DH), a reduced-montage dry-EEG wearable device, achieves sleep staging accuracy (83.5%) comparable to the consensus of five human sleep experts (86.4%), validating its use for automated, longitudinal sleep monitoring.

If you want to track your sleep stages accurately at home without a clinical setup, the Dreem Headband is a validated option. It uses dry EEG electrodes and a machine learning algorithm to classify your sleep stages with accuracy nearly identical to human experts. It is designed to be comfortable for overnight wear and can operate without internet connectivity, making it suitable for longitudinal home use.