Browse the evidence

Maintaining mitochondrial dynamics (balance of fission and fusion) and quality control (mitophagy/biogenesis) is critical for preventing age-related metabolic diseases and neurodegeneration.

Support mitochondrial quality control through regular physical activity, which naturally stimulates mitophagy and biogenesis. Focus on metabolic health (insulin sensitivity) to support the energy demands of these processes.

PPARgamma activation via thiazolidinediones (TZDs) like rosiglitazone and pioglitazone induces a metabolically beneficial shift in lipid repartitioning from visceral and ectopic storage (liver, muscle) to subcutaneous adipose tissue.

If you are prescribed a TZD (like pioglitazone) for diabetes, understand that any weight gain is likely shifting from dangerous visceral/organ fat to safer subcutaneous fat, which is metabolically protective.

PPARgamma activation promotes the browning of white adipose tissue (beige adipocytes) and enhances brown adipose tissue (BAT) function, leading to increased energy expenditure and thermogenesis.

Activating brown fat through cold exposure or potentially PPARgamma-activating strategies can boost calorie burning via thermogenesis.

Adults consuming plant-based diets (vegetarian/vegan) have significantly lower intake and status of Vitamin B12, Vitamin D, Iron, Zinc, Iodine, and Calcium compared to meat-eaters, with vegans showing the lowest levels for B12, Calcium, and Iodine.

If you follow a plant-based diet, you must actively manage your intake of Vitamin B12, Iron, Zinc, Calcium, and Iodine. These nutrients are significantly lower in plant-based diets compared to meat-eaters, especially for vegans. Do not assume plant sources are equivalent; utilize fortified foods, diverse plant sources, and consider supplementation (especially B12) to meet recommended levels.

Plant-based diets provide higher intake of Fiber, Polyunsaturated Fatty Acids (PUFA), Folate, Vitamin C, Vitamin E, and Magnesium compared to meat-eaters.

If you eat a plant-based diet, you are likely getting excellent amounts of Fiber, Folate, and Magnesium. Ensure you are eating enough PUFA-rich foods (nuts, seeds, oils) to maximize these benefits. This is a key advantage of plant-based eating over typical meat-heavy diets.

Vegans and vegetarians have significantly lower intake and status of EPA and DHA compared to meat-eaters, despite potentially higher ALA intake.

If you are vegan or vegetarian, your EPA and DHA levels are likely low, even if you eat flax or walnuts. Consider an algae-based Omega-3 supplement to ensure adequate EPA and DHA intake, as these are critical for health and are not adequately produced from plant ALA.

Adiponectin levels are inversely correlated with visceral adipose tissue mass and obesity, and low levels are associated with insulin resistance, hypertension, and cardiovascular disease, while high levels may have protective anti-atherogenic effects.

Maintaining healthy adiponectin levels, often associated with lower body fat and physical activity, may protect against cardiovascular disease and insulin resistance. Strategies that improve insulin sensitivity may help maintain higher adiponectin levels.

High-sensitivity C-reactive protein (hsCRP) levels are positively correlated with BMI and glycated hemoglobin, and elevated hsCRP (>3 mg/L) is an independent risk factor for the development of diabetic microangiopathy and cardiovascular disease.

Monitoring hsCRP levels can help assess cardiovascular and diabetic risk in obese individuals. Lowering inflammation through weight management and healthy lifestyle choices may reduce hsCRP levels and associated risks.

Rotating shift work, particularly transitions involving evening-to-day shifts or consecutive night shifts, causes significant sleep restriction and circadian misalignment, leading to impaired objective alertness and performance (slower reaction times and more lapses) during night shifts.

If you work rotating shifts, especially nights, expect significant sleep loss and performance impairment. This is worst when transitioning from evening to day shifts or working consecutive nights. Do not rely on how you feel to judge your safety; objective performance remains poor on subsequent nights even if you feel subjectively better. Prioritize sleep duration between shifts, particularly avoiding 'quick returns' from evening to day shifts.

Positive airway pressure (PAP) therapy is more effective than no treatment in improving apnea-hypopnea index (AHI), Epworth Sleepiness Score (ESS), and disease-specific quality of life, and is cost-effective from a societal perspective.

If diagnosed with OSA, CPAP is the most effective treatment. It significantly reduces breathing interruptions, improves sleep quality, and enhances quality of life. While there is an initial adjustment period, the long-term health and economic benefits are substantial.

Elevated levels of host-accessible faecal monosaccharides (fructose, galactose, mannose, xylose) are associated with insulin resistance and metabolic syndrome in humans, mediated by gut microbiota carbohydrate metabolism.

High levels of certain sugars (fructose, galactose, mannose, xylose) found in the gut are linked to insulin resistance. This is driven by specific gut bacteria that break down complex carbs into these simple sugars. Managing gut microbiome composition through diet may help reduce these specific metabolites and improve insulin sensitivity.

Women with PCOS have an increased risk of impaired glucose tolerance and type 2 diabetes regardless of age and BMI, necessitating routine glycaemic assessment.

If you have PCOS, you need to get your blood sugar checked regularly, even if you are thin. The condition itself raises your risk for diabetes, independent of your weight. Do not skip these tests because you feel healthy or look fit.

Women with PCOS are at increased risk for cardiovascular disease and mortality, requiring lipid and blood pressure monitoring regardless of age or BMI.

You need to have your blood pressure and cholesterol checked regularly, even if you are young and feel fine. PCOS increases your risk of heart disease and stroke. This is a standard part of managing PCOS, not just for older women.

Oral administration of 600 mg/day of alpha-lipoic acid (ALA) significantly improves symptoms of diabetic sensorimotor polyneuropathy and prevents disease progression in patients with mild-to-moderate diabetic neuropathy.

If you have diabetic neuropathy, ask your doctor about 600 mg of Alpha-Lipoic Acid daily. Clinical studies show it can reduce pain and numbness and may prevent nerve damage from getting worse over time, especially if you have Type 1 diabetes or are a smoker. It is generally well-tolerated.

The R-enantiomer of alpha-lipoic acid has superior pharmacokinetic parameters, including higher bioavailability and plasma concentrations, compared to the S-enantiomer or racemic mixtures.

When buying Alpha-Lipoic Acid, look for the 'R-enantiomer' or 'R-ALA'. It is absorbed better by your body than the cheaper 'S-enantiomer' or 'racemic' mixtures, meaning you get more benefit from the same dose.

Testosterone replacement therapy (TRT) reliably improves global sexual function (libido, erectile function, sexual satisfaction) in men with functional hypogonadism in the short term.

If you are an older man with confirmed low testosterone and sexual issues (low libido, erectile dysfunction), TRT (specifically starting with transdermal gel) is the recommended treatment to improve sexual function. However, you must be screened for prostate health first. Do not expect TRT to fix weight, diabetes, or bone density issues. If you want children, do not take TRT; ask about gonadotrophin therapy instead.

Chronic insufficient sleep duration is causally associated with adverse health outcomes including obesity, type 2 diabetes, hypertension, cardiovascular disease, and all-cause mortality.

Prioritize getting enough sleep to avoid the high risks of chronic disease. If you are consistently sleeping less than recommended for your age group, you are increasing your risk for obesity, diabetes, and heart disease. Treat sleep with the same seriousness as your diet and exercise.

Adherence to a composite healthy lifestyle index (HLI) comprising non-smoking, moderate alcohol intake, physical activity, normal BMI, and Mediterranean diet adherence is strongly inversely associated with the risk of developing cancer-cardiometabolic multimorbidity (subsequent occurrence of cancer, cardiovascular disease, or type 2 diabetes).

Adopt a composite healthy lifestyle to significantly lower your risk of developing multiple chronic diseases (cancer, heart disease, diabetes). This involves maintaining a healthy weight (BMI 22-23.9), not smoking, engaging in regular physical activity, limiting alcohol intake (0-12g/day), and following a Mediterranean-style diet. The study shows that even after developing one of these conditions, maintaining these habits reduces the risk of developing a second one by approximately 15-25% compared to unhealthy lifestyles.

Increased intake of EPA and DHA lowers the risk of coronary heart disease and cardiovascular mortality, primarily through the modification of risk factors such as triglycerides, blood pressure, and inflammation, as well as through anti-arrhythmic and anti-thrombotic mechanisms.

To support heart health, aim for higher intakes of EPA and DHA, ideally through fatty fish consumption or supplements. This is associated with lower risks of coronary heart disease and cardiovascular mortality. Key benefits include lowering triglycerides, blood pressure, and inflammation. While recent studies have been mixed, the overall body of evidence supports a protective role, especially for secondary prevention in those with existing heart disease.

When eccentric and concentric resistance training are matched for maximum load or total work, they produce similar increases in whole muscle size (hypertrophy), despite inducing distinct structural adaptations.

If your goal is maximum muscle size, you do not need to prioritize eccentric-only training. As long as you match the total work or the load used in concentric training, eccentric training will build similar muscle mass. However, expect different structural changes: eccentric training tends to increase fascicle length (muscle belly length), while concentric training tends to increase pennation angle (fiber packing density). For general hypertrophy, either mode works if the stimulus is matched.

Eccentric resistance training primarily increases muscle fascicle length (serial sarcomere addition), whereas concentric resistance training primarily increases pennation angle (parallel sarcomere addition).

To optimize specific functional goals, consider the structural changes: eccentric training lengthens the muscle fibers (fascicles), which may improve range of motion and force at longer lengths. Concentric training packs fibers more densely (pennation), which may improve force production at shorter lengths. For general aesthetics, either works, but for sport-specific range of motion, eccentric emphasis might be beneficial.

Vitamin D supplementation reduces the incidence of acute respiratory tract infections, with the effect being more significant in patients with severe vitamin D deficiency (<10 ng/mL).

Taking vitamin D supplements can help reduce the risk of getting acute respiratory infections. This benefit is strongest if you currently have severe vitamin D deficiency. If your levels are normal, the benefit may be smaller.

Integrating sleep, sedentary behavior, light-intensity physical activity (LIPA), and moderate-to-vigorous physical activity (MVPA) into a unified 24-hour activity cycle (24-HAC) provides a more accurate assessment of health outcomes than evaluating these activities in isolation, as time spent in one activity directly displaces time in others and creates physiological synergies.

Stop viewing exercise in a vacuum. Your health is determined by how you spend all 24 hours. Prioritize getting 7+ hours of sleep, as this is the foundation. Then, look at your waking hours: minimize prolonged sitting by standing or moving lightly (LIPA) frequently, and aim for 150 minutes of moderate-to-vigorous activity per week. Recognize that moving more during the day can help you sleep better, and sleeping better gives you the energy to move more.

Low muscle strength (dynapenia) is independently and significantly associated with increased all-cause mortality in older adults, whereas low muscle mass (sarcopenia) alone is not significantly associated with mortality unless accompanied by low muscle strength.

For adults over 50, prioritize building and maintaining muscle strength (e.g., through resistance training) over simply focusing on muscle size or weight. Low strength is a strong independent predictor of early death, whereas having low muscle mass is not a significant risk factor if your strength remains normal. Measure your functional capacity, not just your body composition.