Browse the evidence

For endurance events lasting longer than 2.5 hours, ingesting 60-70 g/h of carbohydrates (up to 90 g/h if tolerable) improves performance by maximizing exogenous carbohydrate oxidation rates.

If your race is longer than 2.5 hours, aim to consume 60-70 grams of carbohydrates per hour. If you can handle it, try up to 90 grams per hour. To maximize absorption and reduce stomach upset, use drinks that contain both glucose and fructose. Practice this exact intake during your long training runs to ensure your stomach can handle it on race day.

Following the thirst mechanism and drinking ad libidum (400-800 mL/h) is the recommended hydration strategy for endurance athletes to avoid exercise-associated hyponatremia (EAH).

Don't force yourself to drink large amounts of water if you aren't thirsty. Instead, drink when you feel thirsty, aiming for about 400-800 mL per hour. If you sweat a lot or exercise for a long time, include some sodium in your drinks (300-600 mg/h) to help prevent low sodium levels.

Adopting a flexitarian or semi-vegetarian diet (SVD) is associated with lower body weight, reduced BMI, and lower body fat percentage compared to non-vegetarian diets.

If you want to lose weight or improve metabolic health, you don't need to go fully vegan. Adopting a flexitarian diet—where you eat meat occasionally (e.g., less than once a week) or exclude red meat but eat poultry/fish—is associated with lower BMI and body fat compared to standard non-vegetarian diets. Focus on reducing red and processed meats while increasing plant-based foods.

Adopting a flexitarian or semi-vegetarian diet (SVD) is associated with a reduced risk of type 2 diabetes and improved metabolic health markers (glucose, insulin, blood pressure) compared to non-vegetarian diets.

To lower your risk of type 2 diabetes and improve metabolic health, consider a flexitarian diet. This involves eating meat occasionally (e.g., less than once a week) or excluding red meat while eating poultry and fish. Studies show this pattern is associated with lower diabetes prevalence and better blood pressure control compared to standard non-vegetarian diets.

Lifestyle modifications can improve insulin sensitivity and delay progression to type 2 diabetes, although quantitative evaluation of insulin sensitivity was often missing from early trials.

Lifestyle changes are effective at delaying type 2 diabetes in people with impaired glucose tolerance. While early trials didn't always measure insulin sensitivity directly, it is possible that these changes improve insulin sensitivity. Pharmacological options like metformin are also available.

Creatine supplementation significantly augments lean mass gains (0.36%/wk) and strength gains (1.09%/wk) during resistance training compared to placebo.

Take creatine monohydrate. A common protocol is 20g/day for 5-7 days, then 5g/day. It reliably adds lean mass and strength when combined with resistance training. It is safe for healthy adults.

HMB (beta-hydroxy beta-methylbutyrate) supplementation significantly augments lean mass gains (0.28%/wk) and strength gains (1.40%/wk) during resistance training compared to placebo.

Take 3g of HMB daily alongside resistance training. It helps increase lean mass and strength. It is safe and may improve cholesterol profiles.

Energy intake is more critical than protein intake for maintaining nitrogen equilibrium and lean body mass during training.

Ensure you are eating enough total calories to support your training. If you are not gaining muscle, increasing your total energy intake may be more effective than simply adding more protein.

Adherence to a Mediterranean Diet (MedDiet) improves insulin sensitivity and glycemic control in obese individuals with type 2 diabetes or insulin resistance, independent of significant weight loss.

Adopt a Mediterranean-style eating pattern focusing on extra-virgin olive oil, nuts, vegetables, and whole grains. This specific combination improves insulin sensitivity more effectively than standard low-fat diets, even if you don't lose a lot of weight. Prioritize food quality over strict calorie counting for metabolic health.

Low glycemic index (GI) diets significantly improve glycemic control (HbA1c) in newly diagnosed type 2 diabetes, comparable to medication, and reduce hypoglycemic events.

For newly diagnosed Type 2 Diabetes, choosing foods with a lower Glycemic Index (GI) is a highly effective strategy. This approach improves blood sugar control (HbA1c) to a degree similar to medication and reduces the risk of dangerous low blood sugar episodes. Combine this with weight management and exercise for best results.

Physical food structure (e.g., intact kernels vs. flour) and processing methods (e.g., parboiling, cooling) significantly lower the Glycemic Index (GI) and postprandial glucose response compared to refined forms.

Pay attention to how your food is processed. Eating intact cereal kernels (like barley or rye kernels) or parboiled rice results in a lower blood sugar spike than eating the same grains milled into flour or white rice. Try to keep food in its most natural physical form.

Progressive resistance training (75% 1-RM, 3 sets of 8 reps, 3x/week) performed for one year by healthy elderly adults (mean age 68.2) significantly increases muscle strength (30-97% increase) and causes hypertrophy of both Type 1 and Type 2 muscle fibers.

If you are over 60 and healthy, you can build significant muscle strength and size by lifting weights 3 times a week. Start with a weight you can lift 8 times with good form, do 3 sets, and gradually increase the weight as you get stronger. You do not need to lift extremely heavy weights; moderate intensity (75% of your max) is highly effective and safe.

Daily self-weighing is an effective, low-cost intervention for preventing or slowing weight gain during periods of lifestyle disruption, such as home confinement.

Use a bathroom scale every morning. This is an inexpensive, easy tool to help prevent or slow weight gain during confinement. If you have access to an electronic scale, it can be integrated into telemedicine for remote monitoring.

An intensive weight loss intervention (approx. 8.7% loss) combined with exercise significantly improves physical function (pain, stiffness, walking distance, stair climb) in older obese adults with knee osteoarthritis, despite a concurrent loss of fat-free mass.

For older adults with knee pain and obesity, a structured program combining a significant calorie deficit (approx. 1000 kcal/day below maintenance) with regular exercise (3 times a week) can significantly reduce pain and improve walking ability. While you may lose some muscle along with fat, the reduction in stress on your knees leads to better overall function and less disability. Consistency with meal replacements and self-monitoring is key to success.

Dried purple laver (nori) is a highly suitable natural plant-based source of bioavailable Vitamin B12 for vegetarians, capable of meeting the daily recommended dietary allowance (2.4 μg) with approximately 4 grams of consumption.

If you follow a vegetarian or vegan diet, incorporate dried purple laver (nori) into your meals to maintain healthy Vitamin B12 levels. You only need about 4 grams (roughly 4-5 standard sheets of sushi nori) per day to meet your daily requirement. Avoid relying on Spirulina or Chlorella supplements for B12, as they often contain inactive forms of the vitamin that your body cannot use.

Long-term substitution of 35% of dietary protein with soy protein (totaling ~16g/day) significantly improves cardiovascular risk factors (fasting glucose, total/LDL cholesterol, triglycerides) and reduces inflammation (CRP) in type 2 diabetic patients with nephropathy.

If you have type 2 diabetes and kidney issues, replacing about a third of your animal protein with soy protein (specifically textured soy protein) for at least four years can significantly lower your blood sugar, cholesterol, and inflammation markers. This should be done under medical supervision alongside your standard medications.

Bariatric surgery (RYGB, BPD-DS, LSG) causes significant macro- and micronutrient deficiencies (protein, vitamins B1/B12/D, iron, zinc) due to altered anatomy, malabsorption, and bacterial overgrowth, necessitating lifelong monitoring and high-dose supplementation.

If you have had bariatric surgery, you must take specific, high-dose supplements for life. Standard multivitamins are not enough. You need regular blood tests to monitor levels of protein, B1, B12, D, iron, and zinc. Failure to do so can lead to severe, irreversible health issues.

High carbohydrate availability during prolonged exercise enhances performance time and delays fatigue by maintaining higher carbohydrate combustion rates and slower plasma glucose decline compared to high fat diets.

For prolonged exercise, eating a high-carbohydrate diet for several days prior significantly extends your time to exhaustion compared to a high-fat diet. This is due to better maintenance of blood glucose and higher carbohydrate usage. Simply drinking glucose during exercise when you are already tired does not significantly extend your performance time, suggesting that pre-exercise fuel stores are critical.

Six months of periodized resistance training significantly improves strength, power, and occupational task performance in untrained women, reducing gender differences in physical performance compared to men.

If you are a woman looking to improve your strength and ability to perform physically demanding tasks, engaging in a structured resistance training program 3 days a week for 6 months will significantly boost your strength, power, and endurance. You can choose between programs focusing on explosive movements (3-8 reps) or slower, controlled movements (8-12 reps), and both will improve your occupational performance. This training also helps close the physical performance gap between men and women, making you more capable in demanding jobs.

Specific dietary components, including omega-3 fatty acids, Mediterranean diet patterns, B-vitamins, probiotics, polyphenols, and weight loss, acutely and chronically improve HRV, while high saturated/trans fats and high glycemic carbohydrates reduce it.

To improve your HRV, focus on a Mediterranean-style diet rich in omega-3 fatty acids (found in fish), B-vitamins, probiotics, and polyphenols. Avoid high intakes of saturated and trans fats, as well as high glycemic carbohydrates, which have been shown to reduce HRV. Weight loss is also associated with improved HRV. These dietary changes support autonomic nervous system balance and reduce inflammation, leading to better overall health.

Midage women gain an average of 0.5 kg per year, driven by a daily energy imbalance of approximately 10 kcal, which can be prevented by small, sustained changes in physical activity, sitting time, and energy intake.

To prevent the typical midage weight gain of 0.5 kg per year, you do not need extreme diets or intense workouts. Focus on small, sustainable changes: increase your physical activity slightly, reduce sitting time, and monitor energy intake. These small shifts are sufficient to counteract the tiny daily energy imbalance that drives weight gain.

Incorporating low glycemic index (GI) starchy foods (e.g., legumes, pasta, barley, parboiled rice, pumpernickel) into the diet significantly reduces postprandial glycemic excursions compared to high GI foods (e.g., white bread, potatoes, regular rice), leading to improved glucose control in diabetic patients and reduced LDL/triglycerides in hyperlipidemic patients.

To manage blood sugar and cholesterol, swap high-glycemic starchy foods like white bread, regular rice, and potatoes for low-glycemic alternatives such as pasta, legumes (lentils, beans), barley, parboiled rice, bulgur, and pumpernickel bread. These foods digest more slowly, leading to flatter blood glucose spikes and improved lipid profiles, without restricting your eating habits to boring or unfamiliar foods.

Substituting traditional hummus for energy-dense dips and spreads (e.g., mayonnaise, butter, sour cream) improves overall diet quality and nutrient density while reducing caloric, saturated fat, and sodium intake.

Replace high-calorie, low-nutrient spreads like mayonnaise, butter, or ranch dressing with hummus on sandwiches, baked potatoes, or with vegetables. This single swap reduces saturated fat and sodium while increasing fiber and essential nutrients without requiring you to change your entire diet.

Physical activity enhances sleep quality in adults, with specific benefits observed in older populations.

Incorporate regular physical activity into your routine to improve sleep quality, which is essential for healthy ageing and overall well-being.