Browse the evidence

High dietary fiber intake (specifically insoluble cereal fiber and whole grains) is associated with improved insulin sensitivity and a reduced risk of type 2 diabetes, primarily through gut microbiota-mediated mechanisms such as short-chain fatty acid (SCFA) production.

Prioritize insoluble fiber sources like whole grains and vegetables to support insulin sensitivity. While soluble fiber is beneficial, current evidence suggests insoluble fiber from whole grains may be more critical for preventing type 2 diabetes. Aim to increase intake significantly above current Western averages (often 18-24g/day) toward the recommended 30-35g/day for men and 25-32g/day for women.

Dietary fiber intake is inversely associated with cardiovascular disease (CVD) risk and CVD mortality, with a dose-response relationship showing reduced risk per 7-10g/day increment.

Increase total dietary fiber intake, particularly from cereal and vegetable sources, to reduce CVD risk. Aim for an increment of 7-10g/day of fiber, which is associated with a ~9-10% reduction in CVD risk. Prioritize whole grains and vegetables over ultra-processed foods, as the latter carry CVD risk even when adjusted for fiber content.

Vitamin E supplementation (800 IU/day) significantly reverses steatohepatitis and reduces hepatic steatosis and ALT in non-diabetic patients, but long-term safety concerns exist.

Non-diabetic NAFLD patients may benefit from 800 IU/day Vitamin E to improve liver health, but should be aware of potential long-term risks.

Liraglutide is associated with the second-highest probability of achieving ≥5% weight loss but carries the highest odds of discontinuation due to adverse events among the studied agents.

Liraglutide is a highly effective daily injection for weight loss, ranking second only to phentermine-topiramate in success rates. However, it has the highest rate of side-effect-related discontinuation, so you must be prepared for potential gastrointestinal issues.

Transdermal testosterone gel (50-100 mg/day) administered to hypogonadal men for 180 days significantly improves sexual function, mood, lean body mass, muscle strength, and reduces fat mass compared to baseline and a permeation-enhanced testosterone patch.

If you are a hypogonadal man, testosterone gel therapy (50-100mg daily) for 6 months can significantly improve your sexual function, mood, muscle strength, and reduce body fat. The gel causes much less skin irritation than patches. Monitor your levels to ensure the dose is correct.

Prolonged sitting time is associated with a 30% higher risk of endometrial cancer and a 30% higher risk of colorectal cancer, independent of moderate-to-vigorous physical activity.

Try to minimize prolonged sitting throughout the day. Even if you exercise regularly, breaking up sitting time can further lower your risk of endometrial and colorectal cancers.

Anti-inflammatory interventions (including omega-3 fatty acids, exercise, and cytokine antagonists) significantly improve mood and reduce depressive symptoms, but only in individuals with pre-existing heightened inflammation (e.g., high CRP or IL-6 levels).

If you have depression, ask your doctor about testing inflammatory markers like CRP or IL-6. If these are high, treatments like omega-3 supplements (specifically EPA), exercise, or anti-inflammatory medications might be more effective for you than standard antidepressants alone. If your inflammation is low, these treatments may not help, and you should focus on other therapeutic strategies.

Subjective self-reported measures (e.g., mood, perceived stress, recovery) are superior to objective measures (e.g., blood markers, heart rate, performance tests) for monitoring athlete well-being and detecting training load responses.

Use validated subjective questionnaires (like POMS or RESTQ-S) daily or post-training to monitor how athletes feel. Do not rely solely on blood tests or performance metrics, as these often fail to detect early signs of fatigue or overtraining. Subjective reports are more sensitive to changes in training load.

Higher levels of moderate and vigorous physical activity are robustly associated with increased gut microbiome diversity, independent of major dietary factors and BMI.

Aim for regular moderate (e.g., brisk walking) or vigorous (e.g., running, cycling) physical activity. This study suggests that doing so is strongly linked to a healthier, more diverse gut microbiome, regardless of your exact diet or weight. You don't need to be an athlete; consistency in movement is the key lever identified here.

Higher microbiome diversity is associated with a 'health-related' cluster of host factors (e.g., higher HDL, vitamin D, physical activity) and lower abundance of certain pathogenic genera, while lower diversity is linked to a 'disease-related' cluster (e.g., high BMI, inflammation, diabetes markers).

Focus on building a diverse microbiome through a mix of healthy behaviors: eat plenty of fruits, vegetables, and whole grains, stay physically active, and manage stress. This holistic approach is associated with better clinical health markers and a more resilient gut ecosystem.

The association between specific gut bacteria (e.g., Faecalibacterium, Lachnospira) and health markers is robust and independent of overall microbiome diversity, whereas associations with other bacteria (e.g., Ruminococcaceae) are largely driven by overall diversity.

Don't get bogged down in specific probiotic strains. Instead, focus on lifestyle habits (diet, exercise) that are known to support a healthy microbiome. This study suggests that these habits naturally foster beneficial bacteria like Clostridiales, which are linked to better health outcomes.

Lower grip strength is independently associated with increased all-cause mortality in men aged 60 and older, with higher strength levels conferring a protective effect.

For men over 60, maintaining higher grip strength is a strong predictor of living longer, independent of how much muscle you have or how active you are. Focus on resistance training to maintain or improve hand grip strength, as this functional measure is a key indicator of overall health and longevity.

For men under 60, the rate of decline in grip strength is a more significant predictor of mortality than the absolute level of strength.

If you are under 60, don't just focus on how strong you are today. Pay attention to whether your strength is staying the same, improving, or declining. A steady decline in strength, even if you are still strong, is a warning sign for increased mortality risk. Regular strength training can help maintain or improve strength, mitigating this risk.

The widespread availability of competitive foods (sodas, snacks) in schools is causally linked to increased total calorie, fat, and sugar intake and decreased fruit and vegetable consumption in students.

If you are a school administrator, do not assume that removing soda and chips will bankrupt your food service. Evidence indicates that schools can upgrade to healthier options without losing revenue, and students may actually choose the school lunch more often if the junk food alternatives are gone.

One year of aerobic exercise training increases functional connectivity in the Default Mode Network and Frontal Executive Network in older adults, an effect not observed at 6 months.

To improve brain network efficiency in older age, commit to a 12-month aerobic walking program. Start with 10 minutes and build up to 40 minutes, 3 times a week. Keep your heart rate at 60-75% of your maximum reserve. The benefits on brain connectivity appear after a full year, so consistency is critical.

Increased functional connectivity in the Default Mode Network and Frontal Executive Network following aerobic exercise is associated with improved executive function in older adults.

Focus on aerobic exercise not just for physical health, but for cognitive maintenance. The brain network improvements from walking directly support better executive function, such as task switching and inhibition.

High dietary intake of fructose (particularly from HFCS) causes insulin resistance and metabolic dyslipidemia by bypassing the phosphofructokinase regulatory step in glycolysis, leading to uncontrolled hepatic de novo lipogenesis and triglyceride synthesis.

Avoid high-fructose corn syrup and excessive added sugars. While fructose doesn't spike blood sugar like glucose, it drives liver fat production and insulin resistance when consumed in large amounts, contributing to metabolic syndrome.

High fructose consumption reduces satiety signaling by lowering leptin and ghrelin responses compared to glucose, leading to increased caloric intake and weight gain.

Be aware that fructose does not make you feel as full as glucose. This can lead to consuming more calories overall, contributing to weight gain.

Chronic high fructose intake reduces adiponectin levels, contributing to insulin resistance and impaired lipid homeostasis.

Maintaining a healthy weight and limiting fructose can help maintain adiponectin levels, supporting insulin sensitivity.

Breaking up sedentary time with short breaks (e.g., standing or walking) is beneficially associated with metabolic biomarkers independent of total sedentary time and moderate-to-vigorous physical activity.

Don't just focus on reducing your total sitting time; focus on breaking it up. Stand up, stretch, or walk for a minute every 30-60 minutes. This improves metabolic health markers like blood sugar and triglycerides regardless of how much you exercise.

Sarcopenia assessment in primary care should utilize accessible, low-cost screening tools (SARC-F, Red Flags, Gait Speed) rather than expensive imaging (DXA/MRI) for initial identification.

Primary care providers should screen older patients for sarcopenia using simple, low-cost tools like the SARC-F questionnaire, gait speed tests, or the Red Flag method. If risk is identified, patients can then be referred for more detailed assessment (like DXA) if necessary, rather than relying on expensive imaging for everyone.

Obstructive sleep apnoea (OSA) is independently associated with an increased prevalence of metabolic syndrome, characterized by higher blood pressure, fasting insulin, triglycerides, and lower HDL cholesterol, even after adjusting for obesity and other covariates.

If you have Obstructive Sleep Apnoea, you are at a significantly higher risk for metabolic syndrome (high blood pressure, insulin resistance, bad cholesterol) regardless of your weight. Treating the sleep apnea (e.g., with CPAP) is likely necessary to mitigate these specific metabolic risks, not just for sleepiness.

Dietary fiber intake increases the abundance of Akkermansia muciniphila and improves metabolic parameters in obese individuals.

Increase intake of soluble fibers, such as oligofructose, to boost Akkermansia muciniphila. This natural approach has been shown to improve metabolic health and reverse some effects of obesity in animal models, offering a safer alternative to unproven bacterial supplements.

Higher relative abundance of the gut bacterial family Christensenellaceae is robustly associated with lower body mass index (BMI), reduced visceral adiposity, and improved metabolic health markers (lower triglycerides, higher HDL).

Focus on dietary patterns that support Christensenellaceae: consume adequate fiber (resistant starch, galacto-oligosaccharides) and protein. While you cannot change your genetics, these dietary inputs can increase the relative abundance of this bacteria, which is associated with healthier body composition and metabolic markers. Do not expect a probiotic supplement to replace diet and exercise, as the mechanism is not fully understood and the bacteria are complex to culture.