Browse the evidence

Short sleep duration (less than 7-8 hours) and poor sleep quality are associated with a 9% increased risk of type 2 diabetes for each hour of shorter sleep, mediated by decreased insulin sensitivity.

Aim for 7-8 hours of sleep per night. Each hour of sleep lost beyond this range increases your diabetes risk by 9%. Sleep restriction directly decreases whole-body insulin sensitivity, so prioritizing sleep duration is a critical, non-negotiable part of diabetes prevention.

Sedentary time (sitting, TV watching) independently increases type 2 diabetes risk, with each hour of TV watching increasing risk by 3.4%, regardless of physical activity levels.

Minimize your total sedentary time, especially television watching. Each hour of TV watching increases your diabetes risk by 3.4%, regardless of how much you exercise. Stand up, move, or walk for short periods throughout the day to break up long sitting spells, as this has beneficial metabolic effects independent of formal exercise.

Higher levels of total daily physical activity, measured objectively via actigraphy, are associated with a significantly reduced risk of incident Alzheimer's disease and a slower rate of cognitive decline in older adults.

Focus on moving more throughout the entire day, not just during scheduled workouts. For older adults, this includes daily chores, walking, and general movement. This total volume of activity is linked to a lower risk of Alzheimer's and slower cognitive decline, regardless of whether you perform formal exercise.

SGLT2 inhibitors (e.g., Dapagliflozin, Ipragliflozin) and GLP-1 agonists (e.g., Exenatide) improve endothelial function in T2DM patients, independent of or beyond their glucose-lowering effects.

If you have T2DM, ask your doctor about SGLT2 inhibitors or GLP-1 agonists. These drugs not only lower blood sugar but also directly protect your blood vessels and heart, improving how your arteries expand and contract.

Time-restricted feeding significantly reduces circulating testosterone and IGF-1 levels in resistance-trained males, although this hormonal reduction does not translate to muscle loss or strength deficits in this specific population.

Monitor your strength and body composition, not just blood work. If your TRF protocol lowers your testosterone and IGF-1 but you are still getting stronger and keeping your muscle, the hormonal drop is likely not functionally limiting for you. Do not change your diet based on hormone numbers alone if your performance is stable.

Residing in walkable neighborhoods with good access to recreation facilities is associated with higher levels of physical activity and a lower likelihood of being overweight or obese.

Choose to live in or visit neighborhoods that are walkable and have accessible parks or recreation facilities. If you already live in such an area, utilize the sidewalks and parks for daily activity. If you live in a car-dependent area, seek out specific destinations that encourage walking or cycling for transport or recreation, as the environment itself supports these behaviors.

Multilevel interventions that combine environmental/policy changes with individual education and social support are more effective than individual-focused interventions alone.

Support community-level policies that make healthy choices easier (like better school lunches or walkable parks) while also engaging in personal health education. Recognize that individual effort is amplified by supportive environments, and advocate for systemic changes in your community.

High levels of sitting time are associated with increased all-cause and cardiovascular disease mortality risk, but this association is attenuated or eliminated in adults who meet or exceed current physical activity recommendations (specifically ≥300 minutes/week of moderate-to-vigorous physical activity).

If you sit for more than 6 hours a day, your risk of early death increases significantly unless you are highly active. To neutralize this risk, you need to engage in at least 300 minutes per week of moderate-to-vigorous physical activity (like brisk walking, jogging, or sports). Simply meeting the minimum 150-minute guideline reduces but may not fully eliminate the risk if you sit very long hours; higher activity volumes provide better protection.

Substituting 3% of total energy intake from plant protein for animal protein (specifically processed or unprocessed red meat) is associated with significantly lower all-cause and cardiovascular mortality.

To lower your risk of dying from heart disease or other causes, swap 3% of your daily calories from animal protein (especially processed and unprocessed red meat) with plant protein (beans, nuts, legumes). This swap is most beneficial if you have other unhealthy lifestyle habits like smoking, being overweight, or being inactive. You do not need to change your total protein amount, just the source.

High intake of animal protein is associated with higher cardiovascular mortality, while high intake of plant protein is associated with lower all-cause and cardiovascular mortality, particularly in individuals with unhealthy lifestyle factors.

If you smoke, drink heavily, are overweight, or are inactive, the source of your protein matters more for your heart health. High animal protein intake increases your risk of dying from heart disease, while high plant protein intake lowers your risk of dying from any cause. Focus on getting protein from plants, especially if you have other health risks.

In patients with high triglycerides or metabolic syndrome, non-HDL cholesterol is a superior predictor of cardiovascular risk and a valid secondary treatment target compared to LDL cholesterol alone.

If you have high triglycerides or metabolic syndrome, ask your doctor to check your non-HDL cholesterol. It gives a more accurate picture of your heart disease risk than LDL alone and is calculated from your standard lipid panel without extra cost.

Western diets should reduce the n-6 to n-3 fatty acid ratio from the current 10-25:1 to approximately 1-2:1 to support cardiovascular health, normal development, and homeostasis.

Shift your fat sources. Reduce intake of corn, soybean, and sunflower oils (high in n-6) and increase sources of alpha-linolenic acid (ALA) like flaxseed, canola, and walnuts, while incorporating marine sources of EPA/DHA. Aim for a dietary ratio of n-6 to n-3 closer to 4:1 or lower, rather than the typical 15:1 found in Western diets.

Increasing dietary alpha-linolenic acid (ALA) reduces platelet aggregation and improves cardiovascular risk markers, although it is less potent than long-chain n-3 fatty acids (EPA/DHA) due to conversion competition with linoleic acid (LA).

If you rely on plant sources like flax or walnuts, minimize high-n-6 oils (corn, soy, sunflower) in your diet. This reduces competition for enzymes, allowing your body to convert more ALA into beneficial EPA/DHA. Note that ALA alone will not lower triglycerides as effectively as fish oil.

Adiponectin levels are inversely associated with obesity and insulin resistance, and low plasma adiponectin is a risk factor for type 2 diabetes, suggesting that boosting adiponectin could be therapeutic.

Maintaining higher levels of adiponectin is protective against diabetes. Since adiponectin levels drop with obesity, strategies that improve metabolic health (like exercise and weight loss) naturally help restore these levels. There are no approved adiponectin supplements, but lifestyle interventions that boost its activity are beneficial.

A Health at Every Size (HAES) intervention, which focuses on weight-neutral health behaviors rather than weight loss, produces statistically and clinically relevant improvements in physiological, behavioral, and psychosocial outcomes compared to conventional weight-loss treatments.

Focus on building sustainable health habits like intuitive eating and enjoyable physical activity rather than targeting a specific weight. This approach improves blood pressure, lipids, and mental well-being without the stress and failure associated with dieting.

Weight cycling, often a result of conventional dieting, is a stronger predictor of mortality and morbidity risk than adiposity (high BMI) itself.

Avoid yo-yo dieting. Repeated weight loss and regain is more harmful to your health than maintaining a higher stable weight. Focus on stable, healthy habits instead.

A lower ratio of fat to carbohydrate oxidation (indicated by a lower 24-hour respiratory quotient) predicts subsequent body weight gain in Pima Indians.

If you struggle with weight gain despite eating what seems like a normal amount, your body might preferentially oxidize carbohydrates over fat (low fat oxidation rate). This metabolic trait predicts weight gain. Focus on strategies that may improve fat oxidation, such as resistance training or specific nutrient timing, rather than just counting calories, as your metabolic efficiency plays a larger role than previously thought.

Low-energy reporters (underreporters) systematically underestimate absolute micronutrient intakes (Fe, Ca, Vitamin C) by approximately 30% compared to non-underreporters, despite often reporting higher micronutrient densities.

If you are restricting calories significantly (underreporting energy intake), you are likely missing out on 30% of your absolute iron, calcium, and vitamin C. Focus on volume and absolute amounts of micronutrient-rich foods, not just their density, to avoid hidden deficiencies.

Adherence to a Western dietary pattern (high in processed foods, refined sugars, saturated/trans fats, and low in fiber/antioxidants) causes systemic inflammation, oxidative stress, and gut dysbiosis, leading to increased risk of chronic diseases including obesity, type 2 diabetes, cardiovascular disease, and cancer.

Reduce intake of ultra-processed foods, added sugars, and refined grains. Increase consumption of fruits, vegetables, whole grains, and nuts to improve antioxidant status and gut health. This shift addresses the root causes of inflammation and oxidative stress associated with chronic disease.

Oral Nicotinamide Riboside (NR) is uniquely and highly bioavailable in humans and mice, significantly elevating blood and hepatic NAD+ levels with superior pharmacokinetics compared to Nicotinic Acid (NA) and Nicotinamide (Nam).

Take Nicotinamide Riboside (NR) orally. Clinical trials show it safely raises NAD+ levels in humans, with effects seen at doses of 100mg to 1,000mg. It appears more effective at boosting NAD+ than common alternatives like Nicotinamide.

A pro-inflammatory diet, as quantified by the Dietary Inflammatory Index (DII), is significantly associated with elevated levels of high-sensitivity C-reactive protein (hs-CRP), a biomarker for cardiovascular risk.

Your daily food choices directly influence your body's inflammation levels. To lower your risk of cardiovascular issues associated with chronic inflammation, prioritize a diet rich in fruits, vegetables, whole grains, and healthy fats (like fish and olive oil), while minimizing red meat, refined grains, and high-fat dairy. This 'anti-inflammatory' dietary pattern is associated with lower levels of C-reactive protein, a key marker of heart disease risk.

Lifestyle factors including smoking, obesity, stress, and pollution accelerate telomere shortening, thereby increasing the pace of biological aging and the risk of age-associated diseases such as cancer and cardiovascular disease.

To slow biological aging, prioritize avoiding smoking, maintaining a healthy weight, managing stress, and minimizing exposure to pollution. These factors directly impact telomere length, a key marker of cellular aging.

Dietary interventions including high fiber, antioxidant-rich foods (omega-3, vitamins C and E), soy protein, and dietary restriction can reduce the rate of telomere shortening and preserve telomere length.

Incorporate more fiber, antioxidants (vitamins C, E, omega-3s), and soy protein into your diet. Consider reducing overall caloric or protein intake if appropriate for your health status, as this may preserve telomere length.

Regular physical exercise is associated with elevated telomerase activity, reduced oxidative stress, and slower telomere shortening, thereby preserving leukocyte telomere length.

Engage in regular physical exercise to help preserve telomere length and reduce oxidative stress.