Browse the evidence

Vigorous physical activity (≥6 METs) is independently associated with a reduced risk of coronary heart disease, whereas the benefits of moderate and light activities are less clear or non-significant in multivariate models.

While any activity is better than none, incorporating vigorous exercise (like jogging, swimming laps, or sports) provides the strongest protection against heart disease. If you cannot do vigorous exercise, consistent moderate activity (like brisk walking) still offers significant benefits, though perhaps slightly less than vigorous efforts.

Non-alcoholic fatty liver disease (NAFLD) is independently associated with a significantly increased risk of cardiovascular disease (CVD) morbidity and mortality, particularly in patients with advanced fibrosis or non-alcoholic steatohepatitis (NASH).

If you have NAFLD, you must prioritize cardiovascular health. Regular screening for blood pressure, cholesterol, and blood sugar is essential, even if your liver feels fine. The presence of fatty liver is a strong warning sign for heart disease, so aggressive management of metabolic risk factors is required to reduce mortality.

NAFLD is associated with an increased risk of cardiac arrhythmias, specifically atrial fibrillation and ventricular arrhythmias, independent of traditional cardiovascular risk factors.

If you have NAFLD, be aware of symptoms like palpitations or irregular heartbeat. Screening for arrhythmias like atrial fibrillation is recommended, especially if you also have diabetes, as the risk is significantly elevated.

There is moderate evidence that sedentary behavior is associated with the incidence of endometrial, colon, and lung cancer, but insufficient evidence to determine if bout length or breaks in sedentary behavior are associated with health outcomes.

Sedentary behavior is linked to higher rates of colon, lung, and endometrial cancer. While we don't yet know if 'breaking up' sitting time helps, reducing your total sitting time is a prudent step for cancer prevention.

MBS serves as an effective bridge to other specialty surgeries (joint arthroplasty, hernia repair, organ transplantation) by reducing surgical risks and complications.

If you need joint surgery, hernia repair, or an organ transplant and are obese, getting MBS first can make the other surgery safer, shorter, and less likely to have complications.

Wrist-worn optical sensors provide accurate heart rate measurements (median error <5%) during controlled laboratory cycling and running, but fail to accurately estimate energy expenditure (median error >20%) across all activities.

Use your wrist-worn device to track heart rate zones for training intensity; it is generally accurate for this purpose. Do not rely on the calorie/energy expenditure numbers for weight loss decisions, as they are frequently off by 20% or more. Focus on effort and duration rather than the specific caloric burn reported.

Device error in heart rate measurement is significantly higher in males, individuals with darker skin tones, and those with higher BMI compared to females, lighter-skinned individuals, and lower BMI individuals.

If you have darker skin or a higher BMI, be aware that your wrist-worn heart rate monitor may be less accurate. Use the data as a general trend rather than an exact number, and verify with manual pulse checks if necessary.

Long-term weight gain (5 kg or more) over a 10-year period significantly increases the incidence of diabetes mellitus in US adults, with risk increasing proportionally to the magnitude of weight gain.

Maintaining a stable weight is a powerful tool for diabetes prevention. If you are currently gaining weight, even modestly (5 kg or 11 lbs), your risk of developing diabetes increases significantly. The more you gain, the higher the risk. Focus on preventing weight gain rather than waiting for obesity to develop.

High baseline microbiota diversity is associated with being a 'responder' to dietary interventions, whereas low diversity is associated with being a 'non-responder'.

If you have a diverse gut, dietary changes might not alter your microbiota much (non-responder). If your gut is less diverse, it might shift more dramatically (responder). This is why personalized nutrition is necessary.

Specific types of dietary fiber (e.g., resistant starch, inulin, beta-glucan) differentially alter gut microbiota composition, with some promoting beneficial SCFA-producing bacteria while others have minimal or no effect.

Vary your fiber sources to support a diverse gut microbiota. Include resistant starch (cooled potatoes/rice), inulin (chicory root, garlic), and beta-glucan (oats). Different fibers feed different bacteria, so diversity in fiber sources promotes a more resilient and functional microbiome.

Dietary intake of fish oil rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) significantly suppresses the production of very low density lipoprotein (VLDL) triglycerides and apoprotein B in humans, resulting in lowered plasma triglyceride levels.

To lower high triglycerides, consuming a diet where up to 30% of your calories come from fish oil rich in EPA and DHA (found in cold-water fish or supplements) can significantly reduce the liver's production of triglyceride-carrying particles (VLDL). This effect is driven by suppressing production rather than clearing existing fats, and it works even if your overall free fatty acid levels remain normal.

Prevention of vitamin D deficiency is a public health priority in Europe, as deficiency is easily treatable and its prevalence is unacceptable.

Ensure adequate vitamin D status, especially during winter months in Europe, through a combination of sensible sun exposure (avoiding burning), consumption of vitamin D-rich foods (like oily fish), and supplementation if necessary. This is critical for skeletal health and preventing deficiency disorders like rickets and osteomalacia, particularly for at-risk groups such as the elderly, immigrants, and those with limited sun exposure.

Vitamin D status is determined by a combination of cutaneous synthesis via UVB exposure and dietary intake, with significant variation based on latitude, skin pigmentation, and lifestyle factors.

Understand that your vitamin D status depends on both sun exposure and diet. If you live at higher latitudes (north of 40°N), have darker skin, or spend little time outdoors, you are at higher risk of deficiency and may need to rely more on dietary sources or supplements, especially in winter.

Circadian misalignment causes dysregulation of appetite-regulating hormones (specifically decreased leptin) and impaired glucose metabolism, independent of sleep duration.

Staying up late or working night shifts disrupts your body's natural hormone rhythms, leading to lower levels of the 'fullness' hormone (leptin) and higher blood sugar responses to food. This happens even if you sleep the same amount as someone with a regular schedule.

Low circulating 25-hydroxy-vitamin D levels (below approximately 60 nmol/L) are associated with a linear increase in the risk of cardiovascular disease, including total CVD, coronary heart disease, stroke, and CVD mortality.

Maintaining adequate vitamin D levels (around 60 nmol/L or higher) is associated with a lower risk of cardiovascular disease. However, this is an observational finding, so simply taking high-dose supplements is not proven to prevent heart disease. Focus on general health guidelines for vitamin D intake rather than using it as a standalone heart disease prevention strategy.

Irregular sleep/wake patterns are associated with delayed circadian timing (later melatonin onset) and lower academic performance in college students, primarily driven by irregular light exposure patterns rather than intrinsic circadian physiology.

Maintain a consistent sleep schedule, even on weekends. Irregular sleep delays your internal body clock (melatonin onset) and is linked to lower grades, independent of how many hours you sleep. Use light exposure strategically: get bright light in the morning and limit bright light at night to stabilize your rhythm.

Vegetarians have higher bioavailability of L-carnitine from their diet compared to regular red-meat eaters due to adaptive upregulation of intestinal transporters.

If you are vegetarian, your body has likely adapted to absorb carnitine more efficiently from plant sources and endogenous synthesis than meat-eaters. You likely do not need to worry about carnitine deficiency unless you have other specific health conditions.

Long-term adherence to agrarian diets high in plant-based fiber increases gut microbial diversity and short-chain fatty acid (SCFA) production, whereas Western-style diets low in fiber decrease beneficial Firmicutes and increase pathogenic Proteobacteria.

Prioritize a diet rich in diverse plant fibers (fruits, legumes, whole grains) to support a diverse microbiome and high SCFA production. Avoid long-term adherence to Western-style diets high in fat/sugar and low in fiber, as these reduce beneficial bacteria and increase pathogenic risks. Note that short-term extreme low-carb diets may negatively impact microbiota diversity and SCFA levels.

Twelve weeks of moderate-intensity aerobic exercise (50% VO2max) significantly augments endothelium-dependent vasodilation in healthy humans, whereas mild (25%) and high (75%) intensities do not.

To improve your blood vessel health, aim for moderate aerobic exercise, such as cycling or brisk walking, at 50% of your maximum oxygen capacity. Do this 5-7 times a week for 30 minutes. Avoid very high-intensity efforts, as they may increase oxidative stress without improving vascular function, and very low-intensity efforts, which may not provide sufficient stimulus.

Smoking cessation for at least 4 weeks prior to bariatric surgery significantly reduces postoperative complications.

If you smoke, stop at least 4 weeks before your bariatric surgery. This is not optional; it significantly reduces your risk of complications like wound infections and pneumonia. Seek support to quit, as the 4-week window is crucial for maximizing the benefit.

Leisure time spent sitting for 6 or more hours per day is independently associated with a significantly higher risk of all-cause mortality compared to sitting less than 3 hours per day, regardless of the individual's level of physical activity.

If you sit for 6 or more hours a day during your leisure time, your risk of dying from any cause is significantly higher than if you sit for less than 3 hours, even if you exercise regularly. To mitigate this risk, actively reduce your sitting time by standing up, walking, or moving frequently throughout the day, in addition to maintaining your physical activity routine.

The combination of high leisure time sitting (>=6 hours/day) and low physical activity (<24.5 MET-hours/week) is associated with a substantially higher risk of all-cause mortality compared to low sitting and high physical activity.

Your health risk is highest when you sit for 6+ hours a day AND exercise less than 24.5 MET-hours per week. To minimize this risk, aim to sit less than 3 hours a day and engage in at least 24.5 MET-hours of physical activity weekly. This dual approach offers the greatest protection against mortality.

Pharmacotherapy with sibutramine or orlistat, combined with lifestyle changes, produces modest weight loss (3-5 kg) compared to placebo, with sibutramine showing slightly greater efficacy than orlistat in some trials.

If lifestyle changes alone are not enough, medications like sibutramine or orlistat can help you lose an additional 3-5 kg. These drugs work best when combined with lifestyle changes and require ongoing use to maintain weight loss.

Maintaining linoleic acid (LA) intake at 5-8% of energy is critical for cardiovascular health because it sets a threshold that mitigates the cholesterol-raising effects of saturated fats and cholesterol.

Aim to get 5-8% of your daily calories from linoleic acid (found in vegetable oils like soybean, corn, and sunflower oil). This amount acts as a buffer, preventing saturated fats and dietary cholesterol from raising your bad cholesterol (LDL) levels. Simply reducing total fat without ensuring adequate LA intake may not protect your heart.