Browse the evidence

Vitamin D3 supplementation at high doses (10,000 IU/day loading, then 5,000 IU/day maintenance) raises serum 25(OH)D to 40-60 ng/mL, which is associated with a reduced risk of respiratory tract infections including influenza and COVID-19.

If you are at risk for respiratory infections, consider taking 10,000 IU of Vitamin D3 daily for about a month to boost your levels, then switch to 5,000 IU daily. Aim for a blood test showing 40-60 ng/mL of 25(OH)D. Ensure you are also getting enough magnesium, and do not take high-dose calcium supplements simultaneously to avoid toxicity.

Omega-3 fatty acids improve insulin sensitivity by activating the GPR120 receptor on macrophages, thereby reducing adipose tissue inflammation.

Consuming omega-3 fatty acids may help reduce inflammation in fat tissue and improve insulin sensitivity, but this benefit depends on having a functional GPR120 receptor. Individuals with specific genetic variants of this receptor may not receive the same metabolic benefits.

Physical activity prevents weight gain over time, but the specific dose-response relationship for weight loss and body composition changes is unclear or less strong compared to mortality benefits.

Use physical activity to prevent weight gain over time, but do not rely on it alone for significant weight loss. The dose-response for long-term weight loss is unclear, and combining exercise with dietary changes is likely necessary for body composition improvements.

An 8-week stress management program comprising diaphragmatic breathing, progressive muscle relaxation, and guided visualization significantly enhances weight loss (BMI reduction) and improves mental health outcomes in adults with obesity compared to standard lifestyle instructions alone.

If you are struggling with obesity, adding a structured stress management routine to your standard diet and exercise plan may yield better weight loss results than diet and exercise alone. The study used an 8-week program involving breathing exercises, muscle relaxation, and visualization, practiced weekly with home reinforcement. This approach targets the hormonal and behavioral links between stress and weight gain, such as cortisol-driven abdominal fat storage and emotional eating.

Low-carbohydrate diets (≤60 g/d) produce greater short-term weight loss than higher-carbohydrate diets, but this effect is driven by reduced caloric intake and longer diet duration rather than carbohydrate restriction itself.

If you choose a low-carbohydrate diet (under 60g carbs/day), expect significant weight loss, but understand it is likely because you are eating fewer calories overall, not because of the carb restriction itself. The diet is not superior to other diets if calorie intake and duration are matched. Be aware that evidence for long-term use (>90 days) or in older adults (>50 years) is insufficient.

High-glycemic load carbohydrates promote obesity by stimulating insulin secretion, which partitions calories into adipose tissue, thereby reducing circulating fuel availability, increasing hunger, and lowering energy expenditure.

To manage weight, prioritize the quality of carbohydrates over strict calorie counting. Reduce intake of high-glycemic foods like refined grains, potatoes, and added sugars. Instead, emphasize low-glycemic carbohydrates such as non-starchy vegetables, legumes, and whole fruits. This approach aims to lower insulin levels, reduce fat storage, and decrease hunger, making it easier to maintain a healthy weight without severe restriction.

High-glycemic load diets lower energy expenditure and increase hunger compared to low-glycemic load or low-carbohydrate diets, even when calorie intake is controlled.

If you feel constantly hungry or have low energy, consider that your diet might be slowing your metabolism. Switching from high-glycemic foods to lower-glycemic options or reducing total carbohydrates may help normalize your energy expenditure and reduce hunger.

Individuals with high insulin secretion in response to carbohydrates are more likely to gain weight on high-glycemic load diets and benefit more from low-glycemic or low-carbohydrate diets.

If you struggle with weight loss despite following a low-fat diet, you might have a high insulin response to carbohydrates. Trying a low-glycemic or low-carbohydrate diet may be more effective for you.

The molecular signaling responses to acute resistance and endurance exercise are often similar in untrained or recreationally active individuals, suggesting the interference effect may be less pronounced or mechanistically distinct in this population.

If you are new to exercise, you likely won't experience the 'interference effect' as strongly as an athlete. You can probably combine cardio and weights without worrying too much about blunting gains, as your body is still adapting to both stimuli.

People with severe insulin resistance or diabetes may benefit from reducing total carbohydrate intake.

If you have diabetes or severe insulin resistance, talk to your doctor about reducing your total carbohydrate intake. This may help improve your metabolic health, but long-term data is still being gathered.

Low selenium intake is associated with increased cancer incidence or mortality, although controlled epidemiological studies are limited by a lack of knowledge about precise intake levels.

Ensure adequate selenium intake through a varied diet including seafood, nuts, and grains. While laboratory studies suggest a link between low selenium and higher cancer risk, epidemiological evidence is not yet conclusive, so supplementation should be approached with caution and ideally under medical guidance.

Fruits, vegetables, and whole grain cereals are associated with a reduction in cancer risk, and research should focus on identifying the specific active constituents and their mechanisms.

Frequently consuming fruits, vegetables, and whole grain cereals is associated with a reduced risk of cancer. While the specific active components are still being researched, incorporating these foods into your diet is a recommended strategy for cancer prevention.

Low-intensity cycling with blood flow restriction (BFR) produces similar acute muscle thickness and voluntary contraction responses as high-intensity cycling when total exercise volume is matched.

If you cannot perform high-intensity cycling due to joint issues or preference, try low-intensity cycling (40% VO2max) combined with Blood Flow Restriction (BFR) cuffs. Ensure the total work (volume) matches what you would do at high intensity. This approach yields similar acute muscle swelling and fatigue markers as heavy cycling, making it a viable joint-friendly alternative for stimulating muscular adaptations.

Creatine supplementation (20 g/d) augments post-exercise muscle glycogen storage when combined with a high carbohydrate diet, with effects evident as early as 24 hours post-exercise.

If you are using creatine monohydrate (20 g/d) and consuming a high carbohydrate diet, you may experience greater muscle glycogen storage compared to carbohydrates alone. This effect is visible within 24 hours and lasts up to 6 days. However, consider that creatine loading also causes a 1-2% increase in body weight due to water retention, which might be a trade-off for endurance athletes.

Polyunsaturated fatty acid (PUFA) intake has a cardio-protective effect in studies with follow-up durations of more than 10 years.

In long-term studies (>10 years), higher PUFA intake is associated with a 5% reduction in CVD risk. This suggests PUFA may be protective over time, although overall meta-analysis results were not significant.

Adherence to a healthful plant-based diet pattern is associated with a statistically significant reduction in both the risk of contracting COVID-19 and the severity of the disease.

Adopting a diet rich in fruits, vegetables, and whole grains (high healthful plant-based diet score) is associated with a lower risk of getting COVID-19 and a significantly reduced risk of severe outcomes. This benefit appears to be especially important for individuals in areas with higher socioeconomic deprivation, suggesting that improving access to healthy foods is a key public health strategy.

Administration of 4 g daily of omega-3 carboxylic acids (Epanova) to statin-treated high-risk patients with hypertriglyceridemia and low HDL-C reduces triglycerides by 26-31% and non-HDL-C, but its impact on reducing cardiovascular events is currently unknown and being tested in the STRENGTH trial.

If you are on a statin and still have high triglycerides and low HDL, your cardiovascular risk remains elevated. This trial investigates whether adding 4 grams of a specific prescription omega-3 (Epanova) daily, on top of your statin, can lower those lipids and prevent heart events. While it reliably lowers triglycerides, whether this translates to fewer heart attacks or strokes is still being determined by the STRENGTH trial results.

Manipulating carbohydrate availability during training (e.g., 'train low') to create metabolic stress can upregulate cellular signaling and adaptive responses, potentially leading to superior performance when carefully integrated into an endurance training program.

Do not train low all the time. Use low-carbohydrate strategies only for specific, lower-intensity or shorter-duration sessions where performance outcome is less critical. This triggers metabolic adaptations. For high-intensity workouts, races, or long sessions, ensure high carbohydrate availability to support performance and recovery. Personalize based on your weekly workload.

Lifestyle medicine is distinct from other medical fields because it prescribes lifestyle change as the first and most important therapy for disease treatment and reversal.

Lifestyle medicine treats the root cause of chronic diseases by making lifestyle changes your primary treatment. This means diet, exercise, sleep, and stress management are your first-line 'medication.' Prescription drugs are used only if necessary, not as the primary solution.

Cluster set configurations (brief intraset rest) elicit similar myokine (IL-6 and IL-15) responses to traditional sets during resistance exercise, suggesting that cluster sets can promote similar metabolic and immunological adaptations (such as lean mass gains) while potentially offering greater power adaptations.

If you are struggling to complete heavy squats, try breaking your sets into smaller chunks (cluster sets) with short rests. This study shows you get the same muscle-building signals (myokines) as doing the full set, but it might help you lift more powerfully. It's a valid alternative to traditional sets.

Patients taking GLP-1 receptor agonists or dual GIP/GLP-1 agonists should continue these medications through the peri-operative period rather than withholding them, as evidence suggests withholding is insufficient to reduce aspiration risk.

If you take a GLP-1 or GIP/GLP-1 drug (like Ozempic, Wegovy, Mounjaro, Trulicity) for your upcoming elective surgery, do NOT stop taking it. Stopping it for a week or even three weeks does not guarantee your stomach is empty and may not reduce aspiration risk. Instead, tell your anesthesia team you are taking it so they can use specific techniques (like ultrasound or specific intubation methods) to keep you safe.

Patients taking SGLT2 inhibitors should omit these medications the day before and the day of surgery to prevent euglycemic diabetic ketoacidosis (DKA).

If you take an SGLT2 inhibitor (like Jardiance, Farxiga, or Invokana) for your upcoming elective surgery, stop taking it the day before your surgery and do not take it on the day of surgery. This is critical to prevent a rare but serious condition called euglycemic DKA. Your medical team will monitor your blood sugar closely during your stay and manage it with insulin if necessary, which is the safest approach.

Combined adherence to healthy lifestyle factors (Mediterranean diet, physical activity, non-smoking, moderate alcohol, ideal weight) significantly reduces the risk of developing periodontitis and tooth loss.

Your gum health depends on more than just brushing. Combining a healthy diet (like Mediterranean), regular exercise, not smoking, and maintaining a healthy weight significantly lowers your risk of gum disease and tooth loss, even if your brushing habits are average.

Cardiovascular training should be minimized in frequency and duration to the lowest level necessary for fat loss to prevent interference with strength and hypertrophy adaptations.

Use cardio only as much as needed to lose fat. Do not overdo it, as too much cardio can hurt your muscle gains and strength. Try cycling or full-body modalities to minimize interference with your weightlifting.