Part 3: The Body that Eats

Multiple randomized controlled trials, or consistent large cohort studies with a well-understood mechanism.

• Eat more fiber, from more kinds of plant

  Aim for at least 25 g a day. In meta-analyses the benefit was greatest at 25-29 g, and more may help. The US adult average is about 17 g.

  Topic 12

• Move for insulin sensitivity, not to burn off food

  Aim for 150-300 minutes a week of moderate activity plus resistance training on two or three non-consecutive days.

  Topic 13

• Act early

  With prediabetes, a program aiming at 7% weight loss and 150 minutes of weekly activity cut diabetes incidence by 58% over about three years.

  Topic 13

• Treat GLP-1 drugs as a legitimate medical option

  chosen with a clinician and planned as long-term treatment, since weight usually returns after stopping.

  Topic 13

• Keep alcohol low

  Cirrhosis risk climbs steeply with heavy daily drinking, and in women it rises even at one drink a day.

  Topic 14

• Move about 150 minutes a week at brisk-walking effort

  the dose that lowered liver fat in trials.

  Topic 14

• Lose weight if you carry extra

  A 3-5% loss improves liver fat, but inflammation and scarring generally need more; aim for 10%.

  Topic 14

• Respect medicine labels

  Acetaminophen (paracetamol) caused 42% of 662 cases of acute liver failure at 22 US hospitals.

  Topic 14

• Make water your default drink

  One 12-ounce cola exceeds the WHO's stricter target, under 5% of energy or roughly 25 g of free sugars a day.

  Topic 15

• Take a snoring child seriously

  Pediatric guidelines call for screening all children for snoring, and a sleep study for those with other signs of apnea.

  Topic 16

• Adults: know the three signs

  Loud snoring, observed pauses or gasping, and daytime sleepiness warrant a doctor's visit and possibly a sleep study.

  Topic 16

• Treat excess weight

  A 10% weight loss predicted a 26% fall in the apnea index; drug treatment belongs with a prescriber.

  Topic 16

• Brush with fluoride and cut free sugar

  Use 1,000-1,500 ppm (parts per million) fluoride toothpaste twice a day, with your dentist's guidance on amounts for young children. Keep free sugars below 10% of energy.

  Topic 16

• Treat suspected overdrinking as an emergency

  Headache, vomiting, confusion or seizures after heavy drinking during a long event, especially with weight gain, need urgent care, not more fluid.

  Topic 17

• For diarrhea, use oral rehydration solution

  a mixture of clean water, salt and sugar. Severe dehydration needs medical care, sometimes with intravenous fluids.

  Topic 17

Good observational evidence with a plausible mechanism, or small or few trials.

• Add friction

  Keep hyper-palatable snacks out of sight and reach, and make whole foods the easy option at home and at work.

  Topic 11

• Swap whole meals

  Start with the meals you eat most often. On a metabolic ward, people ate about 500 kcal a day less on minimally processed menus than on ultra-processed ones.

  Topic 11

• Shrink portions and slow down

  Smaller portions, packages and plates reduce intake, modeled at 144-228 kcal a day if sustained across the whole diet.

  Topic 11

• Drink water, and treat alcohol as optional

  Sweetened drinks are among the ultra-processed foods most consistently linked to harm, and with alcohol, less is better and none is fine.

  Topic 11

• Add fermented foods with live cultures

  Trial participants worked up over four weeks to about six servings a day; start with one.

  Topic 12

• Skip the probiotic aisle

  unless a clinician recommends one for a specific reason.

  Topic 12

• Take antibiotics when you need them

  Healthy microbiomes mostly, though not entirely, recover: a reason to avoid unnecessary courses, never to refuse a needed one (Chapter 20).

  Topic 12

• Put your hands in soil

  Garden, grow food, let children dig, and wash hands before eating.

  Topic 12

• Eat oily fish rather than fearing seed oils

  The omega-3 index is the share of omega-3 fats in red blood cell membranes.

  Topic 12

• Change the food around you, not your willpower

  Make minimally processed food the easy default (Chapter 11); across 25 populations, more ultra-processed food went with more body fat.

  Topic 13

• Aim for at least 25 g of fiber a day

  from legumes, whole grains, vegetables and fruit, building up slowly. Benefits peaked at 25-29 g in meta-analyses, and more may help.

  Topic 13

• Eat enough protein

  at least 0.8 g per kg of body weight a day, with 1.2-1.6 g/kg proposed during active weight loss, and not 2 g/kg or more for long periods.

  Topic 13

• Protect your sleep

  If you habitually sleep under 6.5 hours, try to extend it. In 80 such adults with overweight, one sleep-hygiene session added about 1.2 hours a night and cut intake by about 270...

  Topic 13

• Cut sugary drinks first

  In an eight-week trial in 40 teenage boys with fatty liver, the whole household ate meals that held free sugars (added sugars and juice) under 3% of calories.

  Topic 14

• Ask about a liver check

  if you have type 2 diabetes, prediabetes or two or more metabolic risk factors: a FIB-4 (fibrosis-4) score from routine blood tests every one to two years.

  Topic 14

• Skip the detox aisle

  Cabbage-family vegetables measurably sped up a liver enzyme in a 36-person feeding trial; eat them as food, not as a cleanse.

  Topic 14

• Check your water where it matters

  Look up your utility's PFAS results or test a private well. Where PFAS are present, under-sink reverse-osmosis and two-stage filters removed nearly all of them in North Carolina...

  Topic 14

• Cut salt gradually

  In small studies, preferred saltiness fell after two to three months of a 30-50% reduction. On blood-pressure or kidney medication, change salt intake only with your clinician.

  Topic 15

• Do not count on a sweet tooth fading

  In a trial of 33 adults, three months of eating much less sugar made puddings taste about 40% sweeter than they did to controls, but no more pleasant.

  Topic 15

• Train a failing nose

  Sniff four distinct odors from jars, about 10 seconds each, twice daily, for at least 12 weeks; start early and use strong odors. Never put oils in your nose.

  Topic 15

• Protect your nose and plan for its failure

  Do not smoke. Avoid intranasal zinc products; the US Food and Drug Administration warned against three in 2009 (●●●).

  Topic 15

• Breastfeed if you can, without guilt if you cannot

  In a pooled analysis of 41 studies with 27,023 participants, ever-breastfed children had about a third the odds of malocclusion.

  Topic 16

• Drink when thirsty and with meals

  Coffee, tea, milk and water-rich foods such as fruit and vegetables all count; healthy adults in mild conditions need no glass count (Chapter 40).

  Topic 17

• Choose water over sugary drinks

  The swap may modestly help weight; trials of simply drinking more are mixed.

  Topic 17

• Plan a little for heat and long exercise

  Weigh yourself before and after long sessions. Losing more than about 2% suggests drinking more next time; any gain means you drank too much.

  Topic 17

• Offer older relatives drinks in hot weather

  Thirst fades with age, and urine color is an unreliable guide.

  Topic 17

• Drink more for specific conditions, with a clinician

  After a first calcium kidney stone, drinking more cut recurrences over 5 years from 27 in 100 people to 12 in 99.

  Topic 17

Early, small, animal-only, or actively contested.

• Cook more often

  Eating home-cooked main meals more than five times a week, versus fewer than three, was associated with 28% lower odds of overweight in 11,396 UK adults.

  Topic 11

• Treat eating windows as optional

  An overnight fast lets the migrating motor complex run. But in a 12-month trial of 139 adults, eating only between 8 a.m. and 4 p.m.

  Topic 12

• Don't microwave food in plastic

  Heating released the most particles in lab tests.

  Topic 14

• Cook from raw ingredients

  US adults in households that cook dinner most nights eat less sugar than those that rarely cook (119 vs 135 g a day), an association only.

  Topic 15

• Give children food to chew, safely

  Past infancy, offer age-appropriate whole foods that need chewing, not purees alone. Only animal studies and one-time snapshots of people support this.

  Topic 16

• Skip mewing and appliances sold as apnea prevention

  No preventive benefit has been shown. The orthodontists' own white paper advises widening the palate only when there is a real underlying skeletal problem, not as insurance.

  Topic 16