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Part One Why This Works When Diets Don’t 18
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Part Two Know Your Starting Point 52
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Part Three Nutrition (Essential 1) 109
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Part Five Sleep (Essential 3) 25
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Part Six Recovery (Essential 4) 28
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- Kenttämies A, Karkola K. Death in sauna. Journal of Forensic Sciences. 2008;53(3):724–729.
- Garolla A, Torino M, Sartini B, et al. Seminal and molecular evidence that sauna exposure affects human spermatogenesis. Human Reproduction. 2013;28(4):877–885.
- Moretti ME, Bar-Oz B, Fried S, Koren G. Maternal hyperthermia and the risk for neural tube defects in offspring: systematic review and meta-analysis. Epidemiology. 2005;16(2):216–219.
- Raichle ME. The brain’s default mode network. Annu Rev Neurosci. 2015;38:433–447.
Part Seven Connection (Essential 5) 3
- Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspect Psychol Sci. 2015;10(2):227–237.
- Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med. 2010;7(7):e1000316.
- Office of the U.S. Surgeon General. Our Epidemic of Loneliness and Isolation: The U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community. U.S. Department of Health and Human Services; 2023.
Part Eight Supplements, the Last Five Percent 59
- The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. New England Journal of Medicine. 1994;330(15):1029–1035.
- Omenn GS, Goodman GE, Thornquist MD, et al. Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. New England Journal of Medicine. 1996;334(18):1150–1155.
- Goodman GE, Thornquist MD, Balmes J, et al. The Beta-Carotene and Retinol Efficacy Trial: incidence of lung cancer and cardiovascular disease mortality during 6-year follow-up after stopping β-carotene and retinol supplements. Journal of the National Cancer Institute. 2004;96(23):1743–1750.
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- Paulsen G, Hamarsland H, Cumming KT, et al. Vitamin C and E supplementation alters protein signalling after a strength training session, but not muscle growth during 10 weeks of training. The Journal of Physiology. 2014;592(24):5391–5408.
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- Neale RE, Baxter C, Romero BD, et al. The D-Health Trial: a randomised controlled trial of the effect of vitamin D on mortality. Lancet Diabetes & Endocrinology. 2022;10(2):120–128.
- Bischoff-Ferrari HA, Vellas B, Rizzoli R, et al. Effect of vitamin D supplementation, omega-3 fatty acid supplementation, or a strength-training exercise program on clinical outcomes in older adults: the DO-HEALTH randomized clinical trial. JAMA. 2020;324(18):1855–1868.
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- Summoning STRENGTH to question the placebo in REDUCE-IT. Circulation. 2021. (Editorial; see also the investigators’ response, European Heart Journal Supplements. 2020;22(Suppl J):J34.)
- Gencer B, Djousse L, Al-Ramady OT, Cook NR, Manson JE, Albert CM. Effect of long-term marine ω-3 fatty acids supplementation on the risk of atrial fibrillation in randomized controlled trials of cardiovascular outcomes: a systematic review and meta-analysis. Circulation. 2021;144(25):1981–1990.
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- Harris WS, Tintle NL, Etherton MR, Vasan RS. Erythrocyte long-chain omega-3 fatty acid levels are inversely associated with mortality and with incident cardiovascular disease: the Framingham Heart Study. Journal of Clinical Lipidology. 2018;12(3):718–727. Disclosure: the lead author founded and leads the company that markets the Omega-3 Index test.
- National Institutes of Health, Office of Dietary Supplements. Magnesium: fact sheet for health professionals.
- Linus Pauling Institute Micronutrient Information Center. Micronutrient inadequacies in the US population: an overview (NHANES 2007–2010); and Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, DC: National Academy Press; 1998.
- Yamadera W, Inagawa K, Chiba S, Bannai M, Takahashi M, Nakayama K. Glycine ingestion improves subjective sleep quality in human volunteers, correlating with polysomnographic changes. Sleep and Biological Rhythms. 2007;5(2):126–131. See also Bannai M, Kawai N, Ono K, Nakahara K, Murakami N. The effects of glycine on subjective daytime performance in partially sleep-restricted healthy volunteers. Frontiers in Neurology. 2012;3:61; and Inagawa K, Hiraoka T, Kohda T, Yamadera W, Takahashi M. Subjective effects of glycine ingestion before bedtime on sleep quality. Sleep and Biological Rhythms. 2006;4(1):75–77. Disclosure: several authors of these papers were employed by Ajinomoto Co., Inc., a manufacturer of amino acids.
- Soh J, Raventhiran S, Lee JH, et al. The effect of glycine administration on the characteristics of physiological systems in human adults: a systematic review. GeroScience. 2024;46(1):219–239.
- Morton RW, Murphy KT, McKellar SR, et al. A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults. British Journal of Sports Medicine. 2018;52(6):376–384.
- Gholami Z, Paknahad Z. Psyllium supplementation and lipid profiles: systematic review and dose-response meta-analysis of randomized controlled trials. Genes & Nutrition. 2025;20:27.
- 21 CFR § 101.81. Health claims: soluble fiber from certain foods and risk of coronary heart disease (CHD).
- Gaziano JM, Sesso HD, Christen WG, et al. Multivitamins in the prevention of cancer in men: the Physicians’ Health Study II randomized controlled trial. JAMA. 2012;308(18):1871–1880.
- Sesso HD, Christen WG, Bubes V, et al. Multivitamins in the prevention of cardiovascular disease in men: the Physicians’ Health Study II randomized controlled trial. JAMA. 2012;308(17):1751–1760.
- Baker LD, Manson JE, Rapp SR, et al. Effects of cocoa extract and a multivitamin on cognitive function: COSMOS-Mind. Alzheimer’s & Dementia. 2023; Yeung LK, Alschuler DM, Wall M, et al. American Journal of Clinical Nutrition. 2023; Vyas CM, Manson JE, Sesso HD, et al. American Journal of Clinical Nutrition. 2024.
- Loftfield E, O’Connell CP, Abnet CC, et al. Multivitamin use and mortality risk in 3 prospective US cohorts. JAMA Network Open. 2024;7(6):e2418729.
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- Gardner CD, Lawson LD, Block E, et al. Effect of raw garlic vs commercial garlic supplements on plasma lipid concentrations in adults with moderate hypercholesterolemia: a randomized clinical trial. Archives of Internal Medicine. 2007;167(4):346–353.
- Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. New England Journal of Medicine. 2006;354(8):795–808.
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- Stranges S, Marshall JR, Natarajan R, et al. Effects of long-term selenium supplementation on the incidence of type 2 diabetes: a randomized trial. Annals of Internal Medicine. 2007;147(4):217–223.
- 21 CFR § 101.83. Health claims: plant sterol/stanol esters and risk of coronary heart disease.
- Pu SY, Huang YL, Pu CM, et al. Effects of oral collagen for skin anti-aging: a systematic review and meta-analysis. Nutrients. 2023;15(9):2080. See also de Miranda RB, Weimer P, Rossi RC. Effects of hydrolyzed collagen supplementation on skin aging: a systematic review and meta-analysis. International Journal of Dermatology. 2021;60(12):1449–1461.
- National Institute of Diabetes and Digestive and Kidney Diseases. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury: Ashwagandha. Entry updated December 3, 2024.
- Esteban-Fernandez A, Ozcariz E, et al. Fruit and vegetable concentrate supplementation and cardiovascular health: a systematic review from a public health perspective. Journal of Clinical Medicine. 2019;8(11):1914. Disclosure: one author is affiliated with a manufacturer’s science institute.
- National Institutes of Health, Office of Dietary Supplements. Dietary supplements: what you need to know; and National Center for Complementary and Integrative Health, herbs at a glance series.
- Dietary Supplement Health and Education Act of 1994, Pub. L. No. 103-417; and US Food and Drug Administration, Dietary Supplements: questions and answers.
- 21 CFR Part 111. Current Good Manufacturing Practice in Manufacturing, Packaging, Labeling, or Holding Operations for Dietary Supplements.
- Geller AI, Shehab N, Weidle NJ, et al. Emergency department visits for adverse events related to dietary supplements. New England Journal of Medicine. 2015;373(16):1531–1540.
- Tucker J, Fischer T, Upjohn L, Mazzera D, Kumar M. Unapproved pharmaceutical ingredients included in dietary supplements associated with US Food and Drug Administration warnings. JAMA Network Open. 2018;1(6):e183337.
- 21 CFR § 101.36. Nutrition labeling of dietary supplements, including subsection (c) on proprietary blends.
- US Food and Drug Administration. Structure/function claims: small entity compliance guide.
- Ronis MJJ, Pedersen KB, Watt J. Adverse effects of nutraceuticals and dietary supplements. Annual Review of Pharmacology and Toxicology. 2018;58:583–601.
- Lesser LI, Ebbeling CB, Goozner M, Wypij D, Ludwig DS. Relationship between funding source and conclusion among nutrition-related scientific articles. PLoS Medicine. 2007;4(1):e5.
Part Nine The Method of Listening to Your Body 14
- Hall KD, Ayuketah A, Brychta R, et al. Ultra-processed diets cause excess calorie intake and weight gain: an inpatient randomized controlled trial of ad libitum food intake. Cell Metabolism. 2019;30(1):67–77.
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- Mountjoy M, Ackerman KE, Bailey DM, et al. 2023 International Olympic Committee’s (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs). British Journal of Sports Medicine. 2023;57(17):1073–1097.
- Lichtman SW, Pisarska K, Berman ER, et al. Discrepancy between self-reported and actual caloric intake and exercise in obese subjects. New England Journal of Medicine. 1992;327(27):1893–1898.
- Rosenbaum M, Leibel RL. Adaptive thermogenesis in humans. International Journal of Obesity. 2010;34(Suppl 1):S47–S55.
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- Meeusen R, Duclos M, Foster C, et al. Prevention, diagnosis and treatment of the overtraining syndrome: joint consensus statement of the European College of Sport Science and the American College of Sports Medicine. European Journal of Sport Science. 2013;13(1):1–24.
- Gardiner C, Weakley J, Burke LM, et al. The effect of alcohol on subsequent sleep in healthy adults: a systematic review and meta-analysis. Sleep Medicine Reviews. 2025;80:102030.
- Sholzberg M, Hillis C, Crowther M, Selby R. Diagnosis and management of iron deficiency in females. Canadian Medical Association Journal. 2025;197(24):E680–E687.
- Drake C, Roehrs T, Shambroom J, Roth T. Caffeine effects on sleep taken 0, 3, or 6 hours before going to bed. Journal of Clinical Sleep Medicine. 2013;9(11):1195–1200.
- Edinger JD, Arnedt JT, Bertisch SM, et al. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine. 2021;17(2):255–262.
- Schoenfeld BJ, Ogborn D, Krieger JW. Dose-response relationship between weekly resistance training volume and increases in muscle mass: a systematic review and meta-analysis. Journal of Sports Sciences. 2017;35(11):1073–1082.
- Lauersen JB, Bertelsen DM, Andersen LB. The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. British Journal of Sports Medicine. 2014;48(11):871–877.
Part Ten Special Situations 51
- Cowley ES, Olenick AA, McNulty KL, Ross EZ. “Invisible sportswomen”: the sex data gap in sport and exercise science research. Women in Sport and Physical Activity Journal. 2021;29(2):146–151.
- Roberts BM, Nuckols G, Krieger JW. Sex differences in resistance training: a systematic review and meta-analysis. Journal of Strength and Conditioning Research. 2020;34(5):1448–1460.
- Tarnopolsky MA. Sex differences in exercise metabolism and the role of 17-beta estradiol. Medicine and Science in Sports and Exercise. 2008;40(4):648–654.
- Greendale GA, Sternfeld B, Huang M, et al. Changes in body composition and weight during the menopause transition. JCI Insight. 2019;4(5):e124865.
- Greendale GA, Han W, Finkelstein JS, et al. Changes in regional fat distribution and anthropometric measures across the menopause transition. Journal of Clinical Endocrinology and Metabolism. 2021;106(9):2520–2534.
- Greendale GA, Sowers M, Han W, et al. Bone mineral density loss in relation to the final menstrual period in a multiethnic cohort: results from the Study of Women’s Health Across the Nation (SWAN). Journal of Bone and Mineral Research. 2012;27(1):111–118.
- Troìa L, Garassino M, Volpicelli AI, et al. Sleep disturbance and perimenopause: a narrative review. Journal of Clinical Medicine. 2025;14(5):1479.
- Avis NE, Crawford SL, Greendale G, et al. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Internal Medicine. 2015;175(4):531–539.
- Matthews KA, Crawford SL, Chae CU, et al. Are changes in cardiovascular disease risk factors in midlife women due to chronological aging or to the menopausal transition? Journal of the American College of Cardiology. 2009;54(25):2366–2373.
- Black KE, Matkin-Hussey P. The impact of protein in post-menopausal women on muscle mass and strength: a narrative review. Physiologia. 2024;4(3):266–285.
- Manson JE, Crandall CJ, Rossouw JE, et al. The Women’s Health Initiative randomized trials and clinical practice: a review. JAMA. 2024;331(20):1748–1760.
- The 2022 hormone therapy position statement of The North American Menopause Society Advisory Panel. Menopause. 2022;29(7):767–794.
- US Food and Drug Administration. FDA Approves Labeling Changes to Menopausal Hormone Therapy Products. FDA press announcement, February 12, 2026.
- Society for Women’s Health Research. Celebrating the Removal but Cautioning the Removal of All Warnings on HRT. swhr.org, 2026.
- McNulty KL, Elliott-Sale KJ, Dolan E, et al. The effects of menstrual cycle phase on exercise performance in eumenorrheic women: a systematic review and meta-analysis. Sports Medicine. 2020;50(10):1813–1827.
- Colenso-Semple LM, D’Souza AC, Elliott-Sale KJ, Phillips SM. Current evidence shows no influence of women’s menstrual cycle phase on acute strength performance or adaptations to resistance exercise training. Frontiers in Sports and Active Living. 2023;5:1054542.
- Sholzberg M, Hillis C, Crowther M, Selby R. Diagnosis and management of iron deficiency in females. Canadian Medical Association Journal. 2025;197(24):E680–E687.
- American College of Obstetricians and Gynecologists. Physical activity and exercise during pregnancy and the postpartum period. ACOG Committee Opinion No. 804. Obstetrics and Gynecology. 2020;135(4):e178–e188.
- Mountjoy M, Ackerman KE, Bailey DM, et al. 2023 International Olympic Committee’s (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs). British Journal of Sports Medicine. 2023;57(17):1073–1097.
- Watson SL, Weeks BK, Weis LJ, Harding AT, Horan SA, Beck BR. High-intensity resistance and impact training improves bone mineral density and physical function in postmenopausal women with osteopenia and osteoporosis: the LIFTMOR randomized controlled trial. Journal of Bone and Mineral Research. 2018;33(2):211–220.
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- Deutz NEP, Bauer JM, Barazzoni R, et al. Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group. Clinical Nutrition. 2014;33(6):929–936.
- Mitchell WK, Williams J, Atherton P, Larvin M, Lund J, Narici M. Sarcopenia, dynapenia, and the impact of advancing age on human skeletal muscle size and strength: a quantitative review. Frontiers in Physiology. 2012;3:260.
- Bergen G, Stevens MR, Burns ER. Falls and fall injuries among adults aged ≥65 years — United States, 2014. Morbidity and Mortality Weekly Report. 2016;65(37):993–998.
- US Preventive Services Task Force. Interventions to prevent falls in community-dwelling older adults: US Preventive Services Task Force recommendation statement. JAMA. 2018;319(16):1696–1704.
- Sherrington C, Fairhall NJ, Wallbank GK, et al. Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews. 2019;1:CD012424.
- Fell J, Williams AD. The effect of aging on skeletal-muscle recovery from exercise: possible implications for aging athletes. Journal of Aging and Physical Activity. 2008;16(1):97–115.
- Garmany A, Yamada S, Terzic A. Longevity leap: mind the healthspan gap. NPJ Regenerative Medicine. 2021;6(1):57.
- Livingston G, Huntley J, Liu KY, et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet. 2024;404(10452):572–628.
- Wood FA, Howard JP, Finegold JA, et al. N-of-1 trial of a statin, placebo, or no treatment to assess side effects. New England Journal of Medicine. 2020;383(22):2182–2184.
- de Jager J, Kooy A, Lehert P, et al. Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: randomised placebo controlled trial. BMJ. 2010;340:c2181.
- Heidelbaugh JJ. Proton pump inhibitors and risk of vitamin and mineral deficiency: evidence and clinical implications. Therapeutic Advances in Drug Safety. 2013;4(3):125–133.
- Epic Research. After Nearly a Decade-Long Decrease, Testosterone Prescribing Rates Rising Again. Analysis of January 2012–June 2026 data. epicresearch.org, 2026.
- Feldman HA, Longcope C, Derby CA, et al. Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts Male Aging Study. Journal of Clinical Endocrinology and Metabolism. 2002;87(2):589–598.
- Leproult R, Van Cauter E. Effect of 1 week of sleep restriction on testosterone levels in young healthy men. JAMA. 2011;305(21):2173–2174.
- Lincoff AM, Bhasin S, Flevaris P, et al. Cardiovascular safety of testosterone-replacement therapy. New England Journal of Medicine. 2023;389(2):107–117.
- Snyder PJ, Bauer DC, Ellenberg SS, et al. Testosterone treatment and fractures in men with hypogonadism. New England Journal of Medicine. 2024;390(3):203–211.
- Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism. 2018;103(5):1715–1744.
- Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. Journal of Urology. 1984;132(3):474–479.
- Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine. 2021;384(11):989–1002.
- Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide once weekly for the treatment of obesity. New England Journal of Medicine. 2022;387(3):205–216.
- Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. New England Journal of Medicine. 2023;389(24):2221–2232.
- Prado CM, Phillips SM, Gonzalez MC, Heymsfield SB. Muscle matters: the effects of medically induced weight loss on skeletal muscle. Lancet Diabetes and Endocrinology. 2024;12(11):785–787.
- Cava E, Yeat NC, Mittendorfer B. Preserving healthy muscle during weight loss. Advances in Nutrition. 2017;8(3):511–519.
- Lundgren JR, Janus C, Jensen SBK, et al. Healthy weight loss maintenance with exercise, liraglutide, or both combined. New England Journal of Medicine. 2021;384(18):1719–1730.
- Wilding JPH, Batterham RL, Davies M, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension. Diabetes, Obesity and Metabolism. 2022;24(8):1553–1564.
- Aronne LJ, Sattar N, Horn DB, et al. Continued treatment with tirzepatide for maintenance of weight reduction in adults with obesity: the SURMOUNT-4 randomized clinical trial. JAMA. 2024;331(1):38–48.
- Friedrichsen M, Breitschaft A, Tadayon S, et al. The effect of semaglutide 2.4 mg once weekly on energy intake, appetite, control of eating, and gastric emptying in adults with obesity. Diabetes, Obesity and Metabolism. 2021;23(3):754–762.
- Almandoz JP, Wadden TA, Tewksbury C, et al. Nutritional considerations with antiobesity medications. Obesity. 2024;32(9):1613–1631.
- US Food and Drug Administration. Approval of oral semaglutide for chronic weight management. December 2025.
- US Food and Drug Administration. Approval of orforglipron, an oral non-peptide GLP-1 receptor agonist. April 2026.
Part Eleven Putting It Together 10
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- Morton RW, Murphy KT, McKellar SR, et al. “A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults.” British Journal of Sports Medicine 2018;52(6):376–384.
- Wing RR, Phelan S. “Long-term weight loss maintenance.” American Journal of Clinical Nutrition 2005;82(1 Suppl):222S–225S.
- Ding D, Nguyen B, Nau T, et al. “Daily steps and health outcomes in adults: a systematic review and dose–response meta-analysis.” The Lancet Public Health 2025.
- Reynolds A, Mann J, Cummings J, Winter N, Mete E, Te Morenga L. “Carbohydrate quality and human health: a series of systematic reviews and meta-analyses.” The Lancet 2019;393(10170):434–445.
- Schoenfeld BJ, Ogborn D, Krieger JW. “Effects of Resistance Training Frequency on Measures of Muscle Hypertrophy: A Systematic Review and Meta-Analysis.” Sports Medicine 2016;46(11):1689–1697.
- Watson NF, Badr MS, Belenky G, et al. “Recommended Amount of Sleep for a Healthy Adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society.” Sleep 2015;38(6):843–844.
- Drake C, Roehrs T, Shambroom J, Roth T. “Caffeine Effects on Sleep Taken 0, 3, or 6 Hours before Going to Bed.” Journal of Clinical Sleep Medicine 2013;9(11):1195–1200.
- Balban MY, Neri E, Kogon MM, Zeitzer JM, Spiegel D, Huberman AD. “Brief structured respiration practices enhance mood and reduce physiological arousal.” Cell Reports Medicine 2023;4(1):100895.
- Weigle DS, Breen PA, Matthys CC, et al. “A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin and ghrelin concentrations.” American Journal of Clinical Nutrition 2005;82(1):41–48.
How the references were chosen: the book cites the primary source rather than coverage of it. Where a claim rests on a meta-analysis, the meta-analysis is cited, and where the result is contested, at least one trial that disagrees. Observational findings are labeled as observational in the text.
If you find a source that has been characterized incorrectly, Gerry would like to know. Get in touch at gerrymorton.com.