Wellbeing
Protocols

Eat 30+ different plant foods per week. Count grains, nuts, seeds, herbs, and spices — not just fruits and vegetables. Each distinct type counts once. Research shows this single habit produces significantly more diverse microbiomes than those eating 10 or fewer plant types.

Add 1–2 servings of fermented foods daily. Kefir, plain yogurt, kimchi, sauerkraut, and kombucha all qualify. The Stanford RCT showed 10 weeks of this diet reliably increased microbiome diversity and reduced interleukin-6 — a marker linked to rheumatoid arthritis, Type 2 diabetes, and chronic stress.

Replace ultra-processed foods progressively. Define UPFs as anything with ≥5 ingredients you wouldn't cook with at home (emulsifiers, flavourings, hydrogenated fats). A meta-analysis of 26 prospective studies found each 10% increase in UPF consumption raised depression risk by 22%.

Prioritise fibre variety, not fibre quantity alone. From the Stanford trial: short-term high-fibre diets alone did not increase microbiome diversity — variety of plant types matters more than total grams of fibre.

Time-restricted eating (intermittent fasting). 13–16 hour fasting windows show promise for metabolic health and insulin sensitivity in humans. Long-term RCTs in healthy adults are limited. Shows benefit in reducing visceral fat and improving fasting glucose.

Protect 7–9 hours of sleep opportunity. Both short (<7h) and long (>9h) sleep are associated with increased mortality risk. The "sweet spot" is 7–8 hours of actual sleep.

Set a fixed wake time — including weekends. This is the most powerful single sleep hygiene intervention, anchoring your circadian rhythm. "Social jet lag" (>1h variation between weekday/weekend wake times) independently worsens metabolic health, mood, and cognitive performance.

Get morning sunlight within 30 minutes of waking. Light exposure activates melanopsin receptors in the retina, triggering the cortisol awakening response. This anchors the circadian rhythm and prepares melatonin to rise at the correct time in the evening.

Caffeine cut-off before 2 PM. Caffeine has a half-life of 5–7 hours and a quarter-life of 10–12 hours. An afternoon coffee at 3 PM still has significant adenosine-blocking activity at 11 PM, delaying sleep onset and reducing deep sleep quality even when you can fall asleep.

Keep bedroom temperature between 16–19°C (61–66°F). Core body temperature must drop 1–2°C for sleep onset. A cool room supports this thermoregulatory drop. Room temperature is a frequently overlooked sleep factor with strong mechanistic evidence.

No screens 60 minutes before bed. Blue light (460–480 nm wavelength) suppresses melatonin production by up to 50% — delaying sleep onset and reducing sleep quality.

Name and acknowledge emotions rather than suppress them. Emotional suppression correlates with higher physiological stress markers. The ACE research consistently shows that unexpressed emotional experience — particularly from childhood — accumulates in the body as physiological stress.

Practice any structured 8-week mind-body program. MBSR improves emotional regulation, reduces anxiety and depression symptoms, and enhances stress resilience — particularly for adults under chronic occupational stress.

Protect social connection deliberately. Holt-Lunstad's meta-analysis of 3.4 million people found that social isolation carries the same mortality risk as smoking 15 cigarettes per day — greater than obesity or physical inactivity. Regular meaningful contact (not passive social media scrolling) is protective.

Understand the "chimp" model (Prof. Steve Peters). The limbic system (emotional brain) reacts 5× faster than the prefrontal cortex. When triggered, it is 5× stronger. Knowing this prevents self-blame and creates the pause needed for rational response.

Use implementation intentions to manage negative thought loops. Tali Sharot's research shows the human brain has a systematic optimism bias for good news and a pessimism bias for threats — creating anxiety loops. Implementation intentions ("if I notice anxiety about X, I will do Y") are among the most evidence-robust behaviour-regulation tools in psychology.

Train Zone 2 cardio 3–4×/week, 45–60 minutes per session. Zone 2 is the exercise intensity at which you can hold a full conversation — approximately 60–70% of max heart rate. It is the primary driver of mitochondrial density and metabolic efficiency.

Perform strength training 2–3×/week. Muscle mass and grip strength are independent predictors of longevity. A 2022 BJSM meta-analysis found 30–60 min/week of muscle-strengthening activities was associated with 10–17% lower all-cause mortality. Sarcopenia (age-related muscle loss) accelerates after 40.

Add one Zone 5 (high-intensity) interval session per week. 4×4-minute intervals at maximum sustainable intensity (Norwegian 4×4 protocol) are the most efficient stimulus for improving VO₂ max — the single strongest predictor of longevity among all measurable clinical markers.

Eat leafy greens, beetroot, and dark chocolate for nitric oxide. Nitric oxide (NO) regulates vascular tone, blood pressure, and tissue oxygenation. NO production declines 50% from age 40 to 60. Dietary nitrates from leafy greens (arugula, spinach) and beetroot are the most efficient non-pharmacological route to restoring NO levels.

Test for vitamin D deficiency; supplement only if deficient. Three large RCTs (VITAL, ViDA, D2d, combined n>30,000) found supplementation did not prevent cancer, CVD, falls, or diabetes in people who were not deficient. However, correcting actual deficiency (below 20 ng/mL) does have meaningful health benefits.

Fasting/caloric restriction and epigenetic aging. David Sinclair's research suggests 16+ hour fasting windows, along with NMN/NR supplementation, may reverse epigenetic aging markers. The human evidence is preliminary — most compelling data comes from animal models. The diet and exercise principles above have far stronger human RCT evidence.

Walk after every meal. A 10–15 minute walk post-meal blunts the blood glucose spike by 20–35%, directly reducing insulin demand. This is one of the most accessible and evidence-based metabolic interventions available to non-athletes.

Reduce refined carbohydrates and seed oils; increase protein and fibre. Reducing refined carbohydrates (bread, pasta, rice, sugar) and replacing with fibrous vegetables, legumes, and protein reduces insulin demand and supports fat mobilisation.

Exercise at least 3×/week with aerobic + resistance combination. Meta-analysis evidence shows aerobic exercise is the most effective intervention for visceral fat reduction — and unlike caloric restriction, it shows a dose-response: more exercise = more visceral fat lost.

Monitor waist circumference, not just weight. Waist circumference is a proxy for visceral fat. A waist-to-height ratio above 0.5 is a clinical risk marker. Reducing it through exercise is independently associated with reduced cardiovascular and metabolic risk, regardless of total weight change.

Prioritise sleep for metabolic health. Sleep deprivation directly increases insulin resistance within days. Walker's data shows that even one week of 6-hour sleep nights produces insulin-sensitivity profiles comparable to pre-diabetic states.

For active women: avoid fasted training and intermittent fasting. Intermittent fasting suppresses the hypothalamic-pituitary-ovarian axis in active women, disrupts cortisol rhythms, and reduces adaptation to exercise. Instead: eat within 30 minutes of waking and consume protein before training.

Prioritise heavy resistance training, especially perimenopausal. Contrary to intuition, higher-intensity resistance and HIIT training is more appropriate for women in perimenopause/menopause than low-intensity steady-state cardio. Muscle mass loss accelerates after 40; estrogen decline amplifies this.

Understand the 4-phase menstrual cycle when structuring exercise and nutrition. In the follicular phase (days 1–14): higher estrogen allows better performance and carbohydrate tolerance. In the luteal phase (days 15–28): higher progesterone increases core temperature and need for recovery. Training, nutrition, and sleep can be optimised by cycling with hormones.

Track symptoms of perimenopause from the late 30s. Irregular periods, worsening sleep, brain fog, anxiety, and unexplained weight gain — especially around the abdomen — can begin 7–10 years before the final menstrual period. Early recognition enables earlier intervention.

Prioritise protein: 1.6–2.2 g/kg body weight/day. Protein requirements increase during perimenopause because estrogen helps maintain muscle protein synthesis. When estrogen falls, protein intake must compensate. Dr. Sims recommends the higher end for active women.

Treat stress as a cardiovascular risk factor, not just a quality-of-life issue. The PNAS 2012 study showed that chronic stress leads to cortisol resistance, which causes unchecked inflammation — a key driver of arterial plaque buildup. Stress management is cardiac medicine.

Move consistently throughout the day; avoid prolonged sitting. Sitting for 8+ hours/day is independently associated with cardiovascular risk even in people who exercise. Standing up and moving for 2 minutes every 30–45 minutes partially offsets this risk.

Follow a Mediterranean-style dietary pattern. The PREDIMED trial found a Mediterranean diet (olive oil, nuts, legumes, fish, vegetables, whole grains; minimal red meat and processed food) reduced major cardiovascular events by 30% vs. low-fat diet — one of the largest diet-outcome effects ever recorded in a nutrition RCT.

Know your metabolic numbers — not just LDL. Cardiology evidence now supports tracking: fasting insulin (not just glucose), triglyceride-to-HDL ratio (proxy for insulin resistance), hsCRP (inflammatory marker), and waist-to-height ratio, alongside traditional lipid panels.

Eat oily fish 2–3×/week as a minimum for EPA/DHA. Salmon, mackerel, sardines, anchovies, and herring provide the EPA and DHA that meta-analyses consistently show benefit depressive and anxiety symptoms. This is the most evidence-backed dietary intervention for mental health.

Stabilise blood glucose. Erratic blood glucose (driven by refined carbohydrates and meal skipping) creates neurological instability — mood swings, brain fog, anxiety spikes, and poor concentration. Eating regular meals containing protein, fat, and fibre with each meal moderates this.

Reduce or eliminate alcohol. Both Dr. Walker and Dr. Attia point to alcohol as a major disruptor of sleep quality (especially REM sleep) and a neurotoxin in even moderate doses. The evidence on alcohol as a "health food" in small doses has been substantially revised downward.

Consider omega-3 supplementation if fish intake is low. The meta-analysis evidence supports EPA-dominant formulations (≥60% EPA, ≤1g/day) for depression. This is low-risk, low-cost, and evidence-supported as an adjunct — not a replacement — to other interventions.

View food as a neurological input, not just fuel. Every meal either supports or disrupts brain energy metabolism. Shifting from "diet as weight management" to "food as mood and cognition management" is the core insight of nutritional psychiatry.