Dr. Tom Rifai

02/25/2026

Reality Meets Science with Dr. Tom at the Lake Nona Impact Forum.

Morning at .

Grateful to be part of conversations shaping the future of health — and always asking how innovation connects back to physiology.

02/24/2026

I am honored to have been invited to attend the 2026 Lake Nona Impact Forum, which begins tomorrow through February 27th in the beautiful area surrounding Lake Nona in Orlando, FL.

This unique event is an annual invitation-only that convenes a collection of the brightest minds from the health, wellness, and medical innovation ecosystem.

Looking forward to sharing insights, collaborating with peers, and learning from other incredible leaders at .

For more insights, please see the link below.

02/24/2026

Ok … I officially love Publix!

02/23/2026

If It’s in a Box or a Plastic Container, Is It Automatically Bad?

We’ve allowed the ultra-processed food conversation to drift into something overly simplistic.

NOVA asks: Is it ultra-processed?
RMS asks: Is it metabolically smart?

Those are not the same question.

A KitKat and a Greek yogurt with a small amount of “ultra-processed” jam at the bottom can fall into the same broad processing category.

But metabolically, they are not remotely equivalent.

Yes, the fruit preparation at the bottom of many yogurts is technically processed and may contain added sugar. That matters. But dose matters. In the context of a full serving of high-protein Greek yogurt, the overall food remains relatively low in calorie density, high in nutrient density, and not a beverage calorie.

The real drivers of cardiometabolic risk are not the number of manufacturing steps. They are:

• Calorie density — calorie concentration, or simply calories per bite
• Non-viscous beverage calories - liquid calories that don't trigger fullness
• Protein and fiber per calorie
• Sodium balance
• Saturated fat in context
• Hyper-palatability — engineered to override fullness signals

In tightly controlled metabolic ward research, when calorie concentration and hyper-palatability are matched, the large intake differences attributed to “ultra-processing” largely disappear.

Processing is not the exposure variable.

Calories per bite, satiety per calorie, beverage calorie science, and nutrient density are.

A frozen Power Bowl in a box can be metabolically supportive if its calorie density is reasonable and its nutrient profile is strong.

A homemade dessert made with “simple ingredients” can be calorie rich, refined, and hyper-palatable.

CRRAHP foods can exist in any category.

Now, what about plastics?

Concerns about microplastics and packaging deserve continued scientific investigation. But at present, most of the data are correlational, not causal, and the exposure gradients relevant to clinical metabolic outcomes remain unclear. We should reduce unnecessary exposure where practical, without drifting into fear-based absolutism that makes daily life untenable.

If we want clarity for patients and the public, we must move beyond classification systems and toward mechanistic scoring systems that reflect physiology.

That is why we developed the RMS Metabolic Nutrition Score — to measure what actually drives metabolic health, not just how a food was processed or packaged. Coming soon.

Where reality meets science is in mechanism, not moral labeling.

⸻

If you’d like a practical, simple framework for applying these principles in daily life, I invite you to take our free 5-Day Flex5 Crash Course — a concise email series that distills the core principles of metabolic nutrition into actionable steps.
Interested? Personalize The Flex5 Lifestyle to you starting at MyFlex5.com

02/22/2026

My date tonight is… MOM ❤️

Former Medical Director for Detroit Public Schools, Chevrolet Central Office, and Harrison Radiator (basically one step away from Medical Director of General Motors 😉).

She came to America in 1966.
I was born here in 1968.

And from the time I can remember, she’d say:
“All doctors are crazy. Don’t be a doctor. Go to Hollywood. Be a Major League Baseball player. Be a rock star. Do something American. Just don’t be a doctor!”

Well… I clearly didn’t listen and became a crazy doctor anyway — and maybe that’s why, when I was three, she changed my ancient Arabic first name (my grandfather’s, a first-born tradition in the old country), which translates to “the obedient one” — which obviously didn’t apply — and which no one here could pronounce anyway… to TOM.

Yes. She literally pulled the T, O, and M out of my Arabic name and legally renamed me Tom. Not Thomas. Just Tom. In case any of you were wondering. 😄

What I’ve built in medicine has her fingerprints solidly on it. I watched her lead with grit, compassion for everyone — and I mean everyone, from janitor to executive — champion preventive medicine (she was the queen of smoking cessation programs!), and hold standards that didn’t bend.

Long before my epiphany at Michigan State University — as an exercise science major studying for an exam in the cadaver lab — when I overheard a conversation between a professor and several medical students beyond the curtain dividers… and realized medicine was the bridge that blended my otherwise separate passions for psychology, nutrition, and physical activity science.

Thankfully she didn’t kill me when I called her from the empty lecture hall outside the cadaver lab to say I was changing course and applying to medical school.

Truth be told, she said, “That’s great! But remember, I didn’t push you into it — you decided all for yourself… not-so-obedient one.” 🤣

Dinner with the original boss and still a great inspiration❤️

02/22/2026

Two new studies on alcohol & intermittent fasting. It’s aLIVE walk n talk with Dr Tom.

02/22/2026

For years I’ve cautioned about alcohol’s association with health as it is the ultimate example of “the dose makes the poison”.

Even relatively modest intake has been associated with increased breast cancer risk, for instance. We’re talking about levels as low as more than 4 ounces of wine every other day. That is a very tight dosing window for women who are at risk for, or concerned about, breast cancer.

Now…

Some perspective on the latest Mediterranean diet + wine wishful-thinking headlines based on the data attached:

Even here, the dominant observed signal is eating pattern. Period.

A “Mediterranean” style eating pattern consistently lowers cardiovascular risk and all-cause mortality.

But let me be 100% clear on why I just used quotation marks around the word: there is nothing magical about the word “Mediterranean.”

Core longevity nutrition principles transcend ethnicity, geography, and culture.

In fact, as someone of Mediterranean extraction, I stopped pushing the so-called “Mediterranean diet” two decades ago because I found the label can confuse and alienate people and it was not only not necessary to help promote healthy eating, for my programs were better off without using the term other than in limited context and with caveat that there’s nothing magical about Mediterranean.

But, due to about three years after my training of being a big Mediterranean diet promoter, that branding followed me until recently.

Two examples.

When I was Regional Medical Director for Metabolic Health and Weight Management at Henry Ford Health in Detroit, I asked a patient what eating style she would like help with. She began to cry. I thought I had said something wrong! When I asked if I did…She said, “No doctor… I’m just so happy because I thought you were going to put me on the ‘Whitey diet.’”

“Whitey diet”?? I asked what she meant. She said, while wiping tears with a tissue: “You know… that Mediterranean diet”. That hit me hard.

I apologized and laughed at the same time. We instead partnered with our RD using a culturally grounded Healthy African-American nutrition framework and built a pattern that worked beautifully for her. And it did.

Then a Fortune 500 executive. At the end of my first coaching assessment, and as always whether patient or coaching client, I asked what his “non-negotiables” were. His answer, word for word:

“Dr. Tom, I don’t want to hear about any Mediterranean diet bull💩. I’m Indian and there is no reason you can’t help me with healthy Indian food”. That’s verbatim. What was I supposed to do at that point? Hand him a bottle of EV olive oil and wine? 

That’s why in The Flex5 Lifestyle®, nutrition is anchored in durable fundamentals:

Lots of whole plants.
High fiber.
A sweet-spot protein intake.
Healthy fats in context.
No absolute “verboten” foods, even intentional intake of CRRAHP foods and red meat in considered frequency and measured doses enjoyed as calculated risk, but anchored in accountability.

Because moderation without measurement is just storytelling.

Metabolic markers: Lipids. Blood pressure. Insulin sensitivity and psychometrics (remember, metabolic health without mental happiness is not true wellbeing): These define whether something is truly “moderate” for an individual. You cannot calculate risk without data. Otherwise, it we’re just rationalizing.

These principles apply to African-American cuisine. Indian cuisine. Middle Eastern cuisine. Latin cuisine. Asian cuisine. Midwestern or even Southern cuisine. Any cuisine. And I mean just about ANY.

That is the real signal.

As for wine: If you already drink 8 ounces or less with meals, this data suggests it does not appear harmful in that context. That is very different from saying it is protective, and does NOT whatsoever justify starting drinking alcohol “for health.”

And more wine is clearly not better. Higher intake erased the mortality signal, even in the linked paper.

We also need to avoid over-interpreting observational data. Alcohol remains a leading preventable cause of death in the United States.

Approximately 180,000 deaths per year based on recent CDC estimates from 2020–2021.

That includes liver disease, multiple cancers, alcohol-associated heart disease, poisoning, injuries, and crashes fully or substantially attributable to alcohol.

So as I’ve been saying long before it became fashionable to debate this: Alcohol is not a longevity intervention (sorry Dan Buettner).

If someone chooses moderate wine within an otherwise metabolically accountable healthy eating pattern, that is a personal risk decision. But it should never be romanticized as a life-extending tool.

Healthy eating pattern? Yes.
Wine as medicine? No.

If interested in an absolutely free 5 day email education course on The Flex5 Lifestyle, only 5 minutes a day for 5 days to get started, feel free to make The Flex5 Lifestyle yours at MyFlex5.com

AbstractBackground and Aims. The benefits of the Mediterranean diet (MedDiet) are well established. However, one component, wine, remains controversial. Th

02/21/2026

Intensity is overrated.
Consistency wins.

This morning: 20 minutes in my apartment gym before a meeting. Enough.

Here’s what most people miss:

Boom. You cannot out-exercise 8–10 hours of sitting.
Boom. 150 minutes per week is powerful, but it’s a fraction of your waking life.
Boom. Movement spread throughout the day matters more than one heroic workout.

Exercise is the icing.
NEAT is the cake.

Walking. Parking farther away. Standing. “Walk n Talks with Dr Tom.”
That’s where longevity is built.

Then when you do exercise, keep it simple.

Flexio.

Flex = resistance and flexibility.
IO = cardio.

Cover the bases. Personalize it. Repeat regularly. Build in strategic rest.

That’s the Activity domain inside The Flex5 Lifestyle®.

Physical activity doesn’t have to be extreme.
It has to be consistent.
Integrated. Sustainable. Yours.

Start simple. Five minutes a day for five days. A powerful kickstart.

Make The Flex5 Lifestyle® yours at MyFlex5.com.

Then dive deeper with the free “Read Labels Like a Nutrition Pro” on YouTube and learn about food well beyond labels alone.

Small deposits. Compounded.

The Flex5 lifestyle keeps it simple, and by doing so – powerful. Make it yours at MyFlex5.com

02/20/2026

Full fat cheese prevents dementia? Not so fast (sorry Wisconsin).

A new 25 year Swedish cohort is repeatedly being (over) shared as evidence that full fat dairy may lower dementia risk. Yes, it was a large, long term study. And yes, higher intake of full fat cheese was associated with about a 13 percent lower relative risk of all cause dementia.

But association is not protection.

This was observational. That means it can show correlation, not causation. A 13 percent relative difference over decades can very plausibly reflect residual confounding, dietary pattern clustering, socioeconomic differences, reverse causation, or frailty effects in aging populations.

In many European cohorts, higher full fat dairy intake often tracks with more traditional dietary patterns and sometimes lower intake of calorie rich, refined, and hyper palatable foods. Those broader variables are difficult to fully adjust for. We have to be careful not to turn “associated with lower risk” into “brain protective.”

The subgroup finding in people without APOE4 is interesting, but still hypothesis generating. Subgroup analyses within observational data are not proof of mechanism. They are signals that require more rigorous testing.

Big picture, dementia risk is strongly linked to overall metabolic and vascular health. Insulin resistance, hypertension, elevated ApoB containing lipoproteins, physical inactivity, smoking, sleep quality, and overall dietary pattern all matter. There is no compelling causal evidence that saturated fat from full fat dairy independently reduces dementia risk. In contrast, there is strong causal evidence that higher ApoB levels increase atherosclerotic risk, which contributes to vascular cognitive impairment.

The brain requires essential fatty acids, particularly omega 3s. It does not require high saturated fat intake for cognitive protection.

If someone tolerates dairy and enjoys full fat versions in moderation within an overall metabolically sound dietary pattern, that is a reasonable personal choice. But presenting this type of observational association as evidence that full fat cheese lowers dementia risk moves beyond what the science can support.

Context matters. Total dietary pattern matters more than swapping low fat for full fat.

Nuance over headlines. Always - even if it’s not “sexy” or cheesy.

02/19/2026

Walk n Talk Thursday with Dr Tom - reporting from Tallahassee!

02/18/2026

Today marks both Ash Wednesday and the beginning of Ramadan.

For many Christians, Lent begins — a season of reflection, repentance, and renewal.
For Muslims around the world, Ramadan begins — a sacred month of fasting, prayer, discipline, and generosity.

Different traditions. Shared human themes.

Reflection. Restraint. Gratitude. Alignment.

This convergence is personally meaningful to me.

I was raised with Christianity on my mother’s side and Islam on my father’s. And I was blessed that many of my closest lifelong friends, since childhood, are Jewish.

I’ve been blessed with sacred coexistence.

I’ve walked the Via Dolorosa in Jerusalem.
I’ve prayed at the Western Wall.
I’ve visited Bethlehem.
I’ve stood in Mecca.

In each place, what struck me most was not difference — but devotion. A universal human desire for mercy, meaning, forgiveness, and growth.

Within The Flex5 Lifestyle®, Mind Matters welcomes personal spirituality however one chooses — or chooses not — to express it.

For some, that expression is faith.
For others, it is conscience, philosophy, service, family, or a commitment to living with integrity.

Either way, Mind Matters is about values, identity, emotional regulation, and how we orient our lives toward something greater than impulse — while accepting that being human includes imperfection, and that our growth lies in the striving.

Spiritual practice, for those who observe it, can be one of the most powerful forms of intentional self-regulation. And for those without formal faith, the invitation remains the same: pause, reflect, recalibrate, and act in alignment with your values.

May this season — however you observe it — deepen clarity, compassion, and strength.

Reality Meets Science®.
Humanity meets humility.

02/17/2026

We are incredibly proud of our Flex5 Lifestyle® Blackbelt, Ricardo Villarosa of Wayne State University — my medical school alma mater.

Ricardo connected with Flex5 in 2016 when we began our license relationship with Henry Ford Health through Reality Meets Science® to build their metabolic health and weight management program. He stayed the course, continued into Executive Health coaching, and built the skills to dramatically shift his long-term health trajectory.

Yes, there was a 100+ pound weight loss.

But this was never just about weight.

Blood pressure improved.
Insulin sensitivity improved.
Lipids improved.
Musculoskeletal and mental resilience strengthened.

Ten years later, Ricardo doesn’t just have a different body — he has a different probability curve for health span.

That’s what Flex5 is about: skill-powers across Mind Matters, Nutrition, Activity, Environments, and Accountability that compound over time.

If you’re ready to begin, start with our free 5-day, 5-minutes-per-day email course at MyFlex5.com.

Small actions. Big trajectory shifts.
Reality Meets Science®💪

Coming Soon: How I do Business Travel then Mackinac circa 2012-->now Seattle on my Flex5 Journey;-)