Dunbar’s Number and the Limits of the Human Mind

In a world of overflowing inboxes, closets packed with clothes, and hundreds of digital “friends,” we’re constantly inundated with choices and connections. Yet, nature may have already set a quiet boundary, or a cognitive threshold that defines just how much we can meaningfully manage. This idea is known as Dunbar’s Number.

Originally developed to explain the limit of human relationships, Dunbar’s Number now resonates far beyond sociology. It hints at a broader pattern of mental ecology, a natural balance point between meaningful engagement and cognitive overload.

What Is Dunbar’s Number?

British anthropologist Robin Dunbar proposed that humans can maintain stable, meaningful social relationships with about 150 people. This number is based on research into primate brain size and social group complexity, specifically linking the size of the neocortex to the number of relationships a species can manage (Dunbar, 1992).

But the “150” isn’t a flat figure, but it represents the outer ring of a series of concentric social layers, each one decreasing in emotional intensity and time investment.

Dunbar’s Social Circles

  • 5 Close Confidants (e.g., family, best friends)
  • 15 Good Friends
  • 50 Close Acquaintances
  • 150 Meaningful Contacts
  • 500 Acquaintances
  • 1500 Recognizable Faces/Names

This layered model reflects the time and emotional energy required to maintain different levels of connection. And it turns out, it’s not just friendships that have limits.

(O’Grady, 2019)

The Broader Pattern: Where Else Does “150” Show Up?

Though Dunbar’s Number is specific to social cognition, the underlying idea that the brain can only handle so much complexity before performance drops, can be seen in many areas of life. Here are some real-world examples where a “Dunbar-like” limit seems to apply:

Short-Term Memory

Classic psychology research (Miller, 1956) suggests that we can hold 7±2 items in our short-term memory at once. While this number is much smaller than Dunbar’s 150, it reflects the same principle: our mental bandwidth is limited. Just as we can’t juggle endless thoughts, we also can’t nurture unlimited relationships.

Clothing and Possessions

Ever feel like you can’t find anything to wear, even with a full closet? That may be your cognitive load talking. While not exact science, many people report that having around 100–150 clothing items is the sweet spot where they still remember what they own, how to pair items, and what each piece is for.

Beyond that, possessions blur into mental background noise, ust like Facebook “friends” you haven’t spoken to in years.

Workplace Cohesion

Studies suggest that corporate teams function best when kept to 150 people or fewer. Beyond that, communication suffers, silos form, and social trust deteriorates. This principle has influenced everything from military units to organizational design (Hill & Dunbar, 2003).

Personal Library or Interests

You might own thousands of books or have tabs open on dozens of topics. But chances are, you can only actively track and revisit around 100–150 meaningful subjects, books, or areas of ongoing interest. This is where attention, memory, and emotional investment overlap.

Digital Files and Faces

Just like your closet, your desktop or phone storage may hold thousands of files. But in practice, people report that only a few hundred are accessed regularly, and even fewer are remembered without searching. Similarly, the number of recognizable faces we can recall is around, you guessed it is about 1500.

From Brain to Behavior: A Holistic View

So, what does all this mean for those of us pursuing a more mindful, intentional life?

Dunbar’s Number reminds us that less is often more. Whether it’s relationships, wardrobe items, digital clutter, or intellectual pursuits, our well-being depends not on volume, but on depth and manageability. We are not machines for connections. We are human beings wired for meaningful engagement.

From a holistic health perspective, this understanding is vital. Emotional burnout, digital fatigue, and decision paralysis are symptoms of cognitive overload. By curating our social circles, reducing unnecessary possessions, and aligning our mental inputs with our natural limits, we create room for clarity, creativity, and calm.

Just as Taoist teachings advise finding balance in the flow of yin and yang, Dunbar’s insights offer a secular mirror: balance in our connections, in our commitments, and in our consumption.

Final Reflection: Mental Ecology in a Noisy World

We live in a culture that celebrates more. More contacts, more options, more everything. But Dunbar’s Number challenges that notion, whispering a quieter wisdom:

“You are not meant to carry the weight of the world. Just the weight of what matters.”

Knowing your personal thresholds, whether it’s 5 close friends or 150 articles you truly care about, allows you to reclaim agency over your attention and emotional energy. In a way, this is not just science. It’s spiritual clarity.

References:

Dunbar, R. I. M. (1992). Neocortex size as a constraint on group size in primates. Journal of Human Evolution, 22(6), 469–493. https://doi.org/10.1016/0047-2484(92)90081-J

Dunbar, R. I. M. (2018). The anatomy of friendship. Trends in Cognitive Sciences, 22(1), 32–51. https://doi.org/10.1016/j.tics.2017.10.004

Hill, R. A., & Dunbar, R. I. M. (2003). Social network size in humans. Human Nature, 14(1), 53–72. https://doi.org/10.1007/s12110-003-1016-y

Miller, G. A., Jr. & Harvard University. (1956). The Magical Number Seven, Plus or Minus Two: Some Limits on our Capacity for Processing Information. In Psychological Review (Vols. 63–97) [Journal-article]. https://labs.la.utexas.edu/gilden/files/2016/04/MagicNumberSeven-Miller1956.pdf

O’Grady, E. (2019, September 5). Who are the 5 People you Spend the Most Time With? Revolutionizing Self-Care. https://eileenogrady.com/who-are-the-5-people-you-spend-the-most-time-with/

Mastery in the World of Form: Integrating Wealth, Health, and Spirit

In the pursuit of personal evolution, many traditions emphasize the renunciation of material wealth as a path to spiritual enlightenment. Yet this view may overlook an essential truth: the mastery of life requires full engagement with both the spiritual and material realms. Rather than rejecting worldly success, a more holistic path invites individuals to develop discipline, embrace responsibility, and integrate spiritual realization with material abundance.

A balanced life requires strength across physical, emotional, and spiritual dimensions. True power, especially in men, is not measured by dominance or accumulation alone, but by maturity and restraint. Without discipline, power can become dangerous, giving rise to instability and harm. Therefore, self-mastery begins with a commitment to personal responsibility, training the body, focusing the mind, and cultivating inner peace.

One foundational concept in this approach is the idea that wealth and health are not opposites of spiritual life but necessary stages in the ladder of awakening. Through conscious acquisition and enjoyment of material pleasures—followed by the ability to release attachment—one gains not only experience but freedom from the cycles of craving and aversion. This path requires mastering the “world of form,” learning to participate in it fully without being controlled by it. Those who avoid or bypass this stage may find themselves spiritually incomplete. If one believes in reincarnation, this situation may lead to further experiences in future lifetimes to fully integrate these unlearned lessons.

Conscious development can be mapped through the lens of energy centers or chakras, where each stage corresponds to an essential life lesson: from physical grounding and pleasure to peace, joy, love, compassion, and ultimately ecstatic or blissful states of awareness. These are not mere metaphors but practical tools for tracking one’s evolution. A person who cannot access joy or inner peace may need to revisit the foundations of health, safety, and stability before advancing into higher spiritual states.

Central to this journey is the rejection of victimhood. Blaming society, circumstances, or others for one’s failures hinders growth. Only by accepting full responsibility for one’s health, finances, relationships, and spiritual development can one initiate true transformation. This principle applies across life stages, which can be seen as cycles: childhood (0–8), adolescence and young adulthood (8–33), fruition (33–58), correction (58–83), and ultimately the sage or spirit phase (83–108). Each phase carries its own lessons and demands appropriate effort and reflection.

In later life, aging should not be viewed as decay, but as a biological and spiritual opportunity. With proper practice through breathwork, meditation, physical cultivation, and mental clarity, many signs of aging can be reversed or mitigated. The aim is to remain vibrant, focused, and spiritually prepared for death, which, when acknowledged consciously, becomes a motivator for authentic living.

The role of family, lineage, and tradition is also pivotal. Respect for one’s parents and ancestors does not require blind obedience or emotional entanglement but calls for honoring their place in one’s development. This maturity fosters generational healing and sets an example for those who follow.

Integration of spiritual wisdom with material responsibility is not unique to any one culture. Whether through Christian parables, Taoist discipline, or Buddhist insight, timeless truths emerge: the value of discipline, the importance of presence, the need for compassion, and the certainty of death. When viewed through this inclusive lens, spirituality becomes less about belief and more about the embodiment of universal principles.

The ideal individual, a strong, wise, and compassionate being, embodies the archetype of the strategist and warrior. Not through brute strength or spiritual aloofness, but through the unification of effort, enjoyment, reflection, and humility. Mastery is not found in a cave or an office alone, but in the weaving of both. When one lives fully, without excuses or illusions, the path reveals itself not above the world, but through it.

Early Summer in Traditional Chinese Medicine

Fire Element, Circulation, and the Nervous System

As nature enters early summer, Traditional Chinese Medicine (TCM) views this vibrant season through the lens of the Fire element, a phase of maximum Yang, warmth, expansion, and communication. Fire governs not only the Heart and blood vessels, but also the nervous system, emotions, and spiritual awareness. This inner fire fuels both our physical vitality and our mental clarity. In this unique seasonal phase, the flow of Qi, Blood, and Shen (spirit), especially through the veins, arteries, and the Eight Extraordinary Meridians takes center stage.

Understanding the dynamic between the Fire element, cardiovascular and neurological systems, and the deeper energetic channels allows us to harmonize body, mind, and spirit during this high-energy time of year.

🔥 Fire Element and Its Associations

In TCM’s Five Phase (Wu Xing) framework, Fire is associated with:

  • Season: Early Summer
  • Organs: Heart (Yin) and Small Intestine (Yang)
  • Emotions: Joy, enthusiasm, overexcitement, or mania
  • Body Tissue: Blood vessels and the nervous system
  • Sense Organ: Tongue
  • Color: Red
  • Climate: Heat
  • Direction: South
  • Taste: Bitter (Maciocia, 2005; Deadman et al., 2007)

Fire energy is expansive and expressive, symbolizing circulation, communication, and consciousness. When well-regulated, Fire fuels love, clarity, movement, and insight. When excessive, it can consume the mind and disturb the spirit.

❤️ Heart, Blood Vessels, and Nervous Regulation

The Heart (Xin) is considered the “Emperor” of the body, orchestrating the flow of Qi and Blood and serving as the seat of Shen (mind/spirit). TCM describes its functions as:

  • Governing the blood and blood vessels
  • Housing the Shen, which includes consciousness, thought, memory, and emotions
  • Regulating mental activity and sleep (Maciocia, 2005)

The blood vessels, seen as pathways of both Blood and Qi, rely on the Heart’s warmth and rhythm to remain supple and open. But TCM also suggests that nerve-like communication and coordination are part of the Heart’s governance.

In modern integrative interpretations:

  • The autonomic nervous system (ANS), particularly the parasympathetic “rest-and-digest” functions, mirrors the Heart’s role in maintaining emotional and physical balance.
  • Excess Fire may overstimulate the sympathetic nervous system, leading to agitation, insomnia, hypertension, palpitations, and anxiety.
  • Deficient Heart Fire may lead to neurovegetative fatigue, poor concentration, and low vitality (Kaptchuk, 2000).

Thus, the vascular and neurological systems are harmonized through Fire’s balance affecting everything from blood pressure to mood and mental performance.

🧠 Fire Element and the Nervous System

TCM may not anatomically label the nervous system as Western medicine does, but the concepts of Shen, Yi (intellect), and Zhi (willpower) reflect cognitive and neurological activity.

In early summer:

  • Shen becomes more active and outward, seeking expression, connection, and joy.
  • The Du Mai (Governing Vessel) linked with the brain and spine, rises in importance, guiding mental alertness and emotional regulation.
  • The Fire element’s influence supports neurotransmitter balance, sleep-wake cycles, and emotional processing.

From a modern neurobiological point of view, this aligns with the brain-heart connection:

  • Heart Rate Variability (HRV), a marker of nervous system resilience, increases with parasympathetic tone, a goal of Heart-focused qigong and meditation
  • Practices that balance Heart Fire can directly impact the vagus nerve, thereby stabilizing emotions and stress responses (Porges, 2011)

🩸 Extraordinary Meridians and Fire Circulation

The Eight Extraordinary Meridians function as deep energetic reservoirs, regulating circulation, constitutional energy, and emotional integration (Larre et al. (1996). In early summer, these vessels help modulate the Fire element’s rise and distribute Qi and Blood in ways that nourish the whole system.

1. Chong Mai (Penetrating Vessel)

  • Sea of Blood, linked to Heart and uterus
  • Balances hormonal and emotional rhythms
  • When Fire is excess: anxiety, chest oppression, uterine bleeding

2. Ren Mai (Conception Vessel)

  • Nourishes Yin; anchors the Heart through calming fluids
  • Connects deeply to Heart-Yin and Shen stabilization

3. Du Mai (Governing Vessel)

  • Axis of Yang energy; influences brain, spine, and nervous system
  • Becomes overactive when Fire flares upward, causing insomnia or hyperarousal

4. Dai Mai (Belt Vessel)

  • Regulates Qi flow around the waist, harmonizes rising Fire from middle and lower burners

By supporting these vessels through breathwork, meditation, herbs, and seasonal living, we can help regulate the Fire element’s effects on circulatory, emotional, and neurological functions.

🌿 Seasonal Strategies for Summer Balance

🔹 Qigong & Meditation

  • Heart-centered qigong and the Inner Smile meditation bring Shen home to the Heart
  • Breathing practices that lengthen the exhale can calm the nervous system and increase vagal tone
  • Include “Cooling the Fire” meditations to harmonize Du Mai and Shen

🔹 Lifestyle Adjustments

  • Avoid overstimulation, especially from social media, caffeine, or excess sun
  • Go to bed earlier, maintain emotional equanimity
  • Emphasize connection over excitement
  • Prioritize joyful stillness rather than external thrill-seeking

🌀 Summary: Fire’s Intelligence in the Body

Early summer is the season of Shen and circulation, a time when the Fire element stimulates outward movement, connection, and the full flowering of human potential. Yet this power must be anchored. Overexertion, excess heat, and emotional overload can disrupt the Heart, destabilize the nervous system, and drain the blood vessels and extraordinary meridians.

Through awareness, breath, and regulation, we can cultivate a sovereign Heart, a resilient mind, and an inner flame that warms but never burns.

8 Vessels Qigong

References:

Deadman, P., Al-Khafaji, M., & Baker, K. (2007). A Manual of Acupuncture. Journal of Chinese Medicine Publications.

Kaptchuk, T. J. (2000). The Web That Has No Weaver: Understanding Chinese Medicine (2nd ed.). McGraw-Hill.

Larre, C., de la Vallée, E., & Rochat de la Vallée, E. (1996). The Eight Extraordinary Meridians: Spirit of the Vessels. Monkey Press.

Maciocia, G. (2005). The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists (2nd ed.). Elsevier Churchill Livingstone.

Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. W. W. Norton & Company.

Chronic Illness, Shrinking Circles, and the Crisis of Modern Aging

I’ve spent over 40 years teaching others how to live well, not just physically, but mentally, emotionally, and spiritually. I’ve taught classes, delivered lectures, produced hundreds of educational videos, and authored more than 30 books on health, martial arts, mindfulness, personal growth and self-mastery. My mission has always been clear: to help people avoid the slow decline into pain, isolation, and despair that so often accompanies aging.

And yet, here I am at 61 and asking the hard question:

The Uncomfortable Truth Few Want to Face

Over the years, I’ve watched countless people, friends, former students, co-workers, even family members, slide into chronic illness, mental stagnation, and deep loneliness. Their bodies give out. Their thoughts become incessant and negative. Their social circles shrink, often down to nothing. And worst of all, society tends to look away. People in pain make others uncomfortable. We don’t have to age this way, and we certainly don’t have to suffer in silence. Still, the outcomes I see around me are too often the same.

I have never claimed to have all the answers. Only the experience of walking this road with care, curiosity, and a deep respect for the process. I don’t sell miracle cures or promise instant transformation. I’ve simply chosen to live and teach what I know from having stayed on the path.

What’s most heartbreaking is that this pattern isn’t just anecdotal, it’s documented. One of the most important and longest-running psychological studies in history, the Harvard Grant Study, which began in the 1930s and followed hundreds of men (and later women) throughout their entire lives, revealed something striking:

Those who maintained close, supportive connections, with friends, family, or community, aged better, lived longer, and experienced less pain and decline than those who didn’t.

This truth has deeply influenced my understanding of health. It affirmed what I had already intuited through years of teaching: isolation and disconnection are just as deadly as any disease.

Why Is It So Hard to Reach People?

It’s not that people don’t know the truth. Many understand what’s coming, in that neglecting the body, ignoring the breath, resisting change, and isolating oneself will eventually take a toll. But very few choose to act while there’s still time.

I’ve given my best efforts. I’ve tried to be an example. And yes, some have been moved. Some have changed their lives. But the deeper truth is that reaching people at scale, truly reaching them, has always felt like swimming against the tide. There’s an exhaustion that comes with trying to offer healing in a world more interested in convenience than discipline, distraction over reflection, and quick fixes over lasting change.

And Yet… This Work Gives Me Meaning

Despite the fatigue, the frustration, the quiet disappointments, this work still gives me purpose. It is, in fact, the very thing that keeps me well. Without this mission, I might have drifted long ago into the same darkness I warn others about.

  • I teach because it keeps me whole.
  • I guide others because someone once guided me.
  • I keep going because I believe the message matters, even when the audience is small.

So Where Do I Go From Here?

I don’t know exactly. But I do know this. I am no longer chasing a mass audience. I don’t need viral videos or bestseller lists. What I need now is connection with those who truly get it, who are ready, who are willing to walk the path, not just read about it.

Maybe that means smaller, deeper circles of mentorship. Maybe it means fewer books, but more personal conversations. Maybe it means continuing to teach, not from a podium, but from a place of presence.

An Invitation to You, Reader

If you’re reading this, and something in your heart resonates, if you’ve seen the same patterns of decline and loneliness and want a different outcome, I’m here.

I’m still walking along the path. I’m still learning, adapting, evolving.

And I sincerely invite you to walk it with me.

Let’s not wait until the body breaks down or the mind turns sour before we act.

Let’s build strength now in the body, the mind and also in the spirit.

Let’s stay connected to others, to meaning and purpose, and to ourselves.

This is not just about growing older. It’s about growing wiser, deeper, and more alive, together.

_________

Resources & Further Reading

The reflections in this article are deeply informed by the Harvard Study of Adult Development, a landmark longitudinal study that began in the late 1930s and followed hundreds of individuals for over 75 years. Originally known as the Harvard Grant Study, it remains one of the longest and most detailed examinations of adult life and well-being ever conducted.

This research uncovered three essential contributors to long-term happiness and healthy aging:

  1. Warm, supportive relationships – The most consistent predictor of happiness, physical health, and mental clarity was the strength and quality of one’s close relationships. Loneliness and isolation, by contrast, were strongly linked to earlier decline.
  2. Emotional adaptability – Those who fared best over time weren’t those without hardship, but those who learned how to regulate emotions, rebound from setbacks, and find meaning through challenges.
  3. A sense of purpose and engagement – Having work, projects, or passions that felt meaningful — even in later life — was a powerful anchor for mental and emotional resilience.

“Good relationships keep us happier and healthier. Period.”
— Dr. Robert Waldinger, current director of the study

If you’re interested in learning more about these findings and their practical implications for your own life, consider the following resources:

The Golgi Reflex: Nature’s Brake System for Safer Movement

Deep within our muscles and tendons lies a sophisticated intelligence. One that operates beyond conscious control, regulating our strength, flexibility, and safety in every movement. Among the body’s built-in protective systems, the Golgi tendon reflex (also known as the inverse myotatic reflex) plays a pivotal role in preventing injury and maintaining neuromuscular balance.

Whether you’re a martial artist mastering internal softness and explosive force, an older adult regaining balance, or a rehab patient rebuilding function, this reflex is one of the silent forces shaping your movement.

The Golgi Tendon Reflex: A Safety Mechanism Against Overload

The Golgi tendon organs (GTOs) are tiny sensory receptors embedded within the tendons, especially near where muscle fibers attach. These structures monitor tension, not length. When a muscle generates excessive force, the GTOs activate and send signals through Ib afferent neurons to the spinal cord. In response, inhibitory interneurons suppress the alpha motor neurons of the same muscle, causing it to relax,a reflexive release that protects against tendon tears and muscle damage (Kandel et al., 2013).

This response is involuntary, immediate, and essential when lifting something too heavy, absorbing shock from a fall, or stabilizing during sudden force.

(Muscle Spindle and Golgi Tendon Organ, n.d.)

Application in Martial Arts and Internal Cultivation

In martial disciplines, particularly internal arts like Tai Chi, Baguazhang, and Aikido, awareness of the body’s reflex arcs can inform a practitioner’s ability to flow with force rather than oppose it. Here’s how the Golgi reflex relates:

  • Iron Palm training along with Dit Da Jow herbal extracts help to gradually condition the body to tolerate greater tendon strain. Controlled stress during impact training subtly recalibrates the GTO sensitivity over time.
  • Soft styles like Tai Chi and Baguazhang avoid jarring, stretch-activated movements. Instead, working slow, and with controlled tension that stimulates Golgi response, allows the body to yield and remain supple under pressure.
  • In dynamic grappling or throws, as seen in Chin Na, Judo or Hapkido, reflexive yielding through the Golgi pathway helps reduce injury by inhibiting over-tensed muscles at the point of joint load.

Advanced practitioners learn not only to listen to these reflexes, but to train around them, balancing contraction and surrender, strength and softness.

Beyond Martial Arts: Who Else Benefits from the Golgi Reflex?

This reflex isn’t just for warriors or athletes. It’s a vital part of movement safety and performance for everyone:

  • General Population

Everyday actions like lifting groceries, catching a falling object, or stepping off a curb involve sudden shifts in tension. The Golgi reflex modulates effort and prevents injury in such moments.

  • Seniors and Fall Recovery

Age-related proprioceptive decline can dampen these reflexes. That’s why gentle resistance training, balance work, and slow-motion practices (e.g., Tai Chi or aquatic movement) help reengage GTOs, reducing fall risk and enhancing muscular responsiveness (Howe et al., 2011).

  • Stretch and Flexibility Work

Proprioceptive Neuromuscular Facilitation (PNF) stretching uses the GTO mechanism: by contracting a muscle group before passively stretching it, you activate the Golgi reflex, causing deeper relaxation and elongation. This principle is used in yoga, physical therapy, and high-level athletic warmups (Sharman et al., 2006).

  • Rehabilitation

After injury or surgery, the neuromuscular system often becomes overly protective. Isometric contractions, gradual load-bearing, and eccentric movement help reset healthy GTO thresholds. Therapists use these principles to reestablish functional movement patterns without triggering pain or spasm.

Stretch Reflex vs. Golgi Reflex: A Neuromuscular Balancing Act

Reflex TypeGolgi Tendon ReflexStretch Reflex (Myotatic)
TriggerExcessive tension in tendonSudden lengthening of muscle
Sensory ReceptorGolgi tendon organMuscle spindle
ResultInhibits contraction (relaxation)Initiates contraction
PurposeProtects tendon/muscle from ruptureMaintains posture and joint stability
Used InFlexibility work, yielding reflexesPosture, explosive movement

Together, these two reflexes keep the body in dynamic equilibrium, preventing collapse on one end and rupture on the other.

Training Neuromuscular Wisdom

By understanding and training with these reflexes, rather than against them, we unlock more than just flexibility or safety. We cultivate body intelligence.

  • In meditative movement arts, such as Qigong or Tai Chi, this intelligence is described as developing “song” or a state of relaxed, alert readiness.
  • In Western terms, it aligns with developing sensorimotor awareness and reflexive strength: tension when needed, release when wise.
  • In rehab or daily movement, it’s the difference between bracing unnecessarily and moving efficiently.

Whether you’re planting a garden, throwing a punch, or rising from a chair, your Golgi reflex is part of the feedback system keeping you safe, supple, and strong.

References:

Howe, T. E., Rochester, L., Jackson, A., Banks, P. M., Blair, V. A., & Ballinger, C. (2011). Exercise for improving balance in older people. Cochrane Database of Systematic Reviews, (11). https://doi.org/10.1002/14651858.CD004963.pub3

Kandel, E. R., Schwartz, J. H., Jessell, T. M., Siegelbaum, S. A., & Hudspeth, A. J. (2013). Principles of Neural Science (5th ed.). McGraw-Hill Education. https://accessbiomedicalscience.mhmedical.com/content.aspx?bookid=1049&sectionid=59138139

Muscle spindle and golgi tendon organ. (n.d.). https://www.unm.edu/~lkravitz/Exercise%20Phys/spindleGTO.html

Sharman, M. J., Cresswell, A. G., & Riek, S. (2006). Proprioceptive neuromuscular facilitation stretching. Sports Medicine, 36(11), 929–939. https://doi.org/10.2165/00007256-200636110-00002