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Why calorie counting does not work

Why calorie counting does not work

The standard exercise myth is that you will lose weight if you eat less and exercise more. That is true to a certain extent especially if you are eating significantly more than your required calories to begin with. But overall it is recipe for failure. Let us see why calorie counting does not work.

1st Law of thermodynamics

The first law of thermodynamics goes something like this:

Perfectly logical so far. ‘Energy in’ is easy, that is the food and drink that you ingest. ‘Energy out’ is quite a different matter. We think of energy out as exercise; something that is within our control. However, 70% of the energy we use daily is actually our Basal Metabolic Rate (BMR) which is not in our control. The other 30% of the energy we use daily is a combination of passive energy use (walking, fidgeting, cleaning) and active energy use (exercise).

Therefore, most of our energy expenditure is not in our control and is the reason why burning a few hundred calories in the gym makes little difference to our weight. In addition, for the rest of the day your body then tries to conserve energy. Read on and you will discover why it makes even less difference than you think.

What decides our obesity risk?

The popular misconception is that fat people are fat because they are lazy and eat too much. In fact, free will or personal choice only accounts for a small percentage of our weight. The obesity risk is:

  • Hereditary predisposition (genes): 75%
  • Free will: 15%
  • Home environment / parental influence: 10%

That means that our genes account for most of our obesity risk. Everybody has a particular body type that we inherited, but a hundred years ago most people were a normal weight. Sure, people would come in a range of sizes but they would mostly be in the normal weight range. Fast-forward to the modern day and again we have a range of sizes but now two-thirds of people are in the overweight and obese range. The genes have not changed in such a short period of time. The only thing that has changed is our environment, especially our food environment, chronic lack of sleep and increasing stress.

BMI Calculator

BMI CALCULATOR

The ideal BMI is between 18.5 and 24.9 for most people.

1st law of thermodynamics is true only for machines

Let us put the energy in and energy out equation to the test.

If we eat 100 kcal more than we need each day (1 banana, or a few plain biscuits, or half a chocolate bar), then after 1 year we would have consumed 365 x 100 = 36,500 kcal extra.

1 Kg of fat = 7,000 kcal

So, we would expect to gain 36,500 divided by 7000 = 5.2 Kg of fat over a 1 year period.

Does that make sense to you? Let me put it another way. If we continue to eat 100 kcal extra for 5 years, then we would gain 26 kg. That is 57.3 lb or 4 stone 1.3 lb. Believe me when I say that does not happen and here is why.

The Vermont Overfeeding Study 1971

Prison volunteers, with the promise of an early release, were overfed in this experiment to reach a 25% increase in their weight over a 3 month period. At the start of the experiment they were eating around 2,200 kcal daily.

The scientists calculated that they would need to feed the prisoners approximately 3,000 – 4,000 kcal daily to help them achieve the 25% weight increase. In fact it took 8,000 – 10,000 kcal per day! Even then, many of the prisoners never managed to achieve the target weight whilst eating such a massive calorie load.

All the subjects returned to their pre-study weigh within 3 months after returning to their previous eating pattern.

A clue to why it took so many calories to achieve the weight gain comes from the observation that the prisoners were hot to the touch. They were literally burning up as their bodies ramped up their Basal Metabolic Rate to try and burn the extra calories. Their metabolic engines were running hot!

The Minnesota Starvation Experiment 1944

Another experiment performed earlier in the last century tried to study how the human body would cope with starvation. The Minnesota Starvation Experiment was performed in conscientious objectors who volunteered to make themselves useful during the Second World War.

The study subjects were fed a calorie-restricted diet of 1,500 kcal daily for 24 weeks. During this time, they lost an average of 25% of their body weight. However, their Basal Metabolic Rate dropped by 50%. Their heartbeat and breathing became slow and they were cool to touch as they had developed low body temperature. They suffered from depression, anxiety, hypochondria, poor concentration, and low libido. Unsurprisingly, they were preoccupied by thinking about food and especially fantasised about high calorie foods. Why would anyone want to this to themselves, but this is what dieters around the world do to themselves every day.

Refeeding of the subjects caused rapid weight gain and overshoot; i.e. they weighed more afterwards than they did to begin with. They lost muscle mass during their weight loss phase but this was never regained. The weight they gained was almost entirely fat.

It is surprising that this study is not more widely publicised. Low calorie diets are harmful. We have known this for more than 70 years. Why are NHS dieticians and diet companies allowed to propagate this disproven method of weight loss?

The weight set point

The two studies above highlight the important principle that the human body is very good at regulating itself, i.e. homeostasis. For example, we do not need to think about regulating the amount of fluid in our bodies. Our thirst mechanism takes care of our fluid intake, and our kidneys remove any excess.

In the same way, our brain has a weight set point which it tries to maintain. This is regulated through our Basal Metabolic Rate. As soon as we start overeating, our BMR speeds up to get rid of the excess. That is why the Vermont study subjects were hot to the touch; their BMR was high. When we reduce our calorie intake to less than we need, then the opposite happens and our BMR immediately slows down to conserve energy. This is why the Minnesota study subjects started feeling cold.

Just like any living organism, the survival instinct is powerful in human beings. Our bodies work hard to maintain homeostasis and try to overcome our efforts to cause imbalance. When we under-eat and lose weight this threatens our survival and our weight then rebounds afterwards. It then settles at a higher weight set point just in case we decide to starve ourselves again. During the weight loss and then weight regain, we lose muscle mass and gain fat. Our BMR, which relies on our muscle mass, then declines and we find it even harder to control our weight in the future.

The result of yo-yo dieting is a progressively higher weight set point and a body composition of more fat and less muscle that makes weight control difficult.

Hormones control our weight

Our weight is controlled, not by calories, but by the interaction of various hormones acting on the weight set point to maintain homeostasis. What disrupts this balance is the obesogenic environment that we live in. When body weight goes over a certain amount then we become insulin and leptin resistant and our brain becomes deaf to the signals that our hormones are trying to give it. We become permanently hungry despite our high intake of calories.

How to normalise weight

The calories in/calories out mantra has been going on so long that people cannot understand how they can possibly lose weight. Calorie restriction involves misery, going against our survival instinct and is unnatural. The best way to normalise weight is to target the weight set point.

That means:

  • Stop counting calories; not only the ones we eat and drink, but also the calories we burn on the treadmill. Our bodies adjust our BMR immediately to conserve energy if we eat too little or exercise too much.
  • Start thinking long term and not day-to-day. Any drastic cut in calories or over-exercising will be seen as a threat to your survival and will raise the weight set point for the future. The weight set point will take time to settle at a lower level, typically months or years depending on how much your weight is out of step with your optimal weight. You did not become overweight overnight and you will not reduce your weight overnight.
  • Eat real food like people used to eat before the processed, high calorie, high sugar, high fat, high salt, and low fibre food revolution came around. Processed food disrupts your normal weight control mechanism. Your body has not evolved to deal with processed food in a healthy way yet.
  • Sleep 8 hours per day. Lack of sleep increases insulin resistance, increases stress and raises your weight set point.
  • Reduce stress. The stress hormone cortisol raises the weight set point.
  • Your body is made to move. Tone your muscles with activities you enjoy (reduces cortisol and increases insulin sensitivity to reduce the weight set point). You do not need to run a marathon.

Some people may be at the point where their metabolism is completely dysfunctional and the will need the help of medication or weight-loss surgery to help them. That typically happens when the BMI goes over 30-35. Their bodies are telling them that they are always hungry despite getting more than adequate calories.

In all cases, it is best to seek the help of a clinician with an interest in obesity in order to get personalised advice and treatment.

Click here to read about weight loss injections

pill bottle saying miracle cure

‘Cure’ your high blood pressure

“Cure” your high blood pressure

Can you really “cure” your high blood pressure? Conventional wisdom says not. Once you are taking medication then you are on it for life. But let us step back a little and take stock of the problem.

Life expectancy has gradually increased over the past 100 years. In the past, people had generally shorter lives because of a lack of effective medicine and poor sanitation. They often died from infections especially in early childhood. The discovery of antibiotics and use of childhood vaccinations has changed all that. Improved sanitation and waste disposal was also a major factor in reducing these types of infectious diseases. Modern healthcare with new medicines and surgical techniques means that we do not need to worry about these old causes of death and disease.

However, we now live in a new era of chronic diseases such as high blood pressure, diabetes and heart disease. Even HIV is now a chronic disease instead of the killer it used to be. We manage these conditions rather than cure them. That means life-long medicine for most people affected by them.

Many chronic diseases such as high blood pressure are caused by lifestyle choices which we discussed in the previous section. You can therefore manage them better by improving some of your habits.

However, what if you want to reverse these changes so that you no longer have the disease or need to take medicine? In that case, it follows that you will need to make more dramatic changes. This is because you are not trying to manage something but actually trying to undo all of the unfavourable changes in your body.

Dr Dean Ornish showed that you can reverse heart disease changes with the lifestyle heart trial and the intensive lifestyle trial. The principles he used can also be used to ‘cure’ your high blood pressure. He describes this really well in his book ‘Undo it’ in which he emphasises 4 things:

– Eat well

– Move more

– Stress less

– Love more

Arguably the most important of these is maintaining a healthy diet that is plant-based. I would strongly recommend this book to anyone thinking about making dramatic changes that can actually reverse disease processes.

A plant-based diet

In the previous section you read about the DASH diet. The DASH diet is based on the fact that vegetarian populations have generally better (lower) blood pressure than those consuming a standard Western diet. The DASH researchers assumed that people would not be able to make such a big change to their diet to become completely vegetarian. The DASH diet was therefore a compromise diet which contained elements of both. However, the main effect of the DASH diet is from the addition of fruits and vegetables, not the low fat or white meat.

Does that sound paternalistic? It should do, because that’s exactly what it is. Why not tell people that the best diet for blood pressure is a plant-based diet and then let people make up their own minds? They did not give people a choice.

There is no doubt that changing what you eat is one of the most difficult things you can do. However, it does not need to be done all at once and is easier if done gradually especially if you have been eating one way all your life. Your taste palate changes as you try different foods and become easier the longer that you do it.

Changing what you eat to a more plant-based diet is the most beneficial thing that you can do to improve your health. A number of studies have shown that you do not need a different type of diet for every type of disease. One of the most important of these was The China Study, the biggest nutritional study done in humans. Whether it is high blood pressure, diabetes, heart disease or cancer; in all cases, a plant-based diet is best.

What is a plant-based diet?

A plant-based diet is rich in vegetables and fruits, legumes (beans and pulses), whole grains and nuts/seeds.

Vegetarians and vegans are defined by what they exclude rather than what they include in their diets. A vegetarian does not eat meat or fish. A vegan does not, in addition, eat eggs and dairy products.

However, a plant-based diet is defined by what it includes. So you might be plant-based 60% of the time or 80% or 95%. The main thing is that you are trending in the right direction of eating healthier food. This is not only good for your blood pressure but also for virtually every other disease!

obesity

Weight loss

It is possible to reverse and cure high blood pressure just as it is with type 2 diabetes. I witnessed it myself 15 years ago when I saw the first patients undergo weight-loss surgery. As they lost weight, I had to reduce and stop their blood pressure and diabetes medicines as the underlying disease improved.

Now, I am not advocating that everyone with high blood pressure should have weight-reduction surgery. But it does proves a principle, that weight loss can aid in blood pressure control for those who are overweight.

Changing to an unprocessed, plant-based diet makes weight-loss much easier. That is because processed and animal foods are generally high in calories. You can lose weight without feeling hungry or calorie-counting on a plant-based diet.

natural-remedies

Natural remedies

Many people will advise you to eat this food or that supplement to help your blood pressure. However, occasionally eating certain foods or taking supplements is never going to undo the damage of a bad diet.

The main principle is to eat a healthy plant-based diet to begin with. Then, certain foods can act as the fine tuning to improve your blood pressure further. We have scientific evidence for the following foods.

Eat whole grains

Most people know about the harmful effects of sugar. However, fewer are aware that eating refined carbohydrates is almost just as bad. By this, I mean white bread, white rice and white pasta. Some people have made the switch to wholemeal/brown bread, but much fewer have made the switch to wholegrain rice or pasta.

Why is this important? It is because refining these starchy foods to their ‘white’ form removes all the fibre. Fibre helps to reduce the rate at which the carbohydrates are absorbed into your bloodstream as sugars making it more metabolically healthy.

We have sound evidence that eating 3 portions of whole grains per day reduces heart disease and stroke risk by lowering blood pressure. In fact, it reduces the risk by the same amount as taking blood pressure medicine. Making the switch to whole grain foods is a no-brainer!

Flaxseed

Regular intake of flaxseeds has been shown in one study to improve blood pressure even better than some blood pressure medicines. That is powerful.

Make sure to take them in their ground form. You will need to take 2-4 tablespoons per day.

Hibiscus tea

Hibiscus tea comes from the flower of the same name. It is bright red in colour and has a sharp taste like cranberry.

The beneficial effects of hibiscus tea are thought to come from its strong anti-oxidant content. Studies have shown improvements in cholesterol but the most powerful effect is on reducing blood pressure.

Nitrates

Nitrate medicines are used to open up blood vessels in the treatment of heart disease. However, nitrates are also found in common foods and have been shown in studies to have benefits in lowering blood pressure.

The most useful foods in this category and beetroot and greens.

Beetroot juice has been found to reduce blood pressure within hours and the effect lasts all day. Furthermore, drinking beetroot juice regularly has been shown to continuously improve blood pressure over a number of weeks. The right amount to drink seems to be 125ml per day.

However, beetroot juice might be difficult to find and adds up to quite a lot of beetroot. How about other foods that contain nitrates. It turns out that the leafy greens contain even more nitrates than beetroot with the most being found in rocket. That should not be surprising because we have known for a long time that eating greens reduces risk of heart disease.

For more information on proven natural remedies, I would recommend Dr Michael Greger’s book with the tongue-in-cheek title “How not to die”.

Summary

To reverse the changes in your body that have caused high blood pressure over many years, you will need to make a big effort. The most important thing is to change to a more plant-based diet. After that, certain foods can also help as much or even better than some blood pressure medicines.

sofa-surfing

High blood pressure: Lifestyle changes

sofa-surfing

High blood pressure: Lifestyle changes

High blood pressure is a lifestyle condition

You might be surprised to learn that there is no underlying disease process causing high blood pressure in the vast majority of people. High blood pressure is mostly due to lifestyle factors and this is why doctors call it Essential Hypertension.

Some people also have a family history of high blood pressure and this might increase their susceptibility. At the same time, and contrary to popular belief, our DNA is not our destiny. We inherit not only our parents’ genes, but also their way of living and eating. Lifestyle factors, especially what we eat, have a strong effect on how our genes behave. If you have inherited ‘bad’ genes then it just means that you may have to make bigger changes in your lifestyle.

Medication is the treatment for high blood pressure, but it does not treat the underlying condition. It just treats the symptoms; the high blood pressure. That is why medication needs to be taken life-long to be effective.

If high blood pressure is caused by lifestyle choices, then it makes sense that the solution is to make changes to that lifestyle.

In essence:

Cause = lifestyle choices

Cure = lifestyle change

The DASH diet

DASH stands for Dietary Approaches to Stop Hypertension.

The DASH diet became popular after a number of studies showed that dietary changes can improve people’s blood pressure. The studies were based on the observation that vegetarian communities have the lowest blood pressures of any dietary group. Several studies since then have shown this to be true; i.e. that vegetarian diets are best for blood pressure.

The DASH diet consists of:

– Eating fruit, vegetables and whole grains

– Including fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils

– Limiting foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils

– Limiting sugar-sweetened beverages and sweets.

You can find out more written information about the DASH diet here.

Here is a great video which explains what this means in practical terms:

salt

Lay off the salt

Most people know that excessive salt increases your blood pressure. But what is excessive? There are certain limits to salt intake that are advised such as in the DASH diet. However, I would guess that this is too difficult to calculate in real life, not to mention a huge hassle.

Most salt is found in processed foods and these are best avoided for many reasons. The general rule is that you can add a little salt when cooking your food but avoid adding extra at the table.

Exercise regularly

Exercise is medicine and has been proven to reduce blood pressure. Too often, though, the word exercise tends to put people off as they imagine sweaty, muscle-bound men in the gym. Perhaps a better way of putting it might be to become more active or move more.

You do not have to do a great amount of exercise to get benefit. Follow the FITT principles.

– Frequency: Try to be active at least 5 days per week.

– Intensity: Exercise at a ‘moderate’ level. This varies from person to person so try using the ‘talk test’. ‘Moderate’ exercise level means that you will be a little out of breath and will still be able to talk, but will find it difficult to hold a conversation. You can think of it as the pace you might walk if you are late for an appointment. ‘Moderate’ intensity is therefore the same as a brisk walk. If you are exercising too hard, then you will not be able to talk at all. This would be called ‘hard’ and not ‘moderate’ exercise, and is not necessary to get benefit.

– Time: Try and be moderately active for at least 30 minutes per day. This does not have to be all at one time and you can break this up into three 10 minute sessions. There is even an app from the NHS called Active 10 to help you. You do not need to do 10,000 steps as this is a misunderstanding based on a Japanese marketing strategy, and is not based on evidence. The equivalent distance to 10,000 steps is 5 miles for most people. This is difficult to do in a typical working day.

– Type: Aerobic exercise has been studies most in the management of blood pressure. The main principle is that you should use the large muscles in your legs. Examples include brisk walking, swimming, or cycling. If you get bored doing one thing, then try walking or cycling different routes. You can also do different exercises on different days.

Whatever exercise you choose to do, it would be best to do something that you find easy. Too often I have found people starting with long and intense workouts and then stopping completely as their enthusiasm wanes. Start small and do it life-long.

Reduce weight

Diet and exercise are often mentioned in the same breath when talking about weight loss. For some reason, people mainly think of exercise as the main way to reduce weight, and that includes many doctors. Perhaps that is due to all the fitness videos that are advertised in which fat celebrities become slim and toned. They are selling a lie. It is impossible to lose significant weight using exercise alone.

Healthy eating is responsible for 80% of weight loss with exercise contributing the other 20%. A combination of the two is best. Remember that you can out-eat any exercise.

Exercise is great for physical fitness, toning your body and burning calories. However, some people can actually gain weight initially as they gain muscle mass. Increased muscle mass results in a higher metabolic rate. That means you will be burning calories even when you are sedentary.

The most important part of weight loss is healthy eating. That means avoiding sugar and processed foods. This is common to all weight-loss diets. The main thing is to develop good lifelong eating habits.

What usually happens is that people lose weight by being good. They then gain the weight back when they return to the same way of eating that made them overweight in the first place. The best way to lose weight is to make small changes to your diet and make them permanent.

Prohibition

Reduce or stop alcohol

Alcohol increases blood pressure.

The maximum recommended weekly alcohol intake is 14 units for men and women. This limit was designed to reduce heart disease risk. However, there is no safe alcohol limit for cancer.

Alcohol is high in calories. As a rule, we should avoid drinking our calories in order to maintain a healthy weight.

stop-smoking-blood-pressure
No smoking

Stop smoking

It should not come as a surprise that smoking causes high blood pressure. This is just one of the many ways in which it increases the risk of heart disease.

There is widespread awareness of the harmful effects of smoking and no need to go into details. It is sad that awareness itself is not enough to stop people from smoking.

‘Cure’ your high blood pressure

colourful plate of blueberries and raspberries

5 inspiring movies about healthy eating

Photo by Cecilia Par on Unsplash

Most of us have got much more time on our hands as a result of the COVID-19 pandemic. What better use to make of it than to try and improve our health.

How about taking a break from the latest COVID-19 news updates and from binge-watching box-sets. Over the years there have been a number of great documentaries which I have found really inspiring.

The interest in making them has no doubt been triggered by the spiraling rate of obesity, and diabetes in the World. There is certainly no better way to reduce your weight and improve your risk factors for all disease than healthy eating.

Here’s my list of top 5 healthy eating documentaries.

1. Eat, fast and live longer (BBC iPlayer)

We have known for decades that eating less calories makes us live longer!

In this documentary, Dr Michael Mosley travels to USA to see the latest in research about weight reduction and extending lifespan and healthspan. It focuses on different methods of fasting to do this.

Following this trip he wrote about and made famous the 5:2 diet which has become the rage all over the World.

2. The Game Changers (Netflix)

The Game Changers is a professionally-made documentary espousing the benefits of a plant-based diet on elite athletes. It is produced by Jackie Chan, and also Arnold Schwarzenegger who also makes a short appearance.

The documentary is full of interesting facts and dispels some of the myths about the inferiority of plant-based protein compared to animal protein. Did you know that the gladiators ate a mainly plant-based diet? Neither did I.

Well, if it’s good enough for Arnie, then it’s good enough for me.

3. Forks over knives (YouTube)

Forks over knives is the best of the documentaries that show how our current health problems are due to what we view as normal eating.

It features two scientists; Dr Colin Campbell who took part in the longest nutritional study in humans (The China Study); and Dr Caldwell Esselstyn, a cardiac surgeon who showed that you can reverse heart disease by changing your diet.

You would be well-advised to listen to what these gentleman have to say!

4. Super Juice Me! (YouTube)

What happens when you put 8 people with 22 different health conditions on nothing but freshly extracted juice for 28 Days?

Why not find out by watching this very entertaining and inspiring documentary about the benefits of fresh juice on sick individuals.

It is made by the UK juice master Jason Vale and is based on his life experience rather than hard science. Even so, the film is based on sound underlying principles. It gives a message of hope that there is an alternative to medicine to treat chronic disease.

5. How not to die (YouTube)

How not to die is the tongue-in-cheek title to Dr Michael Greger’s book on how to prevent, treat and even reverse chronic disease with a plant-based diet. This video is a presentation that he gave to a medical audience and presents the scientific evidence for his claims.

Michael Greger is an excellent speaker who will entertain you with his banter throughout this presentation. If you want to know the science behind a plant-based diet, then this is the film for you.

boost-immunity

How to boost your immunity

boost-immunity

The escalating problem of COVID-19 cases and deaths has focused our attention on how we can protect ourselves by improving our immunity.

Of course, we should practice social-distancing and hand-washing as preventative measures. We should also self-isolate: the current guidance is for 7 days if you suspect you have the virus and 14 days for household members who are not ill.

What is your immune system?

I am regularly asked how you can change your lifestyle to boost your immune system. Mostly, the questions are about different foods and supplements.

The key to understanding this lies in the word ‘system’. The immune system is not just a single thing that you can increase or decrease. It is made up of a complicated interaction between different cells and processes in your body. A better way of thinking of it might be to think of how you can improve your overall health. The healthier you are, the better you will be at defending yourself against infection and recovering from it.

Eat more plant-based foods

We have known for a long time that eating a diet rich in vegetables, fruits, whole grains, legumes (beans and pulses), nuts and seeds is great for our health. For example, it’s the basis for the Mediterranean diet and the 5 ‘Blue Zones’ in the World where people have the longest lives.

Plant-based foods are packed full of vitamins, minerals and fibre. These help to reduce inflammation in the body and improve our gut health. Since 80% of our immune system is in our gut, this can only be a good thing. We can improve gut health further by eating fermented foods such as yogurt, sauerkraut, kimchi, miso and kefir.

It’s a good idea to limit the amount of meats that we eat and instead try oily fish such as salmon, trout, mackerel, herring, and sardines. In the UK, we have a tradition of ‘meat and two veg’. Most patients I see rarely have a day where they don’t eat meat, chicken or fish. Why not try a meatless-Monday, one vegetarian day per week. You can then try to increase the number of vegetarian days each week. You’ll find that getting your 5 or 7-a-day is not so difficult after all.

Walking through the supermarkets these days and looking at the empty shelves make me wonder what people are trying to achieve. I can understand them buying staples such as rice, pasta, milk and eggs. More puzzling is the buying of highly processed foods such as pizza. Perhaps it’s the stress of the current crisis which is making people crave comfort food. Whatever the reason, processed foods and sugar are more likely to worsen health and ability to fight infection.

Exercise regularly

We all know that exercise is good for us but most of us still don’t get enough of it. Exercise is known to boost our ability to fight infection including viral infections such as the common cold. Using our muscles during exercise has an anti-inflammatory effect. It also helps get our infection-fighting cells called ‘neutrophils’ to the infection site faster and function better. Exercise improves the function of another group of immune cells called ‘macrophage’ which patrol the body guarding against infection. Our thymus gland produces yet another type of cell called a T-cell. The thymus gland starts to shrink from the age of 20 and so does our supply of T-cells. However, exercising can increase your number of your T-cells to the same level as that of younger people.

Exercise also helps us to recover better once we have an infection. Now, I don’t mean that we should exercise whilst we are ill as we are going to need our rest. I mean that we are more likely to make a better recovery if we have been previously exercising regularly.

There is a ‘Goldilocks’ level of exercise though, so you should exercise in moderation. A good guide is the recommended half-an-hour of brisk walking done 5 times per week. Too much exercise can be bad for us and weaken our ability to fight infection. However, I would hazard a guess that most of us probably don’t fall into that athletic category!

Don’t let self-isolation stop you. You can still go for a walk or run, or exercise at home using the countless home exercise programs on YouTube and other internet sites. Personally, I like ‘Beachbody On Demand’ as they cater for virtually every type of exercise. You might also take some inspiration from a Frenchman who ran a marathon on his balcony during the lockdown!

Get some decent sleep

We live in a sleep-deprived society which is causing our health to suffer in numerous ways. These range from tiredness and poor concentration and memory, to low mood and anxiety.

Sleeping is healing. We now know that sleeping less than 6 hours per day reduces our immunity. Experiments haven’t been done in humans, but rats who were stopped from sleeping all died from sepsis (overwhelming infection). We should all be trying to get a minimum of 7-8 hours of sleep at night. There’s some great information of how to improve your sleep from the Sleep Foundation.

Since Boris Johnson introduced the pub and bar ban, the booze shelves in supermarkets are now also empty! Alcohol is one of the most potent disruptors of REM sleep. It can result in the same duration of sleep but it will be more disturbed and less restful. Excessive alcohol intake can also reduce the ability of our bone marrow to produce immune cells. If you want to improve your sleep and boost your immune system, then drink less, and less often!

Caffeine is also a strong disruptor of sleep. It’s in coffee, tea (including green tea), soft drinks, and dark chocolate. Your cuppa or two in the morning may not a big problem, but caffeine has a long half-life of around 6 hours. So any caffeine after 2pm is likely to reduce the quality of your sleep. Beware decaf as it contains around 15-30% of the usual caffeine amount. Try camomile tea instead in the evenings which will help to you to relax and improve your sleep.

Actively reduce your stress

Stress plays havoc with our immune system. It increases our levels of the hormone cortisol in the body and increases inflammation. This makes it more likely for us to get sick and hamper our recovery when we do.

Most of us don’t do anything actively to reduce our stress levels. Watching the TV and reading a book may be relaxing but these activities are not enough to heal our body and mind. Regular exercise and good sleep will help. Studies have shown that mindfulness and meditation reduce our chances of getting sick and reduce the duration of illness. There are numerous apps that can help you get into this including Headspace and Calm. And how about mindful movement exercises such as yoga and tai chi. There are free-to-use YouTube sites such as ‘Yoga with Adriene’.

As with all lifestyle hacks, mindfulness, meditation, yoga and tai chi are only going to be useful for our health if we practise them on a regular basis. So make a plan which includes set days and times when you are going to practise them. Start small, just a few minutes a day is enough to begin with and then increase the time.

Get enough vitamin D

Supplements are another topic that comes up often when we talk about improving health. They are a big money-spinner and you’ll find numerous supplements in the shops that will make fantastic claims. Although it’s nice to think that simply taking a pill or potion will do us wonders, it’s unlikely that they will do us any good, and may actually do us harm. That’s because taking a concentrated ingredient which has been extracted out of a food will promote certain biochemical pathways in the body in an unbalanced way. That doesn’t happen in nature when we eat a whole food.

To date, no single supplement has been found to have a benefit on improving our immunity. That includes the most common one used, vitamin C. However, there is some evidence for the benefits of vitamin D supplements in protecting against respiratory infections.

It’s now March and we’ve just come out of a dark UK Winter so our vitamin D levels will have dropped. We all know that we can make vitamin D from sun exposure, but for dark-skinned individuals such as myself, it’s advisable to take supplements as we absorb less sunlight. I would recommend a minimum of 2000 units per day. Vitamin D can also be found in certain foods such the eggs, mushrooms and oily fish, and is added to cereals and milk.

Lay off the salt

Our body is really good at maintaining normal salt levels in our bodies. But it has to work harder if we eat too much salt. It does this by producing hormones called ‘glucocorticoids’ (steroids). The problem is that these hormones also weaken our immune system.

So, certainly have salt in your food but it might better to avoid extra at the table. Also, processed and junk food are well known to contain high levels of salt and are best avoided.

Maintain a healthy weight

You probably already know that being elderly and having a chronic disease are risk factors for developing severe complications of COVID-19 infection.

Obesity (BMI > 30) is a risk factor for various illnesses including type 2 diabetes mellitus and high blood pressure. Unfortunately, it is also a significant risk factor for developing infections.

To maintain a healthy weight, you first need to achieve a healthy weight! Fortunately, following a healthy whole-foods diet, sleeping well, keeping active and reducing stress are all ways we can do this.

Stop smoking

Stopping smoking may seem obvious but it’s surprising that many people continue to do so. Smokers are more likely to suffer from infections of every sort and from respiratory infections in particular. COVID-19 is a respiratory infection and smokers have a higher risk of developing a severe illness and become hospitalised if they do so.

Stay well

The current COVID-19 crisis will be with us for some time to come, perhaps up to a year or more. It’s natural that we turn our attention to our health at times like these. It also gives us a good opportunity for us to change to healthier habits that will improve our general health for the future.