 are responsible for mounting an attack do not function as effectively as they should and are less able to protect us.
It’s known that diabetes (both type 1 and type 2) is associated with more frequent and more severe infections. In the UK it was noted that compared to non-diabetics those with type 2 diabetes who contracted coronavirus had a threefold increased risk in death and those with type 1 diabetes had a fourfold increase. One study in China revealed that type 2 diabetics with poor glucose control had a 10-fold increases risk of death in comparison with those with better glucose control.
Unlike Type 1 diabetes, which is diagnosed early in life, our chances of developing Type 2 diabetes are significantly impacted by our diet. It’s now known we can reverse it through dietary intervention, something I have witnessed first hand on multiple occasions in my own clinical practice.
Relying on medical intervention alone to save us is a risky business, whether that’s a vaccine to protect us from Covid or medications to manage chronic diseases. In his book, Aseem highlights the fact that obesity appears to reduce the response to vaccination and increase the risk of viruses mutating. This happens because viruses stay in the body for longer as a result of an inability to produce the full immune response, which allows the virus to replicate for longer and produce a new strain. On the other hand, several studies have revealed that exercise can significantly increase the antibody response to influenza vaccine. This goes to show the extent to which medical treatment can be significantly enhanced by improving our diet and lifestyle.
We cannot ignore the impact of ageing on immunity, particularly with coronavirus given that it’s by far the biggest risk factor for death. Those aged over 65 account for 80 per cent of hospitalisation compared to those under 65, and are 23 times more likely to die.
But Aseem points to the fact that the overwhelming majority of those that died from COVID-19 in older age groups had at least one underlying condition, predominantly rooted in poor metabolic health. While we can’t slow down the speed at which the years pass, we can impact the speed at which our body ages through our diet and lifestyle choices.
An individual’s immune system is the result of a number of factors and some of them cannot be changed, such as age and genetics. But many of them can, such as diet, exercise, weight, alcohol and stress. As the saying goes ‘genes load the gun, environment pulls the trigger’.
So what can we do to support our metabolic health in order to support our immune defences? The 21-Day Immunity Plan highlights four key areas to address.
Poor diet is the most significant contributor to metabolic health disorders and is now responsible for more disease and death than physical inactivity, smoking and alcohol combined. Aseem describes ultra-processed foods and drink as “the number one enemy” in our western diets, making up more than a staggering 50 per cent of calories consumed on average in the UK. He highlights the major dietary culprits including a diet low in whole fruit and vegetables, inadequate intake of nuts and seeds, not enough omega 3 fats, not enough fibre, too much sugar, and a high intake of processed meat.
In The 21 Day Immunity Plan he explains how to identify and eliminate ultra-processed foods from your diet and outlines a clear strategy for how to eat to support metabolic and immune health. These principles are based on a nutrient dense, low carb Mediterranean diet approach.
There’s been a lot of publicity around the link between vitamin D deficiency and worse outcomes from coronavirus. A study from Indonesia revealed a ten-fold difference in death rates between those with the lowest levels versus those with normal levels. It’s therefore vital to ensure your vitamin D levels are always optimised. In his book, Aseem discusses the importance of vitamin D and other immune–essential nutrients, along with how to establish your levels and what to do to make sure you’re getting enough.
A BMJ paper on Nutrition, Prevention and Health is quoted as saying: ‘What is clear is that conditions of nutrient deficiency impair the functioning of the immune system and increase susceptibility to infection.’ Ensuring optimal intake of key nutrients is an important step in supporting immune system health.
The immune system is significantly influenced by physical activity. Just a single bout of moderate to vigorous exercise has been shown to enhance the immune system’s ability to function and fight infection more effectively. Over time, with regular exercise, these effects build up to strengthen immune defences. Moderate activity has an anti-inflammatory effect and is well known to improve metabolic health.
However, overly intense and prolonged bouts of exercise can have a negative impact on immune function, especially if the individual is not well rested or nourished. As with so many things, moderation is key. The Chief Medical Officer’s guidelines for adults state that we should be engaging in at least 150 minutes of moderate activity per week and/or 75 minutes of vigorous-intensity activity per week, as well as some form of strength building exercise on at least two days per week.
Chronic stress plays a significant role in the development of most chronic metabolic diseases. In the 21-day plan Aseem shares simple guidance and techniques for how to reduce stress which has proven to be a powerful tool in managing patients with heart disease.
There are three main reasons for a 21 day plan. The first is that for most people it takes three weeks to break any habit, in this case a sugar and ultra-processed food habit.
The second is that most people with adverse metabolic health will start to see marked improvements to their health and/or shape within three weeks. Aseem points to a number of different trials outlining the significant changes that can be made in a short period of time.
The third reason is the need to change the narrative around the impact of lifestyle changes and show that their effect on health can be rapid and substantial. We should use this to motivate ourselves to continue to reap the benefits of improved health for life.
This reflects what I have seen in my own clinical practice. Many of the clients I work with are amazed at how quickly nutrition and lifestyle optimisation can result in significant fat loss, increased energy and improved health markers. Of course, health improvement is a journey and not a quick fix, but it is witnessing the fruits of our labour – so to speak – that keeps us motivated to continue.
Like me, Aseem is a passionate advocate for ‘lifestyle medicine’. We share the fundamental belief that, when taken good care of, our body possesses an innate ability to heal itself. An ability far greater than that of many modern medical practices. We also share the belief that prevention is better than cure and that much can be done to protect ourselves from ill health - way beyond mask wearing and hand sanitising.
Volunteers will be restricted to just 800 calories per day - a third of an adult man's recommended daily intake and almost half of a woman's.
It is possible to put type 2 diabetes into'remission', when blood sugar levels are below the diabetes range and the patient no longer needs to take medication.
The term'reversed' is not often used because it implies cured. But there is no guarantee a person who has had type 2 diabetes is free from the disease forever.
It's easier to get diabetes into remission closer to the time of diagnosis.
Professor Jonathan Valabhji, NHS national clinical director for diabetes and obesity, said: 'This is the latest example of how the NHS, through our Long-Term Plan, is rapidly adopting the latest evidence-based treatments to help people stay well, maintain a healthy weight and avoid major diseases.
Bridget Turner, director of policy campaigns and improvement at Diabetes UK, said the programme is 'an important first step' for patients to access a remission programme within the NHS.
She said: 'We know that some people with type 2 diabetes want and need support from healthcare professionals to lose weight effectively, and now as these programmes are piloted across the NHS they will.
'People with type 2 diabetes who have put their diabetes into remission frequently tell us how it has changed their lives.
Type 1 diabetes is caused when the pancreas does not produce enough insulin to regulate the body's blood-sugar levels, and is generally caused by genetics.
Because type 2 is mostly caused by people's lifestyles, it can be reversed through low calorie and low sugar diets.
The trial comes just more than a month after Boris Johnson's Government launched a drive to tackle obesity after the Prime Minister realised his own weight may have contributed to him ending up in intensive care when he caught coronavirus.
Because BMI is specific to each individual, everybody will have a different threshold at which they are deemed 'overweight' or 'obese' and risk developing diabetes.
The researchers haven't given exact figures, but they say their findings will help doctors identify who is most at-risk of diabetes, based on their weight.
That was the case even when genetic predispositions to the condition - such as a family history of diabetes - were factored in.
'The findings indicate that BMI is a much more powerful risk factor for diabetes that genetic predisposition,' he said.
He has urged the nation to follow his lead, insisting the Government's 'better health strategy' will help people to 'bring their weight down' and better protect the NHS.
The Government's new anti-obesity strategy will attempt to bring an end to confectionery displays at shop checkouts and a ban on adverts for foods high in fat, sugar and salt on TV before 9pm.
Deals such as 'buy one get one free' on unhealthy foods will also be banned, while alcoholic drinks could soon have to list their calorie content.
Mr Johnson said in a video posted on Twitter to mark the launch of the strategy in July that 'like many people I struggle with my weight' and he had 'always wanted to lose weight