The ZOE Health Study

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Updated 22nd June 2022

Five ways to optimize your immune health

Written byTim Spector, MD FRCP FRSB
Reviewed byYella Hewings-Martin, PhD

    Ever since ZOE started back in 2018, our focus has always been on understanding and maximizing health for everyone, whether that’s through the ZOE COVID Study or our work on nutrition and the microbiome

    Now, we’re branching out into wider health studies to shed light on the most pressing health issues facing us today, like cancer, heart disease, mental health, and more.

    We also want to find out what we don’t know yet but should be able to, thanks to the hundreds of thousands of contributors who’ve committed to helping us discover more about how our lives shape our health.

    Read on to discover what we do know about the steps we can all take to improve our health and immunity.

    Introducing the five strands of health

    We’re all born with a set of genes — half from mom, half from dad — which influence our health and risk of developing certain conditions. There are also social and financial factors largely beyond our control that can have a significant impact on our health. 

    But this doesn’t mean that our genes or social situation are our destiny when it comes to health.

    We believe there are five interconnected strands that all feed into our overall physical, mental, and immune health — each of which is centered on behaviors or habits that we can change. Scientists call these "modifiable risk factors."

    These five strands of health are:

    • Diet

    • Sleep

    • Physical activity

    • Mental well-being and brain activity

    • Social life and other health habits

    Over the coming months and years, we’ll be working together with our ZOE Wider Health Studies Contributors and research colleagues at King’s College London to carry out detailed research studies.

    These studies will be aimed at understanding more about how each of these strands contributes to long-term health outcomes and to fill in the gaps in our knowledge.

    Together, it’s a unique combination of committed people working together to find real answers to some of today’s most pressing health challenges.

    We’ll be digging into each of these strands of health in a series of upcoming blog posts, but for now, here’s a brief overview of what we know so far.

    Strand one: Diet

    It all starts with a high-quality, plant-rich diet that supports your metabolic health and gut microbiome — the trillions of microbes that live in your gut and play an important role in health, well-being, and immunity.

    The connection between diet and health has been recognized for hundreds of years, but it’s only in recent years that we’ve seen significant research into understanding how what we eat interacts with our gut microbes and affects our overall health, immune function, and mental well-being.

    To find out more about the connection between diet and health, we’re running a research program called PREDICT — the largest in-depth nutrition studies of their kind in the world, with thousands of participants in the U.K. and U.S.

    And we also explored how diet affects COVID-19 risk — as well as the impact of the pandemic on diet and lifestyle — through the ZOE COVID Study.

    Over the past few years, our research has revealed important insights into nutrition and the microbiome, such as the finding that even genetically identical twins have unique responses to the same foods, and that the quality of your diet affects the microbes in your gut and your metabolic health.

    We’re not saying that diet is a cure-all or can replace medical treatment, but improving the quality of your diet and eating in a way that supports your microbiome feeds into all aspects of your health.

    Strand two: Sleep

    As well as helping you stay alert and active through the day, getting a good night’s sleep is an important factor in overall health and mental well-being. Poor sleep has a major impact on health, yet 1 in 3 people don’t get enough.

    Research also shows that sleep is closely connected to metabolic health. Many studies have shown that sleeping patterns have an impact on blood sugar control for people with type 2 diabetes. 

    Recent results from our PREDICT study also showed that this connection holds up in the general population.

    Having a poor night’s sleep or an irregular weekly sleep pattern was associated with a less healthy blood sugar response to breakfast the following morning, potentially leading to short- and long-term health challenges.

    It can be tough to get enough good quality sleep, particularly if you’re stressed or have small children, but our research shows that going to bed just a little bit earlier could make a difference to your energy levels and metabolic health.

    Strand three: Physical activity

    It’s not surprising that staying physically active has a positive effect on health and mental well-being, backed up by a huge amount of research showing that everyone can benefit from being more active.

    This doesn’t necessarily mean flogging yourself in the gym or running marathons — unless that’s what you love to do, of course.

    The best activity is the one you actually do and enjoy, whether it’s playing sports, dancing, gardening, walking, or anything else. Moving regularly in a way that makes you feel good and gets your heart rate up, whatever your level of ability and fitness, will still have a positive impact on your health.

    Strand four: Mental well-being and brain health

    Our physical and mental health are closely intertwined, so it’s good to see that psychological well-being has been put much higher up the health agenda than in the past. This is especially important given the pressures of the COVID-19 pandemic on our mental health.

    As well as finding ways to support your mental well-being and reduce stress, research has shown that doing activities that keep your brain active — such as reading books, playing games, or doing puzzles — may delay the onset of dementia.

    Doing activities we enjoy is also beneficial for mental health, such as music, crafting, or spending time in nature. Having pets and gardening bring an added bonus of increasing the diversity of beneficial microbes in your gut and contributing to better health.

    We’re also now starting to learn more about the connection between nutrition and mental health.

    Intriguingly, there’s a growing body of evidence to show that gut health is connected to mental health, and that a plant-rich Mediterranean-type diet may help with depression — an idea that’s been put to the test in clinical trials (such as this one and this one.)

    We would never suggest that anyone should stop taking medication for their mental health without consulting their doctor, but given that a significant proportion of people don’t respond to antidepressant drugs, it’s time we looked at the broader picture of health to find other approaches that might help.

    Strand five: Social life and health habits

    This final strand covers our social interactions and how we live our lives.

    There are decades of research showing that having a strong social network is linked to better health and a longer life. And it’s well known that our own health behaviors tend to mirror those around us.

    In terms of personal health habits, smoking is a cause of many life-limiting health conditions, such as heart disease, cancer, and lung disease, leading to millions of deaths worldwide every year. If you’re a smoker, quitting is the single best thing you can do for your health. 

    And while drinking alcohol in moderation isn’t very risky for most people (especially if it’s polyphenol-rich red wine), regularly drinking to excess is clearly linked to many serious diseases.

    It’s also important to get to know your body and baseline health so you can spot when something’s not right for you. Other things that will help to keep you healthy include getting all your recommended vaccinations (including your COVID shots and booster), and taking up cancer screening when invited.

    And finally, given that we’ve lived through a global pandemic and there are plenty of other infectious diseases out there, you can also take steps to avoid catching whatever bugs are going around.

    Remembering to wash your hands after using the bathroom and before handling food will help to protect against stomach upsets. In turn, you can do your bit to protect others by staying home if you’re feeling unwell and wearing a mask if you go out, to avoid spreading your germs to those around you.

    Small steps add up when it comes to health

    It’s important to remember that there are no quick fixes, trendy fads, or impossible promises here. There’s no one-size-fits-all diet, perfect immune-boosting supplement, or guaranteed way to avoid cancer or any other condition.

    Humans are complicated, messy biological beings, so understanding what contributes to health and disease is equally complex.

    And while there are some things that we do know are beneficial for our health — such as quitting smoking, eating more plants, and being more active — there’s still a lot we need to find out.

    Importantly, these strands of health are woven together and support each other. But they can also impact each other. For example, bad sleep leads to poorer metabolic responses and a tendency to snack on less healthy foods for an energy boost.

    Some of these strands may be easier to improve than others, depending on your circumstances and pre-existing conditions. But the good news is that taking positive steps in any of these areas, however small, will take you in the right direction to maximize your health.