With 80 per cent of chronic disease attributable to lifestyle and linked environmental factors and within the lifestyle hierarchy, poor diet being the most important contributor, the coronavirus pandemic has not only added to our vulnerability and lack of immunity, “but also taught us to look to a brighter future,” says a new book by a leading NHS-trained cardiologist and a pioneer of lifestyle medicine.

“What has been missing from the mainstream media discussion and public health messaging surrounding the virus is that the underlying root cause of these conditions is related to lifestyle (fuelled by the environments in which we grow, live and work) and that dietary changes alone, as my own medical experience with patients has also demonstrated, could rapidly and substantially improve many of these risk factors,” Dr. Aseem Malhotra writes in “The 21-Day Immunity Plan – How to Rapidly Improve Your Metabolic Health and resilience to Fight Infection” (Hatchette).

“Beyond my observations as a medical scientist and my duties as a clinical doctor to share knowledge on the link between metabolic health and immunity,” what Covid-19 has also done is to expose areas in health systems and personal well-being “that have long been neglected, and in themselves have made us more vulnerable to such a pernicious virus”, Malhotra writes.

“But in spite of the tragedy, the disturbing statistics and heart-breaking stories that have collectively gripped the world, we can draw from the lessons the virus has taught us and look to a brighter future,” he adds.

Malhotra then presents his 21-day immunity plan, adding for good measure that lest it be mistaken as a quick-fix measure, his experience is that three weeks “is that for most people it takes…to break any habit, or for many what is a form of addiction to sugar and ultra-processed food” –- these two being the bugbear of major health issues.

“Over the course of the three weeks, you will follow an eating plan, you will be required to move your body daily, carry out breathing exercises, monitor and improve your sleep habits and be seeking to reduce your stress and improve your mental well-being by making a concerted effort to nurture and celebrate time with friends and family,” Malhotra writes.

Quite naturally it begins with EAT.

So, “Enjoy” three meals per day maximum, at least two-four tablespoons of extra virgin olive oil daily, one small handful of tree nuts (walnuts et al) daily, at least five-seven portions of a variety of fibrous vegetables and low-sugar fruits a day, vegetables in at least two meals a day and oily fish (salmon, mackerel et al) at least three times a week.

“Avoid” all added sugars, fruit juice, honey and syrups; avoid all low-quality carbohydrates and starchy foods that lack fibre; and avoid all ultra-processed foods.

“Fast” by gradually reducing the time window in which you eat from 12 hours to eight hours –- ultimately aiming to fast for 16 hours a day and for your eating window to be between 10 a.m. and 6 p.m., 11 a.m. and 7 p.m. or 12 p.m. to 8 p.m. “Eat according to your hunger levels…if you feel you need to eat three meals in that short time frame, that’s fine, but many people get by with just two and they include some healthy snacks in between”, Malhotra advises.

“Move” — go for a brisk walk of at least 30 minutes on five days each week; you want to aim to get your heart rate within a range of 50-70 per cent of your maximum, which is related to your age; to calculate this, deduct your age from 220 –- for example, if you’re aged 40 then the figure would be 180; if you’re starting to exercise like this for the first time, then start with 10 minutes and gradually build up; do not sit for more than 45 minutes at a time –- take two-minute movement breaks.

“Breathe” in slowly, slowly, counting for five seconds in your head and then breathe out; another technique is to breathe in for four seconds through the nose, hold it for seven seconds, and then exhale for eight seconds; start for 10 minutes every day and then build up to 20 and even 30 minutes.

“Socialise” –- make an effort to increase time spent with friends and family each week; its’ not just good for mental health but also helps mitigate stress.

“Sleep” a minimum of seven hours each night.

Has something been left out? You bet it has!

Can I consume alcohol? It’s good to have a few days completely off alcohol each week, but if you do like a tipple, then stick to the current recommended limit of 14 units (50 ml) a week and drink like they do in the Mediterranean –- no more than a glass of red wine with your evening meal, which at that dose may even provide a benefit in protecting your heart.

If I’m a vegetarian or vegan can I follow the 21-day plan? Yes, although if you’re vegan don’t forget you’ll likely need a Vitamin B-12 supplement.

At the bottom line, what after 21 days? “If it’s going well, and you’re starting to see results, just carry on,” Malhotra writes, by “sticking to the 80/20 rule” of following the plan for at least 80 per cent of the time.

“The time for action on metabolic health and investment in well-being is long overdue. If we don’t act, there may even be more misery and devastation when the next pandemic comes around,” Malhotra concludes.