Tim Spector: The health tips I'd give my 20-year-old self

Telegraph

01-07-2025

I spent my 20s studying as a medical student and then working as a junior doctor. My life was what I could fit in around incredibly tough hours, often barely sleeping or having any time to think about food or exercise at all.
It was the 1980s and I was hopping around hospitals in London. I would have loved for someone to tell me about the importance of diet and lifestyle, how to develop healthy habits and how much they're needed later in life. That would have been really helpful.
Most people are certainly not leading balanced lives in their 20s, and yet recover because they're young and resilient. Nonetheless, it's important to start being healthy as early as you can.
Around a decade ago, my son, Tom, did an experiment I was going to do myself as part of his genetics degree dissertation. The experiment involved eating McDonald's twice a day for 10 days to see how it would affect his gut health. He lost 30 per cent of his gut microbes and it took him years to recover them.
So, if you abuse your health and gut microbes, even in your youth, it can take a long time for them to recover. I wish I'd known this.
1. Sleep more consistently, when you can
No one ever talked about the importance of sleep back when I was in my 20s.
For those intensive years as a junior doctor, I was sleep-deprived most of the time. I was regularly working 72-hour shifts on just a few hours of sleep and then binge sleeping on the days I wasn't on the ward. I knew how to crash out at 6pm after a long shift and wake at 8am the next morning.
We didn't really question it, as you knew your bosses had done the same, and you got more experience much faster by working long shifts – it was just the sacrifice you made as a doctor. But I couldn't do it again, that's for sure.
Researchers recently worked out that functioning on such little sleep is equivalent to going around having drunk half a bottle of wine when you're seeing patients. So we really weren't at our best and shouldn't have been allowed near a car, but, after a few years, if you didn't make too many blunders, you had seen everything, so it did prepare us for the future.
If you could do without sleep, you were seen as cool and the toughest of the junior doctors. It was a badge of honour if you could make do on only four hours a night.
If you could cope well on little sleep and, importantly, fall back to sleep easily, you would often do acute or emergency work. I didn't cope with it well, so I went for a specialty where I didn't have to get up routinely at night, which was rheumatology. However, it took a long time, a lot of work, and a few sleepless nights to get there.
I do try to sleep much more evenly now that I realise how important it is for our health. Our research at ZOE has found that people who don't sleep for long enough or have poor sleep quality have much larger spikes in their blood sugar levels the next day, leaving them hungry and seeking carbs. Regularly changing your sleep schedule also has an impact.
As a result, I now aim to be in bed before 11pm every night, to try and keep my sleep timings as consistent as possible. I also wear earplugs and an eye mask, and I've changed my curtains to blackout. I also stop using my phone after 10 pm to get rid of anything that could disrupt my sleep and reduce its quality. This has really helped.
2. Eat less toast and more nuts
Most of the stuff I was eating in my 20s was fairly revolting, apart from days when I'd dine out at an Italian or Indian restaurant, which was a rare treat and meant I'd have some decent food.
My breakfast was cereal or toast and marmalade – croissants and pastries weren't a big thing in the 80s.
Lots of my other meals were hospital food, which was absolutely appalling and probably hasn't improved much. I would often get an English breakfast or a plate of chips from the canteen, and there wasn't a vegetable in sight. Or I would pick up a tuna sandwich from the hospital cafe – I wasn't strong enough to resist the lure of the meal deal.
For snacks, I had too much low-quality toast, as you could get it at any time of the day or night on the wards. It was always a nice comfort treat, but I would have been much better off munching on a large handful of nuts, or even dark chocolate, rather than bread, which spiked my blood sugar.
I might have had a yogurt once a week, but it was a flavoured one and probably low-fat, which is much less healthy. Only women and kids had yogurt in those days; it wasn't a macho thing to have. I also used to love orange juice. I wish someone had told me that it was not a 'health food' and was actually bad for me.
The occasional banana was about the only fruit I remember eating. I was probably fairly constipated and would have definitely benefited from more fibre.
It's pretty grim when I think about what I was eating – it's amazing I'm still alive. But when you're young, you're pretty resilient.
I don't really blame my old self because it was really tough. Faced with long working hours, survival was really all I was interested in. And we didn't question things back then. We had no real concept of health. I thought rice was healthy, and fat of any kind might be bad for you – so not cooking with too much olive oil, butter or lard – but that was about it.
In retrospect, getting more variety would have been good. Now, I always aim for 30 plants a week, carry around some mixed nuts and seeds, and include fermented food at most meals.
I also had no concept of giving my gut a rest, so I was basically eating all the time, as 'little and often' was the current dogma. Eating better would have stopped my weight from creeping up. I was pretty skinny when I started medicine, around 11st (70kg), and when I was really busy, it stayed at that level until I was 30, but then it started to increase by about a kilogram per year.
3. Drink less beer – and have alcohol-free days
Obviously, like nearly everyone, I drank too much in my 20s but that was the culture then. When we weren't working really hard, we'd be out partying.
When I was based at St Bart's Hospital in central London, it was opposite Smithfield meat market, where you could always find somewhere for a drink at any hour of the day or night. There was also our own cheap student bar that was open until 3am.
I drank anything I could get hold of – I wasn't very fussy. I'd have beers, wine, gin or vodka, though I didn't smoke or take drugs. My mum had put me off smoking as she was a chain smoker.
These days, I aim for a maximum of 14 units a week (equivalent to seven 175ml glasses of wine or seven pints of low-strength beer). I've talked about the modest cardiac benefits of red wine, but that's not all I drink – I enjoy beer, and I'll have the occasional gin and tonic.
I aim to have a couple of alcohol-free days a week, but that goes to pot on holidays. But I'm now a big fan of alcohol free beers and kombucha, which are tasty non-alcoholic options.
4. Try different types of exercise – and do more of it
I played cricket and rugby at school and university, but I didn't do much exercise in my 20s. I probably should have, but I wasn't aware of any of my colleagues having the time to do any either.
Saying that, I'm sure we were hitting around 20,000 steps a day on the days we were working, because we were just used as slaves to do everything all over the hospital. I was running up and down really long corridors for days on end.
I also would pick up running each time I had an exam, which there are lots of in medicine, even after you qualify. I didn't particularly enjoy it as exercise, but it was effective at reducing stress and clearing my mind. I remember thinking: 'Oh my god, I can't study anymore, I've got to go for a run'.
It would have been great to have been introduced to yoga or pilates, as that would have helped me later in life with being more flexible because, like most people, I ended up having back pain in my early 30s. This was because my toes seemed a long way from my fingers, and I'd never stretched in my life.
I got better at exercising in my 30s; I'd go to the gym once a week. They didn't really exist before that unless you were a bodybuilder, which I was not – I was quite puny. Dance classes and aerobics also took off, so I did that for a while, but never very seriously.
These days, I mix it up. I do some yoga classes, I'll do some weights, and cycle for real or on my Peloton bike. In the summer, I swim most days and do mountain biking. Just as with food, a variety of exercise is good as it uses different muscles and different parts of the brain.
5. Spend more time with your loved ones
I was dreadful at staying in touch with my family in my 20s. I left home at 17 and rarely saw my parents – maybe two or three times a year, which is completely different to how often I see my own kids now.
But that was cultural – I don't think I was very different from my friends and colleagues. We all rebelled against our parents, and it was a very different scene.
What's important is that you have a support group to link up with. It doesn't have to be your parents, it could be close friends or another form of community, so you don't get isolated. I wish someone had told me that when you're young, you make a lot of your best friends, who you keep with you all your life. I still see many of my school friends regularly and realise how supportive it is to have regular contact and a good dose of sarcastic teasing.
Make time to catch up with old friends and your parents. It's the friends that drift off; your parents will usually be there – though they're not always, if they die early like my father did when I was 21. I regret not spending more time with him.
Meeting socially is important for longevity. With my family, we do Christmas together, have an annual skiing holiday together, and, when we're in London, we have a Sunday lunch or meal out every other week. We see quite a lot of each other, but not so much that we're sick of each other and start fighting.
All in all, I feel immensely grateful to be fit and well, given the way I mistreated my body in my youth. It's a testament to the resilience of life and our bodies. We can't turn back the clock, but we can start afresh today. Eating a diverse range of plants, limiting alcohol, keeping active and maintaining close relationships are all evidence-based ways to stay healthy as we age.