Now is not the time. Or is it?

A delicate topic has been simmering for weeks among researchers, doctors, nutritionists and the like on social media:  the link between metabolic dysfunction (obesity, type 2 diabetes, insulin resistance, high blood pressure) and poorer outcomes in COVID-19.

I’ve read the research and there are real concerns. UK cardiologist, Dr Aseem Malhotra, named his recent article on this subject: “COVID-19 and the Elephant in the Room”.  Metabolic health researcher, Ivor Cummins, was recently interviewed about it and completely misinterpreted by a tabloid journalist who concluded: “now is not the time to give up custard creams”.

What are people to make of this? Is it fair or realistic to focus on losing weight or controlling weight at a time when many people are stressed enough already, exercise is restricted, choice of foods is restricted and access to the food cupboard is decidedly unrestricted?

I think that journalist was right to a certain extent. Fretting over diet (or anything really) isn’t going to help the immune system. Crash dieting is likely to be stressful for the body at the very time that it needs nurturing. And of course there’s a very real worry for some people about getting access to any food at all, never mind access to special food.

But neither Ivor Cummins nor Aseem Malhotra make statements without scientific evidence. Like me, they work with people with metabolic dysfunction in both a voluntary and professional capacity. It could be argued that it would be negligent to avoid telling people about this important piece of the COVID-19 puzzle.

So the big question for me becomes: where does this leave a person with weight or other metabolic health concerns at this difficult time?

My answer is that this need not be overwhelming. If you are in a place where you can take some small steps towards improving your health, it might be easier than you think.

I tell my patients that there are two points of action that can make a big difference:

Action Point #1 Select a small change that is doable for you.

Can you do any of these?

  • Go to bed half an hour earlier.
  • Relax for an hour before sleep with a novel, music, an audiobook, a meditation?
  • Switch off screens (phones, TV, laptop, etc,) an hour before sleep.
  • Leave at least a one-hour gap between food and bedtime.
  • Get some daylight on your face in the morning, not through glass, not long after waking.
  • Bare some flesh in the sun around mid-day (research shows 9 minutes is great for boosting vitamin D production but take care not to burn).
  • Set a reminder on your phone to stand up and move around at least once an hour.
  • Look up some breathing exercises.
  • Shop around online for free guided meditations.

All or any of these things can help optimize sleep and mitigate stress, both of which are vitally important to metabolic health and the health of the immune system.


Action Point #2 Use up but don’t re-buy processed, food-like products.

This is the number one dietary change you can make to move towards better metabolic health. It’s not possible for everyone under lockdown. But are there one or two factory-made products you could phase out?


  • Which products would your great-grandmother not recognize as food?
  • Become a food analyser: ask yourself about each item, “fake or real?”
  • Do you know what each ingredient on the label actually is? If not, it’s probably a highly-processed product.
  • Can you swap an industrially-processed food for a real food – oven chips for a potato popped in the oven/microwave, crisps for nuts, biscuits for oatcakes, bought cakes/desserts for natural yoghurt served with fruit and nuts?
  • Reassess your go-to nurturing foods – can you climb up from sugary chocolate to darker chocolate? Can you afford to replace custard creams with fresh (or tinned) fruit and cream? Can you keep your sweet indulgence to once a day, a time when you relax and really enjoy it guilt-free, and then have a plan for alternative, real and lower-sugar, foods at other times of day?
  • Use up processed foods you have in while making sure they don’t take up more than a quarter of your plate at a time.
  • Consider which foods you are using for important protein – meat, fish, cheese, eggs, quinoa, beans, etc. – and then consider how you can add a green or colourful vegetable or some salad.
  • How much of your shopping list is real food? Meat, fish, cheese, eggs, nuts, seeds, yoghurt, cream, vegetables, salad, fruit? Fresh is good but foods that are easy to store such as eggs, nuts/seeds/nut butter, tinned sardines/tuna/salmon/mackerel are packed with nutrients. Frozen veg is great to have at hand.
  • If vegetables feel bland and boring, try sauteeing them in olive oil and butter with a pinch of salt. Try a stir-fry with whatever veg you have to hand: garlic and ginger are your friends (as are spices, herbs, pepper, soy sauce, fish sauce, chili flakes).
  • If you’re concerned for someone unable to go out, ask if you could (safely) drop them something green – a cabbage, say, or a pack of green beans or broccoli. (Some kind souls good at cooking are making an extra lasagne to drop off for a relative or neighbour in need.)

You’ve got this.



Worried about elderly relatives during the flu season?

Elderly people are particularly vulnerable during the flu season.

Here are my top 9 diet and lifestyle tips to help you support their health this winter.

  1. Remind them of the staples of their youth. Liver. Eggs. Sardines. These are some of the most nutrient-rich foods on the planet. They provide a range of vitamins and other nutrients that are hard to find enough of in most other foods. We’re talking vitamins for immunity (yes, including A and D), healthy fats for healthy body cells, iron, calcium, too long a list to detail here. I see these three foods as a kind of health insurance. Past generations knew this. Our older citizens know this. They just need reminding. Liver and onions? Boiled eggs? Omelettes? Sardines on toast?
  1. Switch out the fake. The next single most important thing you can do is to help them transition to real foods. Ditch the fake cream (cream substitutes made from processed oils but sold alongside the real thing). Ditch the fake butter (margarine, ‘spread’). Ditch the low-fat yoghurts. Ditch the ready meals. Fake foods fuel inflammation and displace actual nutrients. Tell them that they had it right in the past – real cream, real (‘best’) butter, eggs for breakfast, a bit of meat with some veg, plain full-fat yoghurt or a little fruit as dessert.
  1. Take them a portion or two of casserole (or stew or broth) once a week. Take turns with another relative. Or if they cook, remind them that cheaper cuts of meat can be put in a slow cooker to make a useful stew that can be eaten for more than one day. Lend them a slow cooker for winter? Our need for protein rises as we age and we need it to keep our muscles strong (strong enough to allow us to get up off the floor if we fall). Many older people are just not getting enough. And meat provides them with so much more too – zinc, for example, that plays an important role in immunity.
  1. Take them a fresh vegetable or two. A cauliflower that caught your eye. Some carrots you had spare. A savoy cabbage that will last for days. If cooking’s a challenge, a bag of pre-cut veg that can be cooked in the microwave.
  1. Check their food cupboard. Do they have solid staples such as tinned fish and tinned fruit for when they can’t get out? Would they object to some olive oil?
  1. Take them out. If they rely on others, are they getting outside every day? Daylight and fresh air – these are things the older generations always knew were important. Babies used to be wrapped up and put outside in their prams for air every day. Daylight is important for setting our wake-sleep rhythms and improving the quality of our sleep, which in turn supports many parts of our health – including our immunity. Sadly, the support is not always there for elderly people to get outside every day. Troubleshoot how this could be done for your loved ones.
  1. Encourage them to move. Sitting in a chair for long periods unfortunately tells our heart and lungs that we don’t need them to be so strong. If their doctor allows, is there someone who could accompany them on a short walk once a day? Are they fit enough to join a local health walk? Safely get up and walk around the house or garden once every hour?
  1. Check they are remembering to drink. As mobility reduces, it can be tempting to drink less so as not to get up and go to the toilet as often. Even fitter people can feel less thirst with age. Remind them that the body needs water to function well. A post-it note can be used as a reminder to have a small glass of water between meals.
  1. Get them a medication review with their GP or pharmacist.




January’s Primal Food of the Month

When colds and flu are in the air and January does its thing, what is one thing we can do to give ourselves the best chance at staying healthy?

My answer to this at the moment is…

BROTH (AKA stock, stew, casserole, gravy)

This has come up so often in conversations and consultations recently that I thought it’s time to put broth in the spotlight.

Broth is mainly identified by its ability to turn into a jelly-like structure when cold. It has lots of good healing proteins that are soothing to our digestion and provide building blocks for the intestinal lining, our joints, skin and other connective tissue. There’s a reason jelly has always been used in hospital food and chicken soup has been a traditional approach to colds.

The link with immunity is that much of our immune system depends on how good our digestion is – being able to absorb vitamins, minerals, amino acids and fatty acids from our food is, of course, important to every aspect of our health. But the digestive tract also has its own immune system and plays a huge role in helping us fight off invaders.

So, if you’re looking for something extra to help you get through winter, broth could be the answer.

For many years I tuned out at the mention of broth or stock. Too hard. Too much cooking. Hours in the kitchen with bones and things. Even now, as a nutritionist, I am a reluctant cook.

But it doesn’t have to be beyond reach for people like me. There are two options, depending on whether you’re up for sieving:

  1. Stock: Use leftover chicken carcass or other meat bones OR buy chicken or other meat on the bone. Put in a pan with water, salt and pepper, boil up, simmer for 2.5 to 3 hours. Sieve to get stock without bones – this is the part I dislike, it’s hot but it’s over in seconds. Salvage meat to put back in if you used bones with meat on. Let it cool before putting it in the fridge. Most people like to skim the fat off. Serve heated through in mugs or use as the liquid in vegetable soups.
  2. Stew: Buy meat not on a bone, such as stewing beef, brown it in the bottom of a pan in olive oil or ghee, add some veg (frozen green beans are good), salt and pepper, water, herbs (such as mixed herbs) or spices (such as smoked paprika), boil up, simmer for 2.5 to 3 hours. Serve as soup or stew (we like to add a spoonful of sour cream at the table).

There are lots of good recipes around, with ideas for things to add to the simmering bones and, of course, fantastic stews and casseroles. But it doesn’t have to be fancy.


My Primal Superfoods

There is such a lot of talk about ‘superfoods’: the media like to pick up on the latest crazes such as blueberries, goji berries or kale, which are apparently going to save us from various illnesses. It is interesting how often ‘superfoods’ are fruits and vegetables. Healthy-eating websites and diet articles, in particular, often feature images of huge, colourful smoothies or bowls of fruit. Primal health is about making sure that what we eat is nutrient-dense, so smoothies, fruit and ‘superfoods’ definitely have a place in a Primal eating pattern. But there is a bigger picture:

> Smoothies can make it very easy to eat (drink?) a lot of sugar (yes, it’s natural sugar – mostly fructose – but this can still be problematic for the body to handle in large quantities). At least smoothies contain the fibre from the fruits – unlike juices, which concentrate the sugar without the beneficial fibre – but Primal-aligned smoothies contain a little less fruit and more fat and protein through additions such as full-fat yoghurt, coconut milk/cream/oil, avocado, seeds, etc. Smoothies can in fact be a useful way to hide these filling, nutrient-dense ingredients, as well as nutrient-dense greens, such as baby spinach, for people who don’t like the taste of such things on their own. The key, for me, is to watch that smoothies are not just a glass full of sugar.

> Primal eating means basing at least one meal a day on a plate full of vegetables, often with a variety of types and colours, so that we get a good selection of health-giving antioxidants and other wonderful nutrients from things that grow. But, these essential vegetables, ‘superfoods’ or not, are turned into a more satisfying and nutritious Primal meal with the addition of some quality protein and fat. See Mark Sisson’s Big A## Salad:  Salad adventureMark’s 2017 ‘keto’ salad . I keep a selection of things in the fridge – a bag of rocket, a bag of baby spinach, a cucumber, tomatoes, radish, mushrooms, whatever – ready to throw into a bowl and top with tuna, or leftover chicken, or olives, or chunks of feta cheese and then drizzle with apple cider or balsamic vinegar and olive or avocado oil. This kind of meal is designed to keep blood sugar levels evenly balanced, fill us up, and exploit the power of fat to improve our absorption of nutrients from vegetables (oil- or egg-based dressings for salads, as well as butter melted onto vegetables, are not traditional pairings for nothing!).

> When Mark Sisson was asked last year what he thought about ‘superfoods’, he pointed out that his superfoods would include things like liver, egg yolks and wild salmon, as well as common foods such as onions and garlic. It is interesting to see just how nutrient-dense some basic foods are — foods that are a lot less exotic than the ones touted in the media — and they are certainly not all fruits and vegetables. The U.S. Department of Agriculture provides a national nutrient database and I plan to group together some nutrient figures from this for a future post on some common Primal foods. In the meantime, if you are interested, take a look at Zoe Harcombe’s discussion on this topic.

The Primal Blueprint’s focus on meat, fish, poultry, eggs, nuts, seeds, vegetables, fruit and healthy fats allows lots of room for individuals to shape their meals to suit their personal tastes, tolerances and cultural traditions. The key is unprocessed, nutrient-dense foods – which foods people choose within this framework might vary wildly. Someone asked me what my top ten superfoods would be and I came up with the list in the table below. If you were looking to include more unprocessed, nutrient-dense foods in your life, what would your personal top ten superfoods look like?


My Primal Superfoods  



Scrambled, boiled, omelette, fried, poached.


SMASH Hits: Sardines/Mackerel/ Anchovies/Salmon/Herring


Tinned boneless sardines, smoked mackerel, salmon fried/baked/smoked. Anchovies grilled on lettuce(!!) Haddock.





Roast, minced, stew, stir fries. Bacon/salami/chorizo/paté. Drumsticks/thighs/steaks/chops.


Green/Leafy Veg



Lettuce, rocket, spinach, broccoli, brussel sprouts, cress, red/white/green cabbage, kale, chard, asparagus, courgettes.


Coloured/Other Veg



Peppers, sweet potatoes, potatoes, tomatoes, carrots, beetroot, parsnips, cucumber, red/brown/spring onions, mushrooms, cauliflower, butternut squash, swede, garlic, ginger, herbs and spices.





In half with salt, pepper and vinegar; mashed with spicy Mexican food; in guacamole; in smoothies.





Almonds, pecans, macadamias, walnuts, cashews, brazils. Ground almonds in baking.




From a jar in brine usually; sometimes in a pot in oil.


Fats (unrefined, heat/air/light-stable): olive oil, coconut oil, goose fat, butter, avocado oil.


Used to cook with. Olive oil or avocado oil on salads or in home-made mayonnaise.


Full-Fat Dairy


Full-fat plain yoghurt, cheese, fresh cream, sour cream.


Occasional treats:



85% cocoa chocolate; 100% cocoa in baking; coconut butter; berries, apples and other fruit; limited dates, honey or maple syrup in baking.



Why is Primal any different to other diets?

Everyone tells you their diet is The One. If you only follow their instructions then you will be thin/healthy/happy/perfect, etc. Popular British newspapers feature a never-ending parade of diets that will supposedly transform your life. There is, no doubt, room for all kinds of diet, considering that the world has all kinds of people. And yet, many people have tried so hard to lose weight and get healthy but struggle to get anywhere. Or they lose weight and then put it back on again later. Why do I think Primal can be any different?

The articles and external links on this website give deeper explanations and research references, but my quick answer is this:

above all, primal-aligned eating lets me feel well and manage my weight without feeling hungry

Yes, it takes willpower to switch over to primal. Cleaning out the pantry, re-stocking with primal foods, and planning what you will cook takes some thought and effort. But willpower becomes less important even after a few weeks because, crucially, primal-aligned foods keep you fuller for longer.

This is important because, as many of us know, losing weight is easier than keeping the weight off long-term. Willpower is great until you just can’t keep it up anymore! Our bodies eventually just want to make up for the ‘famine’ and get some food on board. This is why we try not to call Primal a ‘diet’ – it is designed to be something that more people can sustain forever.

The key is in the hormonal response to different foods. Hormones such as insulin, ghrelin, glucagon and leptin all influence our appetite and metabolism. You can read about these hormones anywhere, but if you’re not up for that level of science, it is important to consider at least the importance of insulin:

So many doctors, nutritional therapists, type 2 diabetes experts, and other health commentators are now realizing that if we can keep our insulin production low and stable (through our food choices), good things happen:

  •  we are less likely to lay down fat in our fat storage cells
  • we are more likely to be able to burn the fat that we have already laid down in our fat storage cells (insulin keeps it locked away)
  • we are less likely to have low blood sugar ‘crashes’ that make us reach desperately for high sugar foods
  • we are more likely to avoid the blood-sugar-related conditions that develop from long-term high insulin levels, such as insulin resistance, type 2 diabetes and their associated problems
  • we have a better chance of avoiding the conditions exacerbated or caused by the inflammatory effect of high insulin levels

Primal eating takes into account all of this information on insulin (and related appetite and metabolism hormones) and highlights nutrient-dense, real foods which:

  • tend to be naturally low in carbohydrates and therefore make it easier to keep insulin levels low and stable as described above.
  • provide our bodies with the nutrients we need, helping to remedy some of the deficiencies we may have built up over the years and helping us to feel satisfied.
  • contain the natural fats that can be used for vital functions in our bodies, help us absorb nutrients, contribute to stable insulin levels, and keep us full for longer.
  • exclude many damaging foods that deplete, irritate or overwork our bodies.
  • form the basis for specialist diets designed to heal all sorts of chronic conditions (the Wahls Protocol and the GAPs diet come to mind).

Many kinds of diet will contribute to health and weight management. What successful diets have in common is that they encourage the reduction of sugar and processed food. Primal goes further by also reducing less obvious sources of sugar (such as starch-based grains) and in focusing on the all-important nutrient-density.

Of course, Primal is just another diet option among many but I think that anyone who is wondering why they are not losing weight even though they are not over-eating or who has lost weight only to put it back on again will instinctively know that there has to be more to losing weight than just trying to eat less and do more exercise.

Are you an all-or-nothing person?

The 80/20 Rule, transition foods, moderation and ‘cheat days’

When health coaching, one of the first things I like to know about a client is whether they are someone who likes to jump in at the deep end in life or whether they are a one-step-at-a-time kind of person.

The Primal Blueprint offers a simple 80/20 rule: if you eat well 80% of the time, then it won’t matter too much if you ‘go astray’ for 20% of the time. For many people, this means that they can ease into new ways of eating and just aim as high as they can, with no worries if they don’t change everything at once. It means that if you really need that piece of toast to go with your eggs at breakfast, then don’t let that knock you off course, just try not to fill the rest of your day with non-primal foods. It doesn’t mean only aiming for 80% – it’s more about aiming for 100% but being very happy with 80%.

I know people who work very well with this concept. Sugar in your cup of tea? Why not, it’s only a teaspoonful and it might be very important for your morning routine or general relaxation. Primal living is, above all, about getting the most enjoyment out of your food and your life. In the scheme of a fairly primal way of eating and living, that teaspoonful doesn’t amount to much. It’s a perfect roadmap for many people, allowing them to create their own framework of eating and knowing that they can be relaxed about certain foods that are not considered ‘primal-aligned’ but which are important to them.

The 80/20 rule can also be used as a transition crutch: swap some foods for primal-aligned foods but keep some others, aiming eventually for a greater percentage of primal-aligned eating. I am a great believer in food swapping – I did this inadvertently when I gave up desserts and milk chocolate. I knew I always went hunting for snacks in the evening, so I had some full-fat yoghurt and oat cakes to hand. I hadn’t come across the Primal Blueprint at this time so I didn’t know that oatcakes weren’t ideal, but they provided a good transition away from sweet treats.

It’s great when a client can identify foods that they could swap out as part of their transition. No one else can suggest what is right for you, though, or tell you when the right time is for you. I remember when, years ago, a healthy-eating friend suggested that I eat nuts instead of chocolate – all I could see was some barren wasteland of a dull, boring life. There was no way I was ready for that at the time and it was only several years later that I knew I was ready to make a change to my excessive chocolate and cake consumption — and do it my way.

My transition to primal-aligned eating seemed to be an ‘in at the deep end’ kind of thing – I just took the plunge and never looked back. I see myself as an ‘all or nothing’ kind of person. And yet, looking back, I didn’t really do it like that. I gave up the obviously sugar-heavy foods first (desserts and milk chocolate) and then, around two years later, ditched the hidden-sugar foods: the starches and processed foods. I suppose that not having to give up everything at once made it easier – some people go through the ‘low-carb flu’ when they do it fast – and yet I do now wish that I had known sooner that some of the things I was filling up on were not really helping me (huge bowls of fruit salad, muesli, brown rice, lentil soup).

We all have to find our own way. For me, constructing my own framework of eating works well – once I have decided what I can and cannot eat, I appreciate the clarity and know that if I stick within my own guidelines, I can relax and enjoy the food. There’s no need to be continually making decisions; the decisions are made and I just work within that. People who write about willpower would probably say that I am helping myself to avoid willpower fatigue. Our willpower seems to have limits and if we keep having to use it too much, we wear it out and end up with much weaker willpower by the end of the day.

Of course, the nature of primal-aligned foods also means that willpower is not really as big a deal as it sounds: for a start, I never need to be hungry. The foods score quite high on satiety due to the effect they have on hormones; they also taste and feel great. And while filling foods that don’t cause blood sugar swings mean less need for sweet treats, I’ve found a whole world of substitutes for milk chocolate whenever treats are needed (and when feeding children, I believe good healthy treats are definitely needed), including very dark chocolate (85% cocoa), strawberries and cream, full-fat yoghurt, macademia nuts, coconut butter, and various home-made primal-adapted ice cream/pancake/cookie recipes.

The other reason I see myself as an all-or-nothing kind of person is that I have never been very good at moderation. One piece of cake, one crisp, one bite of a Mars bar and then no ability to refrain from having more. I like food. So, the 80/20 rule works really well for people I know but it just isn’t for me in my day-to-day eating. I like my ‘rules’ and I feel comfortable within them. Where I do use 80/20, though, is when it comes to particular foods that don’t come up all the time but which I want to be able to enjoy. For example, a speciality food from the country or region where I am on holiday – paella in Spain, even though I don’t normally base my meals on a plate full of rice, a Cornish pasty from my favourite farm shop in Cornwall, even though I wouldn’t normally touch wheat.

Like other people in the primal/paleo/ancestral-health world, I use primal-approved ingredients to adapt favourite recipes: ground almond instead of flour, butter instead of margarine/industrially-produced vegetable oil, etc. But there are just some foods that I want to be able to enjoy whole-heartedly, just not that often: proper Italian pizza comes to mind. A couple of times a year is fine and, although the wheat does affect me, I can tolerate it enough and enjoy a great family night out. There are all kinds of primal/paleo adaptations, from cauliflower pizza base to no base at all (yes I do do this sometimes) but, for me, being able to enjoy a good-quality regional speciality fits perfectly well into the mindset of primal-aligned living.

And this is where we come to ‘cheat foods’ or ‘cheat days’. Primal health just doesn’t do the concept of cheating – write your own rules, allow into your own framework the foods or meals that you really don’t want to miss out on and think about how often you are likely to have them. If you’re finding that the whole framework is becoming full of non-primal-approved foods, then of course this won’t be a primal lifestyle any more and you can either decide that primal isn’t for you or you can work on swapping some foods or meals around to get back to 80/20. But if you are creating your own way of living, accept that some foods (and experiences) will be a part of your landscape for very good reasons. Enjoy them, never feel guilty, and know that your overall eating is good enough to accommodate them.

If you have any tips and tricks and thoughts on these things, do write them below in the comment section.