Tim Spector’s six steps for lifelong health

This article is from the 'Firm Foundations' issue of InTouch, your alumni magazine. Read the full publication here.

Pioneering King’s Professor, Tim Spector OBE, reflects on the impact of his work over his time at King’s and how we can build a foundation of good physical and mental health for all.

Tim Spector is a man who wears many hats. He has been a rheumatologist, an epidemiologist, an author, an entrepreneur, a health policy advocate, a nutritionist and, most recently, a media figure.

However, if you look more closely, Tim has really been just one thing all along – someone who is deeply invested in improving people’s health. Whether that’s through research, improving treatments or overhauling systems, it always comes back to his vision of how we can build healthy futures for everyone.

Mass data

The first step in Spector’s vision for a healthier future is better and greater information sharing. ‘I think a reason the NHS, as a whole, is behind some other countries in terms of communications, is our obsession with confidentiality of health data and it falling into the wrong hands. We’d rather have poor communications between doctors that’s unimaginable in other countries. When, in reality, 99% of people’s data is not very interesting to steal.’

This is Professor Spector, the epidemiologist. Epidemiology - the study of the distribution of disease in human populations and the practice of looking for patterns that can tell us about symptoms, prevention and cure – is what brought Tim to King’s.

Tim’s flagship project was Twins UK. In it, he and his team took 15,000 identical twins and monitored their health for 25 years. By taking two genetically identical people and marking how differences in lifestyle affected their health, the study gained many insights into which behaviours result in ill-health and what we might do to prevent it. Which leads us to the second of Tim’s steps – prevention.

Preventative medicine

‘Preventative medicine is crucial for any developed country’, says Spector. And in his view, the UK government isn't doing it well enough. ‘The saddest thing is we’re the country that invented epidemiology and we’re now the country in Europe with the least preventative medicine focus.’

The intersection of big data (large and varied collections of data) and preventative medicine is where Tim’s work with King’s overlaps with his current project, ZOE.

Primarily known for its glucose monitors, blue cookies and personalised diet advice, the ZOE app also asks users to record the physical response to their new diet. This data is amassed, shared with King’s and used to inform advice on the best diet for good health. This brings us to Spector’s top priority area for change.

Nutrition

‘I think of all the things you can do, diet is probably the most important,’ Tim explains. ‘Estimates suggest diet can reduce common diseases by about 80%. If we all have that optimal diet, we'll be saving [the NHS] £85 billion a year.’

Sharing his views on improved diet has been at the centre of Spector’s work in recent years. Alongside the ZOE app, he has raised awareness of the gut microbiome and the role gut bacteria could play in our health. From gut-health shots in Marks and Spencer, to his most recent Netflix series, Hack your Health: the Secrets of your Gut, Spector has become one of the most recognised faces in nutrition.

His next project takes the shape of a cookbook. Through the book, he hopes to teach people more about eating in a way that is conducive to gut-health and how to make this a daily reality. ‘I love the fact that it’s practical – people who don’t want to read a whole textbook are happy to read a cookbook and flick through it and get some tips.’

Tim says his favourite recipe in the book is a fresh take on a classic lasagne. ‘We’re using wholewheat pasta, changing the meat for lentils and mushrooms, and a butterbean cream layer with some silken tofu instead of the bechamel. And then cheese on top. That’s my comfort food.’

Personalised programmes

Spector’s view on highly effective nutrition to benefit our health goes one step further. And this is really where ZOE comes in for the individual.

‘For 20 years, we were all encouraged to “eat less, move more”. Well, that failed. I think people realise one-size fits all guidelines don’t work.’ He points, in particular to ZOE’s recent randomised control trial, comparing people taking the ZOE approach, with people following USDA nutritional guidelines.

‘One was telling to you reduce calories, eat more fruit and veg and have low fat products, and the ZOE one was saying, forget calories. This is a personalised approach. And ZOE won easily. So I think we’ve proven it works. We can do a much better job and tailor it to people so they can stay on it longer. I think that’s the key. I think people do like personalised approaches. And they’ve realised we’re not all genetically engineered mice, designed to eat the same way.’

This approach, Spector is learning, has benefits beyond our physical health. ‘We see ZOE improves mood. Energy is the first thing that changes when you go on those diets and no one has measured that before. When you see a GP they don’t usually say “what is your mood like out of 10?” or ask if your mood has changed in the last year. It’s not been part of medicine. We have this barrier between psychiatry and medicine. I’m really interested in that interface.’

Commercial innovation

The next part of Tim’s vision is overhauling the relationship between research, clinical practice and the patient.

‘Universities are very good at coming up with ideas; theories, early stage work. But they can be less good at putting it out there for the public,’ he says.  

While recognising that universities house the minds that can revolutionise our health, he also identifies challenges they might face compared to a commercial organisation. He expands: ‘a university needs at least a year to get various agreements and approvals on forms. And sometimes, even if they're appropriate, they can be stopped by the government. And then there’s the manpower needed to do it, and the process of getting grants for it.’

His solution is for universities to work more in partnership with small, agile spin-offs and startups, like ZOE, to push progress on: ‘I think the future is really about combining the broad talent you've got in universities, with small, very focused startups that can put things into practice.’

The recently launched London Institute for Healthcare Engineering is just one of many examples of how King’s is breaking the mould and putting this theory into practice.

Led by one of Spector’s collaborators on the COVID-19 app, Professor Sebastien Ourselin, the Institute is helping academics take their research and build it into commercially viable healthcare products. It then helps the products make their way into clinical settings at Guy’s Hospital, closing the gap between research and patients receiving the care they need.

Outreach

An unexpected result of Spector’s more commercial work, and the final piece of his puzzle, has been his newfound appreciation for outreach, and making sure healthcare messages reach the public.

‘I learned in COVID how to talk to the public and how to gain that trust. It really pointed out the importance of two-way conversation – you have to give them something back in return. Whereas I think most researchers have a rather one-way view of the public. People sign up, fill in your questionnaire and a few years later, you write the paper, and we might put something in the acknowledgments. But if you can give people this instant feedback, as we did in COVID, they become partners.’

This vision of the public as partners, not recipients, is one of the reasons Spector thinks he has amassed such a significant following. He now has more than 2.3 million social media followers, the ZOE podcast is the number one health and lifestyle podcast in the UK, and he has fronted two Netflix shows – something he’d like to continue.

‘They’re very time consuming for the number of seconds you’re on screen. But it’s huge reach – it’s global. When do you ever get global reach? Translated into 25 languages; people all over the world saying they’ve seen you. Much better than a Channel4 series that gets missed. I think Netflix, YouTube, they’re the future of medical info programmes.’

And that, ultimately, is Professor Spector’s uniqueness – his ability to think outside the confines of one medical specialty, disease or institution. His vision for health is one that has grown at King’s and recognises the inter-connectedness of all parts of healthcare, truly moving us closer to lifelong health for everyone.