Darshan Shah, MD, is a health and wellness specialist, board-certified surgeon, published author, entrepreneur, and founder of Next Health, the world’s first and largest Health Optimisation and Longevity clinic. With expertise in all body systems, he has performed over 20,000 surgical procedures, including trauma surgery and complex reconstructive procedures. As a Longevity Medicine specialist, he has advised thousands of patients on how to optimise their well-being and extend their health span and lifespan. Dr. Shah began his career at an accelerated MD program and earned his medical degree at the age of 21, becoming one of the youngest doctors in the United States. He continued his training at the Mayo Clinic, one of the most prestigious medical institutes in the country. After earning his board certification, he opened medical/surgical centres throughout California, started four other companies in the Health and Wellness space, and has published a book, authored numerous papers, and patented medical devices. Dr. Shah’s belief in continual education and self-improvement has earned him alumni status at Harvard Business School, Singularity University, and other prestigious institutions.
In this interview I speak to Darshan Shah, MD, one of the world’s foremost health and wellness experts. Dr. Shah discusses the extraordinary power of our immune system, what harms and helps our immune system, and how people in high performance careers can work with their bodies to optimise immune and long-term health.
Q: How incredible is our immune system?
[Dr Darshan Shah]: The miracle of life poses a fascinating question: How does this marvel that sustains us exist? The process of evolution itself is a miracle. Consider our immune system, which operates in two distinct manners. Initially, we have what is termed immediate immunity. This kicks in the moment any infection or injury is detected, deploying an instant response to manage the situation right away. A key component of this immediate action is inflammation, which not only combats the threat but also initiates the healing process from the outset. Following this, there’s the memory system. Remarkably, the immune system can autonomously recall, independent of our brain, if a specific pathogen has previously invaded our body. Utilising this memory, it can then swiftly orchestrate a targeted assault against the invader. Thus, we see these two systems working in harmony to confront every challenge our body encounters, not limited to infections but extending to injuries, cancer, and even the elimination of our own cells that are deteriorating and becoming harmful. It’s as if our body hosts its own military, comprised of various branches and specialised roles, all designed to preserve our life.
Q: How should we think about immunity day to day?
[Dr Darshan Shah]: Many people prioritise nutrition, make sporadic trips to the gym, and so on, allowing the immune system to recede into the background—until illness strikes. Suddenly, the question arises: Why isn’t my immune system performing as it should? Especially if sickness becomes a frequent unwelcome guest, one might wonder about the effectiveness of their immune defence. The truth is, much like any other organ, the immune system operates within the broader ecosystem of your overall health. Your general well-being plays a crucial role in the vitality of your immune response. And yes, factors as seemingly simple as inadequate sleep can significantly impact your immunity for the following 24 hours. Operating on less than six hours of sleep, your immune system may function at merely 40 to 50% of its full potential. This is why individuals who suffer from poor sleep quality, including those with sleep apnoea, exhibit a higher incidence of cancer and Alzheimer’s disease. The immune system’s role extends beyond combating infections; it’s also key in eliminating cancerous cells and malformed proteins that can lead to Alzheimer’s, among other tasks. Therefore, a compromised immune system is not just more susceptible to infections but also to a host of chronic diseases. Thus, the foundational pillars of health—exercise, sleep, nutrition, and stress management—all significantly influence our immune function.
Q: What is the role of exercise and immunity?
[Dr Darshan Shah]: Let me share something with you that might just blow your mind. I’m a huge advocate for the Pareto principle—this idea that 20% of your actions can yield 80% of your results. When you channel your energy into those pivotal actions, you’ll witness incredible enhancements, not just in your immune health but in your overall wellness too. Interestingly, when it comes to nutrition and exercise, it often boils down to what you shouldn’t do, rather than what you should.
For nutrition, the game-changer according to the Pareto principle is cutting out ultra-processed foods. These are the items produced in factories, laden with chemicals, inflammatory oils, and excessive sugars, all of which severely compromise your immune system. This damage primarily occurs through your gut. Dubbed the microbiome, your gut acts as a fortress against external threats, housing 90% of your immune system. Consuming a diet heavy in ultra-processed foods disrupts this delicate ecosystem, leading to a diminished gut microbiome. Consequently, toxins infiltrate our bloodstream, triggering an overactive immune response.
As for exercise, the focus surprisingly isn’t on gym workouts. It’s about reducing sedentary time. Incorporating movement into your day, regardless of structured exercise, can significantly boost your health. To put it in perspective, every hour spent sitting beyond four hours daily increases mortality risk by 10%. I tackle this with a walking desk, using a treadmill at a low speed throughout my workday. While some might see this as extreme, I view it as an efficient way to blend productivity with health. However, a more accessible strategy is the concept of “exercise snacks.” Established by research, this involves setting a timer to remind you to get up and move for five minutes every 45 minutes, effectively countering the effects of prolonged sitting.
Q: What is the role of stress in our immunity?
[Dr Darshan Shah]: Stress is an inevitable slice of life, and battling to eliminate it entirely might be a lost cause. For those lucky enough to experience minimal stress, more power to them—that’s fantastic. Personally, stress is a constant companion in my life, and I anticipate it always will be. The real issue arises when mental stress morphs into physical strain, affecting our physiology and biology. Prolonged stress triggers a surge in cortisol levels, and when these levels remain elevated for too long, they wreak havoc on our health, particularly through our immune system.
So, what’s the countermeasure? Surprisingly, it circles back to the advice I shared earlier. If you manage to take a break, even just for 5 to 10 minutes every 30 to 45 minutes, it acts as a circuit breaker for cortisol secretion from your adrenal glands, allowing your cortisol levels to decline. Without these breaks, cortisol levels escalate, and your body starts to accept this heightened state as the new normal. This means that any subsequent stress could push your cortisol levels even higher. By incorporating those brief, regular breaks, you prevent a recalibration of your body’s cortisol threshold, keeping it within a healthier range.
Q: How can we stop getting sick with air travel!?
[Dr Darshan Shah]: …what many people don’t realize is they often attribute getting sick to factors like poor air quality, touching various surfaces, or being in close contact with others. While these elements may contribute, they’re relatively easy to counteract with measures like hand sanitiser. However, the real culprit behind the sickness often goes unnoticed: it’s the disruption to our circadian rhythm caused by traveling across time zones. Our bodies are designed to operate on a consistent circadian pattern over long durations. Historically, humans didn’t cross time zones as we do today; it’s a relatively new phenomenon. The impact of changes in light exposure, sleep schedules, and mealtimes can significantly disturb our circadian rhythm. When this rhythm is off-kilter, it throws our body’s hormones—including stress hormones—out of balance, which is where the true problem lies.
To mitigate the effects of time zone travel, here are a couple of practical tips. First, if your trip is shorter than a week, try to stick as closely as possible to your regular schedule from home. This can be achieved by optimising your sleep routine and environment to align with your usual timings, even in a new time zone. Additionally, the timing of your meals plays a crucial role in maintaining your circadian biology. When I’m traveling, especially on a plane, I make it a point not to eat the in-flight meals. Not eating at all is preferable to eating at the wrong time, as the latter can disrupt your entire circadian rhythm. If you do need to eat, aim to do so at the same times you would at home, regardless of the local time in your new destination. It always puzzles me when airlines serve breakfast right after take-off on overnight flights, claiming it’s to help passengers adjust to the new time zone. If your stay is under a week, it’s better to remain on your original time zone schedule.
Q: How do supplements impact our immunity?
[Dr Darshan Shah]: Let me set the stage for my response by highlighting that, ideally, if you’re consuming a nutritious diet rich in whole foods, with 500-800 grams of vegetables daily, one gram of protein per pound of lean body mass, and incorporating high-quality fats into your meals, you likely wouldn’t need supplements. Yet, the reality is, not many of us have the luxury of someone preparing two fresh salads daily, alongside a perfectly portioned piece of grass-fed protein or sustainably sourced fish—especially when traveling, as you mentioned earlier.
Under such circumstances, having a few key supplements on hand becomes beneficial to stay nutritionally balanced. Traveling or indulging in a cheat meal can significantly deplete our nutrient levels, leaving little room for dietary lapses. Our bodies demand continuous nourishment due to constant nutrient utilisation.
Therefore, there are certain fundamental supplements I believe are essential for daily intake, considering the common deficiencies among most individuals. Vitamin D tops this list, as it’s a critical supplement that many should consider. Despite the possibility of testing for Vitamin D levels in your blood, in my experience with thousands of patients, only a handful have naturally adequate levels.
Another indispensable supplement is high-quality fish oil or its vegetarian/vegan alternatives, to ensure a sufficient intake of omega-3 fatty acids. Lastly, regarding immune system support, Vitamin C and zinc are two pivotal immune-modulating supplements. These are particularly advisable for travel periods or times when you’re not feeling your best overall.
Q: Do vegetarian and vegan diets impact immunity?
[Dr Darshan Shah]: … the suitability of a vegetarian or vegan diet really hinges on the approach one takes. There’s a stark contrast between those who prioritise whole, clean foods and those who lean heavily on processed, packaged products labelled as vegan-friendly. These products may not contain meat but are often laden with chemicals. The key to a nutritious vegetarian or vegan diet is focusing on whole foods—those that are cultivated from the earth. Opting for organic produce, which you can easily find at your local farmer’s markets, is a wise choice. These markets are treasure troves of organic, nutrient-rich foods that support a healthy diet.
Another concern with vegetables today involves their origin and how they reach our tables. Many vegetables are grown in distant lands, genetically modified, and then shipped over long distances, sometimes being stored in freezers for extended periods. This process can significantly diminish their nutrient density. Therefore, the closer your food’s source is to its point of purchase and consumption, the better. Purchasing locally grown produce ensures you’re getting the freshest, most nutrient-packed vegetables available, supporting not just your health but also local farmers.
Q: is there merit to regular bloodwork and preventative scans?
[Dr Darshan Shah]: …my answer is a resounding yes, and here’s why: Western medicine, while exceptional in treating and diagnosing diseases and cancers, has largely remained static for nearly half a century. However, advancements like whole body scans, previously reserved for assessing the extent of stage four cancers, are now becoming more affordable and accessible. I often emphasise that cancer’s most formidable foe is early detection, ideally at stage one. With technologies such as whole body MRIs becoming available, detecting cancers early when they are most treatable—as opposed to stages three or four, where survival rates drastically decrease—becomes a game-changer.
Furthermore, I advocate for what I term becoming the CEO of your own health. This analogy resonates particularly with business-minded individuals. Consider this: would you check your business’s key performance indicators (KPIs) only once a year, relying on a consultant to interpret them? Of course not. Yet, many treat their health’s KPIs—such as annual blood tests—with a similar lack of engagement, merely waiting for a doctor’s reassurance before moving on, only to return when ill. We all know that the KPIs of health are not static; they fluctuate within a spectrum from optimal to warning to critical levels. Being proactive and informed about your health means understanding these biomarkers long before issues arise.
To empower my patients, I focus on educating them about ten or so crucial biomarkers, guiding them to understand what these figures signify and their optimal ranges. This approach enables individuals to monitor their health actively because, ultimately, no one is more invested in your well-being than you are.
Q: What are some of the things we could all do to improve our immunity?
[Dr Darshan Shah]: I believe that within each domain of health, there’s a critical aspect to consider. Echoing our earlier discussion on the Pareto principle, especially in the context of nutrition, minimising the intake of ultra-processed foods in your daily diet is crucial. We also touched upon the importance of sleep, and nowadays, there are various sleep tracking devices available, like rings and bracelets. While I don’t see a need for permanent usage, employing one for a duration of 8 to 12 weeks can offer insightful data on your sleep patterns, highlighting actions that may positively or negatively impact your rest. Given their increased affordability and ubiquity, a sleep tracker used for a set period to optimize sleep, then passed on to a family member, could prove highly beneficial.
Another topic I frequently address with my patients is the significance of incorporating strength training into their exercise regimen. The prevailing notion from our upbringing that cardio alone suffices for health is misleading. In reality, muscle mass is the powerhouse of your metabolism, playing a pivotal role in preventing osteoporosis. Moreover, sarcopenia—or the loss of muscle mass—is linked to a host of health issues, including neurodegenerative diseases, cancer, heart attacks, and metabolic syndrome. Thus, maintaining adequate muscle mass is imperative.
But how does one achieve this? Firstly, it’s essential to assess your current muscle mass. This can be done through various methods, such as a DEXA scan or specific scales that measure muscle mass. Once you have this information, comparing it against the norms for your age, gender, and weight is crucial. Subsequently, targeting these benchmarks through strength training protocols can significantly enhance your health and longevity.