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We're constantly being told
how to live our lives.

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But what's the health advice
you can really trust?

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In this series we use our
expertise to guide you...

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.. through the contradictions
and the confusions.

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We'll get to the heart of the debate...

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.. and ensure you get the
information you need.

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We're here when you don't
know where to turn.

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I'm Michael Mosley. In this series
I'm joined by a team of doctors.

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Together we'll cut through the hype,

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the headlines and health claims.

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This is Trust Me, I'm A Doctor.

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This time we're in London, where
we're going to be finding out

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if you can lower your cholesterol
just by changing your diet...

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- I'm top of the class.
- Yes, you are!

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.. witnessing an amazing new treatment
for a hospital superbug...

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It is like a doctor's dream.

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.. asking is there
is a cure for snoring?

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THEY SNORE

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Are our shoes damaging our bodies?

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And how to remove ticks safely.

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Oh, no, that's horrible.

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On Trust Me, I'm A Doctor
we like to investigate

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the things that you're interested in.

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So recently we did a poll

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and high up was, how can
I avoid heart disease?

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Now, this is a subject that
is dear to my own heart

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because I know that I'm at high risk.

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So I decided to take
part in a big experiment

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we're doing here in London.

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More of that later.

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But first, Dr Chris van Tulleken
is on a different mission.

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I want to investigate the
products on our shelves

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that are sold on the promise
of improving our health.

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How do we know we're not
just wasting our money?

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And there is perhaps no area where
the marketing is more intense

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than personal hygiene.

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The soap, bath and shower products
market in the UK last year

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was worth a staggering £1.5 billion.

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But do we really need them,
or are we wasting our money?

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Pretty much everyone in this country
uses soap or shampoo regularly

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in one form or another.

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WOLF WHISTLE

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These days many of us

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two or three times a day strip
the oils and greases from our skin

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with products like this -- with
shampoos, with shower gels.

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And then we get out of
our baths and showers

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and we use these products
-- moisturising creams --

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to replace those oils and greases.

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So is it just a never-ending
cycle of illogicality,

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or could it actually be bad for us?

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What's your post-bath or shower routine?

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Body lotion.

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So don't you think it's weird that
you wash all the oils and grease off

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your skin and then you put oils and
grease back on your skin afterwards?

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- Yeah, it is. - Why are we washing
it off to put it all back on again?

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So, I'm going to investigate the
two parts of our washing cycle.

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First, the scrub.

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Now, most of the products
we used to take the grease

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and oils off our body
contain detergents.

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So what I want to know is, are
these chemicals doing us any good?

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I'm determined to find out,

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with some help from experts
at the University of...

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Bath.

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So, Sarah, there's an ingredient
I've noticed that seems to be

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second or third on the list.

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This sodium lauryl sulfate.
Now, I use this in the lab

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and we're quite cautious about using it.

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It's quite a strong irritant, so
what is it doing in my shampoo?

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The reason it's in all these
products is that it's very good

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at helping oil mix with water.

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That's how you can clean
your hair and your body.

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But it is quite an aggressive
irritant, as you say,

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so prolonged use or prolonged exposure
to SLS can damage your skin.

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SLS is used in soaps and body
washes as well as shampoo,

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and to find out just how damaging
it is, I'm going to leave

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dilute SLS on my skin for several days.

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So, this is completely painless.

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'But before I start,

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'Sarah is testing the rate
at which my skin loses water,

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'a good measure of how healthy
it is as a barrier.'

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The water loss from your skin

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is nine grams of water per
metre squared per hour.

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'Nine is a level you'd expect
for normal, healthy skin.

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'We'll repeat this test at the
end of the experiment and, if I'm

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'losing more than nine grams then,
it means it's bad news for my skin.

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'Next, we dip a piece of gauze in SLS,

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'cover it and tape it
to my left forearm.'

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I'll do this every day for the next
three weeks, putting fresh SLS

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on my left arm at bedtime

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and leaving it against
my skin overnight.

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HE GARGLES

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TOILET FLUSHES

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Three weeks later, I'm back
in Bath for an expert opinion

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from Professor Richard Guy.

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I haven't actually been
examining this very much.

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I just sort of put on the
stuff at night and left it.

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But looking at it in the cold light
of day, it is red, isn't it?

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- It's quite red.
- And it's looking quite inflamed and scaly.

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How damaged do you think it is?

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Let's make another
measurement, shall we?

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So if you can just hold it.

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'At the start of our experiment
my water loss reading was nine.

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'Straight away I can see
it's now much higher,

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'so my skin is losing more water.'

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This number is going... really
through the roof, isn't it?

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It's much, much higher, yeah.

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If we were to remove completely
the barrier layer of your skin,

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the value would be...
somewhere around 18.

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So you've got up to 33, nearly, there.

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So I'm halfway to having
the top layer of my skin

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completely peeled off.

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That's correct.

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I've essentially given
myself eczema here.

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It looks like eczema,
it feels like eczema.

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We've done experiments exactly
like you've performed on yourself

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but in a much bigger
cohort of individuals.

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And we've seen exactly
the same types of things.

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And so to the second part
of our washing cycle.

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After using harsh detergents,
our skin can feel dry,

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and so we put on moisturisers.
But what are they doing?

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Time for my other arm
to get some action.

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I'm going to do another experiment
on my right forearm.

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I'm going to use a very normal,
widely available moisture cream.

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I'm going to moisturise just the
top bit of this right arm here.

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I'm not going to moisturise
the bit near my wrist.

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I'm repeating this routine
for three weeks.

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Now, I'd expect a moisturiser
to make my skin moister.

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In other words, my skin should
be losing less water

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where I put the cream.

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But in fact the figures
for the skin I moisturised

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and the skin I didn't are
almost exactly the same.

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At least in terms of measurement
of my skin's effectiveness

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as a barrier, in this experiment,

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moisturising was essentially
a waste of time and money.

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In the context of this
particular experiment,

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I think the answer to that would be yes.

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So over the course of my experiment,

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moisturisers did nothing
to improve my skin.

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So I, for one, am not going
to waste my money on those.

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But I'm more concerned
about the effect of SLS.

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So how worried should we be?

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In terms of products that are washed
off -- shampoos, conditioners,

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body washes, whatever -- I think
if you've got normal skin,

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probably there's not a
great deal to worry about.

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However, if you've got
dermatitis, eczema,

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then I think you'd be better off
avoiding, if at all possible,

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the use of products that contain
these powerful detergents like SLS.

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Even for short contact.

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And there's one type of product
in particular to be aware of.

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Aqueous creams, that are sold to
relieve skin conditions like eczema,

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actually contain SLS,

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even though they're designed
to be left on your skin.

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So take care when you're buying
skin and hair products

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and, if you're concerned, there
are lots of SLS-free ones

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readily available on the high street.

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But they're not always marked as such

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so you may have to look at the
ingredients list just to check.

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SLS is particularly powerful,

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but in fact in almost all soaps,

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body washes and shampoos
there are detergents

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and they will remove the
natural oils from your skin.

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You may find that reducing your
exposure to any kind of detergent

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improves the health not only of
your skin, but also your wallet.

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As a medical journalist, I have
covered a huge range of subjects,

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but there is one that is
particularly close to my heart

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and that is cholesterol.

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Now, like 60% of people in the UK,
I have an elevated cholesterol score

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and that puts me at greater risk
of heart disease and stroke.

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What's more, the latest headlines
suggest having even slightly

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higher cholesterol in our 30s and 40s

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could raise our risk of heart
disease by up to 40%.

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Now, like a lot of people,

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I have wrestled with the
cholesterol conundrum.

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The obvious thing to
do is to take statins,

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and undoubtedly they work.

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They lower cholesterol

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and they also reduce your risk
of having a heart attack.

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But in some people they also
have significant side-effects.

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These range from muscle aches
to worries about memory loss.

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So I want to know, can I lower
my cholesterol without statins

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by being smarter about the food I eat?

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To find out, we've recruited
a gang of willing volunteers

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who all have high cholesterol.

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And with the help of experts
at King's College London,

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we're going to see if we can lower
their levels through diet alone.

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All our volunteers have a personal
interest in taking part.

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Why did you decide to do this study?

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When I went to the GP he said,
"Bad cholesterol is bad."

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My parents both have high cholesterol.

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I would always prefer to
find a natural solution

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to a health problem if I possibly can.

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What we're not trying to do is
get rid of cholesterol altogether.

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In fact, it's an essential substance
we all need to live and function.

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For example, our bodies
use it to make vitamin D

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and the hormones oestrogen
and testosterone.

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Problems start when we end
up with too much cholesterol

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and, specifically, too
much of the wrong kind.

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When your doctor tests
your cholesterol levels,

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as well as the total figure,

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there are two other results
to look out for.

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One is LDL, known as bad cholesterol,

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because it can clog up your arteries.

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The other is HDL, which is seen as good

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because it actually removes
cholesterol from your arteries.

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Now, Tim is about to take
some of my blood to measure

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my cholesterol levels, which are
measured in millimoles per litre.

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Now, in a healthy individual,

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your total cholesterol
should be less than five,

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00:12:20,620 --> 00:12:23,810
your bad cholesterol, which is
LDL, should be less than three,

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and your good cholesterol, which
is HDL, should be more than one.

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00:12:28,220 --> 00:12:31,780
And I suspect that not all of
my numbers are going to be good.

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00:12:33,500 --> 00:12:37,010
And they're not. My total
cholesterol is eight.

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My HDL, the good cholesterol,
is excellent at 2.5.

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But my bad cholesterol, LDL,
is depressingly high at 5.5.

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So I want to bring that down.

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As for our volunteers, they
also have unhealthy scores.

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But we're going to try and improve them.

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We're splitting these brave
volunteers into three groups.

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Each group will be changing
their diet in a different way.

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Group one are going to be cutting
out foods said to raise cholesterol,

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so these are all the foods they're
not going to be eating.

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Group two don't have
to give up any foods,

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but they are going to
be eating more oats.

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And group three, they're going to be
eating a daily handful of almonds.

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We want to put to the test

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the claim that these diets could
help cut our cholesterol.

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Dr Scott Harding will be helping run
our trial to see how well they work.

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So the group who are
cutting out cholesterol,

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what are they going to be doing?

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Any type of fat that comes from an
animal source contains cholesterol,

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so what they're going to do

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is to switch these usual animal
sources of fats with something

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that's either vegetable-based
fats or a low-fat option.

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So reducing cholesterol is in effect

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going to be changing their
fat profile as well.

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This means that eggs, red meat
and high-fat cheese are out,

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00:14:03,740 --> 00:14:08,010
replaced by lean, skinless meats
and vegetable-based spreads.

238
00:14:08,060 --> 00:14:11,850
But what about the groups
who are adding foods?

239
00:14:11,900 --> 00:14:16,460
First, the oat group. They'll
be eating 75 grams per day.

240
00:14:17,540 --> 00:14:19,410
How will the oats lower cholesterol?

241
00:14:19,460 --> 00:14:23,170
So, there's a sticky, or
viscous, fibre in porridge.

242
00:14:23,220 --> 00:14:26,250
It's also found in high
concentrations in barley as well.

243
00:14:26,300 --> 00:14:28,650
And it's a soluble fibre
called beta-glucan.

244
00:14:28,700 --> 00:14:32,490
And there are a number of studies
now that show that consuming

245
00:14:32,540 --> 00:14:35,810
three grams of beta-glucan
per day for most people

246
00:14:35,860 --> 00:14:38,970
will lower their cholesterol
in the area of 5% to 10%.

247
00:14:39,020 --> 00:14:41,050
The beta-glucan in oats does this

248
00:14:41,100 --> 00:14:43,770
by binding with the
cholesterol in your gut

249
00:14:43,820 --> 00:14:47,370
and stopping it from being
absorbed into the bloodstream.

250
00:14:47,420 --> 00:14:49,490
And the almonds? How
will the almonds work?

251
00:14:49,540 --> 00:14:52,530
The group consuming almonds
is going to be consuming

252
00:14:52,580 --> 00:14:56,130
two of these doses per day, so
this works out to about 60 grams.

253
00:14:56,180 --> 00:14:59,570
- One dose will cover an entire Post-it Note.
- OK.

254
00:14:59,620 --> 00:15:02,010
Mm... I like almonds.

255
00:15:02,060 --> 00:15:04,690
What is it about them
that lowers cholesterol?

256
00:15:04,740 --> 00:15:06,650
Some of it could be the
phytosterol content.

257
00:15:06,700 --> 00:15:09,290
So phytosterol is the plant
version of cholesterol

258
00:15:09,340 --> 00:15:11,730
and that's been shown
in numerous studies

259
00:15:11,780 --> 00:15:13,410
to lower your cholesterol levels.

260
00:15:13,460 --> 00:15:16,170
It could also be the nature
of the almond itself --

261
00:15:16,220 --> 00:15:17,530
it doesn't get broken down

262
00:15:17,580 --> 00:15:19,450
as it passes through
your digestive tract

263
00:15:19,500 --> 00:15:22,770
and it may be interfering
with lipid absorption,

264
00:15:22,820 --> 00:15:24,090
so fat absorption in general,

265
00:15:24,140 --> 00:15:26,050
which affects the
cholesterol absorption.

266
00:15:26,100 --> 00:15:27,570
- Can I...?
- Yes, thank you.

267
00:15:27,620 --> 00:15:31,450
Each group will be given
instructions telling them

268
00:15:31,500 --> 00:15:34,660
how to integrate these changes
into their normal diet.

269
00:15:37,060 --> 00:15:39,490
My three sets of volunteers
have now embarked

270
00:15:39,540 --> 00:15:41,610
on their three very different diets,

271
00:15:41,660 --> 00:15:43,130
and I'm about to join them.

272
00:15:43,180 --> 00:15:45,330
Well, sort of -- I'm actually
doing to try something

273
00:15:45,380 --> 00:15:47,370
which is even more radical.

274
00:15:47,420 --> 00:15:50,490
I'm going to try combining
all these interventions,

275
00:15:50,540 --> 00:15:53,850
and other potentially
cholesterol-busting foods,

276
00:15:53,900 --> 00:15:56,040
in an epic diet challenge.

277
00:15:56,700 --> 00:16:00,290
I want to see just how low
I can get my cholesterol to go

278
00:16:00,340 --> 00:16:02,140
without medication.

279
00:16:03,100 --> 00:16:05,170
We'll find out more about my diet

280
00:16:05,220 --> 00:16:08,260
and about the results of
our study later in the show.

281
00:16:12,940 --> 00:16:14,610
Here we are in the heart of London

282
00:16:14,660 --> 00:16:17,770
with our lovely Trust Me
I'm A Doctor video booth.

283
00:16:17,820 --> 00:16:20,810
People have been dropping in to
ask their burning health questions

284
00:16:20,860 --> 00:16:23,050
which we do our very best to answer.

285
00:16:23,100 --> 00:16:26,250
And our first question this time...

286
00:16:26,300 --> 00:16:29,020
Is there a cure for snoring?

287
00:16:32,140 --> 00:16:34,540
One for A&E doctor Saleyah Ahsan.

288
00:16:35,940 --> 00:16:38,530
One in four of us are snoring culprits,

289
00:16:38,580 --> 00:16:42,140
giving our bodies -- and
our partners -- a hard time.

290
00:16:45,740 --> 00:16:47,850
Hands up who snores?

291
00:16:47,900 --> 00:16:49,130
- I've been told I do.
- Yeah.

292
00:16:49,180 --> 00:16:50,570
It's like a chainsaw...

293
00:16:50,620 --> 00:16:52,050
SNORING

294
00:16:52,100 --> 00:16:54,010
- Does anyone snore here?
- He does. - I snore.

295
00:16:54,060 --> 00:16:55,370
What does it sound like?

296
00:16:55,420 --> 00:16:57,360
SHE SNORES, THEY LAUGH

297
00:16:59,100 --> 00:17:02,570
When you go to sleep, the muscles
in your throat and neck

298
00:17:02,620 --> 00:17:04,170
relax and go floppy.

299
00:17:04,220 --> 00:17:06,530
This makes the airways narrow,

300
00:17:06,580 --> 00:17:09,210
so air has to be forced
out through them,

301
00:17:09,260 --> 00:17:13,260
which makes the soft tissues
rattle and vibrate.

302
00:17:14,900 --> 00:17:16,730
But how can we stop it?

303
00:17:16,780 --> 00:17:18,810
Here are some top tips

304
00:17:18,860 --> 00:17:21,860
and some brand-new and
exciting research to try.

305
00:17:24,900 --> 00:17:27,850
Avoid alcohol before bedtime.

306
00:17:27,900 --> 00:17:31,330
Booze relaxes the muscles of
the soft palate and the throat,

307
00:17:31,380 --> 00:17:34,300
causing the airways to narrow even more.

308
00:17:37,180 --> 00:17:40,620
There's a reason why we're
told to lie on our sides.

309
00:17:42,180 --> 00:17:44,930
When we lie on our
back, our tongue, chin

310
00:17:44,980 --> 00:17:50,090
and the skin and fat around here
can relax and squish our airways.

311
00:17:50,140 --> 00:17:52,340
And finally...

312
00:17:53,780 --> 00:17:56,210
If your snoring comes
mainly from your nose,

313
00:17:56,260 --> 00:17:58,690
you could try this nasal strip.

314
00:17:58,740 --> 00:18:01,810
Basically, they work by pulling
your nostrils apart.

315
00:18:01,860 --> 00:18:04,450
And if your snoring comes
mainly from your mouth,

316
00:18:04,500 --> 00:18:07,810
you could try this mouthpiece.

317
00:18:07,860 --> 00:18:11,860
It works by essentially forcing
you to breathe through your nose.

318
00:18:15,180 --> 00:18:18,250
But the best way to keep
those airways open

319
00:18:18,300 --> 00:18:19,930
and stop the snoring?

320
00:18:19,980 --> 00:18:21,370
Strengthen your muscles.

321
00:18:21,420 --> 00:18:25,970
'A brand-new study has shown that
doing a simple set of exercises

322
00:18:26,020 --> 00:18:29,850
'every day can drastically
reduce snoring.

323
00:18:29,900 --> 00:18:34,050
'They have allowed us
to reveal their secret.'

324
00:18:34,100 --> 00:18:38,250
So, get your tongue, push it
to the roof of your mouth.

325
00:18:38,300 --> 00:18:40,240
On your hard palate...

326
00:18:40,980 --> 00:18:43,810
And then push your tongue backwards.

327
00:18:43,860 --> 00:18:45,370
Kind of makes you want to gag a bit.

328
00:18:45,420 --> 00:18:46,490
WOMAN AHHS Does it, yeah?

329
00:18:46,540 --> 00:18:48,090
Can you feel it?

330
00:18:48,140 --> 00:18:50,450
Up... and backwards.

331
00:18:50,500 --> 00:18:52,850
SHE LAUGHS

332
00:18:52,900 --> 00:18:57,690
Another one is push your tongue
down on your soft palate

333
00:18:57,740 --> 00:19:00,840
and the tip of your tongue
forward, like that...

334
00:19:02,060 --> 00:19:04,170
So it's like it's almost
stretching your tongue.

335
00:19:04,220 --> 00:19:05,570
Show me?

336
00:19:05,620 --> 00:19:06,730
Uh-huh, like that.

337
00:19:06,780 --> 00:19:08,690
Can you feel it kind of stretching?

338
00:19:08,740 --> 00:19:10,290
Fantastic, she's doing it!

339
00:19:10,340 --> 00:19:11,650
THEY LAUGH

340
00:19:11,700 --> 00:19:14,210
Open your mouth wide.

341
00:19:14,260 --> 00:19:16,850
And you know the dangly bit, the uvula?

342
00:19:16,900 --> 00:19:19,530
Push it upwards and go, "Ah".

343
00:19:19,580 --> 00:19:23,330
ALL: Ah...

344
00:19:23,380 --> 00:19:24,530
Brilliant!

345
00:19:24,580 --> 00:19:27,610
'For the best results, you
need to do these exercises

346
00:19:27,660 --> 00:19:31,290
'for two minutes each three times a day,

347
00:19:31,340 --> 00:19:35,940
'and in the study, snorers saw
improvements after three months.'

348
00:19:37,500 --> 00:19:41,490
All these exercises and more
are available on our website

349
00:19:41,540 --> 00:19:43,370
if you want to give them a go.

350
00:19:43,420 --> 00:19:45,890
Or suggest that someone else does.

351
00:19:52,820 --> 00:19:57,890
Still to come -- a remarkable new
treatment for a hospital superbug,

352
00:19:57,940 --> 00:20:00,700
and the best way to stop hiccups.

353
00:20:03,300 --> 00:20:04,900
But first...

354
00:20:06,380 --> 00:20:09,090
Backache and knee-ache
are both very common,

355
00:20:09,140 --> 00:20:11,490
and they may be linked,
because when you stand up,

356
00:20:11,540 --> 00:20:14,010
you carry your weight through
your spine, knees,

357
00:20:14,060 --> 00:20:17,330
to the end of your feet, where
you normally find shoes.

358
00:20:17,380 --> 00:20:19,570
Now, shoes are a relatively
recent invention --

359
00:20:19,620 --> 00:20:21,690
at least from an
evolutionary perspective --

360
00:20:21,740 --> 00:20:24,650
and, as surgeon Gabriel Weston
has been finding out,

361
00:20:24,700 --> 00:20:27,740
if you change your footwear,
you can improve your health.

362
00:20:29,100 --> 00:20:34,370
80% of us will experience back
pain and around 14% suffer from

363
00:20:34,420 --> 00:20:36,450
some form of osteoarthritis

364
00:20:36,500 --> 00:20:39,580
that can affect the
hips, knees or ankles.

365
00:20:41,220 --> 00:20:44,860
But could it be that some of our
problems are actually caused...

366
00:20:46,140 --> 00:20:47,810
.. by our shoes?

367
00:20:50,780 --> 00:20:54,210
I've seen reports that claim
just about every kind of shoe

368
00:20:54,260 --> 00:20:56,090
you can think of is bad for you,

369
00:20:56,140 --> 00:20:58,740
whether for your joints or your back.

370
00:21:01,780 --> 00:21:04,050
High heels get a really bad press,

371
00:21:04,100 --> 00:21:06,810
but are they the worst culprits?

372
00:21:06,860 --> 00:21:08,690
And what can we do about it?

373
00:21:08,740 --> 00:21:12,490
To find out, we've come
to the centre of Glasgow

374
00:21:12,540 --> 00:21:14,650
and set up our own catwalk,

375
00:21:14,700 --> 00:21:18,970
rigged with some hi-tech
kit to analyse how we walk.

376
00:21:19,020 --> 00:21:23,570
And Dr Jody Riskowski of Glasgow's
Caledonian University

377
00:21:23,620 --> 00:21:28,810
is going to show one shopper
what high heels really do to us.

378
00:21:28,860 --> 00:21:32,090
You're obviously committed
to wearing your high heels.

379
00:21:32,140 --> 00:21:35,530
Is this the sort of shoe you'd
usually use to be out and about?

380
00:21:35,580 --> 00:21:38,210
Em, I think if I came to
Glasgow, shopping, yes,

381
00:21:38,260 --> 00:21:39,890
I'd like to wear a pair of heels.

382
00:21:39,940 --> 00:21:44,410
When you look at what heels do to
your feet, it's pretty frightening.

383
00:21:44,460 --> 00:21:48,330
They can lead to painful bunions and
even damage the bones themselves.

384
00:21:48,380 --> 00:21:52,130
But what are they doing
further up the body?

385
00:21:52,180 --> 00:21:55,370
To show us, Jody's kit
can make a computer model

386
00:21:55,420 --> 00:21:57,570
of the skeleton as people walk.

387
00:21:57,620 --> 00:22:02,060
Perhaps unsurprisingly, wearing
heels does affect our posture.

388
00:22:03,460 --> 00:22:05,450
We tend to sort of rotate the hips

389
00:22:05,500 --> 00:22:08,010
such that the trunk or
the torso rotates forward

390
00:22:08,060 --> 00:22:11,810
and the hips and the pelvic
and the butt go backwards.

391
00:22:11,860 --> 00:22:16,660
So heels give us a catwalk strut,
but what's that doing to our joints?

392
00:22:18,180 --> 00:22:21,730
The blue arrow shows how the pressure
travels up from our feet

393
00:22:21,780 --> 00:22:23,410
and into our joints.

394
00:22:23,460 --> 00:22:26,050
When barefoot, the pressure
goes up directly

395
00:22:26,100 --> 00:22:30,850
and safely through our knee joint,
but in heels, it's off-centre.

396
00:22:30,900 --> 00:22:34,530
This can twist our knees, damage
the soft tissues in the joint

397
00:22:34,580 --> 00:22:37,340
and put us at risk of osteoarthritis.

398
00:22:39,860 --> 00:22:44,100
So is the solution to wear something
more comfortable? Flat shoes?

399
00:22:45,780 --> 00:22:49,610
Ron, I see you're wearing some
kind of outdoorsy footwear.

400
00:22:49,660 --> 00:22:52,170
Are these the kind of shoes
that you would usually wear?

401
00:22:52,220 --> 00:22:53,730
Generally, yeah.

402
00:22:53,780 --> 00:22:56,290
They're easy on the feet, if you're
on your feet all day long.

403
00:22:56,340 --> 00:22:59,210
But flat shoes have their own dangers.

404
00:22:59,260 --> 00:23:02,930
When we walk in them, our heel
strikes the ground with force,

405
00:23:02,980 --> 00:23:05,610
and this sends pressure
up through the leg

406
00:23:05,660 --> 00:23:08,210
which can affect our knees and back,

407
00:23:08,260 --> 00:23:10,890
and, as if that wasn't bad enough,

408
00:23:10,940 --> 00:23:13,650
there's something else
a lot of us get wrong --

409
00:23:13,700 --> 00:23:15,570
our shoe size.

410
00:23:15,620 --> 00:23:20,450
If you're anything like me, you won't
have had your feet measured in ages.

411
00:23:20,500 --> 00:23:25,610
But our feet change with time --
up to two shoe sizes in 40 years,

412
00:23:25,660 --> 00:23:27,730
when we're adults.

413
00:23:27,780 --> 00:23:31,890
What typically happens with ageing
is that the arch drops a little bit,

414
00:23:31,940 --> 00:23:34,170
which is then what helps
spread the foot out.

415
00:23:34,220 --> 00:23:36,810
And wearing shoes that are too small

416
00:23:36,860 --> 00:23:40,850
can create pressure at the
side and front of the foot.

417
00:23:40,900 --> 00:23:43,700
That can also affect
our joints and back.

418
00:23:45,140 --> 00:23:49,770
Too high, too flat, too small.

419
00:23:49,820 --> 00:23:51,930
So what can we do?

420
00:23:51,980 --> 00:23:54,570
With shoes that some
people might call bad,

421
00:23:54,620 --> 00:23:56,450
what we can do is add some of the good.

422
00:23:56,500 --> 00:24:01,330
Firstly, whatever style you prefer,
make sure you get your feet measured

423
00:24:01,380 --> 00:24:04,890
so you can be sure you're
buying the right size.

424
00:24:04,940 --> 00:24:07,370
Secondly, if you're buying flat shoes,

425
00:24:07,420 --> 00:24:10,610
choose ones that have some support
for your arch and heel,

426
00:24:10,660 --> 00:24:15,010
or you can be fitted with a corrective
insole called an orthotic.

427
00:24:15,060 --> 00:24:16,930
This is a full-length orthotic

428
00:24:16,980 --> 00:24:20,690
and it's just designed as cushioning
so added cushioning and support.

429
00:24:20,740 --> 00:24:23,690
And that can help alleviate
some of the aches and pains

430
00:24:23,740 --> 00:24:27,090
that you might feel under the heel
after a long day of wearing flats.

431
00:24:27,140 --> 00:24:29,050
You can find them on the high street,

432
00:24:29,100 --> 00:24:33,330
but specially-fitted ones can be
better if you have foot problems.

433
00:24:33,380 --> 00:24:36,890
Finally, if you like heels,
then for everyday use,

434
00:24:36,940 --> 00:24:39,850
choose heels that are lower and wider.

435
00:24:39,900 --> 00:24:42,490
These tend to cause fewer problems.

436
00:24:42,540 --> 00:24:45,250
And if you know your
favourite shoes are bad

437
00:24:45,300 --> 00:24:49,330
but can't bear to ditch them, then
simple foot exercises can help

438
00:24:49,380 --> 00:24:51,890
relieve some of the
stresses and strains.

439
00:24:51,940 --> 00:24:54,690
Generally, we would start with
a tennis ball as a massage,

440
00:24:54,740 --> 00:24:57,610
so you step on it and then
just roll it around.

441
00:24:57,660 --> 00:25:00,410
And that's particularly good
for the heel and the arch,

442
00:25:00,460 --> 00:25:02,410
and then sometimes for the forefoot,

443
00:25:02,460 --> 00:25:04,850
the golf ball tends to
be a little bit better.

444
00:25:04,900 --> 00:25:06,890
I think I would still wear my high heels

445
00:25:06,940 --> 00:25:09,410
but I would certainly
think about getting home

446
00:25:09,460 --> 00:25:14,530
and trying the golf ball because you
do get that tension in the toe area.

447
00:25:14,580 --> 00:25:18,410
And picking up marbles with your
toes strengthens your foot muscles

448
00:25:18,460 --> 00:25:20,290
and reduces pain.

449
00:25:20,340 --> 00:25:24,250
Exercises like these can help look
after your feet and counteract the

450
00:25:24,300 --> 00:25:29,770
effects of shoes that may look good
but aren't doing us any good at all.

451
00:25:29,820 --> 00:25:31,330
Now, most of us

452
00:25:31,380 --> 00:25:34,970
don't want to consider changing
the kind of shoes we want to wear,

453
00:25:35,020 --> 00:25:39,930
but what I've seen is there are
things that we can do just to make

454
00:25:39,980 --> 00:25:44,450
those healthier choices to enable
us to choose the shoes we want

455
00:25:44,500 --> 00:25:47,580
but still have healthy feet and bodies.

456
00:25:59,220 --> 00:26:03,970
Earlier in the programme, we started
our big cholesterol experiment.

457
00:26:04,020 --> 00:26:06,410
We're testing whether
we can lower our levels

458
00:26:06,460 --> 00:26:09,210
by eating more oats, more almonds,

459
00:26:09,260 --> 00:26:13,580
or reducing our cholesterol by
cutting down on animal fats.

460
00:26:15,780 --> 00:26:19,730
But this is not the only cholesterol
experiment we're running.

461
00:26:19,780 --> 00:26:22,580
I, too, have begun
a challenge of my own.

462
00:26:24,020 --> 00:26:27,930
My cholesterol levels tend to
be high, so I have taken statins

463
00:26:27,980 --> 00:26:31,890
to lower them, but for the next
eight weeks, I'm off all pills.

464
00:26:31,940 --> 00:26:34,570
I'm going to see how far
I can get my levels down

465
00:26:34,620 --> 00:26:37,090
just by making changes to my diet.

466
00:26:38,260 --> 00:26:41,690
I've got this list of the things
that I'm allowed on my new diet

467
00:26:41,740 --> 00:26:44,810
and the things that I am
definitely not allowed.

468
00:26:44,860 --> 00:26:48,410
And top of the list of
not-allowed is red meat,

469
00:26:48,460 --> 00:26:52,540
and that means goodbye to
the mince, beef and bacon.

470
00:26:53,900 --> 00:26:55,930
Goodbye to the prawns.

471
00:26:55,980 --> 00:26:58,810
And it's goodbye to eggs as well.

472
00:26:58,860 --> 00:27:01,370
Now, the butter and cheese,
they have to go.

473
00:27:01,420 --> 00:27:03,290
The milk I'm going to keep.

474
00:27:03,340 --> 00:27:07,010
It's on the banned list, but I
don't think I can do without it.

475
00:27:07,060 --> 00:27:09,890
So I'm left with a decent
amount of food, including,

476
00:27:09,940 --> 00:27:13,290
I'm pleased to say, bottle of red wine.

477
00:27:13,340 --> 00:27:15,610
Now, it's time to add things.

478
00:27:17,100 --> 00:27:19,450
Like some of the
participants in our study,

479
00:27:19,500 --> 00:27:21,900
I'm eating more oats and almonds.

480
00:27:22,820 --> 00:27:26,370
But my list also includes
walnuts, pistachios,

481
00:27:26,420 --> 00:27:28,530
various fruits and vegetables

482
00:27:28,580 --> 00:27:32,580
and some intriguing-looking products
that I've never tried before.

483
00:27:38,140 --> 00:27:41,610
Now, the diet I'm about to go on
was developed by a nutritionist

484
00:27:41,660 --> 00:27:45,130
in Toronto and it's called a Portfolio
Diet because the idea is

485
00:27:45,180 --> 00:27:49,010
that you attack the cholesterol from
all sorts of different angles.

486
00:27:49,060 --> 00:27:51,570
Now, the first thing I'm going
to be eating a lot more of

487
00:27:51,620 --> 00:27:53,730
is soluble or sticky fibre.

488
00:27:53,780 --> 00:28:00,570
You can get it in oats,
also in aubergine or okra.

489
00:28:00,620 --> 00:28:04,700
Plus, there is a lot
in beans and pulses.

490
00:28:05,900 --> 00:28:09,730
Now, the next thing I'm going to be
adding to my diet is plant sterols.

491
00:28:09,780 --> 00:28:12,410
As the name implies, you
get them from plants.

492
00:28:12,460 --> 00:28:15,370
You can also get them
in special margarines.

493
00:28:15,420 --> 00:28:18,810
I'm also going to be eating something
I have never tried before

494
00:28:18,860 --> 00:28:20,930
and that is soya.

495
00:28:20,980 --> 00:28:24,380
And finally, I'm going to
be eating a lot more nuts.

496
00:28:27,060 --> 00:28:29,020
So, how did I get on?

497
00:28:30,980 --> 00:28:34,690
I'm currently filming in the
Gambia for another series,

498
00:28:34,740 --> 00:28:38,930
but I'm still sticking to my diet
of porridge and lots of nuts.

499
00:28:38,980 --> 00:28:42,250
But I'm also branching out
in some of the local cuisine.

500
00:28:42,300 --> 00:28:44,170
This is porridge Gambian-style.

501
00:28:44,220 --> 00:28:46,250
I think it's mainly made out of couscous

502
00:28:46,300 --> 00:28:48,850
so I suspect it's not going to
do the same thing as the oats.

503
00:28:48,900 --> 00:28:50,490
I'm back in the UK.

504
00:28:50,540 --> 00:28:52,330
Time to try something completely new,

505
00:28:52,380 --> 00:28:55,780
something I have never sampled
before -- that is soya milk.

506
00:28:58,380 --> 00:29:00,380
Doesn't look fantastic.

507
00:29:01,700 --> 00:29:04,170
All I can say is it's really boring.

508
00:29:04,220 --> 00:29:06,050
It has almost no flavour.

509
00:29:06,100 --> 00:29:09,050
It's certainly been an
interesting experience.

510
00:29:09,100 --> 00:29:11,210
But will the results be worth it?

511
00:29:11,260 --> 00:29:13,860
We'll find out later in the programme.

512
00:29:18,300 --> 00:29:21,370
Back in London, more people
are coming to our video booth

513
00:29:21,420 --> 00:29:23,890
to record their health questions.

514
00:29:23,940 --> 00:29:26,090
Is there a cure for hiccups?

515
00:29:26,140 --> 00:29:28,580
One Dr Chris van Tulleken.

516
00:29:30,980 --> 00:29:35,130
Hiccups are one of those things
that everyone gets at some point.

517
00:29:35,180 --> 00:29:39,490
And there are a whole load of
theories as to what causes them

518
00:29:39,540 --> 00:29:41,050
and how to get rid of them.

519
00:29:41,100 --> 00:29:42,370
HE COUGHS

520
00:29:42,420 --> 00:29:45,530
- Something scary, usually. - Does that work?
- Yeah, I find it does. - What?

521
00:29:45,580 --> 00:29:48,570
- You just get a mate to do something
frightening? - Yeah, or hold my breath.

522
00:29:48,620 --> 00:29:50,370
If you sit in a dark
cupboard, it goes away.

523
00:29:50,420 --> 00:29:52,970
Isn't that an old wives' tale,
like if you've got the hiccups,

524
00:29:53,020 --> 00:29:55,620
you're meant to go in a dark cupboard?

525
00:29:55,980 --> 00:29:59,010
So what's going on is hiccups
are a spasm of a big muscle

526
00:29:59,060 --> 00:30:00,730
in your body called the diaphragm.

527
00:30:00,780 --> 00:30:03,730
The diaphragm sits as a sheet
of muscle under your lungs

528
00:30:03,780 --> 00:30:05,730
and it moves up and down
and helps you breathe.

529
00:30:05,780 --> 00:30:07,770
And if you get a spasm of that muscle,

530
00:30:07,820 --> 00:30:11,090
you get that sudden intake of
breath and you also get a spasm

531
00:30:11,140 --> 00:30:14,090
in your voice box, in your larynx,
so you get that characteristic...

532
00:30:14,140 --> 00:30:17,010
like that. And that's
what's so embarrassing.

533
00:30:17,060 --> 00:30:19,970
It's only by knowing what
causes those muscle spasms

534
00:30:20,020 --> 00:30:23,730
that we can work out
how to cure hiccups.

535
00:30:23,780 --> 00:30:27,250
At the more housewives'-remedies
end of the spectrum are techniques

536
00:30:27,300 --> 00:30:30,650
that just try to give your brain
something else to think about

537
00:30:30,700 --> 00:30:34,130
and hope that the hiccups
then sort themselves out.

538
00:30:34,180 --> 00:30:37,650
For example, you could put some
sugar on the back of your tongue

539
00:30:37,700 --> 00:30:40,490
and then wait till it
dissolves to eat it.

540
00:30:40,540 --> 00:30:43,330
Like that. A bit distracting.

541
00:30:43,380 --> 00:30:47,290
You can take a bit of lemon and
suck it as if it was a sweet.

542
00:30:47,340 --> 00:30:50,250
All of them are distracting,
and it's the same principle

543
00:30:50,300 --> 00:30:54,770
that a lot of people recommend that
a fright will sometimes distract you.

544
00:30:54,820 --> 00:30:56,170
- BALLOON POPS
- Argh!

545
00:30:56,220 --> 00:30:59,770
And then there are the slightly
more medical cures.

546
00:30:59,820 --> 00:31:01,610
Some people think that hiccupping

547
00:31:01,660 --> 00:31:03,570
is to do with low levels
of carbon dioxide.

548
00:31:03,620 --> 00:31:04,930
Now, I'm not sure I believe this

549
00:31:04,980 --> 00:31:06,930
but there are a couple
of ways that you can raise

550
00:31:06,980 --> 00:31:08,250
the level of carbon dioxide

551
00:31:08,300 --> 00:31:10,410
and they all revolve around
holding your breath

552
00:31:10,460 --> 00:31:12,250
or slowing down your breathing.

553
00:31:12,300 --> 00:31:15,010
My producer has a particular
favourite which is where

554
00:31:15,060 --> 00:31:18,050
you close your eyes and you breathe
in very slowly and you concentrate

555
00:31:18,100 --> 00:31:20,770
and then you breathe out very
slowly and if you can avoid

556
00:31:20,820 --> 00:31:24,970
hiccupping just at that moment when
you breathe out, you'll be cured.

557
00:31:25,020 --> 00:31:27,620
Or finally, researchers suggest this.

558
00:31:28,460 --> 00:31:32,130
You can do diaphragm exercises
to try and relieve the spasm,

559
00:31:32,180 --> 00:31:34,250
you can draw your knees up to your chest

560
00:31:34,300 --> 00:31:37,410
and hold them there for a couple
of minutes, you can lean forward

561
00:31:37,460 --> 00:31:41,530
and compress your chest and try
to relieve the spasm that way,

562
00:31:41,580 --> 00:31:44,090
or you can take in some very
deep breaths and even see if

563
00:31:44,140 --> 00:31:48,060
you can reach up under your ribs
and give the diaphragm a little rub.

564
00:31:49,500 --> 00:31:52,730
These diaphragm exercises
have scientific backing

565
00:31:52,780 --> 00:31:54,090
but when it comes to it,

566
00:31:54,140 --> 00:31:57,010
no-one's totally sure whether
they really work.

567
00:31:57,060 --> 00:32:00,380
And that's a prospect we at
Trust Me simply can't ignore.

568
00:32:01,820 --> 00:32:04,930
Since research into cures for
hiccups is so hard to carry out,

569
00:32:04,980 --> 00:32:07,970
we want to enlist your help to
see what works and what doesn't.

570
00:32:08,020 --> 00:32:10,010
What we need is loads
of different people

571
00:32:10,060 --> 00:32:13,050
to try loads of different things
each time they get hiccups,

572
00:32:13,100 --> 00:32:15,330
and if you want to be
part of the experiment,

573
00:32:15,380 --> 00:32:17,720
you can go to our website at...

574
00:32:18,780 --> 00:32:20,580
.. and sign up.

575
00:32:29,500 --> 00:32:32,530
In my job as an emergency
medicine doctor,

576
00:32:32,580 --> 00:32:36,650
I've seen, time and again, how
devastating the effects can be

577
00:32:36,700 --> 00:32:40,860
if people ignore the warning
signs of serious illness.

578
00:32:41,940 --> 00:32:44,490
If people don't recognise the symptoms

579
00:32:44,540 --> 00:32:47,810
and don't come to see us, their
condition can deteriorate

580
00:32:47,860 --> 00:32:50,610
and it might be too late
for us to help them.

581
00:32:50,660 --> 00:32:55,570
That's why I want to talk to you
about what we call red flags --

582
00:32:55,620 --> 00:33:00,490
the danger signs that can help
you protect yourself or others

583
00:33:00,540 --> 00:33:02,410
from serious illness.

584
00:33:04,020 --> 00:33:08,250
This time, I'm in the Peak District
to look at Lyme disease, something

585
00:33:08,300 --> 00:33:13,410
that's a particular danger at this
time of year as we head outdoors.

586
00:33:13,460 --> 00:33:17,890
Cases have risen more than fourfold
in the UK in just ten years.

587
00:33:17,940 --> 00:33:21,050
It's caused by a bacterial infection

588
00:33:21,100 --> 00:33:24,650
and it's carried by these guys -- ticks.

589
00:33:24,700 --> 00:33:29,290
And they can be found commonly
in places like parks, woodlands,

590
00:33:29,340 --> 00:33:31,820
moors and even gardens.

591
00:33:33,700 --> 00:33:34,970
If left untreated,

592
00:33:35,020 --> 00:33:38,970
Lyme disease can cause
debilitating neurological problems

593
00:33:39,020 --> 00:33:41,130
and has been known to be fatal.

594
00:33:41,180 --> 00:33:43,090
So if you're out in the countryside,

595
00:33:43,140 --> 00:33:46,530
you should try and avoid getting bitten.

596
00:33:46,580 --> 00:33:49,170
Ticks can be sneaky operators.

597
00:33:49,220 --> 00:33:53,970
They climb up long blades of grass
and stalks and lie in wait for people

598
00:33:54,020 --> 00:33:57,010
and animals to brush past --
that's when they latch on,

599
00:33:57,060 --> 00:34:01,450
attach themselves and stay
there for days at a time.

600
00:34:01,500 --> 00:34:04,650
But it's during that time when
they're attached to the body

601
00:34:04,700 --> 00:34:06,490
that we are at risk of them

602
00:34:06,540 --> 00:34:09,980
passing on bacteria to us
which will cause infection.

603
00:34:11,860 --> 00:34:14,650
Getting rid of a tick that's
attached itself to you

604
00:34:14,700 --> 00:34:18,290
as quickly as possible is
therefore really important

605
00:34:18,340 --> 00:34:23,140
and I've come to talk to a group of
climbers about how to do just that.

606
00:34:24,500 --> 00:34:28,730
First up is giving your body
a thorough check for ticks.

607
00:34:28,780 --> 00:34:31,490
Is there, like, a preferred
place that they'd go?

608
00:34:31,540 --> 00:34:36,650
Well, they like warm, dampish
places so knees, toes, armpits.

609
00:34:36,700 --> 00:34:37,730
THEY CHUCKLE

610
00:34:37,780 --> 00:34:41,980
Groins. Basically, give
yourselves a top-to-toe check.

611
00:34:43,500 --> 00:34:46,570
You can help protect
yourself by covering up,

612
00:34:46,620 --> 00:34:50,650
tucking trousers into socks
and wearing insect repellent.

613
00:34:50,700 --> 00:34:55,530
But sometimes, ticks can
get through these defences.

614
00:34:55,580 --> 00:34:59,650
If a tick does manage to latch
on to you, it may feed off you

615
00:34:59,700 --> 00:35:04,370
for around seven days, swelling
up in size before falling off.

616
00:35:04,420 --> 00:35:07,660
That's horrible. That's
absolutely horrible.

617
00:35:09,460 --> 00:35:13,130
And if you find a tick, removing
it carefully is key,

618
00:35:13,180 --> 00:35:18,170
and there are lots of myths
circulating about how to do this.

619
00:35:18,220 --> 00:35:21,330
- Do you burn them out?
- Some tape, like the sticky bit of a plaster,

620
00:35:21,380 --> 00:35:22,490
stick it on and pull it off?

621
00:35:22,540 --> 00:35:24,410
I think my sister had
one when we were little

622
00:35:24,460 --> 00:35:26,970
and she put Vaseline on it and
it's supposed to suffocate it.

623
00:35:27,020 --> 00:35:28,610
- And did it?
- I don't think so.

624
00:35:28,660 --> 00:35:29,850
THEY CHUCKLE

625
00:35:29,900 --> 00:35:32,250
These are all things you shouldn't do.

626
00:35:32,300 --> 00:35:36,060
Instead, you should try to
use a tick-removal tool.

627
00:35:37,380 --> 00:35:41,330
All these bits of kit help you
to remove a tick effectively

628
00:35:41,380 --> 00:35:45,010
without leaving anything behind,
and that's the main point --

629
00:35:45,060 --> 00:35:48,360
you just do not want half
a tick still left in you.

630
00:35:49,180 --> 00:35:53,210
Fortunately, only around 4%
of ticks carry the bacteria

631
00:35:53,260 --> 00:35:57,050
that cause Lyme disease, but if
you're bitten by one of these,

632
00:35:57,100 --> 00:36:00,170
there are some important
red flags to look out for.

633
00:36:00,220 --> 00:36:02,970
This is what you want to
make sure you don't develop.

634
00:36:03,020 --> 00:36:07,570
- You wouldn't miss that, would you?
- No. - It's quite a big rash.

635
00:36:07,620 --> 00:36:12,490
It's darker on the outside
and paler in the middle, yeah?

636
00:36:12,540 --> 00:36:16,090
This distinctive rash is
called erythema migrans.

637
00:36:16,140 --> 00:36:20,410
It occurs in two-thirds of
cases, and if you see it,

638
00:36:20,460 --> 00:36:23,540
you will need to go in and
see your doctor immediately.

639
00:36:24,780 --> 00:36:27,730
You should also watch out
for flu-like symptoms --

640
00:36:27,780 --> 00:36:31,410
red flags like headaches,
muscle pains and fever.

641
00:36:31,460 --> 00:36:35,460
These clues can help us treat
you with antibiotics in time.

642
00:36:36,780 --> 00:36:41,450
If you follow these pieces of advice,
you could identify an infection

643
00:36:41,500 --> 00:36:46,380
and get treatment before it develops
into later-stage Lyme disease.

644
00:36:47,500 --> 00:36:51,730
All this information and more on
every item on the programme is

645
00:36:51,780 --> 00:36:55,380
available on our website at...

646
00:37:04,300 --> 00:37:08,450
Coming up, can home DNA tests
help you lose weight?

647
00:37:08,500 --> 00:37:10,610
And the results of our big experiment --

648
00:37:10,660 --> 00:37:14,540
can changing your diet really
lower your cholesterol?

649
00:37:15,660 --> 00:37:17,850
But first... It's not often in medicine

650
00:37:17,900 --> 00:37:20,970
that you come across a new
therapy that is not only safe,

651
00:37:21,020 --> 00:37:25,730
but 99% effective against a
life-threatening condition.

652
00:37:25,780 --> 00:37:29,490
Well, surgeon Gabriel Weston has
been to Rhode Island in the US

653
00:37:29,540 --> 00:37:32,610
to watch this extraordinary
treatment in operation.

654
00:37:32,660 --> 00:37:35,820
Be warned, however, there
is a certain yuck factor.

655
00:37:39,500 --> 00:37:45,850
As a surgeon, I'm always interested
in new ideas but this one is special.

656
00:37:45,900 --> 00:37:48,770
It's bringing hope for
a radically new approach

657
00:37:48,820 --> 00:37:50,650
to a whole range of conditions

658
00:37:50,700 --> 00:37:53,770
from multiple sclerosis
to Crohn's disease.

659
00:37:53,820 --> 00:37:58,450
At the moment, it's being used to
treat a severe infection of the gut,

660
00:37:58,500 --> 00:38:04,020
something that affects over 17,000
people every year in the UK.

661
00:38:07,220 --> 00:38:09,250
This is Rose Sabatini.

662
00:38:09,300 --> 00:38:13,730
Almost a year ago, she was struck
down by a ruthless bacterium

663
00:38:13,780 --> 00:38:17,170
called Clostridium difficile, or C diff.

664
00:38:17,220 --> 00:38:21,450
It takes control of the gut,
causing inflammation, diarrhoea

665
00:38:21,500 --> 00:38:25,050
and a loss of fluid that can be fatal.

666
00:38:25,100 --> 00:38:30,210
I wake up all hours of the night
and have to rush to the bathroom.

667
00:38:30,260 --> 00:38:31,410
It doesn't stop.

668
00:38:31,460 --> 00:38:35,650
If I take a sip of water, I run to
the bathroom five minutes later.

669
00:38:35,700 --> 00:38:38,640
If I eat a cracker, it
goes right through me.

670
00:38:39,260 --> 00:38:41,130
It's so confining, you know,

671
00:38:41,180 --> 00:38:44,280
because you never know
when it's going to occur.

672
00:38:45,860 --> 00:38:49,530
C diff can be present in a
healthy person but is normally

673
00:38:49,580 --> 00:38:54,650
kept in check by the good bacteria
that exists naturally in the gut.

674
00:38:54,700 --> 00:38:57,890
But if you're given strong
antibiotics, as Rose was,

675
00:38:57,940 --> 00:39:02,660
the good gut bacteria can be wiped
out and allow C diff to thrive.

676
00:39:03,780 --> 00:39:06,970
Once it's taken hold, it
can be impossible to shift,

677
00:39:07,020 --> 00:39:12,490
but an extraordinary new procedure
is now giving patients hope.

678
00:39:12,540 --> 00:39:16,330
It's known as "faecal
microbiota transplant"

679
00:39:16,380 --> 00:39:20,290
and basically involves
taking poo from one person

680
00:39:20,340 --> 00:39:23,420
and implanting it into someone else.

681
00:39:25,540 --> 00:39:29,650
The idea behind FMT is to restore
good, healthy bacteria

682
00:39:29,700 --> 00:39:34,930
to the patient's gut which can
get the C diff back under control,

683
00:39:34,980 --> 00:39:37,730
and poo is extremely rich in bacteria,

684
00:39:37,780 --> 00:39:41,010
so though it sounds pretty unpleasant,

685
00:39:41,060 --> 00:39:43,330
it's a potential life-saver.

686
00:39:43,380 --> 00:39:46,890
I'm about to see one of these
procedures for myself,

687
00:39:46,940 --> 00:39:51,530
carried out by Dr Colleen Kelly,
a pioneer in this field.

688
00:39:51,580 --> 00:39:52,970
My initial reaction was, like,

689
00:39:53,020 --> 00:39:55,730
"OK, this was some kind of a placebo
effect." I mean, I didn't even

690
00:39:55,780 --> 00:39:58,650
believe it myself because I just
thought, "Nothing is this good."

691
00:39:58,700 --> 00:40:01,050
And it really wasn't until
about the seventh patient,

692
00:40:01,100 --> 00:40:05,380
where each time it worked, that I
said, "This is really something."

693
00:40:08,540 --> 00:40:12,210
Dr Kelly is going to transfer some poo

694
00:40:12,260 --> 00:40:14,970
from a healthy donor into Rose's gut.

695
00:40:15,020 --> 00:40:18,050
It has been screened
to make sure it's safe.

696
00:40:18,100 --> 00:40:21,410
Rose, I'm going to get started
and if you're uncomfortable,

697
00:40:21,460 --> 00:40:24,660
let us know and we can give you
a little more medicine, all right?

698
00:40:25,740 --> 00:40:30,570
Dr Kelly inserts a tube into the
gut, guided by a tiny camera,

699
00:40:30,620 --> 00:40:33,450
a procedure known as a colonoscopy.

700
00:40:33,500 --> 00:40:35,810
She's looking for the sigmoid colon,

701
00:40:35,860 --> 00:40:38,700
the lower part of the large intestine.

702
00:40:39,860 --> 00:40:42,530
This is as far as we really need to go.

703
00:40:43,220 --> 00:40:48,570
With the tube now in place,
the material can be implanted.

704
00:40:48,620 --> 00:40:53,260
- Push it right in this way.
- And this is about 300ml
in all? - Yep, correct.

705
00:40:55,740 --> 00:41:00,580
And that's it, we've put all five
in. And I come out pretty quickly.

706
00:41:02,020 --> 00:41:06,570
'The whole procedure has been
completed in just ten minutes.'

707
00:41:06,620 --> 00:41:08,370
Now, we need to wait to see

708
00:41:08,420 --> 00:41:11,940
if the treatment has been
successful for Rose.

709
00:41:18,420 --> 00:41:21,930
But I want to find out more
about how doctors make sure

710
00:41:21,980 --> 00:41:28,330
these transplants are safe so I've
come to OpenBiome in Boston,

711
00:41:28,380 --> 00:41:31,370
a not-for-profit company that collects,

712
00:41:31,420 --> 00:41:36,530
screens and delivers poo to the
clinics and patients that need it.

713
00:41:36,580 --> 00:41:41,620
Overseeing this process is Dr Zain
Kassam, a gastroenterologist.

714
00:41:42,660 --> 00:41:46,210
Way back 30 years ago, when
we were screening blood

715
00:41:46,260 --> 00:41:49,770
for blood transfusion,
we didn't know about HIV.

716
00:41:49,820 --> 00:41:53,210
Do you have any concerns that
there's something that might

717
00:41:53,260 --> 00:41:57,250
be dangerous about taking
someone's ecosystem

718
00:41:57,300 --> 00:42:00,130
- and giving it to someone else?
- Yes, there's absolutely a concern.

719
00:42:00,180 --> 00:42:03,490
But that said, patients with
C-difficile are dying today,

720
00:42:03,540 --> 00:42:06,850
and everything in medicine, whether
it's giving someone an aspirin pill,

721
00:42:06,900 --> 00:42:08,450
has risks and benefits.

722
00:42:08,500 --> 00:42:11,330
We have a very, very rigorous
process where we actually

723
00:42:11,380 --> 00:42:16,210
screen donors before and
after, and so less than 6%

724
00:42:16,260 --> 00:42:19,890
of candidate donors are able to pass
through our rigorous schedule.

725
00:42:19,940 --> 00:42:23,130
It's actually much easier to get
into Oxford or Cambridge or Harvard

726
00:42:23,180 --> 00:42:25,530
than it is to actually be a poop donor.

727
00:42:25,580 --> 00:42:29,970
OpenBiome currently sends transplant
material to hundreds of clinics

728
00:42:30,020 --> 00:42:33,740
across the country, helping
desperate patients like Rose.

729
00:42:36,460 --> 00:42:39,450
It's now been 24 hours
since Rose's procedure,

730
00:42:39,500 --> 00:42:44,220
and amazingly, her horrific pain
and diarrhoea have already improved.

731
00:42:45,460 --> 00:42:47,250
Before I had the procedure,

732
00:42:47,300 --> 00:42:50,900
I probably would have to go
as much as ten times a day.

733
00:42:52,340 --> 00:42:55,580
Today, I think I've only gone...

734
00:42:56,580 --> 00:42:58,650
I only went once this morning.

735
00:42:58,700 --> 00:43:02,700
Just once. Oh, my God, I can't
believe that. Just once.

736
00:43:04,740 --> 00:43:09,170
I feel like I can do
anything. My spirits...

737
00:43:09,220 --> 00:43:14,860
My spirits have been lifted, and
I feel so good. It's wonderful.

738
00:43:18,020 --> 00:43:21,730
It's rare in medicine to come
across a treatment that has

739
00:43:21,780 --> 00:43:25,780
such an immediate impact, and all
from such a simple procedure.

740
00:43:28,220 --> 00:43:32,050
What I've seen here is
like a doctor's dream.

741
00:43:32,100 --> 00:43:37,290
What Dr Kelly has achieved
is a success rate of over 90%,

742
00:43:37,340 --> 00:43:39,250
which is the kind of number

743
00:43:39,300 --> 00:43:43,140
that seems almost more like
a miracle than a real cure.

744
00:43:44,540 --> 00:43:48,210
If Dr Kelly would agree to train
me up over the next couple of hours

745
00:43:48,260 --> 00:43:49,730
and let me go back to the UK

746
00:43:49,780 --> 00:43:54,500
and start doing this procedure
tomorrow, I'd be sold.

747
00:43:56,220 --> 00:43:59,170
Despite its success, faecal
transplant remains

748
00:43:59,220 --> 00:44:04,250
a last-resort treatment for C-diff
in both the US and the UK.

749
00:44:04,300 --> 00:44:08,330
But research in the field
is advancing at pace.

750
00:44:08,380 --> 00:44:12,690
Today, over 100 trials
are under way worldwide,

751
00:44:12,740 --> 00:44:16,050
looking at how our gut bacteria
could be affecting a range

752
00:44:16,100 --> 00:44:21,260
of diseases, from irritable bowel
and Crohn's to multiple sclerosis.

753
00:44:23,460 --> 00:44:28,090
What really interests me about
FMT is that it's part of a broader

754
00:44:28,140 --> 00:44:31,410
thought shift happening
in medicine at the moment.

755
00:44:31,460 --> 00:44:34,250
We need to start thinking
of the human body

756
00:44:34,300 --> 00:44:40,130
less as a pristine vessel and
more as a complex ecosystem.

757
00:44:40,180 --> 00:44:43,890
It's a new approach that could
have a big impact on the way

758
00:44:43,940 --> 00:44:47,060
we treat all sorts of
diseases in the future.

759
00:44:48,700 --> 00:44:51,240
MUSIC: "Dr Wanna Do" by Caro Emerald

760
00:44:53,940 --> 00:44:57,450
Every day, the newspapers run
eye-catching health stories.

761
00:44:57,500 --> 00:44:59,850
But what's the truth
behind the headlines?

762
00:44:59,900 --> 00:45:02,300
Dr Salehya Ahsan investigates.

763
00:45:03,500 --> 00:45:07,650
Recently, it was reported that
the NHS in Essex was starting

764
00:45:07,700 --> 00:45:11,980
to give personalised obesity
treatment based on DNA tests.

765
00:45:13,220 --> 00:45:17,010
It's a small trial based on a
study in Italy which showed that

766
00:45:17,060 --> 00:45:21,410
a personalised weight-loss plan
based around a genetic test helped

767
00:45:21,460 --> 00:45:25,450
people lose a third more weight
than those on a generic diet plan.

768
00:45:25,500 --> 00:45:29,570
So, now we can buy DNA-testing
kits at the chemist,

769
00:45:29,620 --> 00:45:32,850
could we all be doing
this for ourselves?

770
00:45:32,900 --> 00:45:35,570
It sounds tempting for all of us.

771
00:45:35,620 --> 00:45:40,850
Could a simple home DNA test
predict our future, helping us

772
00:45:40,900 --> 00:45:43,810
to diet and lose weight?

773
00:45:43,860 --> 00:45:46,850
Surely, if the NHS is trialling it,

774
00:45:46,900 --> 00:45:49,770
there must be good evidence
that it works.

775
00:45:49,820 --> 00:45:51,360
But is there?

776
00:45:52,700 --> 00:45:55,970
A simple swab of the cheek is
all you need to collect cells

777
00:45:56,020 --> 00:45:58,650
containing your genetic code.

778
00:45:58,700 --> 00:46:02,090
Companies already offer tests to
look for genes known to be linked

779
00:46:02,140 --> 00:46:06,170
to around 100 diseases,
including Alzheimer's,

780
00:46:06,220 --> 00:46:08,690
cancer and hereditary hearing loss.

781
00:46:09,540 --> 00:46:12,970
But can such tests really allow
you to look into your own future,

782
00:46:13,020 --> 00:46:16,010
or to change your health
for the better through

783
00:46:16,060 --> 00:46:18,400
tailoring your diet and habits?

784
00:46:20,220 --> 00:46:25,410
While it's true that some conditions
have a very strong genetic component,

785
00:46:25,460 --> 00:46:28,930
in most cases, it's very complex.

786
00:46:28,980 --> 00:46:34,130
So, even though a test kit might
tell you what gene variant you have,

787
00:46:34,180 --> 00:46:38,380
it's likely that it won't tell you
what this means for your health.

788
00:46:40,100 --> 00:46:43,610
We simply do not know enough at
the moment about the relationship

789
00:46:43,660 --> 00:46:45,890
between our genes and our health,

790
00:46:45,940 --> 00:46:49,570
and that's where the NHS
trial in Essex comes in.

791
00:46:49,620 --> 00:46:53,650
Studies like this are vital to
help discover how much our genes

792
00:46:53,700 --> 00:46:58,020
can tell us, and how that might
benefit our health in the future.

793
00:46:59,780 --> 00:47:03,650
At the moment, we are in the
very early days of understanding

794
00:47:03,700 --> 00:47:08,170
how our genes can influence our health.

795
00:47:08,220 --> 00:47:12,090
Personalised medicine is one
of the big hopes for the future,

796
00:47:12,140 --> 00:47:17,250
but for now, my advice is not to
waste your money on home test kits.

797
00:47:17,300 --> 00:47:20,650
None of them can give you any
information that will make

798
00:47:20,700 --> 00:47:23,300
a significant benefit to your health.

799
00:47:24,860 --> 00:47:27,400
MUSIC: "Dr Wanna Do" by Caro Emerald

800
00:47:32,060 --> 00:47:33,730
On Trust Me, I'm A Doctor,

801
00:47:33,780 --> 00:47:37,020
we try to tackle issues
that most matter to you.

802
00:47:38,740 --> 00:47:41,970
We wanted to find out which
questions you particularly wanted

803
00:47:42,020 --> 00:47:46,610
answers to, so we commissioned
a poll of 2,000 people.

804
00:47:46,660 --> 00:47:50,010
When the results came in, almost
a third of you wanted to know,

805
00:47:50,060 --> 00:47:52,460
"How can I avoid heart disease?"

806
00:47:53,620 --> 00:47:56,850
Now, after cancer, heart disease
is the leading cause of death

807
00:47:56,900 --> 00:48:01,340
in the UK, so what, if anything,
can you do to reduce your risk?

808
00:48:05,260 --> 00:48:08,210
There are a lot of claims
reported in the media.

809
00:48:08,260 --> 00:48:11,700
It seems that just about anything
can be linked to heart disease.

810
00:48:13,340 --> 00:48:15,490
I want you to put down here
things that you think will

811
00:48:15,540 --> 00:48:18,730
increase your risk of heart disease,
things which will reduce the risk

812
00:48:18,780 --> 00:48:22,010
- and things you're not sure about or
which you think are unimportant. - OK.

813
00:48:22,060 --> 00:48:25,300
- So, er...
- So, obesity. - Mm-hmm.

814
00:48:28,420 --> 00:48:31,650
- Oh! - Alcohol! Are you going
"yes" or "no" with alcohol?

815
00:48:31,700 --> 00:48:33,890
Moderate amount's OK, too much is bad.

816
00:48:33,940 --> 00:48:36,490
Too much TV? That's ridiculous
to have that there.

817
00:48:36,540 --> 00:48:39,580
- No, it's not. - It is, cos...
- It just makes you sick.

818
00:48:40,580 --> 00:48:43,210
There's no excuse if you've
got rheumatoid arthritis,

819
00:48:43,260 --> 00:48:45,090
cos you can still do other things.

820
00:48:45,140 --> 00:48:48,170
- Brazil nuts, where would you put them?
- Well, they are radioactive.

821
00:48:48,220 --> 00:48:49,930
[MICHAEL CHUCKLES] OK.

822
00:48:49,980 --> 00:48:52,450
You're supposed to have
a few of them every night.

823
00:48:52,500 --> 00:48:56,660
There's clearly a lot of confusion.
So, how can we get to the truth?

824
00:48:57,660 --> 00:49:00,930
I've come to Glasgow University's
Institute of Cardiovascular

825
00:49:00,980 --> 00:49:05,050
and Medical Sciences to meet one
of the world's leading experts

826
00:49:05,100 --> 00:49:08,420
in the field, Professor Naveed Sattar.

827
00:49:10,900 --> 00:49:12,650
So, what are the risks?

828
00:49:12,700 --> 00:49:15,530
What are the chances of somebody
in the UK having a heart attack?

829
00:49:15,580 --> 00:49:18,490
It depends on your gender,
so roughly speaking,

830
00:49:18,540 --> 00:49:21,570
one in six males will die
prematurely from heart disease

831
00:49:21,620 --> 00:49:23,690
and around about one in ten females.

832
00:49:23,740 --> 00:49:26,810
In total, 80,000 people
have heart attacks

833
00:49:26,860 --> 00:49:30,650
and die from heart disease in the
UK. That's roughly 200 people a day.

834
00:49:30,700 --> 00:49:32,930
200 people a day. That's
quite a figure, isn't it?

835
00:49:32,980 --> 00:49:36,210
Over the last two to three decades,
in particular the last decade,

836
00:49:36,260 --> 00:49:38,570
it's come down substantially,
by at least 50%,

837
00:49:38,620 --> 00:49:41,730
so things that we are doing
in the medical field

838
00:49:41,780 --> 00:49:45,210
are actually having a benefit,
but we have a long way to go, yes.

839
00:49:45,260 --> 00:49:49,010
Do you think there is consensus
around what we should be doing?

840
00:49:49,060 --> 00:49:51,250
I think there's very good
evidence in this area,

841
00:49:51,300 --> 00:49:53,970
more so than many other
parts of medicine,

842
00:49:54,020 --> 00:49:56,650
about what works in terms
of preventing heart disease,

843
00:49:56,700 --> 00:50:00,050
so we know absolutely categorically
that lowering cholesterol

844
00:50:00,100 --> 00:50:03,890
lowers heart disease risks, lowering
blood pressure also helps,

845
00:50:03,940 --> 00:50:06,730
and of course, stopping smoking
is a major beneficial effect

846
00:50:06,780 --> 00:50:09,010
in terms of heart disease risk as well.

847
00:50:09,060 --> 00:50:11,090
Say you were a 50-year-old man.

848
00:50:11,140 --> 00:50:13,210
If you smoke 20 cigarettes per day,

849
00:50:13,260 --> 00:50:16,010
your heart age would be nine years
higher than you really are,

850
00:50:16,060 --> 00:50:21,170
so roughly speaking, talking about
a decade lost because of smoking.

851
00:50:21,220 --> 00:50:23,690
So, how does high blood pressure
relate to heart disease?

852
00:50:23,740 --> 00:50:26,730
When the heart pumps, it delivers
blood through our blood vessels.

853
00:50:26,780 --> 00:50:28,650
High blood pressure, effectively,

854
00:50:28,700 --> 00:50:30,690
is higher pressure in
those blood vessels,

855
00:50:30,740 --> 00:50:33,330
so in a sense, the heart
has to work much harder

856
00:50:33,380 --> 00:50:35,930
to actually create the flow
through the blood vessels.

857
00:50:35,980 --> 00:50:38,650
One of the things we're told is,
cut down on salt consumption.

858
00:50:38,700 --> 00:50:40,810
- Absolutely.
- Is the evidence strong on that?

859
00:50:40,860 --> 00:50:43,610
I think the evidence is strong
enough that certainly salt intake

860
00:50:43,660 --> 00:50:45,410
is associated with high blood pressure.

861
00:50:45,460 --> 00:50:46,930
OK, so, what's the evidence

862
00:50:46,980 --> 00:50:50,690
that certain foods are likely to
affect your risk of heart disease?

863
00:50:50,740 --> 00:50:54,490
There is emerging evidence that
if you have a diet, for example,

864
00:50:54,540 --> 00:50:59,810
in high levels of fibre or fruit
and veg, that might be protective.

865
00:50:59,860 --> 00:51:01,890
Having a Mediterranean-type
diet with nuts,

866
00:51:01,940 --> 00:51:06,050
- it reduces the risk of heart disease by 30%.
- What about meat?

867
00:51:06,100 --> 00:51:09,970
I think the evidence base
is reasonably clear-cut.

868
00:51:10,020 --> 00:51:13,290
Processed red meat is
really quite harmful

869
00:51:13,340 --> 00:51:15,650
in the sense it contains
lots of saturated fat,

870
00:51:15,700 --> 00:51:18,370
and we'd recommend, do not
eat much processed meat.

871
00:51:18,420 --> 00:51:21,530
There is clear epidemiological evidence
that reducing saturated fat

872
00:51:21,580 --> 00:51:24,410
and cholesterol has helped lower
risk of heart disease over

873
00:51:24,460 --> 00:51:27,930
- the last three to four decades.
- What about alcohol, then?

874
00:51:27,980 --> 00:51:29,290
So, obviously,

875
00:51:29,340 --> 00:51:32,010
we love the idea that a bit of
red wine is probably good for us.

876
00:51:32,060 --> 00:51:37,250
- Do you buy that? - I actually don't
buy that. All the evidence about...

877
00:51:37,300 --> 00:51:39,530
- You killjoy!
- I am a killjoy, I'm sorry.

878
00:51:39,580 --> 00:51:41,330
The really important
thing, though, is --

879
00:51:41,380 --> 00:51:43,050
and I'm involved in writing guidelines

880
00:51:43,100 --> 00:51:45,290
for heart disease around the world --

881
00:51:45,340 --> 00:51:48,650
doctors have to get their heads
round new types of evidence,

882
00:51:48,700 --> 00:51:51,730
and I'm reasonably comfortable
now that we cannot see alcohol

883
00:51:51,780 --> 00:51:53,770
as protecting against heart disease,

884
00:51:53,820 --> 00:51:56,410
and that, I think, is probably
a good public health message.

885
00:51:56,460 --> 00:51:58,290
What about aspirin?

886
00:51:58,340 --> 00:52:01,210
So we now recommend that aspirin
is used only in people who already

887
00:52:01,260 --> 00:52:02,810
had a heart attack or a stroke,

888
00:52:02,860 --> 00:52:05,690
whereas people who've not had
a heart attack or stroke,

889
00:52:05,740 --> 00:52:08,250
we probably are moving
away from using aspirin.

890
00:52:08,300 --> 00:52:11,130
The reason being that aspirin
doesn't come without risks.

891
00:52:11,180 --> 00:52:14,370
Roughly speaking, I would say
to you that statins are probably

892
00:52:14,420 --> 00:52:17,330
about 100-200 times safer
than aspirin, for example.

893
00:52:17,380 --> 00:52:20,050
So, you've got the heart, the
heart is obviously a muscle.

894
00:52:20,100 --> 00:52:22,410
- Muscles like exercise.
- Sure.

895
00:52:22,460 --> 00:52:25,610
So, there's good evidence
that doing exercise

896
00:52:25,660 --> 00:52:28,730
lowers your risk of heart disease?
I mean, is there good evidence?

897
00:52:28,780 --> 00:52:30,250
If you look at the evidence,

898
00:52:30,300 --> 00:52:33,770
it looks like people's fitness
does relate to a lower risk

899
00:52:33,820 --> 00:52:36,410
of heart disease, yes,
but the message there is,

900
00:52:36,460 --> 00:52:39,530
take any obvious opportunity
to be physically active.

901
00:52:39,580 --> 00:52:42,810
For example, if you see some stairs
and you have to go up three floors,

902
00:52:42,860 --> 00:52:45,090
don't take the lift, take the stairs.

903
00:52:45,140 --> 00:52:48,690
Run up the stairs, for example,
and if that doesn't work,

904
00:52:48,740 --> 00:52:51,090
I usually say go buy a dog,
but I'm being facetious.

905
00:52:51,140 --> 00:52:52,740
MICHAEL LAUGHS

906
00:52:53,980 --> 00:52:55,730
So, when it comes to heart disease,

907
00:52:55,780 --> 00:53:00,810
it turns out there are plenty of
ways you can reduce your risk.

908
00:53:00,860 --> 00:53:02,450
If you want to avoid heart disease,

909
00:53:02,500 --> 00:53:05,010
then there are three
things you should do.

910
00:53:05,060 --> 00:53:06,490
If you're a smoker, don't,

911
00:53:06,540 --> 00:53:10,290
because smoking doubles your risk
of having a heart attack or stroke.

912
00:53:10,340 --> 00:53:13,930
Get your blood pressure checked, and
if it's high, do something about it.

913
00:53:13,980 --> 00:53:16,250
And finally, get your
bad cholesterol down.

914
00:53:16,300 --> 00:53:17,770
We know you can do it with statins,

915
00:53:17,820 --> 00:53:20,330
but can you do it by
modifying your diet?

916
00:53:20,380 --> 00:53:22,380
We're about to find out.

917
00:53:23,500 --> 00:53:26,570
For the past month, we've had
three groups of volunteers

918
00:53:26,620 --> 00:53:30,130
trying out different ways
to lower their cholesterol.

919
00:53:30,180 --> 00:53:33,690
One group cut down on foods
said to raise cholesterol.

920
00:53:33,740 --> 00:53:38,130
The other two added either
oats or almonds to their diet,

921
00:53:38,180 --> 00:53:42,410
two foods that studies suggest
can lower our levels.

922
00:53:42,460 --> 00:53:45,180
So, how did they all get on?

923
00:53:46,340 --> 00:53:49,850
- Which group were you in?
- Low cholesterol, low fat. - Deprivation.

924
00:53:49,900 --> 00:53:51,570
No sausages and no bacon.

925
00:53:51,620 --> 00:53:53,330
That was the biggest challenge for me,

926
00:53:53,380 --> 00:53:55,610
a week in France without any cheese.

927
00:53:55,660 --> 00:53:57,210
No roast potatoes.

928
00:53:57,260 --> 00:53:59,260
All the foods you like.

929
00:54:00,060 --> 00:54:03,610
- You were the oat-eaters.
- Yes. - Did you enjoy
it? - It was a struggle.

930
00:54:03,660 --> 00:54:06,730
I lost weight. Half a stone.
Well pleased with that.

931
00:54:06,780 --> 00:54:09,690
- Almonds.
- I think we got the best group.

932
00:54:09,740 --> 00:54:11,530
THEY LAUGH

933
00:54:11,580 --> 00:54:14,490
While the volunteers were taking
part in our big trial,

934
00:54:14,540 --> 00:54:18,170
I was doing a different
cholesterol challenge.

935
00:54:18,220 --> 00:54:21,210
My levels were high at the
start, and for eight weeks,

936
00:54:21,260 --> 00:54:24,300
I've been following what's
called a portfolio diet.

937
00:54:25,820 --> 00:54:30,130
I'd cut down on foods with
animal fat, as well as adding

938
00:54:30,180 --> 00:54:33,770
a range of different foods believed
to help lower cholesterol.

939
00:54:33,820 --> 00:54:38,820
Soluble fibre, nuts, plant
sterols, I even tried soy.

940
00:54:40,700 --> 00:54:43,290
I'll be very interested
to see the results.

941
00:54:43,340 --> 00:54:45,530
It may turn to out to
be spectacularly good,

942
00:54:45,580 --> 00:54:48,420
but I wait to be convinced.

943
00:54:49,620 --> 00:54:51,210
The final blood tests will reveal

944
00:54:51,260 --> 00:54:57,530
what has happened to our total
cholesterol, our bad LDL cholesterol

945
00:54:57,580 --> 00:54:59,860
and our good HDL cholesterol.

946
00:55:02,500 --> 00:55:06,050
We all started off with LDL
levels that were too high,

947
00:55:06,100 --> 00:55:09,700
but did our different diets
succeed in bringing them down?

948
00:55:11,140 --> 00:55:14,730
First up, the lower animal fat group.

949
00:55:14,780 --> 00:55:17,970
They came out on top,
with an average 11% drop

950
00:55:18,020 --> 00:55:22,980
in total cholesterol and
a 13% drop in the bad LDL.

951
00:55:24,300 --> 00:55:27,170
The oats group also had
a significant drop,

952
00:55:27,220 --> 00:55:32,220
nearly 9% in total cholesterol
and just over 10% in bad LDL.

953
00:55:33,860 --> 00:55:36,130
But for the almonds
group, little change.

954
00:55:36,180 --> 00:55:40,010
On average, their cholesterol
levels stayed about the same.

955
00:55:40,060 --> 00:55:43,010
So, looking at the group
averages, eating oats

956
00:55:43,060 --> 00:55:46,890
and cutting animal fats
had a significant effect.

957
00:55:46,940 --> 00:55:49,130
Almonds, it seems, were less effective.

958
00:55:49,180 --> 00:55:52,570
But this isn't quite
the end of the story.

959
00:55:52,620 --> 00:55:56,370
Dr Scott Harding has a graph that
shows the individual responses

960
00:55:56,420 --> 00:56:00,690
of each person in the almond group,
and the results are fascinating.

961
00:56:00,740 --> 00:56:02,770
Here you can see the
almonds, half the group

962
00:56:02,820 --> 00:56:05,410
actually had a positive
response, and one individual

963
00:56:05,460 --> 00:56:08,290
had close to an 18% reduction
in their total cholesterol.

964
00:56:08,340 --> 00:56:10,530
And on the other side of the
coin, we've got the people

965
00:56:10,580 --> 00:56:13,010
who had an adverse response,
their cholesterols went up.

966
00:56:13,060 --> 00:56:14,930
- In some cases, significantly.
- Blimey.

967
00:56:14,980 --> 00:56:16,970
It's an intriguing result,

968
00:56:17,020 --> 00:56:21,770
and suggests the response to eating
almonds is highly individual.

969
00:56:21,820 --> 00:56:24,050
I was surprised by the almond results.

970
00:56:24,100 --> 00:56:25,650
There is enough data to support

971
00:56:25,700 --> 00:56:28,330
that it does work in general
for the average person,

972
00:56:28,380 --> 00:56:31,250
but a concept of responders and
non-responders is something that's

973
00:56:31,300 --> 00:56:33,890
been appearing more predominately
in nutritional research.

974
00:56:33,940 --> 00:56:35,850
It's an interesting angle to look at,

975
00:56:35,900 --> 00:56:39,690
- because this is really getting into
personalising nutrition. - I think...

976
00:56:39,740 --> 00:56:42,450
It seems to me that one of the
morals of this thing is that

977
00:56:42,500 --> 00:56:45,250
you have to try it out yourself.

978
00:56:45,300 --> 00:56:47,730
Now, we kept our groups separate.

979
00:56:47,780 --> 00:56:51,290
But what if you combine these
changes to your diet?

980
00:56:51,340 --> 00:56:55,370
Well, that's what I did
with my portfolio diet.

981
00:56:55,420 --> 00:57:00,130
So now, the moment of truth. How
has it affected my cholesterol?

982
00:57:00,180 --> 00:57:03,330
- You want your results?
- Of course I do. I've been very patient.

983
00:57:03,380 --> 00:57:05,370
Well, here's a slide dedicated
just to Michael.

984
00:57:05,420 --> 00:57:09,290
So, when you started, you had a total
cholesterol of eight MMOs per litre.

985
00:57:09,340 --> 00:57:12,130
That's very high. So, overall,
across the eight weeks,

986
00:57:12,180 --> 00:57:17,370
- your total cholesterol was down 30%.
- Whoo! - 42% reduction in your LDL.

987
00:57:17,420 --> 00:57:19,490
- Wow. - So, very significant.
- That's very big.

988
00:57:19,540 --> 00:57:21,650
- That's statin level reductions.
- Bloody hell.

989
00:57:21,700 --> 00:57:24,210
That's the equivalent of a statin.
So, I'm top of the class.

990
00:57:24,260 --> 00:57:26,400
Yes, you are! [THEY LAUGH]

991
00:57:26,620 --> 00:57:30,650
I'm astonished and delighted to
find that my cholesterol level

992
00:57:30,700 --> 00:57:34,930
has fallen by so much. It's similar
to the effect of taking statins,

993
00:57:34,980 --> 00:57:38,330
and all just by changing what I ate.

994
00:57:38,380 --> 00:57:42,690
So can you lower your cholesterol
through diet? The answer is yes.

995
00:57:42,740 --> 00:57:45,490
Whether you can do it
by any particular diet

996
00:57:45,540 --> 00:57:47,890
depends very much on you.

997
00:57:47,940 --> 00:57:51,050
All three of our interventions
brought a degree of success.

998
00:57:51,100 --> 00:57:53,970
In fact, some people saw
a surprisingly big effect

999
00:57:54,020 --> 00:57:56,810
just from eating more oats or almonds.

1000
00:57:56,860 --> 00:57:59,890
And, as my experience showed,
combining different changes

1001
00:57:59,940 --> 00:58:03,370
to a diet can produce
even better results.

1002
00:58:03,420 --> 00:58:05,730
So, why not go and get
your levels tested,

1003
00:58:05,780 --> 00:58:09,410
and if they're high, see if you
can improve them by cutting back

1004
00:58:09,460 --> 00:58:12,770
on animal fats or adding in
some of the foods we've tried?

1005
00:58:12,820 --> 00:58:14,530
If you can lower your cholesterol,

1006
00:58:14,580 --> 00:58:18,210
it should reduce your
risk of heart disease.

1007
00:58:18,260 --> 00:58:20,800
MUSIC: "Dr Wanna Do" by Caro Emerald

1008
00:58:23,780 --> 00:58:25,090
That's it from London.

1009
00:58:25,140 --> 00:58:28,770
Next time, we're coming from York,
surrounded by lots of chocolate,

1010
00:58:28,820 --> 00:58:32,370
and we're going to test out
new ways to cut cravings.

1011
00:58:32,420 --> 00:58:36,850
We'll also be asking, is organic
food actually better for you?

1012
00:58:36,900 --> 00:58:40,340
And how can you spot a
stroke before it happens?

1013
00:58:44,580 --> 00:58:46,690
♪ I just made an appointment

1014
00:58:46,740 --> 00:58:49,330
♪ For a special rendezvous

1015
00:58:49,380 --> 00:58:51,930
♪ To see a man of miracles

1016
00:58:51,980 --> 00:58:53,980
♪ And all that he can do

1017
00:58:59,660 --> 00:59:01,890
♪ Doctor, I want you

1018
00:59:01,940 --> 00:59:04,090
♪ Mm, my Dr Wanna Do

1019
00:59:04,140 --> 00:59:06,330
♪ I can't get over you

1020
00:59:06,380 --> 00:59:08,780
♪ Doctor, do anything
that you want to do. ♪