Episode 1 Health: Truth or Scare


Episode 1

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Every day we're bombarded with conflicting messages about

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how to live a healthy, happy life.

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One minute we're told something is the right thing to do,

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the next it's the complete opposite,

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and we're left without a clue which advice to follow.

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So we've been wading through the confusion

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to separate the scare stories from the truth,

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to help you work out what's best for you.

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Hello, and welcome to Health - Truth Or Scare?

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The series that gets to the bottom of all of those stories

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and headlines that like to make us think they know what's really good

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for our health, but, of course, as you and I have found out,

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Kevin, they so rarely do.

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Today we're talking about conditions that really do

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affect millions of us.

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They might be common,

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but they're also the subject of some serious controversy.

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And today we'll be finding out why.

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Coming up - they're the most widely prescribed drugs in the country,

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but should millions of people really be taking statins?

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Telling people to stop them really is placing them in grave danger.

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Heart attacks and strokes, these are not messing around.

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These are serious bad things you don't want to happen to you.

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And in the wake of reports claiming that thousands might be taking

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asthma medication they don't need,

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I find out if I'm one of them.

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And we'll see what that shows in a little while.

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Now, the chances are that if you're over 50 and you're not one of

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the reported six million people already taking statins,

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then you more than likely know somebody who is.

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The Government and the NHS both say these drugs have saved the lives

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of tens of thousands of people with heart disease.

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But, you know, Kevin, when we look at some of the headlines,

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it's very difficult to find anybody that can agree on whether or not

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statins are actually going to save your life or shorten it.

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If you're taking statins and you read this headline -

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"Are millions taking statins needlessly?" -

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what are you going to think?

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And this one says statins ARE safe

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and we should be giving them to six million more people.

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You couldn't get more of a conflicting argument than that.

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Absolutely. But, as I found out,

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the argument against statins is gaining momentum,

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fanning the flames of a controversy that, quite frankly,

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just won't go away.

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Heart disease. It's long been one of Britain's biggest killers.

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But over the past decade it seems we've started to win

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the battle against it.

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In part, that's believed to be thanks to drugs like statins.

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They help lower the body's cholesterol levels and reduce

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the risk of heart attacks and strokes.

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Now, for me, that's a big deal because my family

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has a history of diabetes and high cholesterol,

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which means we have a greater risk of getting heart disease.

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And if anyone has that elevated risk,

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they could be prescribed statins by their GP,

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not to treat heart disease, but to reduce their chance of getting it.

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It's that that makes statins one of the most widely prescribed drugs

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in the country.

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But they're also very controversial.

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At the heart of the argument is a range of side effects that some

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sufferers say can be debilitating,

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but many experts dismiss.

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A major review of statins has found that the anti-cholesterol drug is

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safe and effective,

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and that any harmful side-effects have been exaggerated.

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But this was met with allegations that statins don't work as well

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as it's claimed.

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The arguments got so heated that it even lead to

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a so-called statins war between the country's leading medical journals -

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one saying reports of side effects are massively overexaggerated,

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another saying the side-effects outweighed the benefits.

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Both sides of the argument are extremely vocal, and,

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you know, I can only imagine how confusing it must be if

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you're offered statins by your GP, to then go on and read negative

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newspaper reports about how you shouldn't touch them.

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And with my family history of high cholesterol there's a good chance

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I might be recommended statins by my GP in the next few years.

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So, before that happens I want to find out if the side-effects

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can outweigh the benefits, and I'm starting with someone

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who has experienced both sides of the argument.

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Coleen Gill was, until recently,

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one of the estimated six million statins users in the UK.

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She says the drug helped change her life after

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a heart attack ten years ago.

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The heart attack was a big shock to the system.

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It was a shock to the family as well.

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Well, they'd said at the hospital

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that I had a really high cholesterol,

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it was off the mark, so to speak.

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And they put me on statins,

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I had to take them when I left,

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as he said, forever.

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Along with some big changes to her diet and lifestyle,

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Coleen says the statins helped transform her health,

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and as a result she even retrained as a fitness coach.

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But after taking statins for more than three years

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she started to develop side-effects.

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I was just starting to get tingling in my fingers and I thought,

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"Why can't I feel my fingers?"

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And I wasn't sure, to be fair,

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whether it was the statins or what,

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but there was talk about side-effects.

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Worried about losing the feeling in her fingers,

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and with her cholesterol safely under control,

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Coleen decided to come off statins altogether,

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against the wishes of her doctor.

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He wasn't really happy for me to come off them completely.

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But you know your own body,

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and I just felt it was right to do that.

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And I haven't looked back.

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Coleen made a controversial decision,

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because the official advice is that once a patient

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has started taking statins, they should take them for life.

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She was one of the reported 20% of users who experience side-effects.

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But with around six million people on statins,

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perhaps it's no surprise that some do.

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Professor Liam Smeeth was part of a wide-ranging review of statins,

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with access to almost five million patients' records.

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I guess one of the questions that the patient will ask is,

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"Hang on a minute, side-effects,

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"what kind of side-effects could I get?"

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Well, there's one side-effect in particular that has received a great

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deal of media attention, and that is where the statins cause muscle pain.

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And the problem we've got is aches and pains are really common,

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virtually everyone gets them at some point or another, and it's

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very difficult to know whether they're caused by the statins or not.

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But there's one much more serious potential side-effect

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that Liam says experts are sure of.

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And it's one that I find quite worrying.

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Statins might increase your risk of developing type II diabetes.

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My family has got a history of diabetes.

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My mum passed away with diabetes, both my sisters have diabetes,

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so would that have a massive effect on you advising me to take statins?

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Possibly, yes.

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I do feel for people here because this is a complicated story to tell.

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Statins do increase your risk of developing diabetes a little bit.

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It's worth taking that small increased risk of diabetes

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because there's huge benefits on heart attacks and strokes.

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Statins reduce your risk of having a heart attack or a stroke

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by something like a quarter or a third.

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But that's certainly not the impression you might get from

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some reports about studies into statins,

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which, Liam says, could have led people to make dangerous

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decisions about their health.

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Do you get frustrated by the headlines telling people

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to stop taking statins?

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I do get frustrated, yeah.

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I get frustrated by headlines saying statins are terrible,

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they don't work, they cause all these terrible symptoms,

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you should stop them.

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The science is clear - these are beneficial drugs

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with low levels of side-effects, as far as we're aware.

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And telling people to stop them

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really is placing them in grave danger.

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Heart attacks and strokes, these are not messing around,

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these are serious bad things you don't want to happen to you.

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It's a compelling argument.

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But within the medical profession

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there are still those critical of statins.

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Dr Malcolm Kendrick is a busy GP

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who has agreed to meet me after work.

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He disagrees with Liam Smeeth,

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and says statins' side-effects are hugely underestimated.

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I think the side-effect issue is much greater than is accepted,

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if you like. There have been studies in the States.

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One showed that over 60% of people stopped taking their statin

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after a year - in 70% of those, it was because of a side-effect,

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an adverse effect.

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I sometimes say to patients,

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"Statins add 15 years to your life -

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"they don't make you live 15 years longer,

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"they just make you feel 15 years older."

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One of the other problems that I don't like is...

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if you're prescribed statins,

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people tend to stop doing other things, healthy things.

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Because they think the statins are going to just do the job.

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They think they're being protected, so they think,

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"I'll take my tablet and I'll do whatever I like."

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So, Malcolm, do you think we should stop prescribing statins altogether?

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No, not entirely.

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The only group of people I would say yeah, it might be worthwhile,

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is men who have already had a heart attack or a stroke or angina

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or some sort of heart disease problem,

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and therefore it's worth trying it.

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And if you get no side-effects, well, fine, carry on,

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it's not a problem.

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Malcolm says the evidence isn't as strong for women,

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whether they have a heart condition or not.

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I say, "You know what?

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"The benefits here are just really non-existent,

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"or so small as to be non-existent."

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There's only one thing everyone seems to agree on, that statins

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are effective for some people who already have heart disease.

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But there are millions taking statins

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who don't have the condition,

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and if your GP says you have more than a 10% chance of developing it

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in the next decade, you could be prescribed statins

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to prevent it happening.

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So what should people faced with that decision do?

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On hand to help is David Spiegelhalter,

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President of the Royal Statistical Society,

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and, crucially, someone who has also been faced

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with the choice of whether to take statins.

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So, David, the dilemma seems to be that, with taking statins,

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it's all about risks.

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Risk with heart disease, risk with side-effects.

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Can statistics help us weigh up that decision?

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I think statistics can really help,

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and I'm relying on it to help me

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because I'm dithering about taking statins myself.

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I'm 63, I've got slightly raised cholesterol

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and I'm taking blood pressure tablets already,

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so I'm at reasonable risk of a heart attack or stroke

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-in the next ten years.

-OK.

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I put myself through a risk calculator,

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you can see online, and it works out I've got about an 18% chance

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of a heart attack or stroke in the next ten years.

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So one way to think about this is through this rather

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frightening-looking display,

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which is 100 possible versions of "me" in ten years' time.

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And 18 of them have got little orange colouring on them,

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which indicates a heart attack or stroke.

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Now, one of these is going to happen,

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and chances are this won't happen and I'll be OK,

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but 18 of these 100,

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I'm going to have had a heart attack or stroke.

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Now, I'd like to reduce that number, and it turns out that,

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if I took statins every day,

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roughly about six of these can be taken off.

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So, David's personal risk of developing heart disease

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in the next decade drops from 18% to 12% if he takes statins.

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Critics say the risk of developing side-effects

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is much greater than the 6% drop

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in the risk of developing heart disease.

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But David disagrees, estimating the risk of side-effects at 2%.

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And so, actually, to put it rather pessimistically,

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maybe 2/100 of these will get some side effects

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from taking the statins.

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I've taken away six of the heart attacks or strokes,

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but I've put in some side effects.

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Now, I think, for me, six versus two, yeah,

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I think it's worth taking the statins for me,

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but for someone else that might not be the case.

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And to show me how that trade-off differs for someone

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with a smaller risk of developing heart disease,

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David is using a hypothetical,

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and I must say rather handsome, example.

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This individual is standing in for someone who's just at the level

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where the official Nice guidelines would recommend

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that their GP offers them statins.

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And that happens when there's about a 10% risk of

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a heart attack or stroke over the next ten years.

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So out of these 100 possible futures for this individual,

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-for 10 of them there's going to be a heart attack or stroke.

-OK.

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If this person takes statins every day for the next ten years,

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about three of these will disappear.

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The side-effects, though, stay at roughly the same level.

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Around two of these people will have reasonably

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severe side effects over the next ten years.

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You've got gain in three of these possible futures,

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but a loss in two of them.

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So the trade-off is much more finely balanced.

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I don't know what to think now, whether or not...

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It's just seeing those two purple ones still there,

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just makes me think that if you are at low risk

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you're going to be probably more inclined to think,

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"Well, I don't need to take them just yet."

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And you might be able to then change your lifestyle a bit,

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take more exercise, improve your diet and so on,

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reduce your drinking.

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When I first started making this film

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I was hoping for a clear answer.

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And while there's no doubt statins are powerful drugs

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if you've already had a heart attack,

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if you haven't then the decision could be much harder.

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The risk of developing side-effects

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is very low, but it's still there.

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So it's up to you to decide if the risk is worth it.

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And, either way,

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statins are just one weapon in the whole armoury of things

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we can use to combat heart disease.

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And that's something Coleen knows well.

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I think you should listen to hear what your body is telling you.

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I think you should think about doing more exercise and eating properly.

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I have to say, Angela, I'm now pretty confident about

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what I think of statins after making that film.

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But clearly it's a controversy that shows little sign of dying down.

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And here's another.

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Because next we're tackling something else that's had its

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fair share of headlines.

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And this one is particularly close to your heart, Angela.

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You're right, Kevin, it is. But I think, anatomically speaking,

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it's probably a bit closer to my lungs

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because what we're talking about now is asthma.

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Now, I have to admit that there aren't quite as many people

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using inhalers as there are taking statins,

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but millions do, and I'm one of them.

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And I never go anywhere without this.

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But, again, there's no shortage of headlines

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that seem to be saying that some of us

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really don't need the medicines

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that are being prescribed by our doctors.

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Take a look at this one.

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"A third of asthmatics may not have the condition."

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Well, you could be forgiven for thinking that really nobody

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has got asthma at all, but I can tell you, as I found out,

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that really is far from the case.

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Keeping fit has always been really important to me,

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but many years ago I was diagnosed with a condition

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which some sufferers say impacts on their ability

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to lead an active lifestyle.

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Now, when I was in my 20s I had what my doctor prescribed

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as an asthma attack.

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And as a result he gave me one of these - an inhaler.

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Now, over the years I've had bouts of asthma

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that have come and then gone.

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But, I'm glad to say that I've never been in a position where it's

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actually got in the way of me enjoying a very active life.

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Now, I can go months, even years, without having an asthma attack

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and I never really know what it is that triggers it.

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But I have to say, having read some of the headlines recently,

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I'm beginning to wonder whether I've actually got asthma at all.

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And that's because in January 2017

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a lot of papers ran the same headline,

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saying a third of people with asthma had been misdiagnosed,

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and that could mean more than one million people in the UK

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are taking medication they don't need.

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GP Andy Whittamore is clinical lead for Asthma UK,

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and he says asthma is a much more complicated condition

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than you might first realise.

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What are the things that might trigger asthma?

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Well, everybody's diffident.

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So if somebody is predisposed to asthma it could be pollution,

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it could be hay fever, allergies.

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Whether it's in the family or not, whether they've got other allergic

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conditions, it could even be hormones and stress, in some cases.

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Does that make it so very difficult to actually diagnose?

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There is not one easy test to say if somebody has got asthma or not.

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And even with the tests we have got,

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none of them fit every pattern of asthma that we see.

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It's not clear cut at all.

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When you put it like that it's easy to think that those headlines

0:16:470:16:50

are accurate.

0:16:500:16:52

But Andy isn't so sure they really apply to us here in the UK.

0:16:520:16:56

I think the important thing to say is this was a snap shot

0:16:560:16:58

in a small group of people in Canada.

0:16:580:17:00

I don't think people should be too concerned that they've got

0:17:000:17:02

the wrong diagnosis, but certainly if they're concerned

0:17:020:17:05

they should speak to their GP or nurse or specialist.

0:17:050:17:08

While the headlines might not be completely accurate, there is

0:17:080:17:11

no doubt there are people in the UK who've been diagnosed with asthma

0:17:110:17:15

when they might in fact have other conditions,

0:17:150:17:17

like vocal cord problems or chronic obstructive pulmonary disease,

0:17:170:17:22

known as COPD.

0:17:220:17:24

They could have spent years being treated for asthma

0:17:240:17:26

that they don't have, so getting the diagnosis right is vital.

0:17:260:17:30

Now, when I was first told I had asthma, back in the '60s,

0:17:360:17:39

it was thought of very differently to today.

0:17:390:17:43

Who's next, please?

0:17:430:17:44

I've not been tested for asthma since,

0:17:440:17:47

so Andy has invited me to his surgery in Portsmouth to find out

0:17:470:17:50

if my 50-year-old diagnosis still stands.

0:17:500:17:54

So, tell me when you were diagnosed.

0:17:540:17:56

Well, I was in my 20s,

0:17:560:17:58

and it just literally came out of the blue.

0:17:580:18:00

I'd covered a story that was a particularly distressing story

0:18:000:18:04

for me, and I came home and the lawn at the front of the house

0:18:040:18:08

had just been cut, and I think I probably took in

0:18:080:18:11

a lot of grass pollen and suddenly I couldn't breathe.

0:18:110:18:15

The attacks subsided and I took myself off to my GP,

0:18:150:18:18

who promptly diagnosed asthma.

0:18:180:18:20

Like a lot of asthmatics,

0:18:200:18:21

my symptoms have come and gone over the years.

0:18:210:18:24

At one point I even thought I may no longer need an inhaler.

0:18:240:18:28

Andy says my experience is common,

0:18:280:18:30

and he's going to run some tests to see if he can find out more about

0:18:300:18:33

whether what I think is asthma really is.

0:18:330:18:37

If you came to me today thinking you might have asthma,

0:18:370:18:40

what I'd be saying to you is,

0:18:400:18:41

"Who else in your family has got asthma?

0:18:410:18:43

"Have you got any other allergies?

0:18:430:18:44

"Hay fever, eczema, things like that,"

0:18:440:18:47

to see what that sort of pattern is.

0:18:470:18:48

After quizzing me about my symptoms,

0:18:480:18:50

Andy is giving me a range of tests to see if my lungs

0:18:500:18:53

are inflamed and my airways constricted -

0:18:530:18:55

two strong signs of having asthma.

0:18:550:18:59

If you could blow into that as hard and as fast as you can.

0:18:590:19:03

OK.

0:19:030:19:04

Something we're doing a lot more of now is spirometry.

0:19:040:19:06

It looks like a mobile phone, doesn't it?

0:19:060:19:08

Keep going, keep going, keep going, keep going, keep going. Good.

0:19:080:19:12

Well done. Not a lot of difference.

0:19:120:19:15

So one new test with this machine is called a feno.

0:19:150:19:17

Breathe in for me.

0:19:170:19:19

Bit harder. Perfect.

0:19:190:19:21

Keep it going. Keep it going.

0:19:210:19:23

And we'll see what that shows in a little while.

0:19:240:19:27

So, having done those tests, what is that going to tell you?

0:19:270:19:30

Well, what those tests will do is tell me how your lungs are now.

0:19:300:19:32

The pattern of symptoms, but also what these results show as well.

0:19:320:19:35

It can tell us whether you're more likely to respond

0:19:350:19:37

to medication or not.

0:19:370:19:39

I'll get the results later on.

0:19:390:19:41

If I do have asthma, it's certainly not severe.

0:19:410:19:45

For others, however, like Louise,

0:19:450:19:47

the symptoms can be much more serious.

0:19:470:19:50

I was diagnosed with asthma when I was 28.

0:19:500:19:53

It's been under control up until two and a half years ago.

0:19:530:19:57

At its worst I can't even leave the house.

0:19:570:19:59

I think it's changed from asthma.

0:19:590:20:01

We have chest conditions in my family,

0:20:030:20:05

and I think it could be maybe one of those chest conditions.

0:20:050:20:09

To find out if she's right, Louise has come to

0:20:090:20:11

a pilot programme called the Mission Clinic,

0:20:110:20:14

which runs specialist tests in GPs' surgeries

0:20:140:20:17

to give patients an accurate diagnosis.

0:20:170:20:19

Asthma consultant Dr Tom Brown regularly sees patients who've lived

0:20:190:20:23

with what they thought was asthma for years,

0:20:230:20:25

only for his team to discover it's not.

0:20:250:20:28

Keep it going as long as you can.

0:20:290:20:31

So in the Mission Clinic last week

0:20:310:20:33

we saw ten patients who had a diagnosis from their GP records

0:20:330:20:38

of asthma, but actually, after the Mission Clinic,

0:20:380:20:41

only five left with a diagnosis of asthma.

0:20:410:20:44

So only 50%.

0:20:440:20:46

The other five patients were diagnosed

0:20:460:20:49

with different breathing problems

0:20:490:20:50

that all require their own unique form of treatment.

0:20:500:20:54

And that's exactly what Dr Tom reveals after Louise's tests.

0:20:540:20:58

But her diagnosis is far from clear cut.

0:20:580:21:01

They suspect she has COPD,

0:21:010:21:03

a long-term lung condition which causes breathing difficulties.

0:21:030:21:07

In terms of the overall diagnosis,

0:21:070:21:10

it may well be that you fall part-way

0:21:100:21:12

between the two diagnoses of asthma and COPD.

0:21:120:21:15

You can have a sort of middle ground condition,

0:21:150:21:17

which we call an overlap syndrome,

0:21:170:21:19

whereby you've got some features of asthma and some features of COPD.

0:21:190:21:22

It's really important that we try and unpick what actually

0:21:220:21:25

the main drivers are, so that we can treat those individually

0:21:250:21:28

to make absolutely sure we get control of your symptoms.

0:21:280:21:32

This could mean that Louise has been on the wrong medication

0:21:320:21:35

for years, leaving her COPD untreated.

0:21:350:21:38

She needs to come back for more tests to confirm the diagnosis,

0:21:380:21:42

but in the meantime she's leaving with new medication

0:21:420:21:45

and she's been referred for help to stop smoking,

0:21:450:21:48

which will definitely help to ease her symptoms.

0:21:480:21:51

I need to take steps in my life

0:21:510:21:53

to have an active life

0:21:530:21:55

and to live for as long as I possibly can.

0:21:550:21:58

I have to say, that when I saw those headlines

0:21:580:22:00

claiming a third of people diagnosed with asthma

0:22:000:22:03

might not actually have it,

0:22:030:22:04

I just assumed they meant people

0:22:040:22:06

didn't really have any sort of problem,

0:22:060:22:08

not that the asthma diagnosis could be hiding another condition

0:22:080:22:11

altogether, one needing very different treatment.

0:22:110:22:15

But while my breathing problems have never been as bad as Louise's,

0:22:150:22:18

I'm still intrigued to find out if my GP got it right back in the '60s.

0:22:180:22:23

Well, Andy, earlier you did some very hi-tech tests,

0:22:230:22:27

-and the conventional tests.

-Yes.

0:22:270:22:29

-What does it prove? Do I have asthma?

-Yes.

0:22:290:22:32

Based on these tests, I think you do have asthma.

0:22:320:22:35

I don't think it's a problem for you at the moment.

0:22:350:22:38

As well as the tests,

0:22:380:22:39

Andy also quizzed me in detail about my health,

0:22:390:22:42

and that helped him learn much more about my asthma.

0:22:420:22:45

He said my attacks don't appear to be triggered by an allergy

0:22:450:22:48

to something like pollen or pollution.

0:22:480:22:50

And knowing that means my medication can be tweaked to make it

0:22:500:22:54

work more effectively for me.

0:22:540:22:56

What I would like to do is try you on some medication

0:22:560:22:58

to see whether we can improve on the breathing tests at all,

0:22:580:23:01

to see whether that improves

0:23:010:23:03

maybe the cough and breathing problems

0:23:030:23:05

that you're getting at the moment.

0:23:050:23:06

Asthma can, of course, change over time,

0:23:060:23:09

so even if you're certain that it is because of your breathing problems,

0:23:090:23:12

there's no harm in asking your GP

0:23:120:23:14

if there are more effective ways to manage it.

0:23:140:23:17

And even though I've had my asthma confirmed,

0:23:170:23:19

I'm still not going to let it get in the way of the sports

0:23:190:23:22

that I enjoy.

0:23:220:23:23

-Good game.

-Well played.

0:23:280:23:30

Still to come, Angela is challenging more claims around asthma,

0:23:350:23:40

this time whether pollution can cause the condition.

0:23:400:23:43

If there's higher pollution days

0:23:430:23:44

you're going to get more asthma attacks,

0:23:440:23:46

you're more likely to get admitted to hospital with pneumonia

0:23:460:23:49

and you're also more likely to have ongoing problems with your asthma

0:23:490:23:53

or with your breathing problems as you get older.

0:23:530:23:56

Last year, dementia overtook heart disease

0:24:010:24:03

as the biggest killer in the UK.

0:24:030:24:06

And for anyone worried about developing it as we get older,

0:24:060:24:09

the advice has not been only to stay healthy and give our bodies

0:24:090:24:12

a workout, but to give our brains a daily workout too.

0:24:120:24:16

So millions of us now do just that,

0:24:160:24:18

whether that's by tackling a crossword,

0:24:180:24:20

doing the puzzle pages in the paper

0:24:200:24:22

or learning a language.

0:24:220:24:23

Or perhaps, as many people have done,

0:24:230:24:25

taking up one of the so-called brain training games.

0:24:250:24:28

The only trouble with that is that when it was revealed that

0:24:280:24:31

some of the companies were making very bold claims about their

0:24:310:24:34

brain training software, actually it had no proof it really worked.

0:24:340:24:39

So the whole idea that we could actually

0:24:390:24:41

train our brains to be better

0:24:410:24:43

started to seem just a little bit far-fetched.

0:24:430:24:45

Were we really protecting ourselves against Alzheimer's

0:24:450:24:48

or just getting a lot better at doing the games?

0:24:480:24:50

Well, the argument that those headlines started is still raging.

0:24:500:24:54

So we've asked Steve Brown to investigate, and see if

0:24:540:24:57

he can stretch his own brain while he's at it.

0:24:570:24:59

As an athlete, I was used to pushing myself hard,

0:25:000:25:03

because I knew the more I exercised the fitter my body became.

0:25:030:25:07

But memory grandmaster David Thomas

0:25:070:25:09

says that the same approach can work for our brains too.

0:25:090:25:13

He says we can all learn techniques to make us smarter,

0:25:130:25:16

because he did exactly that.

0:25:160:25:19

It must be something to do with your brain.

0:25:190:25:21

Surely some people were built better at remembering than others?

0:25:210:25:26

So, for me, I was a fireman, failing my exams.

0:25:260:25:29

I went out and bought this book on memory,

0:25:290:25:31

and just by practising in my bedroom,

0:25:310:25:33

eight months later I go the World Memory Championships

0:25:330:25:37

and come fourth.

0:25:370:25:38

And I also became a Guinness record-breaker for reciting

0:25:380:25:41

pi to 22,500 digits.

0:25:410:25:44

That's a lot of numbers!

0:25:450:25:47

And David says anyone can do what he's done.

0:25:470:25:50

With a bit of applied thinking, we can all make our brains better.

0:25:500:25:53

To prove it, he's showing me how to memorise 50,

0:25:530:25:56

yes, just 50 numbers.

0:25:560:25:59

The greatest thing about improving your memory is it's not based

0:25:590:26:02

on intellect or intelligence. It's based on techniques.

0:26:020:26:05

So it's not about the size of your brain

0:26:050:26:07

or how good your brain is -

0:26:070:26:09

it's about learning and using your brain to the best of its ability?

0:26:090:26:13

It's just simple association, that's all it is.

0:26:130:26:15

David tells me to associate pairs of numbers with famous people

0:26:150:26:18

in places around my house.

0:26:180:26:20

And by remembering the sequence or story of where they appear

0:26:200:26:24

I'll also remember the numbers. That's the theory, anyway.

0:26:240:26:27

So what you do is you turn each number into a letter,

0:26:270:26:30

So one is A, two is B, three is C.

0:26:300:26:32

-So 23 would be BC.

-Yeah.

0:26:320:26:34

That becomes Bill Clinton.

0:26:340:26:36

Right, OK.

0:26:360:26:37

So, at the end of your drive,

0:26:370:26:38

imagine Bill Clinton giving a speech.

0:26:380:26:41

Yeah, OK. So I'm pulling up and there's Bill Clinton.

0:26:410:26:45

'Not all the numbers have to follow alphabetical order.

0:26:450:26:47

'In fact, mixing it up can make them more memorable.

0:26:470:26:50

'Take the number 10, for example.'

0:26:500:26:51

Who would you say is the most memorable Prime Minister?

0:26:510:26:55

-Let's go with Thatcher because it's going to be a memorable...

-Yeah.

0:26:550:26:58

So I've got to put faces and names to numbers,

0:26:580:27:01

put them around my house, remember it, and reel them off?

0:27:010:27:04

Yeah.

0:27:040:27:06

Sounds like a wager to me.

0:27:060:27:08

Let's see how we get on.

0:27:080:27:10

David has given me a week to memorise all 50 digits,

0:27:100:27:13

but it's the biggest thing I've probably had to learn since school,

0:27:130:27:16

so it's definitely going to stretch my little grey cells.

0:27:160:27:19

David's techniques are really impressive, and they've been used

0:27:190:27:22

by professional memory experts for generations the world over.

0:27:220:27:25

But it turns out they can also be beneficial to those of us

0:27:250:27:28

that aren't studying to be memory grandmasters.

0:27:280:27:32

Because, according to the headlines,

0:27:320:27:34

challenging our minds and keeping them active could have

0:27:340:27:37

a big impact on the biggest killer in the country - dementia.

0:27:370:27:40

But when it comes to the best way to do it, they really can't agree,

0:27:400:27:44

and the most controversial methods of all

0:27:440:27:47

are the so-called brain training games

0:27:470:27:49

that millions of us around the world play every day.

0:27:490:27:52

While some stories say they make you smarter and help fight dementia,

0:27:520:27:56

others say brain training is a waste of time,

0:27:560:27:59

and last year one American company was fined for making claims

0:27:590:28:03

their games had health benefits, without having any proof.

0:28:030:28:08

I've never really tried those apps,

0:28:080:28:10

but I know my mum was a big fan for a while,

0:28:100:28:12

after my Auntie Margaret beat her at one game that said it could

0:28:120:28:15

judge the age of a player's brain.

0:28:150:28:17

My age was something like 87, and then I said,

0:28:170:28:21

"So what's this all about?"

0:28:210:28:22

And she done the game and she came out at 25 or something.

0:28:220:28:27

-She's six years older than me...

-Yeah.

-..so I was none too pleased.

0:28:270:28:30

So I thought, "Right, there's no way Auntie Margaret

0:28:300:28:33

"is going to be younger than me."

0:28:330:28:35

So my mum practised and practised to get the better of Auntie Margaret,

0:28:350:28:39

but she quickly realised how to get the better of the game.

0:28:390:28:42

So if on one of the segments I didn't achieve five, the maximum,

0:28:420:28:46

I'd switch it off and start again,

0:28:460:28:48

because it was all about beating the previous score.

0:28:480:28:52

It's practice, and the more you practise

0:28:520:28:54

the quicker and better you get.

0:28:540:28:57

Now my mum has traded in the brain training games

0:28:570:28:59

for crosswords and sudoku.

0:28:590:29:01

Not because she thinks they're going to make her brain any younger,

0:29:010:29:04

but simply cos she enjoys them.

0:29:040:29:06

And some stories have also poured scorn on the suggestion

0:29:060:29:09

there might be anything beneficial about brain training of any kind.

0:29:090:29:13

But, if the results of some of the latest research into dementia

0:29:130:29:16

is anything to go by, those critics may have jumped the gun.

0:29:160:29:20

The Alzheimer's Society, which is behind the research,

0:29:200:29:22

says there's a mounting body of evidence

0:29:220:29:24

that brain training does work.

0:29:240:29:27

They are funding a huge study with thousands of volunteers

0:29:270:29:29

all over the age of 50.

0:29:290:29:31

Now, part of this study is using brain training games to influence

0:29:310:29:35

the ageing process and even help combat the onset of dementia.

0:29:350:29:39

I'm meeting Anne Corbett from the Alzheimer's Society...

0:29:390:29:42

-Hi.

-How are you?

-Very well. How are you?

-Very well, thanks.

0:29:420:29:45

..who is the research lead of this ground-breaking project.

0:29:450:29:49

Anne, tell me a little bit about the Protect study.

0:29:490:29:52

We're interested in following people over 50

0:29:520:29:54

over quite a long time to see how their brain function changes

0:29:540:29:58

and what influences how it changes.

0:29:580:30:00

And the brain training games is a nested study within Protect.

0:30:000:30:05

And these brain training games aren't like the ones my mum did.

0:30:050:30:08

They are designed to measure whether brainpower changes

0:30:080:30:10

over the length of the study.

0:30:100:30:12

So things like memory, problem-solving, language.

0:30:120:30:16

Things like that.

0:30:160:30:17

And we can look at how someone's performing on that and say,

0:30:170:30:19

"Are you normal for your age?"

0:30:190:30:21

And, indeed, if we're looking at them over a long period of time,

0:30:210:30:24

we can say, "Is your performance changing,

0:30:240:30:27

"and is there something we should be worried about?"

0:30:270:30:29

And that's why we've got these two separate packages.

0:30:290:30:31

And what's most encouraging is that for some older people,

0:30:310:30:35

getting better at the game translates into improvement

0:30:350:30:37

in everyday tasks like cooking, shopping and using public transport.

0:30:370:30:42

There was a correlation - people's day-to-day lives and

0:30:420:30:45

their functions got better through playing these games?

0:30:450:30:47

-Yes, when they were playing these games.

-Wow.

0:30:470:30:50

But despite these positive signs,

0:30:500:30:51

Anne's not quite as dismissive

0:30:510:30:53

of some of those critical stories as I was expecting.

0:30:530:30:57

"Brain training games may be a waste of time.

0:30:570:30:59

"Scientists say that there's little evidence of real-world benefits."

0:30:590:31:03

But that's contradictory to what you're seeing

0:31:030:31:05

in some of your studies.

0:31:050:31:06

In a way I sort of agree with them, in that they're saying

0:31:060:31:09

there is little evidence, and we do need a lot more research.

0:31:090:31:12

There are a lot of brain training games and programmes out there

0:31:120:31:15

that people pay an awful lot of money for,

0:31:150:31:18

and some games are supported by clinical trials,

0:31:180:31:21

and those games we might say are beneficial.

0:31:210:31:24

-Like this, for example?

-Potentially like this.

0:31:240:31:27

We've seen statistically significant benefit

0:31:270:31:30

in people playing these games.

0:31:300:31:32

A lot of the games out there don't have that kind of support.

0:31:320:31:34

But for the games that do work,

0:31:340:31:36

have their successes been exaggerated?

0:31:360:31:39

What do you make of this?

0:31:390:31:40

"Online brain training cuts risk of dementia by a third."

0:31:400:31:44

That's a bit stronger than anything we'd like to say.

0:31:440:31:46

We can be pretty sure that brain training helps

0:31:460:31:49

the way that your brain works,

0:31:490:31:51

but to directly jump and say that it cuts your risk of dementia,

0:31:510:31:54

especially by a third, I'm not quite sure where that's come from.

0:31:540:31:57

It might still be a few decades until we get concrete proof

0:31:570:32:01

that brain training really does help fend off dementia,

0:32:010:32:04

but the early results are encouraging.

0:32:040:32:06

Meanwhile, I'm a few days into the memory challenge David set me,

0:32:070:32:11

and it's definitely stretching my brain.

0:32:110:32:13

It was tricky just trying to remember 50 digits,

0:32:140:32:18

but then when he started saying,

0:32:180:32:19

"Right, you need to make the number into a story,"

0:32:190:32:23

it just seemed like it meant more and more and more thinking,

0:32:230:32:26

but it's starting to make more sense now.

0:32:260:32:29

Improving your memory is just one way

0:32:290:32:31

you can challenge your brain.

0:32:310:32:32

There are other methods that it's claimed can help fend off

0:32:320:32:35

dementia too.

0:32:350:32:36

Bonjour, everybody.

0:32:380:32:39

'This is a local class of Alliance Francaise,

0:32:390:32:42

'a group of nine people,

0:32:420:32:43

'four of them over 50,

0:32:430:32:45

'who meet every week to learn French.

0:32:450:32:47

'And, I have to say,

0:32:470:32:49

'it takes a bit more brainpower than some of those brain training games.'

0:32:490:32:53

HE SPEAKS FRENCH

0:32:530:32:55

'Some of the members are very clear about why they started the course.'

0:32:570:33:00

So why are you learning French?

0:33:000:33:02

A few years ago I read a few articles in newspapers

0:33:020:33:06

and they were saying that proficiency with

0:33:060:33:09

a second language can ward off dementia.

0:33:090:33:11

It's quite a challenge, really, to learn French.

0:33:110:33:14

It's a good activity to do,

0:33:140:33:16

it's good for my memory, I think.

0:33:160:33:19

I thought I needed something, you know, to keep my brain going.

0:33:190:33:21

We have a good group and it's a nice social occasion as well.

0:33:210:33:25

Two examples -

0:33:250:33:26

one is in terms of place

0:33:260:33:29

and the other is in terms of time.

0:33:290:33:32

'There's a big difference between the brainpower it takes to

0:33:320:33:34

'learn a language and the amount required to get a top score

0:33:340:33:37

'in a brain training game.

0:33:370:33:39

'But Dr Clare Walton from the Alzheimer's Society says

0:33:390:33:42

'that doesn't matter -

0:33:420:33:43

'challenging your brain at all is what counts.'

0:33:430:33:46

-So we're just going to go to this room.

-Let's go.

0:33:460:33:49

So older people that keep their brains challenged

0:33:490:33:51

in their later years by playing games, crosswords, reading,

0:33:510:33:55

tend to have lower rates of dementia as they get older.

0:33:550:33:58

So it's really important that you keep challenging your brain.

0:33:580:34:01

You can think of it like a muscle.

0:34:010:34:03

If you keep exercising it it will stay fit and healthy.

0:34:030:34:06

There's evidence to show that people that have complex jobs

0:34:060:34:09

and also people that know two languages across their whole lives,

0:34:090:34:12

so bilinguals, have lower rates of dementia as well.

0:34:120:34:15

But what makes activities like this so good for your brain

0:34:150:34:18

is that they combine learning with socialising.

0:34:180:34:21

We do know that being more physically active,

0:34:210:34:24

staying socially connected

0:34:240:34:25

and eating healthily can reduce your risk.

0:34:250:34:28

So, really, for me, I think the best activities you can do

0:34:280:34:30

are the things that bring all of those together,

0:34:300:34:32

and it should be things you enjoy as well.

0:34:320:34:34

So it could be joining a dance class,

0:34:340:34:36

a table tennis group,

0:34:360:34:38

playing bridge.

0:34:380:34:39

Something that keeps your brain sharp and challenges you.

0:34:390:34:42

And despite claims that brain training is a waste of time,

0:34:420:34:45

Clare says that there's evidence some apps might work

0:34:450:34:47

in the battle against dementia too.

0:34:470:34:49

So do you find it exciting thinking there is positive development

0:34:490:34:52

in this area now?

0:34:520:34:54

I do find it exciting.

0:34:540:34:55

You know, a person gets dementia every three minutes in the UK,

0:34:550:34:59

so we have to find ways on a large scale that people can start

0:34:590:35:03

keeping their brains healthy.

0:35:030:35:05

And we don't know that brain training is the answer yet

0:35:050:35:07

for dementia, but we are seeing

0:35:070:35:09

that people can improve their daily activities by playing these games.

0:35:090:35:14

But not all brain training games are equal.

0:35:140:35:17

So Clare says look at the evidence a company provides to check

0:35:170:35:20

their games really do what they say.

0:35:200:35:22

And of course be cautious of any game

0:35:220:35:24

that says it can definitely prevent or delay dementia,

0:35:240:35:28

because, while signs are positive, the evidence isn't yet solid.

0:35:280:35:31

Whether you choose a brain training app or something else entirely,

0:35:310:35:35

there's no doubt we can make ourselves smarter by giving

0:35:350:35:38

our little grey cells a workout.

0:35:380:35:40

The key is to make sure it's a hard one.

0:35:400:35:43

Which brings me back to my own personal challenge.

0:35:430:35:46

Morning, son.

0:35:480:35:49

Back home with my mum,

0:35:490:35:50

it's time to see if David's memory tips have worked.

0:35:500:35:53

It's D-Day, really,

0:35:530:35:55

because I've got to see if I can do it,

0:35:550:35:56

and so will you please be my adjudicator

0:35:560:36:00

and let me know if I've got it right?

0:36:000:36:02

-Time to put you to the test. Come on, then.

-Right. OK, so...

0:36:020:36:05

Two,

0:36:050:36:07

three,

0:36:070:36:08

one,

0:36:080:36:10

six,

0:36:100:36:12

four,

0:36:120:36:13

eight, seven...

0:36:130:36:15

Come on, come on.

0:36:190:36:21

Seven,

0:36:240:36:25

eight,

0:36:250:36:27

one, one,

0:36:270:36:29

four, three.

0:36:290:36:31

What do you reckon?

0:36:320:36:34

I reckon I got it.

0:36:340:36:35

-Yeah!

-Yes!

0:36:350:36:38

-Come on!

-Well done, you.

-Come on.

0:36:380:36:40

Did I get it? Like, at 100%?

0:36:400:36:43

Look at that. Look at that.

0:36:430:36:46

100%.

0:36:460:36:47

Earlier in the programme I was looking into the suggestion

0:36:520:36:55

that asthma might be being over-diagnosed,

0:36:550:36:58

and I wanted to find out whether or not it was true.

0:36:580:37:01

And of course what I discovered is that it's all rather

0:37:010:37:04

a lot more complicated than the headlines would have us believe.

0:37:040:37:08

Here in Britain, the number of people who suffer from asthma

0:37:080:37:11

has really hardly changed for a number of years,

0:37:110:37:13

but there is another story that's been getting an awful lot

0:37:130:37:16

of column inches that might lead you to believe we are about to see

0:37:160:37:20

an incredible rise in the number of cases,

0:37:200:37:24

and that involves air pollution.

0:37:240:37:26

I know that if I'm walking through a congested city centre

0:37:290:37:32

I can find it harder to breathe due, I think,

0:37:320:37:34

to the pollution in the air.

0:37:340:37:36

Some two thirds of asthma sufferers say air pollution

0:37:360:37:39

makes their asthma worse,

0:37:390:37:41

and it's more likely to trigger an attack.

0:37:410:37:44

So when the poor quality of London's air made headlines

0:37:440:37:47

at the start of 2017, some reports even called

0:37:470:37:50

for the capital's children to be given protective masks

0:37:500:37:53

on their way to school.

0:37:530:37:55

But Martha Massaquoi has been taking precautions

0:37:550:37:57

for a few years already, to help her asthmatic son Gawanda.

0:37:570:38:02

Thank you. Be careful.

0:38:020:38:05

Martha and Gawanda live in a busy area of south-east London,

0:38:050:38:09

where the air pollution can really exacerbate Gawanda's asthma.

0:38:090:38:13

This morning they're being joined by child respiratory health expert

0:38:130:38:16

Dr Abigail Whitehouse, who is going

0:38:160:38:18

to investigate how the air pollution nearby

0:38:180:38:21

might affect Gawanda's breathing.

0:38:210:38:23

So tell me a bit about Gawanda's asthma.

0:38:230:38:26

-When did it start?

-It started when he was a baby.

0:38:260:38:29

How often does he need to use his inhaler?

0:38:290:38:31

If we go out and we are walking on the main road,

0:38:310:38:35

then halfway through the journey he will say, "I need my inhaler."

0:38:350:38:40

Whereas if we're walking in areas where it's more cleaner,

0:38:400:38:45

then he doesn't need it so much.

0:38:450:38:48

Abigail is swapping Gawanda's schoolbag for a pollution monitor,

0:38:480:38:51

to find out how much nasty air he breathes in

0:38:510:38:54

on his over two mile round-trip to school.

0:38:540:38:57

The journey usually takes about 25 minutes

0:38:590:39:02

through side streets and back roads,

0:39:020:39:04

all carefully chosen to avoid walking along the busy main road.

0:39:040:39:08

It takes longer, but Martha knows that her low pollution route

0:39:080:39:11

means that Gawanda is less likely to need his inhaler.

0:39:110:39:14

Which way are we going?

0:39:170:39:18

That way or are we going...?

0:39:180:39:20

It is a pain, but it's a decision I have to make -

0:39:200:39:23

whether to go through polluted areas

0:39:230:39:26

and give him medicine,

0:39:260:39:28

or go through a cleaner area

0:39:280:39:31

and avoid giving him the inhaler as much as we can.

0:39:310:39:35

Martha thinks she's doing her best

0:39:350:39:37

to reduce the chances of Gawanda having an asthma attack

0:39:370:39:40

because of the air pollution.

0:39:400:39:42

But Abigail says even just the small amount of time they spend

0:39:420:39:45

near the main road can expose him to high levels of pollution.

0:39:450:39:49

If you're on a longer route to school past a main road

0:39:510:39:54

you'll see that the levels will go up as you leave the house,

0:39:540:39:57

they'll peak every time traffic stops nearby

0:39:570:40:00

or you're at a crossing,

0:40:000:40:02

but it's these peaks that are the things we worry about the most.

0:40:020:40:05

While those peaks make an asthma attack more likely,

0:40:050:40:09

there are now claims that they could also cause new cases of asthma.

0:40:090:40:13

But Abigail says it's not that clear cut.

0:40:130:40:15

The air pollution might just have kick-started the condition

0:40:150:40:18

in people who were always destined to develop it anyway.

0:40:180:40:21

So if you've got a family history of asthma then you're likely

0:40:230:40:25

to get asthma yourself as you get a little bit older.

0:40:250:40:27

But you then still need something to trigger it.

0:40:270:40:30

The evidence is coming that air pollution also

0:40:300:40:32

has this trigger effect,

0:40:320:40:33

bringing on asthma in people that are disposed to it already.

0:40:330:40:37

It's impossible to know whether Gawanda's asthma

0:40:370:40:40

was triggered by air pollution,

0:40:400:40:41

but it does undoubtedly make an attack more likely.

0:40:410:40:45

At the end of the school day,

0:40:450:40:46

Abigail's returning with the results of those tests.

0:40:460:40:49

-So shall we have a look at the results?

-Yes.

-OK.

0:40:490:40:52

So, this is a graph of your walk to school.

0:40:520:40:56

The equipment measures particles of black carbon in the air,

0:40:560:40:59

a little like soot.

0:40:590:41:00

It's the main component of all air pollution.

0:41:000:41:03

And you see about three minutes after we walked out the door

0:41:030:41:05

there's a big peak.

0:41:050:41:07

And that's when we made it down onto the main road.

0:41:070:41:10

And then we walk on to that side road.

0:41:100:41:12

The peaks correspond with when they're on the main road

0:41:120:41:14

and the dips are when they're on the side roads.

0:41:140:41:17

So where is this roughly?

0:41:170:41:20

Martha says the peaks match the places were Gawanda

0:41:200:41:24

is most likely to struggle to breathe and ask for his inhaler.

0:41:240:41:27

They're all at the points where their route takes them

0:41:270:41:30

along or across the main road,

0:41:300:41:32

where traffic is worse.

0:41:320:41:33

Wherever you've got traffic jams and slow cars,

0:41:330:41:35

that's where you're going to get your highest air pollution,

0:41:350:41:38

cos the cars are just pumping it at him.

0:41:380:41:40

Martha's relieved to hear she's made the right decision to change

0:41:400:41:43

their route to minimise their exposure to pollution.

0:41:430:41:46

Basically what you're saying then is it's best for us to continue

0:41:460:41:50

taking that route.

0:41:500:41:51

You're definitely avoiding the bulk of the pollution

0:41:510:41:53

by walking that way, which is good.

0:41:530:41:55

Unfortunately, there isn't another route

0:41:550:41:58

to avoid even more of the pollution.

0:41:580:42:00

But there are tips on how to limit the pollution

0:42:000:42:02

they are exposed to even more.

0:42:020:42:05

You've got a nice wide pavement,

0:42:050:42:06

walk right next to the buildings, rather than next to the road.

0:42:060:42:09

It's probably a bit safer, and also there's less pollution

0:42:090:42:12

cos it kind of drops off as you move away.

0:42:120:42:15

So the good news is that, for those of us who already have asthma,

0:42:150:42:18

there are ways to avoid too much exposure.

0:42:180:42:21

And although there is some truth in headlines linking rising pollution

0:42:210:42:24

to asthma, it's not quite as simple as claims

0:42:240:42:27

that a surge in air pollution

0:42:270:42:28

will lead to a surge in new cases of asthma.

0:42:280:42:31

Some of the headlines in today's programme really took me by surprise

0:42:370:42:41

because they made really complicated arguments appear so simple.

0:42:410:42:45

I know. And, you know,

0:42:450:42:46

it would've been so easy for someone to see those headlines

0:42:460:42:48

about statins and asthma,

0:42:480:42:51

and, as a result, make really life-changing decisions

0:42:510:42:54

about their medication without having all the facts.

0:42:540:42:58

Well, it goes without saying that none of those decisions

0:42:580:43:01

should be made without the help of your doctor.

0:43:010:43:03

And, on that note, I'm afraid that's all we've got time for today.

0:43:030:43:07

Thank you very much for joining us,

0:43:070:43:09

-and, until next time, bye-bye.

-Bye-bye.

0:43:090:43:11

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