Episode 1 Health: Truth or Scare

Every day we're bombarded with conflicting messages about

how to live a healthy, happy life.

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

the next it's the complete opposite,

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

So we've been wading through the confusion

to separate the scare stories from the truth,

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

Hello, and welcome to Health - Truth Or Scare?

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

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

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

Kevin, they so rarely do.

Today we're talking about conditions that really do

affect millions of us.

They might be common,

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

And today we'll be finding out why.

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

but should millions of people really be taking statins?

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

Heart attacks and strokes, these are not messing around.

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

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

asthma medication they don't need,

I find out if I'm one of them.

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

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

the reported six million people already taking statins,

then you more than likely know somebody who is.

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

of tens of thousands of people with heart disease.

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

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

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

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

"Are millions taking statins needlessly?" -

what are you going to think?

And this one says statins ARE safe

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

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

Absolutely. But, as I found out,

the argument against statins is gaining momentum,

fanning the flames of a controversy that, quite frankly,

just won't go away.

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

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

the battle against it.

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

They help lower the body's cholesterol levels and reduce

the risk of heart attacks and strokes.

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

has a history of diabetes and high cholesterol,

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

And if anyone has that elevated risk,

they could be prescribed statins by their GP,

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

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

in the country.

But they're also very controversial.

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

sufferers say can be debilitating,

but many experts dismiss.

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

safe and effective,

and that any harmful side-effects have been exaggerated.

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

as it's claimed.

The arguments got so heated that it even lead to

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

one saying reports of side effects are massively overexaggerated,

another saying the side-effects outweighed the benefits.

Both sides of the argument are extremely vocal, and,

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

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

newspaper reports about how you shouldn't touch them.

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

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

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

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

who has experienced both sides of the argument.

Coleen Gill was, until recently,

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

She says the drug helped change her life after

a heart attack ten years ago.

The heart attack was a big shock to the system.

It was a shock to the family as well.

Well, they'd said at the hospital

that I had a really high cholesterol,

it was off the mark, so to speak.

And they put me on statins,

I had to take them when I left,

as he said, forever.

Along with some big changes to her diet and lifestyle,

Coleen says the statins helped transform her health,

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

But after taking statins for more than three years

she started to develop side-effects.

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

"Why can't I feel my fingers?"

And I wasn't sure, to be fair,

whether it was the statins or what,

but there was talk about side-effects.

Worried about losing the feeling in her fingers,

and with her cholesterol safely under control,

Coleen decided to come off statins altogether,

against the wishes of her doctor.

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

But you know your own body,

and I just felt it was right to do that.

And I haven't looked back.

Coleen made a controversial decision,

because the official advice is that once a patient

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

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

But with around six million people on statins,

perhaps it's no surprise that some do.

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

with access to almost five million patients' records.

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

"Hang on a minute, side-effects,

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

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

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

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

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

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

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

that Liam says experts are sure of.

And it's one that I find quite worrying.

Statins might increase your risk of developing type II diabetes.

My family has got a history of diabetes.

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

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

Possibly, yes.

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

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

It's worth taking that small increased risk of diabetes

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

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

by something like a quarter or a third.

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

some reports about studies into statins,

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

decisions about their health.

Do you get frustrated by the headlines telling people

to stop taking statins?

I do get frustrated, yeah.

I get frustrated by headlines saying statins are terrible,

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

you should stop them.

The science is clear - these are beneficial drugs

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

And telling people to stop them

really is placing them in grave danger.

Heart attacks and strokes, these are not messing around,

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

It's a compelling argument.

But within the medical profession

there are still those critical of statins.

Dr Malcolm Kendrick is a busy GP

who has agreed to meet me after work.

He disagrees with Liam Smeeth,

and says statins' side-effects are hugely underestimated.

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

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

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

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

an adverse effect.

I sometimes say to patients,

"Statins add 15 years to your life -

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

"they just make you feel 15 years older."

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

if you're prescribed statins,

people tend to stop doing other things, healthy things.

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

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

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

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

No, not entirely.

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

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

or some sort of heart disease problem,

and therefore it's worth trying it.

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

it's not a problem.

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

whether they have a heart condition or not.

I say, "You know what?

"The benefits here are just really non-existent,

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

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

are effective for some people who already have heart disease.

But there are millions taking statins

who don't have the condition,

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

in the next decade, you could be prescribed statins

to prevent it happening.

So what should people faced with that decision do?

On hand to help is David Spiegelhalter,

President of the Royal Statistical Society,

and, crucially, someone who has also been faced

with the choice of whether to take statins.

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

it's all about risks.

Risk with heart disease, risk with side-effects.

Can statistics help us weigh up that decision?

I think statistics can really help,

and I'm relying on it to help me

because I'm dithering about taking statins myself.

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

and I'm taking blood pressure tablets already,

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

-in the next ten years.

-OK.

I put myself through a risk calculator,

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

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

So one way to think about this is through this rather

frightening-looking display,

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

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

which indicates a heart attack or stroke.

Now, one of these is going to happen,

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

but 18 of these 100,

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

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

if I took statins every day,

roughly about six of these can be taken off.

So, David's personal risk of developing heart disease

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

Critics say the risk of developing side-effects

is much greater than the 6% drop

in the risk of developing heart disease.

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

And so, actually, to put it rather pessimistically,

maybe 2/100 of these will get some side effects

from taking the statins.

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

but I've put in some side effects.

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

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

but for someone else that might not be the case.

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

with a smaller risk of developing heart disease,

David is using a hypothetical,

and I must say rather handsome, example.

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

where the official Nice guidelines would recommend

that their GP offers them statins.

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

a heart attack or stroke over the next ten years.

So out of these 100 possible futures for this individual,

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

-OK.

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

about three of these will disappear.

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

Around two of these people will have reasonably

severe side effects over the next ten years.

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

but a loss in two of them.

So the trade-off is much more finely balanced.

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

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

just makes me think that if you are at low risk

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

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

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

take more exercise, improve your diet and so on,

reduce your drinking.

When I first started making this film

I was hoping for a clear answer.

And while there's no doubt statins are powerful drugs

if you've already had a heart attack,

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

The risk of developing side-effects

is very low, but it's still there.

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

And, either way,

statins are just one weapon in the whole armoury of things

we can use to combat heart disease.

And that's something Coleen knows well.

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

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

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

what I think of statins after making that film.

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

And here's another.

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

fair share of headlines.

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

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

it's probably a bit closer to my lungs

because what we're talking about now is asthma.

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

using inhalers as there are taking statins,

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

And I never go anywhere without this.

But, again, there's no shortage of headlines

that seem to be saying that some of us

really don't need the medicines

that are being prescribed by our doctors.

Take a look at this one.

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

Well, you could be forgiven for thinking that really nobody

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

that really is far from the case.

Keeping fit has always been really important to me,

but many years ago I was diagnosed with a condition

which some sufferers say impacts on their ability

to lead an active lifestyle.

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

as an asthma attack.

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

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

that have come and then gone.

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

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

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

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

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

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

And that's because in January 2017

a lot of papers ran the same headline,

saying a third of people with asthma had been misdiagnosed,

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

are taking medication they don't need.

GP Andy Whittamore is clinical lead for Asthma UK,

and he says asthma is a much more complicated condition

than you might first realise.

What are the things that might trigger asthma?

Well, everybody's diffident.

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

it could be hay fever, allergies.

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

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

Does that make it so very difficult to actually diagnose?

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

And even with the tests we have got,

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

It's not clear cut at all.

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

are accurate.

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

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

in a small group of people in Canada.

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

the wrong diagnosis, but certainly if they're concerned

they should speak to their GP or nurse or specialist.

While the headlines might not be completely accurate, there is

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

when they might in fact have other conditions,

like vocal cord problems or chronic obstructive pulmonary disease,

known as COPD.

They could have spent years being treated for asthma

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

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

it was thought of very differently to today.

Who's next, please?

I've not been tested for asthma since,

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

if my 50-year-old diagnosis still stands.

So, tell me when you were diagnosed.

Well, I was in my 20s,

and it just literally came out of the blue.

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

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

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

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

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

who promptly diagnosed asthma.

Like a lot of asthmatics,

my symptoms have come and gone over the years.

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

Andy says my experience is common,

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

whether what I think is asthma really is.

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

what I'd be saying to you is,

"Who else in your family has got asthma?

"Have you got any other allergies?

"Hay fever, eczema, things like that,"

to see what that sort of pattern is.

After quizzing me about my symptoms,

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

are inflamed and my airways constricted -

two strong signs of having asthma.

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

OK.

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

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

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

Well done. Not a lot of difference.

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

Breathe in for me.

Bit harder. Perfect.

Keep it going. Keep it going.

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

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

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

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

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

to medication or not.

I'll get the results later on.

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

For others, however, like Louise,

the symptoms can be much more serious.

I was diagnosed with asthma when I was 28.

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

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

I think it's changed from asthma.

We have chest conditions in my family,

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

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

a pilot programme called the Mission Clinic,

which runs specialist tests in GPs' surgeries

to give patients an accurate diagnosis.

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

with what they thought was asthma for years,

only for his team to discover it's not.

Keep it going as long as you can.

So in the Mission Clinic last week

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

of asthma, but actually, after the Mission Clinic,

only five left with a diagnosis of asthma.

So only 50%.

The other five patients were diagnosed

with different breathing problems

that all require their own unique form of treatment.

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

But her diagnosis is far from clear cut.

They suspect she has COPD,

a long-term lung condition which causes breathing difficulties.

In terms of the overall diagnosis,

it may well be that you fall part-way

between the two diagnoses of asthma and COPD.

You can have a sort of middle ground condition,

which we call an overlap syndrome,

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

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

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

to make absolutely sure we get control of your symptoms.

This could mean that Louise has been on the wrong medication

for years, leaving her COPD untreated.

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

but in the meantime she's leaving with new medication

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

which will definitely help to ease her symptoms.

I need to take steps in my life

to have an active life

and to live for as long as I possibly can.

I have to say, that when I saw those headlines

claiming a third of people diagnosed with asthma

might not actually have it,

I just assumed they meant people

didn't really have any sort of problem,

not that the asthma diagnosis could be hiding another condition

altogether, one needing very different treatment.

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

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

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

-and the conventional tests.

-Yes.

-What does it prove? Do I have asthma?

-Yes.

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

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

As well as the tests,

Andy also quizzed me in detail about my health,

and that helped him learn much more about my asthma.

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

to something like pollen or pollution.

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

work more effectively for me.

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

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

to see whether that improves

maybe the cough and breathing problems

that you're getting at the moment.

Asthma can, of course, change over time,

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

there's no harm in asking your GP

if there are more effective ways to manage it.

And even though I've had my asthma confirmed,

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

that I enjoy.

-Good game.

-Well played.

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

this time whether pollution can cause the condition.

If there's higher pollution days

you're going to get more asthma attacks,

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

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

or with your breathing problems as you get older.

Last year, dementia overtook heart disease

as the biggest killer in the UK.

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

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

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

So millions of us now do just that,

whether that's by tackling a crossword,

doing the puzzle pages in the paper

or learning a language.

Or perhaps, as many people have done,

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

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

some of the companies were making very bold claims about their

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

So the whole idea that we could actually

train our brains to be better

started to seem just a little bit far-fetched.

Were we really protecting ourselves against Alzheimer's

or just getting a lot better at doing the games?

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

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

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

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

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

But memory grandmaster David Thomas

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

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

because he did exactly that.

It must be something to do with your brain.

Surely some people were built better at remembering than others?

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

I went out and bought this book on memory,

and just by practising in my bedroom,

eight months later I go the World Memory Championships

and come fourth.

And I also became a Guinness record-breaker for reciting

pi to 22,500 digits.

That's a lot of numbers!

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

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

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

yes, just 50 numbers.

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

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

So it's not about the size of your brain

or how good your brain is -

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

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

David tells me to associate pairs of numbers with famous people

in places around my house.

And by remembering the sequence or story of where they appear

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

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

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

-So 23 would be BC.

-Yeah.

That becomes Bill Clinton.

Right, OK.

So, at the end of your drive,

imagine Bill Clinton giving a speech.

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

'Not all the numbers have to follow alphabetical order.

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

'Take the number 10, for example.'

Who would you say is the most memorable Prime Minister?

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

-Yeah.

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

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

Yeah.

Sounds like a wager to me.

Let's see how we get on.

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

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

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

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

by professional memory experts for generations the world over.

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

that aren't studying to be memory grandmasters.

Because, according to the headlines,

challenging our minds and keeping them active could have

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

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

and the most controversial methods of all

are the so-called brain training games

that millions of us around the world play every day.

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

others say brain training is a waste of time,

and last year one American company was fined for making claims

their games had health benefits, without having any proof.

I've never really tried those apps,

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

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

judge the age of a player's brain.

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

"So what's this all about?"

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

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

-Yeah.

-..so I was none too pleased.

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

"is going to be younger than me."

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

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

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

I'd switch it off and start again,

because it was all about beating the previous score.

It's practice, and the more you practise

the quicker and better you get.

Now my mum has traded in the brain training games

for crosswords and sudoku.

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

but simply cos she enjoys them.

And some stories have also poured scorn on the suggestion

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

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

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

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

says there's a mounting body of evidence

that brain training does work.

They are funding a huge study with thousands of volunteers

all over the age of 50.

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

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

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

-Hi.

-How are you?

-Very well. How are you?

-Very well, thanks.

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

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

We're interested in following people over 50

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

and what influences how it changes.

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

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

They are designed to measure whether brainpower changes

over the length of the study.

So things like memory, problem-solving, language.

Things like that.

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

"Are you normal for your age?"

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

we can say, "Is your performance changing,

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

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

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

getting better at the game translates into improvement

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

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

their functions got better through playing these games?

-Yes, when they were playing these games.

-Wow.

But despite these positive signs,

Anne's not quite as dismissive

of some of those critical stories as I was expecting.

"Brain training games may be a waste of time.

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

But that's contradictory to what you're seeing

in some of your studies.

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

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

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

that people pay an awful lot of money for,

and some games are supported by clinical trials,

and those games we might say are beneficial.

-Like this, for example?

-Potentially like this.

We've seen statistically significant benefit

in people playing these games.

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

But for the games that do work,

have their successes been exaggerated?

What do you make of this?

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

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

We can be pretty sure that brain training helps

the way that your brain works,

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

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

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

that brain training really does help fend off dementia,

but the early results are encouraging.

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

and it's definitely stretching my brain.

It was tricky just trying to remember 50 digits,

but then when he started saying,

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

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

but it's starting to make more sense now.

Improving your memory is just one way

you can challenge your brain.

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

dementia too.

Bonjour, everybody.

'This is a local class of Alliance Francaise,

'a group of nine people,

'four of them over 50,

'who meet every week to learn French.

'And, I have to say,

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

HE SPEAKS FRENCH

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

So why are you learning French?

A few years ago I read a few articles in newspapers

and they were saying that proficiency with

a second language can ward off dementia.

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

It's a good activity to do,

it's good for my memory, I think.

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

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

Two examples -

one is in terms of place

and the other is in terms of time.

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

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

'in a brain training game.

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

'that doesn't matter -

'challenging your brain at all is what counts.'

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

-Let's go.

So older people that keep their brains challenged

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

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

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

You can think of it like a muscle.

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

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

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

so bilinguals, have lower rates of dementia as well.

But what makes activities like this so good for your brain

is that they combine learning with socialising.

We do know that being more physically active,

staying socially connected

and eating healthily can reduce your risk.

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

are the things that bring all of those together,

and it should be things you enjoy as well.

So it could be joining a dance class,

a table tennis group,

playing bridge.

Something that keeps your brain sharp and challenges you.

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

Clare says that there's evidence some apps might work

in the battle against dementia too.

So do you find it exciting thinking there is positive development

in this area now?

I do find it exciting.

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

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

keeping their brains healthy.

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

for dementia, but we are seeing

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

But not all brain training games are equal.

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

their games really do what they say.

And of course be cautious of any game

that says it can definitely prevent or delay dementia,

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

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

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

our little grey cells a workout.

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

Which brings me back to my own personal challenge.

Morning, son.

Back home with my mum,

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

It's D-Day, really,

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

and so will you please be my adjudicator

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

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

-Right. OK, so...

Two,

three,

one,

six,

four,

eight, seven...

Come on, come on.

Seven,

eight,

one, one,

four, three.

What do you reckon?

I reckon I got it.

-Yeah!

-Yes!

-Come on!

-Well done, you.

-Come on.

Did I get it? Like, at 100%?

Look at that. Look at that.

100%.

Earlier in the programme I was looking into the suggestion

that asthma might be being over-diagnosed,

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

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

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

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

has really hardly changed for a number of years,

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

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

an incredible rise in the number of cases,

and that involves air pollution.

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

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

to the pollution in the air.

Some two thirds of asthma sufferers say air pollution

makes their asthma worse,

and it's more likely to trigger an attack.

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

at the start of 2017, some reports even called

for the capital's children to be given protective masks

on their way to school.

But Martha Massaquoi has been taking precautions

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

Thank you. Be careful.

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

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

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

Dr Abigail Whitehouse, who is going

to investigate how the air pollution nearby

might affect Gawanda's breathing.

So tell me a bit about Gawanda's asthma.

-When did it start?

-It started when he was a baby.

How often does he need to use his inhaler?

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

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

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

then he doesn't need it so much.

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

to find out how much nasty air he breathes in

on his over two mile round-trip to school.

The journey usually takes about 25 minutes

through side streets and back roads,

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

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

means that Gawanda is less likely to need his inhaler.

Which way are we going?

That way or are we going...?

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

whether to go through polluted areas

and give him medicine,

or go through a cleaner area

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

Martha thinks she's doing her best

to reduce the chances of Gawanda having an asthma attack

because of the air pollution.

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

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

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

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

they'll peak every time traffic stops nearby

or you're at a crossing,

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

While those peaks make an asthma attack more likely,

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

But Abigail says it's not that clear cut.

The air pollution might just have kick-started the condition

in people who were always destined to develop it anyway.

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

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

But you then still need something to trigger it.

The evidence is coming that air pollution also

has this trigger effect,

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

It's impossible to know whether Gawanda's asthma

was triggered by air pollution,

but it does undoubtedly make an attack more likely.

At the end of the school day,

Abigail's returning with the results of those tests.

-So shall we have a look at the results?

-Yes.

-OK.

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

The equipment measures particles of black carbon in the air,

a little like soot.

It's the main component of all air pollution.

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

there's a big peak.

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

And then we walk on to that side road.

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

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

So where is this roughly?

Martha says the peaks match the places were Gawanda

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

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

along or across the main road,

where traffic is worse.

Wherever you've got traffic jams and slow cars,

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

cos the cars are just pumping it at him.

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

their route to minimise their exposure to pollution.

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

taking that route.

You're definitely avoiding the bulk of the pollution

by walking that way, which is good.

Unfortunately, there isn't another route

to avoid even more of the pollution.

But there are tips on how to limit the pollution

they are exposed to even more.

You've got a nice wide pavement,

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

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

cos it kind of drops off as you move away.

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

there are ways to avoid too much exposure.

And although there is some truth in headlines linking rising pollution

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

that a surge in air pollution

will lead to a surge in new cases of asthma.

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

because they made really complicated arguments appear so simple.

I know. And, you know,

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

about statins and asthma,

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

about their medication without having all the facts.

Well, it goes without saying that none of those decisions

should be made without the help of your doctor.

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

Thank you very much for joining us,

-and, until next time, bye-bye.

-Bye-bye.