Episode 3 Health: Truth or Scare


Episode 3

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Every day, we're bombarded with conflicting messages

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about how to live a healthy, happy life.

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One minute, we're told something's 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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Today, we're unpicking some of the confusing claims

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about items you might well have in your bathroom cabinet.

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It's the little pill with big powers.

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But should more of us be taking an aspirin a day?

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I've got to be absolutely honest, if I don't take it,

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the next day, I know about it.

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From soothing cuts and burns to helping weight loss

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and even treating IBS,

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do all the claims about aloe vera really stack up?

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There's lots of different causes for IBS.

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-Some people think IBS is started by stress.

-Yes, definitely.

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-Sometimes, it's started by their poor diet.

-That's right.

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So the thought that one particular substance,

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whether it be medicine or whether it be aloe vera,

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can be the cure for it is ridiculous,

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because you're not treating the cause.

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And is it time to toss the floss?

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We investigate claims that flossing between your teeth is pointless.

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We do have very good evidence about brushing your teeth.

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When we get down to flossing,

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we don't have the same amount of evidence.

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You know, there aren't too many drugs

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that can be bought for just a fraction of a penny a pill.

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And yet, they are so powerful

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they are frequently referred to as "wonder drugs".

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But I tell you,

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aspirin has been linked to all manner of health benefits.

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One of the many headlines here...

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And I can add to that list, actually.

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It goes from curing sepsis to battling certain cancers,

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boosting the chances of getting pregnant, even,

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to reducing your risk of heart disease and stroke, of course,

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-which we've known for a long time.

-Absolutely.

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I've heard it's meant to be indispensable

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for people who have had a heart attack.

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And, of course, those who want to reduce

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the risk of having another one.

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Absolutely.

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Well, it turns out that the list of things

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that aspirin really can apparently do is longer than your arm.

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But it's also been said to have some very dangerous side effects,

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which I think is quite a worry.

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So I thought it was time that I set out to discover

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if aspirin really is one of the wonder drugs of the 21st century.

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Just about to do a first stretch of the narrowing here.

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Heart patient Ray Goodwin is in the middle of an operation

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to fit what's called a stent -

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a small tube that will help open up one of his arteries...

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-So I'm coming in here, all right? Have you got the wire?

-Yeah.

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..and improve blood flow to the heart.

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The success of this operation has been helped enormously

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by the fact that last night

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Ray took a massive 600 milligram dose of this drug.

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Now, we're not talking here about something that's a pioneering

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or a multi-million pound drug

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which is right at the cutting edge of medical science,

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this is a drug that's been around for well over 100 years.

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It's aspirin.

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In specialist heart and chest hospitals,

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like this one in Liverpool, aspirin really is essential

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because it reduces the chances of blood clotting...

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And maybe just zoom in a little bit.

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..simplifying surgery for staff

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like consultant cardiologist Raphael Perry.

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The wire's gone down the blockage nice and smoothly.

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Dr Perry, can I just ask you, how important aspirin is

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to enable you to do this operation successfully?

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It's really making it safer, in terms of...

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..occasionally, when you've got instruments in the small arteries,

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there's a propensity to clotting and blocking the artery,

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maybe flying off down other arteries,

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so the pre-loading with aspirin and any other drugs during the procedure

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mitigate against that.

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So, the bottom line is, really,

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you couldn't have done this operation without aspirin.

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Absolutely. We wouldn't do the procedure without.

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For most of us, me included, aspirin is a humble painkiller.

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But you don't have to look far for claims that,

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in homes and hospitals up and down the country,

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it's much more than that.

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It's credited with increasing the chances of falling pregnant,

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curing sepsis, targeting tumours,

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fighting some cancers and fending off others.

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But the boldest claims attached to this humble little pill

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all revolve around one idea -

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that lots of us should be taking a small dose of aspirin every day.

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When Ray leaves here,

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that's just what he'll be told to do for the rest of his life.

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It'll help keep the blood flowing through the stent

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and, of course, his heart.

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-All done?

-All done.

-Successful?

-Successful.

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-He's on aspirin now.

-He's on aspirin.

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And his other usual drugs, if you like, for him to continue on.

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And if he doesn't get any symptoms in the next three months,

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you'd imagine you'll have a long-term success

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from that stent procedure,

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-not just a short-term value.

-Brilliant.

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-So a good morning's work, then.

-Not bad.

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Up on the wards, dozens of patients will all leave here

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with instructions to take a small dose of aspirin a day.

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And that's just what David has been doing for the past seven years.

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David, you're looking very cheerful.

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-But I gather you've had quite a serious operation.

-Yes.

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-Yes, quite serious.

-What did they do?

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I've had a bypass graft

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and they've changed the aorta valve.

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Dare I say, I got two for the price of one!

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It was quite complicated, by the sound of it.

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But, now, aspirin...

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How important has aspirin been to you?

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Because you had a heart attack how many years ago?

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The first one I had

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was probably about seven years ago, I would have thought.

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But I've been on soluble aspirin ever since.

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But I've got to be absolutely honest, if I don't take it,

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the next day, I know about it.

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-Would you have thought something as humble as an aspirin...

-No.

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-..could be that...

-No.

-..important to you?

-No. No.

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No. When my doctor said, "I'm putting you on aspirin,"

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I thought, "Well, I took aspirin as a kid."

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You know, it was sort of the last resort, aspirin.

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But I never thought that it would still be going now.

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-But it obviously is.

-Yeah.

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-And how long now before you go home?

-I'm hoping early next week.

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Well, David, we hope that you do get home next week

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-and that you stay well.

-Thank you so much. Lovely to meet you.

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And pleasure to see you, too. Thank you.

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David and, indeed, many of the other patients in this hospital

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will be told to take aspirin

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to treat the heart conditions they already have.

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But looking at some of the reports about aspirin,

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there are claims that it would benefit those of us

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who don't have a heart problem.

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Dr Raphael Perry says they are broadly true.

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Well, there is good evidence

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that taking aspirin daily is of benefit,

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because it reduces the effects of vascular disease,

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in particular, heart attack and stroke.

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There's a lot of data published on this,

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which is, should people just take aspirin

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in the hope that they're not going to have something wrong with them in the future?

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And if you aggregate all those trials,

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there is a benefit in taking aspirin

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to reduce both heart and vascular disease.

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But there's a catch... Aspirin has side effects.

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You can have...

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quite significant bleeding side effects.

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And you have to pick the patients that are going to benefit most

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in order to mitigate that risk, in a sense.

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So people should be aware that, if they're taking aspirin,

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-it will thin their blood significantly.

-Absolutely.

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Although rare, the greater chance of bleeding

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can increase the risk of some types of strokes.

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And aspirin can also irritate the stomach lining,

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causing indigestion, nausea

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and, in extreme cases, even leading to ulcers.

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Dr Perry says, if you've only got a very low risk

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of developing heart disease,

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an aspirin a day isn't right for you.

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You just have to take that into the mix and say, "Is it worth it?"

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And for someone who's 40 and well, with no family history,

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normal cholesterol, no risk factors for heart disease,

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then the risk of them having a heart attack

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or something develop with their heart

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over that ten years is very low.

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It's maybe 4% or something of that order.

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And once it starts to creep up to that 15% or a higher risk,

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then the value of aspirin becomes more significant.

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But some reports don't always make that trade-off clear.

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And seeing stories like this about an American study,

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which recommended that everyone over the age of 51

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should be taking a small dose of aspirin a day,

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you might be tempted to do the same thing

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without knowing the full story.

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What strikes me is that aspirin

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is such a cheap thing to buy over the counter,

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it would be very easy for people to think

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that they have to self-medicate,

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just go and buy it because they think there might be a risk.

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But you, obviously, would recommend against that.

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I think that it's a long-term treatment.

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The benefit isn't really evident until year ten or 11.

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I would always recommend that,

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if you're going onto something long-term, in particular,

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then you should do that through your doctor

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-with some advice and a professional view.

-Mm.

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But while the vast majority of us

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don't need to take an aspirin a day,

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elsewhere in the hospital, there are dozens of patients who do.

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Including bypass patient Doreen.

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Doreen, you look very happy for a lady

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-who's had pretty major surgery, I think.

-Thank you very much.

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-What was your surgery?

-I had a triple bypass.

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Good Lord!

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So what have they told you now about aspirin in the hospital?

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They just explained to me that, obviously,

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I now need to take some aspirin,

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just to help me through my heart condition.

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So, yes...

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And you may have to be on it for a very long time.

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I don't mind. It's one of those, isn't it?

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I've been given my second chance.

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So...I'm going to take that second chance, aren't I?

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You're Ian, aren't you?

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Hello, Ian, how are you doing today? What have you had?

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I've had a bypass operation.

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-How are you feeling?

-Absolutely perfect.

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-Are you taking your aspirin?

-Yes, I am.

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Well, you'll be up and about doing the fandango before you know it.

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I will do, yes.

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When Doreen and Ian return home,

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they'll take with them aspirin provided by the hospital's pharmacy.

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Danny, hello, good to see you.

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Danny Forrest is the hospital's deputy chief pharmacist.

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So, Danny, we're right in the nerve centre of the hospital here,

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in the pharmacy.

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Have you any idea how many boxes of aspirin

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or how many individual aspirin tablets

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you send out of here in a year?

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Well, something in the region of about 6,000 boxes of aspirin

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are dispensed from this pharmacy every year.

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-And how many tablets in a box?

-28.

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And it's 10p a box, so...

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That's 168,000 aspirin every year in this hospital.

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In the whole of England last year,

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doctors wrote a massive 26 million prescriptions for aspirin.

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But the cost is comparatively small.

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In fact, aspirin is so cheap that this place spends just £600

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on its supply for the whole year.

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Do you think that's why perhaps,

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amongst all the drugs that are available to us,

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because we're familiar with it, that's what makes it so popular?

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Perhaps. But also, again, it's very cheap.

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A lot of the newer drugs are costing

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anywhere in the region of £40, £50, sometimes £100 per box.

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So in the cash-strapped NHS,

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in terms of its cost effectiveness,

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it's high up on the list.

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Every day, Danny and his team send hundreds of aspirin

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to wards and clinics around the hospital.

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And because this one specialises in cardiac treatment,

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every single department uses it.

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So we have medicine, we have cardiology here,

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we also have cardiac surgery.

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So it'd be sent to patients that have had cardiac bypass grafting,

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patients that have had valve replacements.

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I have to say, I am rather taken aback by the number of aspirin

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they get through here in a week, never mind in a year.

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But then, this is a hospital that specialises in heart disease,

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so what would you expect?

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But then, of course, the one area where you can honestly say

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that aspirin is a miracle drug is in treating cardiac patients.

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There are other areas, though, where it's not such a miracle drug,

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even though there are plenty of reports

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that might make you think that it is.

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Some suggest it might cure sepsis or even help increase

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the chances of some women getting pregnant.

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But unfortunately, there's just not enough evidence

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for aspirin to claim those accolades.

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There is, however, a mounting body of research that says

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it could be a powerful weapon against another big killer, cancer.

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And Nicola Smith from Cancer Research UK says that,

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for the most part, these stories can be believed.

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The evidence around cancer prevention and aspirin

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has been building for some decades now.

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There are some cancer types where we have really good evidence

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that aspirin could reduce the risk of those cancers developing.

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Bowel, oesophageal and stomach cancer,

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we have good evidence that if you take an aspirin every day,

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between 50 and 65, that you will have a lower risk of those cancers.

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But there's a word of caution here, too, and it's just the same as for

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anyone tempted to take an aspirin a day to prevent heart disease.

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If you're taking higher doses and taking it every day

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for a number of years, which is what's needed to see

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the benefit in terms of reducing the risk of cancer,

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there are potential side-effects,

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and those are things like strokes,

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but also gastrointestinal bleeding, so bleeding in your stomach,

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for example, and that can kill in some instances.

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It also claimed aspirin could be powerful in treating cancer

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that's already developed,

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but Nicola says there's not enough evidence to prove that just yet

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because, perhaps surprisingly for a drug that is more than

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a century old, new uses for it are still being uncovered.

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There are some trials that are ongoing looking at whether

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aspirin might be able to stop cancer returning.

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So it wouldn't be the first thing you're given when you go in

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for cancer treatment, but there are trials looking at whether

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it might be helpful in terms of stopping the cancer coming back.

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There are also trials looking at aspirin alongside

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other conventional cancer treatments,

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so for example we're funding a trial looking into radiotherapy

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and whether, if people are taking aspirin while they're having

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radiotherapy for rectal cancer, that the outcomes are better.

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But that's still a work in progress.

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While that research continues, aspirin's powers against cancer

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remain in prevention rather than treatment.

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But back in Liverpool,

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it's a different story when it comes to heart disease,

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and Danny feels that in the future aspirin may prove indispensable

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to an even wider range of patients.

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Can you see aspirin in the future being used for things other than

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pain relief, for cardiovascular?

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We're now hearing that it may have some effect on some cancers.

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Is there no end to what it's going to be able to do?

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I know there is a lot of interest within the fields of oncology

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and obstetrics and gynaecology, so who knows?

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But I think certainly aspirin's here to stay for a good while longer.

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Back at the operating theatre, Ray,

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who I last saw having a stent fitted,

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has recovered from his surgery and is ready to go home.

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-You've waited for me.

-Oh, look at that! Happy man.

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Want to see your happiness.

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How are you feeling?

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I'm feeling like I should jump over the world.

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-Oh!

-And I probably could.

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-Well done.

-Oh, it's fantastic.

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-Thanks for letting us join you in there.

-Well, I'm glad you did.

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-And I'm glad it was a success.

-Amazing.

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-So, all health in the future to you.

-Dancing on Monday.

-Absolutely.

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-Strictly Come Dancing next November. Are you on? Partnership?

-I'm on.

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When I started making this film,

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obviously I was already aware of some of the properties that

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aspirin had, but was I sure that it could be described as a wonder drug?

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Well, maybe not.

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And certainly, some of the claims made for it

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are a bit difficult to believe.

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But nevertheless,

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having seen what has happened here in this hospital,

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I think there's no doubt that aspirin really is

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a life-changing and in many cases life-saving drug.

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And I'm sure Ray would agree.

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Well, from a truly remarkable drug that, well,

0:16:290:16:33

I suppose it's been around for the best part of 100 years now,

0:16:330:16:35

-hasn't it?

-Yeah.

0:16:350:16:36

To one that I think has been around for even longer than that

0:16:360:16:39

but has only very recently come to the fore, and that's aloe vera.

0:16:390:16:44

Now, for most of the time I think it's been used for treating burns,

0:16:440:16:47

-I think I'm right in saying.

-That's right, yeah.

0:16:470:16:49

But, well, these days it's cropping up

0:16:490:16:51

in all sorts of beauty-based products,

0:16:510:16:53

everything from shampoos and toothpaste to body creams and,

0:16:530:16:57

well, just about everything you can imagine.

0:16:570:16:59

Yeah, and that's because some of the claims being made for how good

0:16:590:17:02

aloe vera is for us are, well, pretty dramatic.

0:17:020:17:05

It's even been said to help treat IBS and Type II diabetes.

0:17:050:17:09

Bold statements.

0:17:090:17:10

But almost as vocal as its fans are its critics,

0:17:100:17:13

who say, "Well, the science really doesn't stand up."

0:17:130:17:16

So, with its popularity fanned by aloe vera parties

0:17:160:17:18

in living rooms up and down the country,

0:17:180:17:21

I thought the only way for me to really find out

0:17:210:17:24

if it's all it's cracked up to be

0:17:240:17:26

was, well, to throw a party of my own.

0:17:260:17:28

My invitation's still in the post, then, is it?

0:17:280:17:31

HE CLEARS HIS THROAT

0:17:310:17:32

It's the latest must-have health product

0:17:400:17:42

with all kinds of supposed medicinal and healing properties.

0:17:420:17:46

Aloe vera is in just about anything these days.

0:17:460:17:50

Mouthwash.

0:17:500:17:51

Juice.

0:17:510:17:53

Sham...poo.

0:17:530:17:55

Toothpaste.

0:17:550:17:56

And facemasks.

0:17:560:17:58

The market is worth billions.

0:17:590:18:02

And with celebrities widely reported

0:18:020:18:04

to have added it to their beauty regimes and their diets,

0:18:040:18:07

the aloe vera craze shows no sign of slowing.

0:18:070:18:10

But there's another side to the story, too,

0:18:110:18:14

with some very bold claims about how it can treat conditions

0:18:140:18:17

such as irritable bowel syndrome, diabetes

0:18:170:18:20

and even cancer.

0:18:200:18:23

It doesn't take too much of an internet search

0:18:230:18:25

to see how aloe vera really can divide opinion.

0:18:250:18:28

Bodies like the Royal College of Nursing

0:18:280:18:30

warn that claims about the health benefits of aloe vera

0:18:300:18:33

should be met with caution, while Cancer Research UK

0:18:330:18:36

says that there is no scientific evidence to prove

0:18:360:18:39

that aloe vera can treat any type of cancer,

0:18:390:18:42

and that it may cause severe side-effects when used in this way.

0:18:420:18:45

One thing that some of these sites do agree

0:18:450:18:48

is that aloe vera can treat burns.

0:18:480:18:51

But, other than that, the jury's still out.

0:18:510:18:54

So I'm having a little soiree to find out if this wonder plant

0:18:550:18:58

is everything it's cracked up to be.

0:18:580:19:00

And, oddly enough, it's aloe vera parties like this

0:19:000:19:03

that have led to the huge rise in the super plant's popularity.

0:19:030:19:06

-DOORBELL

-Come on in, welcome.

0:19:060:19:08

-You OK?

-How are you?

0:19:080:19:09

'My guests include aloe vera fans Leila and Domitilla,

0:19:090:19:12

'two medical herbalists, Dalbinder and Sue...'

0:19:120:19:15

Yeah, come on in, come on in.

0:19:150:19:16

-How are you? You all right?

-Hi, yes.

0:19:160:19:17

'..GP Dr Arun Ghosh,

0:19:170:19:19

'dermatologist Dr Juba Haffejee...'

0:19:190:19:21

Doctor Juba. Nice.

0:19:210:19:23

'..and, finally, dietician Dimple Thakrar.'

0:19:230:19:25

Very well. Welcome to our aloe vera party.

0:19:250:19:27

'They all use aloe vera,

0:19:290:19:31

'or have patients and clients who ask them about it,

0:19:310:19:34

'but they don't all agree on its merits.

0:19:340:19:37

'I'm getting the party started with aloe's best-known use, for the skin.

0:19:370:19:41

'This is one area that is agreed to be quite effective,

0:19:410:19:44

'and it's the one Domitilla, Leila and herbalist Dalbinder

0:19:440:19:48

'all say they use it for.

0:19:480:19:50

'Dermatologist Dr Haffejee agrees,

0:19:500:19:52

'but says we shouldn't get carried away.'

0:19:520:19:55

Well, aloe vera has soothing properties.

0:19:550:19:58

It will soothe the skin, it will moisturise the skin

0:19:580:20:02

and, you know, if somebody has a sunburn for example, you know,

0:20:020:20:05

if you've got aloe vera handy, not a bad thing.

0:20:050:20:08

There's a lot of evidence out there for its benefits on the skin,

0:20:080:20:12

from its antimicrobial properties, anti-ageing properties...

0:20:120:20:15

But really, when you look at the literature,

0:20:150:20:18

although there's a lot of interesting evidence out there,

0:20:180:20:21

the quality of the evidence isn't as good as what we would like.

0:20:210:20:25

At the moment, we've got a lot of questions unanswered.

0:20:250:20:29

You know, if it works for the patient, great.

0:20:290:20:31

But I think a lot more evidence needs to be undertaken.

0:20:310:20:35

As Dr Juba says, skincare is the one area

0:20:350:20:38

where aloe vera's claims do have some medical support.

0:20:380:20:42

It's been shown in small studies to be effective

0:20:420:20:44

at treating burns and wounds.

0:20:440:20:47

But aloe vera fan Leila loves it in another product altogether. Drinks.

0:20:470:20:52

If you're constantly drinking aloe vera...

0:20:520:20:54

I'm not talking, like, for a couple of weeks, I'm talking months,

0:20:540:20:57

-you know, to actually see the benefits.

-OK.

0:20:570:21:00

You know, your hair will be better condition, your nails,

0:21:000:21:02

your skin, and you'll just feel better.

0:21:020:21:04

The biggest claims for aloe vera are for its effects

0:21:040:21:07

on digestive conditions like irritable bowel syndrome, or IBS.

0:21:070:21:12

Domitilla, who used to run her own business

0:21:120:21:14

selling aloe vera products, claims it really works.

0:21:140:21:16

I can tell you that I have saved some people

0:21:180:21:21

from going on the operating table.

0:21:210:21:24

Through IBS, colitis...

0:21:240:21:28

All of these, internally, are very terrible problems.

0:21:280:21:33

NICE, the Government's health watchdog, has said that

0:21:330:21:36

it discourages people from using aloe vera to treat IBS.

0:21:360:21:39

The reason why NICE have chosen to say it's not to be used...

0:21:390:21:43

The problem is that, when it's given for a long period of time,

0:21:430:21:46

people become resistant to it,

0:21:460:21:47

and it can actually cause problems with the bowel.

0:21:470:21:49

So there's lots of different causes for IBS.

0:21:490:21:51

-Some people's IBS is started by stress.

-Exactly that.

0:21:510:21:54

Sometimes it's started by their poor diet.

0:21:540:21:56

Sometimes it's because they're positionally sitting down all day,

0:21:560:21:59

-and not stimulating their bowels.

-That's right.

0:21:590:22:01

So the thought that one particular substance,

0:22:010:22:03

whether it be medicine or whether it be aloe vera,

0:22:030:22:06

can be the cure for it is ridiculous,

0:22:060:22:07

because you're not treating the cause.

0:22:070:22:09

Aloe vera has also been used as a natural remedy to treat

0:22:090:22:13

constipation for years. But it can have side effects of diarrhoea

0:22:130:22:16

and cramping, as well as being linked to kidney and liver problems.

0:22:160:22:21

It's for this reason, in 2002, the US Food and Drug Administration

0:22:210:22:25

banned it from being sold over the counter as a laxative.

0:22:250:22:29

But there's another popular use of aloe vera, for weight loss.

0:22:290:22:33

Indeed, Domitilla believes they helped her to lose weight,

0:22:330:22:37

and some of her customers come to her hoping for similar results.

0:22:370:22:41

But what does dietician Dimple Thakrar think?

0:22:410:22:44

-Would you advocate aloe vera for weight loss?

-No.

0:22:450:22:49

I certainly wouldn't be advocating aloe vera for weight loss,

0:22:490:22:52

and the reason for that is a lot of the weight loss programmes

0:22:520:22:56

-that include aloe vera are actually a very low calorie diet.

-OK.

0:22:560:23:01

So, if you were to take a very low calorie diet,

0:23:010:23:04

and I'm talking 600, 700 calories a day, you would lose weight.

0:23:040:23:08

-Definitely lose weight with that!

-It's not rocket science.

0:23:080:23:12

Dieticians warn against any kind of very low calorie diet,

0:23:120:23:15

because it's very easy to miss out on essential nutrients too.

0:23:150:23:19

And Arun says when that is combined with another side-effect

0:23:190:23:22

of some aloe vera products, there could be serious implications.

0:23:220:23:25

Some people can actually get adverse reactions, they can actually

0:23:250:23:28

break out in rashes, their bowels can actually be quite...

0:23:280:23:31

Quite strongly react to it. So always take those things with caution.

0:23:310:23:36

Some aloe vera products can cause adverse reactions

0:23:360:23:39

when they're eaten or drunk,

0:23:390:23:41

if they contain the rind or the latex of the plant.

0:23:410:23:44

Many companies avoid those parts of the plant and just use the gel

0:23:440:23:48

from the centre of the leaf in their products.

0:23:480:23:50

But Domitilla says it's always important

0:23:500:23:53

to read the label to be sure.

0:23:530:23:54

Now, when the aloe vera becomes laxative

0:23:540:23:57

is when the company uses the rind.

0:23:570:23:59

So what you're reading when you're buying a product,

0:23:590:24:02

you must read - does it have the rind?

0:24:020:24:04

If it has the rind, go away from it.

0:24:040:24:07

After casting doubt on aloe vera's weight loss credentials,

0:24:070:24:10

dietician Dimple's equally quick to question some other claims too.

0:24:100:24:15

We've got internal cleansing tablets, or colon cleansing.

0:24:150:24:19

-What are your thoughts on this?

-The same sort of thing.

0:24:190:24:22

It does have a natural laxative in it,

0:24:220:24:25

and that is going to obviously cleanse your colon.

0:24:250:24:28

But, actually, your colon doesn't need to be cleansed.

0:24:280:24:32

-It's meant to have bacteria in it.

-How can they...

0:24:320:24:35

How can they advertise that and sell that if, medically, it's not sound?

0:24:350:24:40

Because aloe vera doesn't come under a drug, it's actually a food.

0:24:400:24:44

So therefore it's not regulated in the same way

0:24:440:24:46

as a drug would be regulated.

0:24:460:24:48

But while some of the adverse effects linked to aloe vera

0:24:480:24:51

aren't always easy to find out about,

0:24:510:24:53

the claims for how great it is can be hard to miss.

0:24:530:24:56

An article last year said that taking aloe vera

0:24:560:24:59

lowered your blood cholesterol,

0:24:590:25:00

lowered your blood pressure and improved your immune system.

0:25:000:25:03

-What are your thoughts on that?

-This was some work done in rats,

0:25:030:25:06

and it's not been extrapolated to the human.

0:25:060:25:10

So therefore, again, more evidence - we need more evidence.

0:25:100:25:13

And I always think, "How would I treat my own family?"

0:25:130:25:16

My dad's diabetic and he's hypertensive.

0:25:160:25:18

I certainly won't be going out and buying him aloe vera juice

0:25:180:25:21

to try and treat that for him.

0:25:210:25:22

Until we get that evidence, we cannot recommend aloe vera,

0:25:220:25:26

and we cannot say that it does the things that you've said,

0:25:260:25:31

lowering cholesterol, blood sugars...

0:25:310:25:33

People think, "Oh, maybe I can just treat my blood pressure

0:25:330:25:36

"or my blood sugar by using aloe vera."

0:25:360:25:39

So a viewer who has now been introduced to aloe vera,

0:25:390:25:42

they've seen the headlines saying,

0:25:420:25:43

"Aloe vera can help you with weight loss,

0:25:430:25:45

"it can improve your immune system," what's the answer?

0:25:450:25:48

So what they need to do is do their research.

0:25:480:25:50

They need to find out, where is the evidence?

0:25:500:25:53

If they're not sure, they need to be speaking to their medics.

0:25:530:25:57

What they shouldn't be doing is googling it

0:25:570:25:59

and reading the first thing that comes up on Google.

0:25:590:26:02

And I'm not anti-aloe vera in any shape or form,

0:26:020:26:04

but what I want my patients to be is well-informed.

0:26:040:26:07

We've got to be really careful that they're getting

0:26:070:26:09

reasonable information so they can make their own informed decision.

0:26:090:26:12

'So, with a resounding word of caution for anyone using aloe vera

0:26:120:26:16

'on anything other than their skin, my guests start to head home.'

0:26:160:26:20

We asked some of the companies behind the leading aloe vera brands

0:26:210:26:24

about the things my guests discussed and they told us that their

0:26:240:26:27

products are enjoyed by millions of people seeking

0:26:270:26:30

a natural alternative to support their health.

0:26:300:26:34

Some pointed out that not all companies made claims about

0:26:340:26:37

the medical benefits of using their products.

0:26:370:26:40

And one brand added that its on-pack instructions make it clear that

0:26:400:26:43

their products are not a substitute for a healthy balanced diet,

0:26:430:26:47

and that anyone with existing medical conditions should

0:26:470:26:50

always seek advice from their GP before using them.

0:26:500:26:53

It was really good, it was really insightful, I learned quite a lot.

0:26:550:26:59

Obviously, I've got my own ideas about aloe vera.

0:26:590:27:02

They're still the same, I'm still going to use the products.

0:27:020:27:05

It just shows, it's really difficult for the general public to

0:27:050:27:08

make an informed decision about things.

0:27:080:27:10

There's so much in the press that they've got to really make sure

0:27:100:27:13

that they understand and are happy with.

0:27:130:27:15

I met a lot of interesting people that had different views on

0:27:150:27:18

the aloe vera, I enjoyed it so much.

0:27:180:27:21

Very, very awakening.

0:27:210:27:23

I think aloe vera's a wonderful plant, it's got its benefits.

0:27:230:27:26

I don't think it's the miracle that it's maybe held up to be.

0:27:260:27:30

'I have to say, after what I learned tonight, I agree with Sue.

0:27:300:27:34

'Not all the claims really stand up to scrutiny

0:27:340:27:38

'and whilst for the most part, they won't do you any harm,

0:27:380:27:41

'we should probably all be wary of any claims that aloe vera is a cure for all ills.'

0:27:410:27:45

Now, for millions of people,

0:27:500:27:52

cleaning your teeth doesn't just stop when you're done brushing.

0:27:520:27:55

-Angela, do you floss?

-Only on those occasions when I know I've got something kind of stuck

0:27:550:27:58

in between them and there is no other way of getting it out but I...

0:27:580:28:02

I put my hands up, I'm not a regular flosser.

0:28:020:28:04

Well, I've got to put my hand up as well because I only used to floss

0:28:040:28:07

just before I went to the dentist until obviously the dentist said,

0:28:070:28:10

"Kev, you've got to floss all of the time."

0:28:100:28:12

Now, when we woke up to this headline...

0:28:120:28:14

I mean, we can't have been the only ones taken aback and left

0:28:160:28:19

wondering whether we'd been wasting time and money for all those years.

0:28:190:28:22

It's a pretty positive statement, that, isn't it?

0:28:220:28:25

So, we asked committed flosser Danny Crates if

0:28:250:28:28

he would look behind these headlines and find out once and for all

0:28:280:28:31

whether or not we'd actually all be a lot better off by getting

0:28:310:28:34

to bed just a couple of minutes earlier and moving that reel

0:28:340:28:37

of floss out of the bathroom cabinet and dropping it in the bathroom bin.

0:28:370:28:42

DANNY: Like millions of others, I start and end my day in the bathroom,

0:28:530:28:56

taking the time to care for my pearly whites.

0:28:560:28:59

Now, I'm a committed flosser and I've been using trusty little

0:29:000:29:03

flossing wands like this twice a day, every day, for years.

0:29:030:29:07

I always believed that flossing keeps my mouth

0:29:070:29:11

that little bit cleaner and in better shape than it would if I didn't.

0:29:110:29:15

But last year, a story hit the news that poured cold water all

0:29:150:29:19

over my twice daily ritual.

0:29:190:29:21

It said there is no evidence that flossing does any good.

0:29:210:29:24

Now, for decades,

0:29:240:29:26

dentists have recommended we should floss once a day.

0:29:260:29:28

But how useful is flossing?

0:29:280:29:31

An investigation by the Associated Press suggests there is

0:29:310:29:33

insufficient proof that it's beneficial.

0:29:330:29:36

But those reports were quickly met by others telling us not to give up.

0:29:360:29:40

Because, just as our dentists have long been telling us,

0:29:400:29:43

flossing cleans between our teeth,

0:29:430:29:45

keeps plaque at bay and helps us avoid fillings.

0:29:450:29:48

So, with all the conflicting information, the future of

0:29:490:29:51

the floss in my bathroom cabinet is, well, hanging by a thread.

0:29:510:29:56

But what is going on inside my mouth when I floss?

0:29:560:29:59

And is it really as good for my gnashers as my dentist has been telling me?

0:29:590:30:02

CHOIR SINGS

0:30:020:30:06

To help me find out, I have recruited a group of people

0:30:060:30:09

whose teeth are on show more often than most, the Salford Choral Society.

0:30:090:30:14

'They've agreed to take part in our very own flossing experiment.

0:30:180:30:21

'Now, it's time to see which dental habits produce the most decibels.'

0:30:240:30:27

Who here flosses regularly?

0:30:290:30:31

THEY SING NOTE

0:30:320:30:35

'Not exactly taking the roof off there.'

0:30:370:30:40

So, who here flosses but not regularly?

0:30:400:30:42

THEY SING NOTE

0:30:440:30:46

'That was definitely a few decibels louder than our regular flossers.'

0:30:480:30:51

Who has never flossed before?

0:30:510:30:54

THEY SING NOTE

0:30:560:30:59

'Finally hitting a quiet low note there are our non-flossers.

0:30:590:31:02

'But what are the reasons behind our choir's flossing habits?'

0:31:030:31:06

I am a flosser.

0:31:060:31:08

Because I was advised by my dentist, because my gums were bleeding.

0:31:080:31:12

When my electric toothbrush doesn't remove all the stuff between my teeth, I floss.

0:31:120:31:17

I've been advised by my dental hygienist to floss at least once a day.

0:31:170:31:21

I don't always live up to her commands, I'm afraid.

0:31:210:31:24

The first fillings I ever had in my life were for cavities

0:31:240:31:28

between my teeth, so the dentist said, if I'd flossed

0:31:280:31:31

I probably wouldn't have had them.

0:31:310:31:33

And I've flossed ever since and I haven't had any more fillings.

0:31:330:31:36

It just doesn't appeal to me, I don't think it works.

0:31:360:31:39

And it looks painful and I hear tales of people who have cut

0:31:390:31:42

their gums with their floss.

0:31:420:31:44

Of the 52 singers that put their hands up, 11 have never flossed,

0:31:460:31:50

27 claim to do it occasionally

0:31:500:31:53

and only 14 floss every day.

0:31:530:31:56

It might not sound like many, but it's roughly the same as the

0:31:560:31:59

national average, because less than a quarter of us floss regularly.

0:31:590:32:03

Is there a chord that's going to show these beautiful pearly whites?

0:32:040:32:08

I think so. Roddy?

0:32:080:32:10

PIANO PLAYS CHORD

0:32:100:32:12

THEY SING SUSTAINED NOTE

0:32:120:32:15

I don't know about the choir's 14 flossers

0:32:170:32:20

but I floss because I've been told it's vital for getting rid of

0:32:200:32:23

bacteria which causes tooth decay and gum disease.

0:32:230:32:27

It's a message dentist Ben Atkins delivers to his patients every day.

0:32:280:32:32

Floss, traditionally,

0:32:330:32:35

has been used to clean in between the patient's teeth.

0:32:350:32:38

That's often the place we get all our dental decay starting.

0:32:380:32:41

So, we take round about a metre of floss, so what we'll do then

0:32:410:32:45

is get to the top of the tooth and slide up and down.

0:32:450:32:49

And then you move on from one side and you roll it on,

0:32:490:32:52

so you're using a fresh piece of floss, so it's cleaning,

0:32:520:32:54

not transferring the bacteria around,

0:32:540:32:56

and you go back into the same place and lean on to do the side

0:32:560:32:59

of the tooth and go up and down, until it goes squeakily clean,

0:32:590:33:01

so you'll actually hear a slight squeak, and everything's clean there.

0:33:010:33:05

It's quite tricky but it's to make sure we don't get

0:33:050:33:08

a build-up of plaque, which eventually can cause gum

0:33:080:33:11

disease or decay and holes in our teeth.

0:33:110:33:14

'When put like that, it all sounds very simple.

0:33:140:33:18

'And quite different to the impression I got from some of those reports.

0:33:180:33:22

'But when I showed some members of the choir those stories,

0:33:220:33:25

'they had the same instant reaction as me.'

0:33:250:33:28

Flossing teeth has no health benefit.

0:33:280:33:31

It'll make me feel less guilty when I don't floss.

0:33:310:33:34

THEY LAUGH

0:33:340:33:36

It would make me continue to not floss.

0:33:360:33:38

"Flossing is a waste of time, now they tell us!"

0:33:380:33:41

I disagree with it because I know it's had benefits for me.

0:33:410:33:44

It's difficult to believe that it does any good, the floss.

0:33:440:33:47

I disagree, I floss once a day and after a meal,

0:33:470:33:52

if stuff is stuck between your teeth, it does get rid of it.

0:33:520:33:56

'But as a lifelong flosser, I think it does do some good,

0:33:560:34:00

'so to find out whether flossing is really a waste of time,

0:34:000:34:03

'I've asked the choir to help us run a test.

0:34:030:34:06

'We've asked 10 members who either floss regularly,

0:34:070:34:09

'occasionally, or not at all, to let us test the levels of plaque-causing bacteria in between their teeth.'

0:34:090:34:15

I'm going to pass these around, take one of these flossing wands.

0:34:150:34:19

'If flossing really does reduce the amount of bacteria,

0:34:190:34:22

'then the flossers should all have less of it between their teeth than the non-flossers.'

0:34:220:34:26

So, how was your first flossing experience?

0:34:260:34:29

-Horrid!

-THEY LAUGH

0:34:290:34:31

-It's hard to get in between your teeth.

-It is.

0:34:310:34:34

'With all the samples bagged up,

0:34:340:34:35

'I'm sending them off for expert scrutiny -

0:34:350:34:39

'to Doctor Chloe James of the University of Salford,

0:34:390:34:42

'who is an expert in the microbiology of the mouth.

0:34:420:34:44

'Thanks to the unique mix of saliva, fluid and food,

0:34:460:34:49

'the mouth is the perfect place for bacteria to thrive.

0:34:490:34:52

'Chloe's going to compare the amount of pathogenic bacteria of

0:34:530:34:56

'those who do clean in between their teeth versus those that don't.'

0:34:560:35:01

That's the bacteria that can cause plaque that leads to tooth decay,

0:35:010:35:05

and can also cause periodontal disease,

0:35:050:35:08

otherwise known as gum disease.

0:35:080:35:10

What I'm expecting to see is that we'll get more material

0:35:110:35:15

from those people that don't normally clean between their teeth,

0:35:150:35:18

because there'll be a lot of compacted food and bacteria there.

0:35:180:35:22

A number of larger studies have been done similar to this study

0:35:220:35:26

and they have found, in certain cases,

0:35:260:35:28

that flossing makes a big difference,

0:35:280:35:31

particularly for children. If they are being flossed by a professional,

0:35:310:35:36

depending on your technique,

0:35:360:35:38

flossing can determine

0:35:380:35:39

how much bacteria you're able to dislodge from between your teeth.

0:35:390:35:43

Chloe will leave these samples to culture for 72 hours,

0:35:430:35:47

and we'll find out the results later.

0:35:470:35:50

But while that's happening,

0:35:510:35:52

I'm off to find out more about the stories that started this argument.

0:35:520:35:56

They first cropped up in America,

0:35:560:35:59

but some reports say there could be implications for the NHS, too.

0:35:590:36:03

One high-profile flossing critic in this country

0:36:030:36:06

is Professor Damien Walmsley

0:36:060:36:08

who's a scientific adviser for the British Dental Association.

0:36:080:36:12

And he says those stories are right.

0:36:120:36:15

Because, even though we've been flossing the decades,

0:36:150:36:17

there's very little proof it actually does any good.

0:36:170:36:21

So, Professor, in some of the press articles,

0:36:210:36:23

you've been quoted as being quite critical of flossing.

0:36:230:36:26

I mean, why is that?

0:36:260:36:27

We don't have the clinical trials,

0:36:270:36:29

the really rigid clinical trials around flossing

0:36:290:36:32

to make categorical statements and say, "Yes, it is beneficial."

0:36:320:36:36

So, we do have very good evidence about brushing your teeth.

0:36:360:36:39

When we get down to flossing,

0:36:390:36:41

we don't have the same amount of evidence.

0:36:410:36:43

But the professor isn't saying we shouldn't clean between our teeth.

0:36:430:36:47

The idea is a good one, because what you're trying to do

0:36:470:36:49

is to disrupt the home of the bacteria.

0:36:490:36:51

But there are other ways of cleaning.

0:36:510:36:53

You do a routine of brushing your teeth for three minutes a day

0:36:530:36:56

and brushing where the tooth comes away from the gum.

0:36:560:36:59

You want to systematically remove the bacteria

0:36:590:37:02

that are formed along the lines of the teeth.

0:37:020:37:05

Now, some people need to get in between the teeth,

0:37:050:37:07

especially if they've got all the teeth like this,

0:37:070:37:10

-and there's these tight gaps.

-Instead of floss,

0:37:100:37:12

the professor says we could use interdental brushes like these.

0:37:120:37:15

They're wider, so fill more of the gaps between our teeth

0:37:150:37:18

and remove more bacteria.

0:37:180:37:20

And if your teeth are really tightly packed,

0:37:200:37:23

that's when floss could come in handy.

0:37:230:37:25

Because cleaning between your teeth at all

0:37:250:37:27

is better than never doing it.

0:37:270:37:29

It's down to when you have that talk with your dentist or your hygienist.

0:37:290:37:33

So, if you're having problems cleaning

0:37:330:37:35

and you've got very, very tight contacts between your teeth,

0:37:350:37:38

then, they may advocate, on top of all the tooth brushing you're doing,

0:37:380:37:41

and the interdental, to do some flossing.

0:37:410:37:43

So, the professor is wary of any report that says

0:37:430:37:46

we should forget about flossing altogether.

0:37:460:37:48

Which makes me feel better about the decades I've spent avidly flossing.

0:37:480:37:53

But I'm not going to concede defeat from my trusty floss just yet,

0:37:530:37:56

so I'm back to Salford with Dr Chloe to get the results of our test.

0:37:560:38:00

Hi, guys.

0:38:020:38:04

'We took samples from ten choir members, some who floss regularly,

0:38:050:38:09

'some who floss occasionally and some who've never flossed.

0:38:090:38:13

'If flossing is effective at reducing the amount of bacteria

0:38:130:38:16

'in our mouths, then the samples from the non-flossers

0:38:160:38:19

'will show more bacteria.'

0:38:190:38:22

-So, are you ready to see the results? ALL:

-Yes!

0:38:220:38:24

Some had to be quarantined.

0:38:240:38:26

LAUGHTER

0:38:260:38:28

That's not true.

0:38:280:38:30

'But the results were a bit of a surprise to Chloe.'

0:38:300:38:33

So, it looks pretty spectacular,

0:38:330:38:35

but what does this actually tell us?

0:38:350:38:37

Overwhelmingly, hopefully, what you can see

0:38:370:38:40

is there's not much difference between them.

0:38:400:38:43

So, depending on whether you are a frequent flosser,

0:38:430:38:45

or you don't floss at all, the level of bacteria

0:38:450:38:48

that we're seeing from the floss there isn't very different.

0:38:480:38:51

It might look like there's more bacteria on some slides,

0:38:530:38:56

but Chloe says there's actually very little difference

0:38:560:38:58

in the number of bacteria. They've just clumped together differently.

0:38:580:39:01

So, even though our sample was small,

0:39:020:39:04

the results seem to back up those scientific studies.

0:39:040:39:08

So, looking at these, would you say there's any benefit in flossing?

0:39:100:39:14

Looking at these results, it's very hard to see a benefit of flossing.

0:39:140:39:17

But that doesn't mean there isn't a benefit of flossing.

0:39:170:39:21

What you can see, OK, there's not a lot of difference,

0:39:210:39:23

but you can see there's a lot of bacteria there.

0:39:230:39:26

So, by that short amount of flossing,

0:39:260:39:28

you were able to dislodge a lot of bacteria from between your teeth.

0:39:280:39:33

Flossing can dislodge bacteria and food.

0:39:330:39:36

Food, if staying between your teeth, gets digested by the bacteria

0:39:360:39:40

and turned into acid, that can lead to tooth decay.

0:39:400:39:43

So, the most bacteria that you can remove from your mouth, the better.

0:39:430:39:47

So, in my opinion, flossing is still very important.

0:39:470:39:50

But, as Professor Damien Walmsley told me earlier,

0:39:500:39:53

flossing isn't the only way to get that bacteria

0:39:530:39:56

from between our teeth.

0:39:560:39:58

When we took the floss samples from the choir last week,

0:39:590:40:02

we just asked them to floss on their upper jaw,

0:40:020:40:04

and gave them interdental brushes for their lower jaws.

0:40:040:40:07

It's much better, I'm enjoying this, yeah..

0:40:080:40:10

Fab!

0:40:100:40:12

When Chloe tested the brushes,

0:40:130:40:15

she discovered they remove far more bacteria than flossing.

0:40:150:40:19

You removed more bacteria and more food from between your teeth

0:40:200:40:24

with the interdental brushes.

0:40:240:40:25

On average, there were about ten times more bacterial cells

0:40:250:40:28

than there were with the flossing.

0:40:280:40:30

And you might expect that because they're bigger.

0:40:300:40:33

So, if our flossers had used those interdental brushes instead,

0:40:330:40:36

there could have been a big difference between them

0:40:360:40:39

-and the non-users.

-Would you say, then,

0:40:390:40:42

from the differences between the floss and the interdental,

0:40:420:40:45

there might be some advantages in using both?

0:40:450:40:47

Yeah, absolutely. Dentists often suggest that you use both.

0:40:470:40:53

One thing that they do have a look at

0:40:530:40:55

is the architecture of your mouth.

0:40:550:40:57

So, some people will have large gaps

0:40:570:41:00

in between some of their teeth

0:41:000:41:02

in which the flossing doesn't really do very much.

0:41:020:41:06

Other people have very tightly packed teeth,

0:41:060:41:08

and they're not going to get an interdental brush anywhere.

0:41:080:41:10

And so, for those people, flossing's more important.

0:41:100:41:13

Do any of you that don't floss,

0:41:130:41:15

are you considering that you might pick up flossing now,

0:41:150:41:18

after seeing those results?

0:41:180:41:20

Not the flossing.

0:41:200:41:22

Because, having experienced them both,

0:41:220:41:24

the interdental brushes were a lot less unpleasant.

0:41:240:41:27

So, how about you? What do you think?

0:41:270:41:29

Well, I've always flossed regularly.

0:41:290:41:31

Never been a fan of the interdental brushes,

0:41:310:41:33

I've always found them really uncomfortable.

0:41:330:41:35

But, I think, seeing these results,

0:41:350:41:37

I definitely see the benefit of using them, and that'll be something

0:41:370:41:40

I'll bring into my dental hygiene. Definitely.

0:41:400:41:42

'So, while it might not be time to toss the floss just yet,

0:41:420:41:46

'it is astonishing that the flossers' teeth

0:41:460:41:48

'didn't have fewer bacteria

0:41:480:41:50

'than those who have never flossed at all.'

0:41:500:41:53

Thank you so much for your help.

0:41:540:41:55

With amazing voices like that,

0:41:550:41:57

I'm sure, whether you're a flosser or not,

0:41:570:42:00

you will have happy teeth and gums.

0:42:000:42:02

Any chance of a little chorus when I leave, though?

0:42:020:42:05

-ALL:

-Yes.

0:42:050:42:07

Three, four.

0:42:070:42:08

# Alleluia! #

0:42:080:42:20

I think it was really reassuring to hear that,

0:42:240:42:27

when it comes to almost all of the claims

0:42:270:42:29

that are made about aspirin,

0:42:290:42:31

-you really can believe what you read.

-It is.

0:42:310:42:35

If only the claims they made about aloe vera were true,

0:42:350:42:37

-we'd have a couple of miracles on our hands, I think, Angela!

-Yes!

0:42:370:42:40

Unfortunately, though, that's where we have to leave it for today.

0:42:400:42:42

But we'll be back very soon to debunk some more headlines.

0:42:420:42:45

-But, until then, thank you very much for joining us. Bye-bye.

-Bye-bye.

0:42:450:42:49

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