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When it comes to our health,
it seems everyone has an opinion and everyone has an agenda.
So what's the health advice you can really trust?
We're here to weigh up the evidence
and use our expertise to guide you...
..through the contradictions and the confusions.
We do the research no-one else has done...
..and put your health at the heart of what we do...
..to ensure you get the information you need.
We're here when you want to know the latest findings
and not just the latest fads.
I'm Michael Mosley. In this series
I'm joined by a team of doctors.
Together, we'll cut through the hype,
the headlines and the health claims.
This is Trust Me I'm A Doctor.
Hello and welcome to a special summer edition
of Trust Me I'm A Doctor.
We're here to get you ready for some sun.
As the sun comes out, or you jet off to find some,
we'll find out just how cheap a pair of sunglasses can be
and still protect your eyes.
How much sun cream we really need.
-Oh, my God.
-It's like war paint.
-I haven't seen that before.
Why enjoying a summer hot tub could be better for us than a workout.
I didn't know any of this stuff before we started
and I thought I knew quite a lot.
How to save lives when there's a heat wave.
Does peeing on a jellyfish sting really work?
And throughout the programme,
I'll be on a particularly energetic mission.
A few more seconds. Nice and high.
# In the summertime when the weather is hot... #
As a medical journalist, I'm always interested in investigating
unusual claims, particularly around health and exercise.
Now, we all know that exercise is good for us
but on a hot summer's day,
do you really want to go out and get hot and sweaty?
We'll be looking at ways you can get the benefits of exercise
without actually doing exercise.
More on that later in the programme.
But first, over to Dr Saleyha Ahsan.
It's in summer that we ditch the layers
and feel most aware of our wobbly bits
and some bits seem to wobble more than others.
If you could slim down and trim down any body part,
which one would it be?
Probably my tummy.
And it's not just about how it looks.
Fat around the tummy is a health issue.
A larger waistline is usually the result of two types of fat -
one is subcutaneous fats
and that's the inch you can pinch under your skin.
The second is visceral fat.
Now, that lies hidden deep within the abdomen
and surrounds vital organs.
Body scans have shown me that I myself have too much visceral fat.
Oh, my God, that's pretty revolting.
All that white stuff in the scan image is fat and it's bad news -
linked to high blood pressure, heart disease and Type 2 diabetes.
So, what can we do about it?
On the internet there are countless quick fixes
that promise to target belly fat.
We all love the idea of a simple trick
that will melt away the spare tyre around our middle
with little effort, but is this really possible?
We're going to find out.
Here at the University of Oxford, we've gathered 35 volunteers
with unhealthy waistlines.
Since I turned 40,
I've been putting on weight predominantly on my belly.
Having had two children I have quite a nice wobbly belly,
so if I could do something about that, that would be brilliant.
We've got two experts with two different ideas
about how to target belly fat.
Diet or exercise?
We've asked each of them to design their own fat-busting programmes
and also to choose one of the most popular internet methods
where there is some scientific reason
to think it might have an effect.
Fredrik Karpe is professor of metabolic medicine
at the University of Oxford.
Fredrik's first group are going to test his own method
that involves simply eating less.
They'll get advice on portion-size control and healthy eating.
They won't change the foods they eat,
they'll simply reduce the amount of each
to a portion no bigger than their fist...
and cut out snacking.
Fredrik thinks that as they lose weight,
the first to go will be the dangerous visceral fat.
The visceral fat has a higher turnover.
If you put on weight, you put it there first.
If you lose weight, you lose it from there first.
His second group will try his chosen internet fad,
adding a daily dose of milk to their diet.
Three glasses of semi-skimmed milk a day.
That's almost a litre a day in total.
Eugh! So, how could this possibly work?
One explanation is that milk has components in it
that will reduce some uptake of the milk fat.
One component of milk, calcium,
has been thought to help stop you absorbing fat from your food
but will it in our experiment?
Our other expert,
Professor Dylan Thompson at the University of Bath,
thinks it's all about exercise.
He also has two groups.
For one, he's designed a programme of light activity.
He's given them simple lifestyle changes to make them more active
and to increase their daily step count.
Just integrating a bit more activity in their daily lives
and using step monitors should help them burn more calories.
That energy will have to come from somewhere
and Dylan thinks it might come out of belly fat.
Some early research seemed to indicate
that when you created an energy deficit through exercise
that you lost weight and fat,
in particular from the visceral compartment.
Dylan's getting his second group to try another of the internet's
favourite tummy-targeting tricks, sit-ups.
They've been given a daily ten-minute ab workout.
It's probably the world's most popular idea
for getting rid of belly fat but does it actually work?
We might expect to see that group improving their fitness
but whether they actually lose any weight around their tummy
is of course a very, very different question.
So for six weeks our four groups slog it out
on their different fat-busting regimes.
And when measuring everyone's waistlines,
as well as other markers of health, like the levels of cholesterol,
sugar and unhealthy fats in their blood.
Most importantly, we're scanning their bodies
to see if they manage to reduce their belly fat
and we'll be back for the results later in the programme.
In summer the sun is obviously at its strongest
and that has its dangers.
So how do you go about really protecting yourself?
Over to Dr Chris van Tulleken.
In addition to making me look undeniably cool, dashing
and mysterious, these sunglasses also serve to protect my eyes
from the sun's damaging ultraviolet radiation,
specifically those UVA and UVB rays,
which can cause cataracts, macular degeneration,
cancer and even sunburn of the eyes.
But with prices ranging from several hundred pounds
to a few hundred pence,
how low can you go and still get glasses that protect you?
To properly protect your eyes,
sunglasses need to block 99 to 100% of UV light.
So, I'm hitting the streets of London to test a selection
of the sunglasses members of the public are wearing.
I'm using a spectrophotometer,
a device that can measure how much UV light
is actually getting through the lens.
This graph shows us the range of wavelengths of light
that are currently hitting the sensor.
With dangerous ultraviolet on the left.
Now to test some glasses.
First up, one of the more expensive brands.
They're the real thing, you think?
And if we put the probe...
It blocks it completely.
-You can keep wearing them.
-They're the real deal.
-I won't throw them in the river.
All the expensive glasses we tested worked well.
But what about mid-range shades?
Now, are these the real deal
-or are these £2 fakes you bought on holiday?
-No, they're like 15 quid.
-OK, so they should work.
-I'll put that on and these take it right down to 0.
-You can keep them. They're working really well.
-You can take them on holiday anywhere in the world.
So these sunglasses, they're British high street.
-Are these going to work?
-Probably not. They might.
And it gets rid of almost all of it, so they work very nicely.
-Look at that. Perfect.
-I think these will protect your eyes
-Thank you very much indeed.
Luckily, British and European standards on sunglasses
are really strict and insist that they block 99 to 100%
of UV light. So, if you're buying them here,
all you have to do is make sure that they've got
the appropriate markings.
In our tests, even the cheapest pairs
turned out to offer enough protection.
So how much did these cost?
£1.50? OK, so, £1.50 and they block ultraviolet light very nicely.
It goes right down to the bottom.
So, I would say blocking nearly 100%.
Good, I can keep my heart sunnies, then?
You can, yeah. They're lovely. They look great. Let's see them on.
-There you go.
-A bargain for £1.50.
# Go get yourself some cheap sunglasses. #
So sunglasses with good protection don't have to come at a hefty price.
But remember, if you bought them online
or as fakes abroad on holiday last year,
they may not be made to the same standards.
This pair that we bought from an online auction site
failed to block all of the UV light.
But let's be honest, even UK regulations can't protect us
from being victims of our own fashion sense.
When I buy my shades, style is everything.
But it has a bigger role in protecting our eyes
than we might think.
Researchers have tested all sorts of different shapes of sunglasses
to measure how effectively they stop UV rays reaching the eye.
The researchers found that glasses that sit far away from the face
let in more ultraviolet light around the edges.
And fans of John Lennon will be disappointed,
if not surprised to hear, that small glasses offer less protection
than large ones, which protect the delicate skin around the eyes.
The best protection of all is of course afforded
by wraparound lenses, so perhaps Bono was onto something after all.
Next time you're buying a pair of sunglasses,
think about the design and don't forget to check the label.
Good protection needn't be expensive.
You can look as cool as me for just a few quid.
# Somewhere beyond the sea. #
Like surgeon Gabriel Weston,
millions of us will be hitting the beach this summer.
But there's a threat lurking under the water.
Around 150 million jellyfish stings occur worldwide every year.
Jellyfish are increasingly common in UK waters
and peak in July and August.
Their tentacles are covered in harpoon-like structures,
which are full of venom.
When they're touched, the venom shoots out
faster than the blink of an eye.
Fortunately, most jellyfish stings are minor
but they can still be really painful
and the advice on what to do about them is confusing
or even contradictory.
But now researchers in Hawaii have done a set of experiments
with some volunteers willing to be stung for science.
So we finally have a definitive list of dos and don'ts.
First, don't panic.
You can actually stop any tentacles still on your skin
from doing more damage by splashing them with vinegar.
The research showed that this stops them releasing more venom.
But this won't do anything for the pain.
For that, the researchers tested some popular remedies
with no success.
Alcohol made the stingers fire even more venom
and putting Epsom salts on the skin seem to make the effects worse.
But what about one of the most infamous suggestions,
to pee on the affected area?
I'm glad to say this isn't recommended
and not just because doing so is a bit...impractical.
Urine gave no benefits at all in experiments,
at least not to the person being peed on.
So what should you do to relieve the pain?
It turns out that jellyfish venom is broken down by heat.
So, if you're stung, apply a heat pack or soak in hot water.
Once the venom has been broken down, it will stop causing you pain
and to break it down fully,
the researchers recommend you keep it hot for half an hour.
If you can get your hands on a hot drink,
that would probably be the right temperature.
Well, I must say that's a relief.
No need to get someone to pee on you,
just find yourself a nice hot cup of tea instead.
# Happy we'll be beyond the sea
# And never... #
MUSIC: In The Summertime By Mungo Jerry
When the sun comes out we're much more likely
to want to go outside and do exercise.
Now, some people do it because they want to get fitter
and most of us just want to get a little bit healthier.
But exactly what difference does physical activity really make
to our health?
To answer that, we've invited someone far more enthusiastic
about exercise than me, GP and fitness fan Dr Zoe Williams.
As a doctor, I'm constantly advising my patients
that being more active will improve their health
but I've never done an experiment to see what actually happens.
If you or I, as an individual, were to change our activity levels,
would that have an impact on our health?
And if so, how long would it take?
Actually, this is an experiment that Dr Matt Cox, here in Liverpool,
has always wanted to do.
So we've gathered a group of 13 volunteers
and before they start our experiment
we're putting them through a barrage of tests to get some basic measures
of how healthy their bodies are.
From the state of their hearts and muscles,
to the levels of sugar and fat in their blood.
Now, we want to find out exactly what changes in their bodies
when they change their activity levels.
The government recommends we all walk 10,000 steps a day
to stay healthy but the average Brit does far less than this, just 3,000.
So, for the next ten days
that's what our volunteers will be limited to.
That means no gym, no sports, no stairs.
Doing so little is harder than it sounds when you're not used to it.
So, what did you have to do in order to really bring that step rate down?
Drive to work, walk around as little as possible at work,
drive home, sit down and even that was coming up to 2,000 minimum.
I'm quite an active person, so ten days of reduced activity
was quite difficult.
Now, we're repeating all the tests to see what aspects of their health
have changed during ten days of just 3,000 steps a day.
We then asked the volunteers to increase
their physical activity levels.
So get off the sofa, take the stairs, walk to work,
maybe even go to the gym or go for a swim.
We made sure they all did exercise equivalent to the government's
recommended 10,000 steps a day.
It's a figure that people all over the world use as a target
but there's surprisingly little research behind it.
Will it make any differences to their health in just ten days?
To find out, we've repeated all the same tests a third and final time.
And now Matt's compared all the results,
he's found that two key measures of health have changed,
even in the short period of our experiment.
So, the first one was aerobic capacity -
how well they can use their heart, their lungs and their blood vessels
to get oxygen from the air into their muscles that are working.
This is what we all think exercise does for us,
feeling fitter and getting less out of breath
but this aerobic capacity is also a good indicator of health
and even how long you might live.
After just ten days of relative inactivity,
some volunteers' readings fell by 15%.
But after ten days of doing 10,000 steps,
they were back up and on the road to recovery.
Matt, though, found something else that changed in our volunteers
that many people would find more surprising.
Interestingly, we also saw that they became poor at controlling
their blood sugar and people might not expect this,
particularly in such a short period of time.
Tiny monitors allowed Matt to measure the volunteers'
blood sugar levels every few minutes.
Sugar levels spike every time we eat
and the graph shows this happening in response to eating breakfast,
lunch and dinner.
Our ability to control blood sugar levels is key to good health.
So, the main thing that we saw
was that once they'd done the inactivity,
but particularly their ability to control their sugar levels
-after dinner was worse.
So, what we can see in the graph is that the red one is there...
is after the inactivity.
So we can see that not only does our blood sugar go higher
but also it stays elevated for a much longer period of time.
OK, so after that period of inactivity,
you would see these peaks going higher
-and taking longer to come back down?
If this got worse,
we'd see that this person's risk of getting diabetes would be increased.
But after ten days of doing 10,000 steps,
their blood sugar control had improved.
So, our experiment has revealed that if you're not so active
and you start doing 10,000 steps a day,
it can bring you two key benefits.
As you might expect, it'll improve your heart and lung health
but more surprisingly,
it'll improve your blood sugar control and all in a matter of days.
It can get very tedious constantly being told that exercise
is good for you and people often ask how much is enough.
So, how can you know whether what you're doing is enough
to be healthy?
Well, a simple measure of your pulse can give you a rough guide.
Dozens of studies have found a link between a high heart rate
and dying early.
You need to measure it when you're at rest, so that's when you've been
sitting still for a good five to ten minutes.
Use a watch to count your beats per minute.
Research has shown that if your resting heart rate
is high, that's 80 beats per minute or above,
then you're at increased risk of early death
in comparison to somebody with a lower heart rate.
If yours is about 60 beats per minute or below,
then whatever you're doing, you're doing something right.
Either that or you're just very lucky.
If your pulse is on the high side,
then the government advice of 10,000 steps a day
could help bring it down.
But not all of us have the time, motivation
or are physically able to do that amount of exercise.
So, are there other ways we can get the same benefits
without putting in the hours?
I want to see if there are a few simple and easy things I can do,
which will give me the benefits of exercise
without actually having to do exercise.
And so, throughout this programme
I'm going to test three surprising new theories.
And I think I'm off to a pretty good start.
Now, we all know there are health benefits to be had
from getting hot and sweaty on a treadmill
or perhaps an exercise bike.
But are there benefits to be had from simply getting hot
in a bath or a sauna?
Dr Steve Faulkner from Loughborough University
certainly thinks so.
-Hi, Michael. Nice to meet you.
Now, I used to have lots of hot baths when I was young
and then I gave it up and I moved to showers,
partly because it was more convenient
but partly because I was actually a bit worried
-that all that heat was bad for me.
So, is there evidence that heat is actually good?
There was a very big study done last year that came out of Finland
where they showed that increased rates of sauna use
in the wider population actually resulted in a reduction
in markers of cardiovascular disease risk
but also overall cause of mortality.
It sounds almost too good to be true.
Could the Scandinavians be on to something with hot tubs and saunas?
To find out, we've recruited a small group of volunteers and me,
to put it to a scientific test.
Although the tubs used by scientists
turn out to be a little less glamorous.
But it's here we'll find out whether just a hot bath
could give us some of the same benefits as exercise.
Each of us is fitted with a monitor to measure our blood sugar levels
throughout the experiment, including mealtimes,
after which our blood sugars will peak.
Steve believes that it's the warming of our muscles
that would trigger any benefits.
Nice and relaxed for me.
So he's using a probe to measure their temperature.
It's not nice.
And the mask we're wearing will help calculate
whether we're burning more calories when we get hotter.
Then, it's bath time.
Just slide your way in.
# Splishing and splashing and wishing and rushing
# It's more fun in here than a zoo. #
Having a bath under laboratory conditions
is not quite as luxurious as I'd hoped but it beats the gym.
I could quite easily go to sleep in here.
Over the next hour, Steve and his team make sure the bathwater
stays at a toasty 40 degrees.
This is remarkably relaxing.
It's hot, though. It's hot.
As well as keeping a close eye on our blood sugar levels
and how many calories we're burning.
And in order to see how a hot bath compares with exercise...
ENERGETIC DANCE MUSIC
We also do an hour's sweating on a bike,
while Steve takes all the same measurements again.
# Pump it up a little more...
..a lot of number crunching later, we're going to find out...
do hot baths give any of the benefits of exercise?
And the answer's quite remarkable.
One of the first things that we were looking at is the energy expenditure
whilst you're actually in the bath
and what we found was about an 80% increase in energy expenditure
just as a result of sitting in a bath for the course of an hour.
So, just lying in a hot bath can help us burn calories...
an extra 61.
Not as many as cycling but then I could read my book.
But what about that other important measure,
our levels of blood sugar or glucose?
Where we started to see differences
is when you look at your peak glucose output.
The peak glucose is basically the amount that your glucose goes up
-after you've had a meal?
And the key thing that's important about peak glucose output
is it's one of the potential risk markers towards things like
developing Type 2 diabetes.
And what we actually found with the bath versus the exercise
is that your peak glucose was actually quite a little bit lower
compared to exercise, which was completely unexpected.
After the hour-long bath, our peak blood glucose levels were 10% lower
than after the exercise.
But why would lying in hot water give us this benefit?
I must admit, I find it very, very surprising.
I didn't know any of this stuff before I started
and I thought I knew quite a lot.
I was really, really surprised by the fact that it seemed to be
even more effective than exercise in reducing the blood sugar peaks.
One of the things that we think is it's down to these things called
heat-shock proteins that are released in response to,
as the name suggests, heat stress.
These heat-shock proteins take some of the sugar
that's in your bloodstream out of the bloodstream
and into the muscle.
Steve thinks that a hot bath keeps our muscle temperature
more consistently warm than exercise
and that this encourages the release of the beneficial
heat-shock proteins into our blood,
where they can help lower our blood sugar levels.
So, perhaps we should all get a little bit more Scandinavian
when it comes to our leisure time.
Whether it's lying back in the tub after a long day at work
or treating ourselves to the occasional sauna.
I must admit, I was really surprised by how big an effect
simply having a hot bath had on our blood sugar levels.
And I can also see that this has a lot of potential for people
who really can't exercise.
Having given up having baths about 20 years ago,
I think I might resume them again.
There are lots of things you can do in the bath
you can't do in the shower.
Still to come, can you get stronger just by thinking about it?
And we reveal what the sun really does to your skin.
Oh, my God! Oh, the freckles!
Most of us welcome the idea of a heat wave.
We know we need to slap on the suntan cream
before we go outside but very few people think about the dangers
of heatstroke or heat exhaustion, though they can affect anyone.
Dr Saleyha Ahsan has been down to the seaside
to demonstrate a few simple techniques
that could save a life.
Here in Britain, we don't get much practice at coping with hot weather,
so when we do experience a sunny spell,
we can easily overheat without even realising it.
This can lead to heat exhaustion,
which if we don't spot the warning signs,
can quickly become heatstroke.
Heatstroke is when the body loses its ability to cool itself
and the body's core temperature becomes dangerously high.
For some, it can kill within 30 minutes,
so it's vital that you know how to recognise the symptoms
and take action.
Every year in the UK there are about 2,000 heat-related deaths
but in a heat wave there can be hundreds more.
The risk is also greater in hot climates
and for those doing strenuous exercise in high temperatures.
But there are some clear warning signs to look out for.
First, you might spot symptoms of heat exhaustion.
These can include heavy sweating, rapid breathing, nausea,
a fast, weak pulse, light-headedness
and a feeling of fatigue.
You might also experience cramp in your muscles.
If you spot any of these signs in yourself or another person,
particularly on a hot day,
it's important to cool the body down as quickly as possible.
One of the key ways that our bodies keep the temperature down
is by sweating but it's essential that you allow that sweat
So, if you see someone suffering from heat exhaustion,
you can help them by removing any unnecessary clothing
and exposing as much skin as possible.
And I'm going to show this group of runners
some other simple steps you can take.
You should seek shade and drink plenty of fluids.
Fanning the skin while it's moist will also help.
I'm just going to sprinkle you with a little bit of cool water, just
onto your skin, mainly, and some of it will go on to your clothes
and that'll keep you cool.
You should also use whatever you have available to cool the skin.
Ice or cold packs are especially good.
What you do, you squeeze it together, right? Squeeze it.
Right, and then it pops like that.
And then shake it round.
Look, feel, it's gone cold already.
Putting something cold on areas where there are major blood
vessels, such as the back of the neck
or the armpits, will help cool you down quickly.
How are you feeling? Is it cooling you down still?
I might keep it on all day.
One useful tip is to put your hands in cold water.
This is amongst the fastest ways to
cool the whole body when you're hot.
Heat exhaustion itself isn't life threatening,
but it is the precursor to heatstroke.
People who succumb to heatstroke will generally look unwell.
They might have difficulty in breathing
and other major warning symptoms.
These can include...
This is a sign that the body is so dehydrated,
it can no longer produce sweat to cool itself down.
People with heatstroke will probably be irritable
and confused and not able to take action for themselves.
So, if you're with a group,
make sure you're looking after each other.
If the person is unconscious, put them in the recovery position.
And if they have a seizure, move nearby objects out of the way
to prevent injury.
And if you notice any of these symptoms,
you should call 999 as soon as possible.
Quick action really can save a life.
With rapid cooling and sufficient rehydration,
most people can survive heatstroke.
For the full list of what to look for and what to do,
visit our website at...
Earlier in the programme, I discovered that just
lying in a hot bath could give me one of the key health
benefits of exercise, helping to keep my blood sugar levels in check.
Now I'm continuing my search for ways to get my body fitter
and healthier with minimum effort.
Theory number two.
Now, it looks very unlikely, but could doing this...
..allowing yourself to be gently stretched by someone else,
give you some of the more important benefits of exercise?
# Bend me, shape me, anyway you want me
# As long as you love me... #
This might look bizarre, it's certainly lazy,
but we've come across some tantalising evidence from Hawaii
and South Korea that suggest it could actually improve your health.
Here at the University of Wolverhampton,
Dr Ian Lahart is going to help us
find out if it's true.
I can see why being stretched is very pleasant,
but why on earth should it make any difference to your health?
Well, previous research in diabetics and those at risk of diabetes seems
to suggest that being stretched
by somebody else for 20 minutes is beneficial.
It sounds very odd,
but could having your muscles stretched really make you healthier?
To find out, we've recruited ten volunteers
who are hoping that this passive stretching effect might be true,
as, for some of them, exercise is particularly difficult.
I have MS.
So energy's not always good.
The more weight you put on,
the less exercise you do.
And it's like a vicious circle, isn't it?
Time to put being stretched to the test.
All our volunteers spent 20 minutes having their limbs
stretched by our team of sports therapists.
# Ooh, baby, baby... #
As we did in our bath experiment, we're testing
three key measures that normally improve with exercise -
blood sugar levels, heart rate,
and the number of calories they're burning.
# Push it good Ah, push it... #
To see if simply being pushed and pulled around really does give us
some of the benefits of exercise, Ian's crunched the numbers.
# Pu-push it real good... #
So I don't know what the results are
and I'm as eager to find out as you are. Ian.
Well, what we found was when you stretch,
your blood glucose levels were 23% lower than when you didn't stretch.
When our volunteers weren't being
stretched, a sugary drink
raised their blood sugar
levels as you'd expect.
But when their muscles were
stretched, after having
exactly the same drink, their blood
sugar levels actually fell.
It's a very surprising result.
We found that your heart rate was 17% higher with stretching.
And we found that your energy expenditure, so the amount of
calories that you were burning, was 126% higher with the stretching.
-That's amazing. I'm really... You know.
-It's surprising, isn't it?
They burnt nearly 100 extra calories per hour,
equivalent to a stroll, simply from lying down.
Even the most hopeful on the team hadn't anticipated that.
Were you surprised by the size of this?
Yeah, I was surprised that it was a 23% improvement from doing
no stretching so, yeah, very surprising.
A similar effect to what we see during exercise.
When we exercise, our muscle cells take glucose from our blood
and use it as fuel, and this helps lower our blood sugar levels.
So in exercise, what's happening is the glucose is being
taken into the muscles to burn. What's happening in this case?
Why is the glucose going into the muscles?
Well, we think that it's
the stimulus that is caused
by the stretch, so once there's
tension on the muscle, that helps
to move a glucose transporter
from within the cell to the
surface of the cell.
And this allows more glucose to
enter into the cell.
So, simply putting some tension into our muscles causes glucose to
be pulled out of our blood and into our cells,
where it's burnt as fuel instead of doing us harm.
If you can't get out and do exercise,
this could be a real health boon.
Now, those who are likely to benefit most from passive stretching
are people who are bed-bound or perhaps just unable to do exercise.
But I like the thought that if you're at home,
perhaps you're watching the television, you can
benefit from just doing a few stretches, and by doing so,
bring your blood sugar levels down.
For six weeks, four groups of volunteers have been taking
part in our experiment in Oxford to find out
if it's possible to rid ourselves of dangerous belly fat.
Two groups have been trying diets under
instruction from Professor Fredrik Karpe.
One group are simply eating smaller portions at each meal.
A second group are trying a popular quick fix,
drinking three glasses of milk a day.
The other two groups have been doing exercise with
Professor Dylan Thompson.
His first group are on a programme increasing their
physical activity levels...
..whilst his second group are doing that famous quick fix, sit-ups.
And we've been measuring their health, their waistlines
and scanning their bodies to see what differences
the regimes have made.
Testing over, it's the moment we've all been waiting for.
Have any of our groups managed to lose any belly fat?
Dylan, what happened?
OK, so the activity group, you lost a modest amount of weight
over the six weeks, just over a kilo.
But we didn't see any change in visceral fat, the internal
abdominal fat which is the one we consider bad fat.
Although they didn't lose any fat,
those on Dylan's activity programme
became much healthier.
Their blood pressure reduced, as did
the levels of unhealthy
fat in their blood.
I didn't lose much weight, but, to be honest, with the increased
-exercise, I could actually tell at the end of the six weeks.
I felt a lot better.
So, being more active was good, but not a belly-fat buster.
But what about Dylan's chosen internet quick fix, sit ups?
The group neither lost weight nor belly fat, but on average,
their waistlines got an impressive two centimetres smaller.
Actually, what this is really telling us is that you've
improved your muscle tone, so you're able to keep your tummies in
even without trying and, as result of that, you will look and feel
better, but it hasn't been achieved through a change in fat mass.
I guess people might see it as a quick fix,
but clearly it isn't, because it hasn't really done an awful lot.
And now for Fredrik's results.
Starting with his chosen diet fat, milk.
You actually didn't lose any weight overall, there was no weight loss.
If we look at the visceral fat,
the bad fat inside your body, there was no loss there either.
So, milk didn't reduce our volunteers' belly fat,
but surprisingly, despite adding it to their normal diet,
they didn't gain any weight either, so it may have stopped them
craving other things.
Definitely reduced my appetite, the nibbling etc in the evenings.
So I thoroughly enjoyed the exercise.
And finally, what about the group who followed his
portion control programme?
So this group did very well indeed.
On average, you lost almost 4kg in body weight.
If you look at the total body fat that was lost, it was about 5%.
If we look specifically into the visceral fat,
that was 14% of that was lost.
This group also reduced
their cholesterol and blood pressure
and measured a five-centimetre
reduction in their waistlines.
-Lost two notches on my belt.
-Being able to get into clothes is amazing.
So, yeah, just overall, really happy with it all.
So it seems that when it comes to defeating belly fat,
we have a clear winner in the battle of diet versus exercise.
Whilst being more active made our volunteers healthier, the trick
to losing fat, and the bad stuff in particular, lies in how much we eat.
Surprisingly, you can target the dangerous visceral fat,
but not by any weird tricks but by the simplest answer in the book,
by eating a little less at every meal.
Now, that might not sound ground-breaking,
but the fact that we've shown you can reduce fat so quickly,
particularly the belly fat that's so bad for us, is important.
And for the extra health boost, you can combine that with exercise.
And for those who want a slim waist just for the look of it,
we've shown that sit-ups really help.
If you want help to get rid of your own muffin tops,
go to our website at...
The American poet Walt Whitman once said,
"Keep your face always to the sunshine." Is this good advice?
Now that summer's here, should I be out in the rays or, instead,
should I be slapping on the suntan lotion and keeping to the shadows?
The latest government guidelines state that we need to protect
ourselves from strong sunlight and that there is no safe way to tan.
But they also recommend some sun exposure
to build up levels of vitamin D,
which helps control the amount of calcium in your body
needed to keep your bones and teeth healthy.
So is it safest always to protect ourselves from the sun,
or is our health at greater risk from avoiding it?
How much is too much sun?
I've come here to get the views of two leading experts with very
different points of view.
First up is Dr Richard Weller,
dermatologist at the University of Edinburgh.
He thinks the benefits of being in the sun could outweigh the risks.
What's the best evidence that
sunshine might actually prolong life?
One of the biggest killers is heart disease and strokes.
You're about 100 times more likely to die of a stroke or a
heart attack than you are of skin cancer.
And there's a growing body of evidence suggesting that sunlight
reduces the risks of heart disease and stroke.
And we've shown that a substance called nitric oxide is
released from the skin when sunlight hits it, goes into the circulation
and lowers blood pressure.
Now, so far, we've just shown an effect lasting for an hour or so.
But I'm about to start a clinical trial actually
giving people with high blood pressure ultra violet
every day to see if we can lower that blood pressure permanently.
So how long should we spend in the sunshine?
I think you shouldn't get sunburnt.
-But apart from that, it's fine, is it?
-I think so.
I see no evidence for an alternative to that.
I think the important thing is that children do not get
sunburnt in childhood, because that's known to be a risk
factor for melanoma, and melanoma is the skin cancer that matters.
What's the difference between melanoma
and non-melanoma skin cancer?
So melanoma arises from melanocytes, the pigment cells of the skin.
What leads to that is quite complex.
It appears to be the intermittent sun exposure,
sunburn in particular, is a risk factor for that.
Now, 80% of patients with melanoma are cured, but 20% aren't.
So that's the skin cancer that worries us most.
There's probably about a quarter of a million non-melanoma
skin cancers a year in Britain.
The death rate is vanishingly small for them.
There is a study from Denmark.
They looked at the entire population over the age of 40,
and they found those with non-melanoma skin cancer were
less likely to be dead, and, particularly,
less likely to have had a heart attack.
So, probably, your life expectancy goes up
when you're diagnosed with a non-melanoma skin cancer.
So what do you say to patients who have a non-melanoma skin cancer?
-I congratulate them.
-Do you REALLY congratulate them?
I think a longer life span is a cause for celebration.
So I had one removed very recently on my chest.
-Should I be going away...
-You should be celebrating.
-..singing and dancing?
-Singing and dancing. Yes.
The guidelines suggest that, particularly
if you are fair-skinned, you only really need to be
out in the sunshine, roll up your sleeves, for about five minutes.
Yeah, well the NICE guidelines are all related to vitamin D production.
It's this fixation on vitamin D,
this kind of belief that all the benefits
of sunlight come from vitamin D, which clearly they don't.
So, yes, a short amount of sunshine
if you are fair-skinned might be enough for vitamin D.
What we need to be looking at, though, it's not vitamin D,
but death, life and health.
So, for Dr Weller, the benefits outweigh the risks.
A controversial view, but is he right?
Charlotte Proby is Professor of Dermatology
at the University of Dundee.
She thinks the guidelines on sun protection don't go far enough.
Now, Richard feels that we shouldn't worry too much
about non-melanoma skin cancers,
that you can just kind of cut them out, remove them
and they're a marker for the fact that you have been exposed to
lots of sun, and that's a good thing. What do you make of that?
Well, I don't think Richard has my patients.
I think they would disagree with him.
I see patients who are getting two or three skin cancers a year
and, believe me, you would avoid getting one of those
aggressive non-melanoma skin cancers if you possibly could.
What about Richard's claim that being exposed to sunlight
lowers your blood pressure and, therefore,
may reduce your risk of heart disease and stroke?
If it was truly a big factor,
you would expect that parts of the world like Australia would
have very much less cardiovascular death than you see in other
parts where they don't have so much sun.
He argues that life expectancy is three years greater in Australians
than in people in Scotland, two years greater than people in the UK.
Well, again, there are huge confounders.
Australians are out doing a lot more exercise, and I think exercise is
the main factor and diet, perhaps, in their cardiovascular risk.
Presumably, the main benefits from sunshine,
as far as you're concerned,
come from vitamin D, plus, perhaps, a little bit of mood boosting.
-How long would you need to do it for?
-If you're fair,
you only need to be out for a relatively short time,
somewhere between five
and 15 minutes in the middle of the day if you've got a fairly
large skin area that's exposed is plenty to make your vitamin D.
And if you stay out in the sun, having made your maximum
vitamin D, all that happens is you break it down again.
-Right, so it actually goes down after a period of time.
So, is there such a thing as a safe tan?
Well, there isn't, unless you have a dark skin.
So you need to know your skin type.
If you are fair, and particularly if you get freckles or you burn,
then you're damaging your skin,
and that the freckles are a sign of damage, not a sign of a tan.
So when do you start using some protection?
I put my sunblock on every day from mid-to-late March,
certainly by the time the clocks have changed,
and I would wear it every day, rain or shine, throughout the summer
until about the end of September.
And I always advocate to go for the big numbers, 45 or 50,
particularly as that helps with the anti-ageing.
So, there you have it, experts with very different points of view.
Now, where my experts would absolutely agree, is it
is a really bad idea to get burnt, particularly if you are a child.
As you can probably tell,
I'm not that worried about getting a tan
and I cannot imagine slapping on the suntan lotion throughout
the spring and summer months,
but I think in future I will take a little bit more care of my skin.
# Ooh, it was the sunshine
# Is she making sunshine... #
It's clear we need to take care of our skin in the sun,
but it can be all too easy to get carried away on our summer
holidays and let our skin burn, especially if we go abroad.
As a skin cancer surgeon, I spend the majority of my time
in the operating theatre, cutting out skin cancers.
So even though I love a beautiful day as much as the next person,
when I'm on a beach like this, and I can see people sunbathing
until they go bright red, it makes me really, really twitchy.
In the sun, our body tries to defend itself from harmful
ultraviolet radiation by producing a pigment called melanin
that absorbs the UV.
Melanin is what makes us go brown.
But when we expose our skin to more UV than our melanin can handle,
we end up with sunburn,
and that's when the dangers of the sun outweigh the benefits.
In fact, if you've had any sunburn at all,
you have doubled the risk of melanoma which is the most
deadly skin cancer, and that risk only increases with
every episode of sunburn that you allow yourself to get.
If your skin is damaged by the sun,
one sign you might see is freckles, permanent changes that occur
when the skin tries to protect itself by producing more melanin.
But even if you think you're freckle-free, you probably aren't.
I've got a camera that can highlight damage that isn't
obvious to the naked eye.
To me, you have lovely fair skin, I can't see much sun damage,
-but have a look in here and tell me what you think.
Oh, my God, all the freckles.
The camera can detect ultraviolet light
and reveals previously invisible dark spots where your skin has
produced more melanin to absorb UV.
These spots aren't harmful in themselves,
but they are a sign that your skin is being exposed to
a level of UV that will damage it in other ways, ageing it
and ultimately, if you let yourself burn,
putting you at higher risk of skin cancer.
-So what do you think? How do you feel when you see that?
Does it make you want to be a bit more careful about how
you are out in the sun?
Absolutely. Yeah, yeah.
The good news is it's estimated that 86% of skin
cancers could be prevented
if we all took some simple steps to look after our skin.
So you've had that scary look in our camera there.
I'm going to give you some sun cream now and I just want you to
put some on your face and have a look and tell me what you can see.
-Oh, my God.
-It's like war paint.
-I haven't seen that before.
It's amazing, isn't it?
Sun creams are designed to absorb UV rays very efficiently,
as our camera reveals.
The blacker it looks on the camera, the more UV it's absorbing.
Whatever it was that you had on before you did this
was definitely not enough when you see now what amazing
-kind of protection that's giving you.
-Look at that.
-It looks like you've got a mud mask on.
-It really does.
When you are choosing a cream, the sun protection factor or SPF
tells you how much longer you can spend in the sun before you'll burn.
So if you naturally burn in, say, ten minutes,
then SPF 15 should keep you safe for 150 minutes.
But you do need to slather it on.
There's evidence that if you use it sparingly,
you might only get a third of the protection promised on the label.
You should also remember to reapply sun cream after getting wet.
Although sun creams claim to be water resistant,
this does not mean they are waterproof.
Preventing sunburn is the only sure-fire way
of protecting against skin damage and most skin cancers.
So if you are going out on a hot day, cover up,
slap on plenty of sunscreen and enjoy the sun safely.
Now, I do plenty of exercise, but to be honest,
I do it because I think it's good for me, not because I enjoy it.
And that's why I'm always on the lookout for little cheats,
ways of getting the benefits of exercise without having to
put in all that effort.
Already in this programme,
I've discovered the health benefits of hot baths
and having my muscles stretched.
Now for my final fling.
I might just have found the laziest get fit alternative of them all.
How about not doing anything physical,
just using your imagination instead?
Well, some intriguing research from the field of neuroscience
suggests that simply imagining ourselves doing exercise
could make our muscles stronger.
It's called motor imagery, apparently.
Now, this one really does seem very unlikely.
How can simply thinking about doing exercise make you stronger?
Time to do a test.
We recruited seven Trust Me
viewers who admit their muscles could do with a bit of a workout.
I don't do very much activity at all.
Very little exercise during the week.
I try and avoid it if I can help it.
I'm afraid I've got very lazy in my old age.
Push, push, push, push, push...
We're going to see whether their muscles can get stronger
simply by thinking about exercising them.
Professor Tony Kay
at the University of Northampton starts off by testing how
strong their calf muscles are before the experiment begins
by making them push a heavy plate as hard as they can.
Then he uses ultrasound to measure the size of their muscles.
His final test is to zap them with an electrical impulse.
This allows Tony to measure how
-much of their muscles our volunteers are actually using.
Tony suspects they have muscle fibres they're not making
the most of at the moment.
Now Tony needs to teach them their key activity over the next month.
How to really convincingly think about doing exercise.
And he's going to get them to think about the pushing exercise
they have just done every day to see whether this makes them stronger.
It's not just about picturing yourself in the chair
and seeing your foot and seeing the force trace,
it's also about the sensation of the brace against your ankle.
And Tony is putting them on a pretty strict daily thinking schedule.
Each session will be about 15 minutes.
And there'll be 50 contractions in those 15 minutes.
Over the next four weeks, they maintain their gruelling
strength training regime...
..with the distinct advantage that they
can do it from the comfort of their own beds.
After a month, they're back to repeat all the tests
they did at the start.
Have their calf muscles got stronger just by imagining exercise?
OK, so what were the results?
OK, well, the primary result was that we did improve our strength.
As a group, you increased your strength by approximately 8%.
-Are you surprised by the outcome? ALL:
Very surprised, but very pleased.
So, on average, the whole group got 8% stronger.
And one volunteer managed a whopping 33% increase.
It's an extraordinary result, but what's the explanation?
Well, Tony's measurements show that their muscles weren't bigger,
so they certainly haven't grown more muscle.
-ELECTRIC SHOCK ZAPS
But the electrical stimulation test gave the answer.
These results showed, by the end of the month of thinking,
our volunteers were simply using
more of the muscle fibres they already had.
What we showed was an increase of approximately 20%
in our ability to activate the muscle.
Our volunteers had gone from using
just 50% of their muscle fibres to 70%.
So how can mental imagery produce these sort of physical effects?
The mental imagery is a rehearsal of the skill,
so you're better at recruiting the muscles in an orderly fashion
so that we can activate a larger percentage of the muscle,
and that then produces more force and we become stronger.
OK, so when it comes to exercise, it is the thought that counts.
Motor imagery helps us use our muscles more efficiently.
It's already used by top athletes, but it could be useful for those who
are injured or cannot do physical activity, to avoid losing strength.
Now, I was surprised by the size of the effect
and I think I'll probably give it a go.
After all, one of the main advantages of doing this is
that if anyone catches you with your eyes shut, you can
always say, "I'm actually doing a strenuous workout."
Go to our website at...
..to hear Tony's audio guides
to help think yourself stronger.
That's it from us.
We'll be back soon with a new series
when we'll be asking,
"Does glucosamine really help our joints?"
And, "Which is sweatier,
"natural or synthetic fabric?"
# Doctor, I want you
# Mmm, my Doctor Wanna Do
# I can't get over you
# Dr, do anything that ya wanna do
# Doctor, I want you
# Mmm, my Doctor Wanna Do
# I can't get over you
# Dr, do anything that ya wanna do... #
As the sun comes out (or not!) the doctors are back doing science research on our behalf. While we prepare to bare our bodies on the beach, Dr Saleyha Ahsan and the University of Oxford test whether it is really possible to bust belly fat, and skin surgeon Gabriel Weston takes a special camera on the streets to see how protective sun cream actually is. Dr Chris van Tulleken tests how cheap a pair of sunglasses we can buy and still be assured protection from damaging UV light. And as the warmer weather tempts more of us to do some exercise, GP Zoe Williams makes a guest appearance to test what it's really doing for our health, whilst Michael Mosley investigates some surprising ways to get the benefits of exercise without doing any at all.