Episode 3

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0:00:04 > 0:00:08We are constantly being told how to improve our lives.

0:00:08 > 0:00:11Every day, we are bombarded by health claims -

0:00:11 > 0:00:15how to get fit, slim down, look young.

0:00:16 > 0:00:19But all too often, that advice can be confusing...

0:00:21 > 0:00:24..contradictory.

0:00:26 > 0:00:30So, how do you know what's best for you?

0:00:31 > 0:00:36I'm Michael Mosley. In this series, I'm joined by a team of doctors.

0:00:36 > 0:00:41Together, we'll use our expertise to cut through the confusing adverts,

0:00:41 > 0:00:43headlines and health claims.

0:00:43 > 0:00:47This is Trust Me I'm A Doctor.

0:00:51 > 0:00:55We're in Lancaster, to do a fascinating experiment

0:00:55 > 0:00:58to see if planting trees can make us healthier.

0:00:58 > 0:01:02Could there be a new and unlikely-sounding way to treat migraines?

0:01:02 > 0:01:05Can I have a glass of your house red, please?

0:01:07 > 0:01:11What is the truth about the risks of hormone replacement therapy?

0:01:11 > 0:01:12That's what he said! It doubles it!

0:01:12 > 0:01:16- He did, he said it. - I can tell you, it is not true.

0:01:17 > 0:01:20Are smoothies really good for you?

0:01:20 > 0:01:23And is coffee really bad for you?

0:01:23 > 0:01:27But first, probiotics, those yoghurty health drinks...

0:01:27 > 0:01:29Now, it's claimed they will improve your gut,

0:01:29 > 0:01:31your immune system, all sorts of things,

0:01:31 > 0:01:33but do they?

0:01:34 > 0:01:38Dr Chris van Tulleken is in search of the truth.

0:01:42 > 0:01:44Every year in the UK,

0:01:44 > 0:01:48we spend three-quarters of a billion pounds on probiotic products,

0:01:48 > 0:01:53full of live bacteria which we hope will do us some good.

0:01:53 > 0:01:57- What have you bought that has got probiotics in it?- The Activia.

0:01:57 > 0:02:01- Did you buy the Activia because it's got probiotics in it? - That was one of the reasons, yes.

0:02:01 > 0:02:02I mean, they're not for me.

0:02:02 > 0:02:06- How long have you been taking them? - Six or seven years maybe.

0:02:06 > 0:02:08What do you think they do for you?

0:02:08 > 0:02:11It puts healthy bugs in, instead of all the horrible stuff going around here.

0:02:11 > 0:02:15- So, for you, it's about a healthy gut?- Yes.

0:02:17 > 0:02:19The idea of probiotics

0:02:19 > 0:02:23is that they add specially cultured live bacteria to your gut.

0:02:23 > 0:02:27Every one of these products contains a different magic ingredient.

0:02:27 > 0:02:29Yakult has Lactobacillus casei Shirota,

0:02:29 > 0:02:31named after the man who developed it.

0:02:31 > 0:02:34Actimel has another Lactobacillus in it.

0:02:34 > 0:02:38The Activia contains Bifidus Regularis.

0:02:38 > 0:02:41The choice is overwhelming. But do they really work?

0:02:41 > 0:02:46Is a simple dose of daily bacteria all we need to keep our gut healthy?

0:02:48 > 0:02:50You probably remember the old adverts

0:02:50 > 0:02:52claiming science is on their side.

0:02:52 > 0:02:57It's scientifically proven to support your body's defences.

0:02:58 > 0:03:02Now, here comes the science - the real science.

0:03:02 > 0:03:04Your gut is full of all sorts of bugs,

0:03:04 > 0:03:08including 100 trillion bacteria.

0:03:09 > 0:03:12And you have your own, personal, complex mix.

0:03:13 > 0:03:17They help you absorb nutrients from food, metabolise drugs,

0:03:17 > 0:03:20and they are also in constant contact with your immune system,

0:03:20 > 0:03:23teaching it what is and isn't a threat.

0:03:25 > 0:03:29Probiotics are supposed to add more of these useful bacteria.

0:03:29 > 0:03:33But do they? And what effect do they have?

0:03:33 > 0:03:39Gut specialist James Kinross at Imperial College London has been studying the evidence.

0:03:39 > 0:03:42Probiotics, whilst you take them, will remain within the system.

0:03:42 > 0:03:46But when you stop taking them, they get flushed out.

0:03:46 > 0:03:50So, er, if you can get it to work,

0:03:50 > 0:03:52it will only work for the duration that you take it,

0:03:52 > 0:03:56and there's no guarantee that it will work in the same way between two different people,

0:03:56 > 0:03:59because we have different species of bacteria.

0:03:59 > 0:04:04Is there any evidence that probiotics just generally make you healthier, even if you're not ill?

0:04:04 > 0:04:09There's very little evidence that it's going to make you live longer or generically be healthier.

0:04:09 > 0:04:11- Do you ever take them? - I don't, actually, no,

0:04:11 > 0:04:15but I would if I had diarrhoea or irritable bowel syndrome,

0:04:15 > 0:04:19and I'd tell my patients to take them in specific circumstances.

0:04:19 > 0:04:22But I don't take them every day, because I don't believe

0:04:22 > 0:04:24it'll make a difference to my long-term health.

0:04:26 > 0:04:29In fact, the European Food Safety Authority agrees

0:04:29 > 0:04:31that there's simply not enough evidence

0:04:31 > 0:04:35to allow commercial probiotic companies to make the health claims they used to.

0:04:35 > 0:04:39These companies have now changed their advertising.

0:04:41 > 0:04:45Danone, who make Activia and Actimel, and Yakult,

0:04:45 > 0:04:49say they stand by their health claims but comply with the law in EU.

0:04:49 > 0:04:52They say their claims are backed by years of research

0:04:52 > 0:04:55and are approved in many other countries.

0:04:55 > 0:04:59But I've heard of a new line of research in this area.

0:04:59 > 0:05:02What if I said there was an alternative to probiotics,

0:05:02 > 0:05:04that something as simple as eating a bag of oats

0:05:04 > 0:05:07could have a really beneficial effect on the health of your gut?

0:05:07 > 0:05:10A bag like this costs less than a pound,

0:05:10 > 0:05:11it'll last me all week,

0:05:11 > 0:05:14I think it's worth putting to the test.

0:05:14 > 0:05:18This is a new, and considerably cheaper, approach.

0:05:19 > 0:05:21The concept is simple.

0:05:21 > 0:05:23Instead of trying to add more bacteria to our guts,

0:05:23 > 0:05:26just give the ones we all already have a bit more food.

0:05:26 > 0:05:30It seems like some of the bacteria that are really good for us

0:05:30 > 0:05:32thrive on oats.

0:05:32 > 0:05:35So that's what I'm going to feed them -

0:05:35 > 0:05:39100g a day, every day, for four weeks.

0:05:41 > 0:05:45Runny oats, thick oats,

0:05:45 > 0:05:48oats with sugar, oats with salt...

0:05:49 > 0:05:53I just hope my gut bacteria are appreciating all of this.

0:05:59 > 0:06:02To find out, I've also been sending samples of my faeces

0:06:02 > 0:06:06to some lucky researchers at the Rowett Institute in Aberdeen.

0:06:06 > 0:06:10They've been carrying out DNA analysis on my poo samples

0:06:10 > 0:06:14to see what effect the oats have had on the bacteria in my gut.

0:06:14 > 0:06:17Dr Karen Scott has the final results.

0:06:18 > 0:06:23So, this looks like a DNA fingerprint from a crime TV show, doesn't it?

0:06:23 > 0:06:27That's effectively what it is. It's a fingerprint of your poo sample.

0:06:27 > 0:06:30So every column is a different poo sample.

0:06:30 > 0:06:34- So these are the weeks - one, two, three, four, five, six, seven.- Yes.

0:06:34 > 0:06:36This is your first week, when you were on your normal diet,

0:06:36 > 0:06:39and then the four weeks on the oat diet.

0:06:39 > 0:06:45Each row of white blobs corresponds to a particular kind of bacterium found in my gut.

0:06:45 > 0:06:49The brighter the blob, the more of that bacterium there are.

0:06:49 > 0:06:53And it's clear that some of them have been having a field day on the oat diet.

0:06:53 > 0:06:56What this might represent, then,

0:06:56 > 0:06:59- is one of these bacteria that really likes oats.- That's right.

0:06:59 > 0:07:01How exactly are they good for me?

0:07:01 > 0:07:06We know that different gut bacteria produce different by-products

0:07:06 > 0:07:09as they ferment the food that you ingest,

0:07:09 > 0:07:13and oats seem to be particularly good at stimulating the growth of bacteria

0:07:13 > 0:07:17that produce some of the very beneficial by-products.

0:07:17 > 0:07:21Some of these are good for the health of your gut lining,

0:07:21 > 0:07:25some of them are more important in terms of heart health.

0:07:26 > 0:07:28It seems the fibre in the oats

0:07:28 > 0:07:31has been feeding up some of my own personal gut bacteria

0:07:31 > 0:07:36and, in return, they have been producing chemicals that have been good for me.

0:07:36 > 0:07:40It's like having a trillion tiny pets inside me

0:07:40 > 0:07:42that I have to monitor what they eat.

0:07:42 > 0:07:46- You have to look after them! - I've got to look after them.

0:07:46 > 0:07:49This new research on oats is only in its early stages,

0:07:49 > 0:07:53but there's a lot of interest now in foods containing fibre that could act like this,

0:07:53 > 0:07:57boosting our existing gut bacteria.

0:07:57 > 0:07:59We already know that people who eat a lot of fibre

0:07:59 > 0:08:02have a reduced risk of heart disease.

0:08:02 > 0:08:05So whilst we wait for detailed research trials,

0:08:05 > 0:08:08I'm happy to carry on my new routine of porridge breakfasts...

0:08:08 > 0:08:11..and the occasional flapjack.

0:08:11 > 0:08:14You know, what's amazed me here is that...

0:08:14 > 0:08:16..a simple change in my diet for a few weeks

0:08:16 > 0:08:18has had a dramatic effect

0:08:18 > 0:08:21on the health of the bacteria in my gut.

0:08:21 > 0:08:26And while there are certain specific medical conditions that do benefit from probiotics,

0:08:26 > 0:08:28for most of us who are healthy,

0:08:28 > 0:08:31eating oats is much cheaper alternative.

0:08:39 > 0:08:42As we all become more environmentally aware,

0:08:42 > 0:08:47you'd imagine our towns and cities must be getting cleaner and greener.

0:08:47 > 0:08:53Yet headlines like these claim that air pollution is still taking years off our lives.

0:08:53 > 0:08:56This is the sort of issue we like to investigate.

0:08:56 > 0:09:00So, how do you measure your exposure to air pollution, and what can you do about it?

0:09:00 > 0:09:03I've come to Lancaster to find out.

0:09:03 > 0:09:06CAR HORN BEEPS

0:09:06 > 0:09:10Researchers at the university have been testing some unusual solutions.

0:09:10 > 0:09:13But first, the Hunter family have kindly volunteered

0:09:13 > 0:09:16to help us measure the effects of air pollution -

0:09:16 > 0:09:19Mark, an electrician, Emma, a hairdresser,

0:09:19 > 0:09:22their daughters Olivia and Eva,

0:09:22 > 0:09:23and Arthur the dog,

0:09:23 > 0:09:27all living on the busy A6.

0:09:27 > 0:09:30For them, like so many others,

0:09:30 > 0:09:34there's a constant stream of traffic going past their house.

0:09:34 > 0:09:39I worry about the traffic going past all the time, the amount of cars and the pollution.

0:09:39 > 0:09:44I find it very dusty in this house, compared to where we lived before

0:09:44 > 0:09:46just because of, I think because of the pollution.

0:09:46 > 0:09:49- I don't know what pollution is. - EMMA LAUGHS

0:09:50 > 0:09:53We want to see how much air pollution they're exposed to,

0:09:53 > 0:09:58so we have given them individual pollution monitors.

0:09:58 > 0:10:00Put it on, ready for school.

0:10:00 > 0:10:02The little tubes that they pin up near their heads

0:10:02 > 0:10:06will suck in the same air as they do throughout the day,

0:10:06 > 0:10:08and a laser inside will constantly monitor

0:10:08 > 0:10:12how many soot particles that includes,

0:10:12 > 0:10:16as they enjoy a perfectly normal day...

0:10:18 > 0:10:21..driving to work,

0:10:21 > 0:10:22walking and play...

0:10:22 > 0:10:28So, which are the activities that expose us to the most air pollution

0:10:28 > 0:10:32and what could we all do to reduce exposure?

0:10:32 > 0:10:35We'll find out later in the programme.

0:10:44 > 0:10:47But first, we've asked the residents of Lancaster

0:10:47 > 0:10:51what questions they'd really like our team of doctors to answer.

0:10:51 > 0:10:55I like the taste of smoothies, but are they good for me?

0:10:55 > 0:10:58One for Dr Saleyha Ahsan...

0:11:01 > 0:11:06Smoothies are marketed as healthy snacks, full of fruity goodness,

0:11:06 > 0:11:09but their strong flavours hide their true nature.

0:11:09 > 0:11:12I've hit the streets to demonstrate.

0:11:13 > 0:11:16Just based on taste, which one tastes sweeter?

0:11:16 > 0:11:19- That one tastes sweeter, the coca-cola one.- OK.

0:11:19 > 0:11:21I would say this one, then, has the most.

0:11:21 > 0:11:24Actually, it's the smoothie,

0:11:24 > 0:11:27and it's got seven percent more sugar.

0:11:28 > 0:11:30And we've not been cheating.

0:11:30 > 0:11:33A survey published in 2013

0:11:33 > 0:11:39found that out of 52 smoothies, 41 had more sugar than coca-cola

0:11:39 > 0:11:41and all had more calories.

0:11:41 > 0:11:45They're not as healthy as their marketing would have you believe.

0:11:45 > 0:11:48One of the reasons why fruit tastes so good

0:11:48 > 0:11:50is because it's got a high sugar content.

0:11:50 > 0:11:52If you eat fruit sensibly,

0:11:52 > 0:11:55it's fantastic for you.

0:11:55 > 0:11:58Like many plant products, fruit contains fibre

0:11:58 > 0:12:01and compounds that are good for you.

0:12:01 > 0:12:03But smoothies are very concentrated,

0:12:03 > 0:12:08and that packs in a lot of sugar, along with the good stuff.

0:12:08 > 0:12:10If you love smoothies, keep them as a treat

0:12:10 > 0:12:14and don't use them as a cornerstone for a healthy diet.

0:12:23 > 0:12:27Throughout the series, Gabriel Weston is scouring the world

0:12:27 > 0:12:30for radical new treatments for common health problems,

0:12:30 > 0:12:33things that could change the future for thousands of us

0:12:33 > 0:12:36if trials are successful.

0:12:36 > 0:12:39This time, I've heard of a new way to treat a condition

0:12:39 > 0:12:43that affects about eight million people in the UK,

0:12:43 > 0:12:46a condition that turns this from being the perfect meal...

0:12:46 > 0:12:48Can I have a glass of your house red, please?

0:12:48 > 0:12:51..into a nightmare.

0:12:51 > 0:12:55And I have a particular interest as I'm a sufferer myself...

0:12:55 > 0:12:57..of migraines.

0:12:57 > 0:13:00Something as simple as wine or cheese, seafood or chocolate

0:13:00 > 0:13:02can trigger an attack.

0:13:04 > 0:13:07Far from being just bad headaches,

0:13:07 > 0:13:12people who have migraines can experience very dramatic symptoms.

0:13:12 > 0:13:15So, is there a way to get rid of them?

0:13:15 > 0:13:18Andy Bloor is a university lecturer,

0:13:18 > 0:13:22but he is also a sufferer of extreme migraines.

0:13:22 > 0:13:26So, Andy, I can see there's no reason to be wearing sunglasses,

0:13:26 > 0:13:30- do you have a migraine now? - I'm having a migraine attack, yes.

0:13:30 > 0:13:35- I'm having to focus and concentrate on just walking in a straight line. - Right.

0:13:35 > 0:13:37And when you couple that with having to form sentences,

0:13:37 > 0:13:40which, again, I'm really having to focus on,

0:13:40 > 0:13:41it's a bit of a struggle.

0:13:41 > 0:13:44People often think that a migraine is just a bad headache,

0:13:44 > 0:13:49but what you're describing is proper neurological symptoms from your headache.

0:13:49 > 0:13:53Yes. Somebody once described it as a full-on body assault. That's a good way to describe it.

0:13:53 > 0:13:55HORNS BEEP LOUDLY

0:13:55 > 0:13:58Migraines are still little understood,

0:13:58 > 0:14:03but seem to happen because of the way sensory information is processed by the brain.

0:14:03 > 0:14:07People who have a predisposition to them have sensitive periods

0:14:07 > 0:14:11when strong flavours, like cheese or chocolate,

0:14:11 > 0:14:14or bright lights and loud noises can overload their sensory system.

0:14:14 > 0:14:17If too many of these triggers build up at once,

0:14:17 > 0:14:21they can reach a threshold and cause a migraine attack,

0:14:21 > 0:14:24when all the senses become heightened.

0:14:24 > 0:14:28Andy had his first attack in his early 20s.

0:14:28 > 0:14:32You're a senior lecturer here in Canterbury, at the university,

0:14:32 > 0:14:36how do you manage your condition alongside those responsibilities?

0:14:36 > 0:14:39There I am, lecturing in front of a group of students,

0:14:39 > 0:14:42and I might start losing my balance,

0:14:42 > 0:14:44I might start slurring my words, struggling to find my words,

0:14:44 > 0:14:47and, yes, quite frankly, it's very embarrassing.

0:14:47 > 0:14:49If there was a treatment out there

0:14:49 > 0:14:53that might offer you some significant improvement in your symptoms,

0:14:53 > 0:14:57- what would that mean to you? - It would revolutionise it.

0:14:57 > 0:14:59It's been almost 20 years I've had migraines,

0:14:59 > 0:15:02I can't remember a time when these things didn't blight my life.

0:15:02 > 0:15:05It stops you doing the things you want to do,

0:15:05 > 0:15:08it stops you being the person you want to be.

0:15:08 > 0:15:12Because migraines are so poorly understood,

0:15:12 > 0:15:14new treatments to deal with them are rare.

0:15:14 > 0:15:19The standard advice for treating migraine hasn't changed for years

0:15:19 > 0:15:24avoid triggers, try and maintain regular patterns of sleep and diet,

0:15:24 > 0:15:26and when attacks do occur,

0:15:26 > 0:15:29hit them hard with safe, high-dose painkillers.

0:15:30 > 0:15:33Usually, ground-breaking medical advances

0:15:33 > 0:15:36are made in the world's leading hospitals,

0:15:36 > 0:15:38but this one came out of the blue

0:15:38 > 0:15:42from, of all places, the beauty clinic.

0:15:42 > 0:15:46Supposedly the elixir of youth in a tiny bottle,

0:15:46 > 0:15:48it's known as Botox.

0:15:48 > 0:15:52Some clients, though, found it did more than smooth their brows,

0:15:52 > 0:15:55it soothed their migraines, too.

0:15:55 > 0:15:59This gave researchers a new insight into the condition.

0:15:59 > 0:16:02So, what is Botox actually doing?

0:16:02 > 0:16:07Andy has volunteered to go under the needle of Dr Mark Weatherall,

0:16:07 > 0:16:09here at Charing Cross Hospital in London.

0:16:09 > 0:16:14- Hi, Andy. Nice to see you.- Hi, Mark. - Hi. Nice to see you. Do come in.

0:16:14 > 0:16:19Mark is going to give Andy a total of 31 injections of Botox

0:16:19 > 0:16:23in his face, head, neck and shoulders,

0:16:23 > 0:16:28aiming not for specific muscles, but for regions carrying sensory nerves.

0:16:28 > 0:16:30OK, so just give me a frown.

0:16:30 > 0:16:32OK, and just relax.

0:16:32 > 0:16:35- So we're going to start here. Are you ready to go?- Mm-hm.

0:16:35 > 0:16:37So...

0:16:38 > 0:16:41- How are you feeling, Andy? - I'm OK.- Yes.

0:16:41 > 0:16:44I'm not the happiest person with needles.

0:16:44 > 0:16:49Some of the areas are similar to those targeted in cosmetic wrinkle treatments,

0:16:49 > 0:16:51but the aim is different.

0:16:51 > 0:16:54So we think that Botox, when it's treating migraine,

0:16:54 > 0:16:59is affecting sensory information, not the muscles themselves.

0:16:59 > 0:17:02Botox stops nerves carrying their signals.

0:17:02 > 0:17:06These include the signals from the brain to contract muscles,

0:17:06 > 0:17:10causing smooth, expressionless Botoxed faces.

0:17:10 > 0:17:14But it seems also to stop nerves carrying sensory signals TO the brain

0:17:14 > 0:17:19and it came as a surprise that this helps many migraine sufferers.

0:17:19 > 0:17:23It's given researchers an unexpected insight

0:17:23 > 0:17:26into what's causing migraines.

0:17:26 > 0:17:30When you finish a treatment like this, Mark, how long do you expect to wait?

0:17:30 > 0:17:34Interestingly, some people notice a benefit very quickly

0:17:34 > 0:17:36within a few days.

0:17:36 > 0:17:40Typically, most people will start to notice an improvement within a couple of weeks.

0:17:49 > 0:17:50So, Andy, when we met last,

0:17:50 > 0:17:54you were wearing dark glasses and you looked white as a sheet.

0:17:54 > 0:17:58Today, you look like a different man. How have you been feeling since we last met?

0:17:58 > 0:18:00I'm a lot better than when I saw you last!

0:18:00 > 0:18:04Some people describe having Botox as being like a light switch, that it switches them off.

0:18:04 > 0:18:07For me, it's better to say it's a dimmer switch,

0:18:07 > 0:18:09it's brought down the intensity for me.

0:18:09 > 0:18:15I know that your attacks were having a very significant impact on all aspects of your life.

0:18:15 > 0:18:17Can you tell me how that's changed?

0:18:17 > 0:18:21It has given me more freedom to be confident about doing things,

0:18:21 > 0:18:24not thinking, "What happens if...?" or "Can I...?"

0:18:24 > 0:18:27When I met friends at the weekend, I was able to enjoy myself

0:18:27 > 0:18:32and not worry about having a migraine that was going to debilitate me so badly.

0:18:33 > 0:18:37So this is a story of true serendipity

0:18:37 > 0:18:39a treatment being discovered by chance

0:18:39 > 0:18:41that actually sheds light

0:18:41 > 0:18:45on the causes of the condition itself.

0:18:45 > 0:18:48It's also reminded me that so often in medicine,

0:18:48 > 0:18:51the best solutions, the breakthroughs even,

0:18:51 > 0:18:55arise in the places that we least expect them.

0:19:02 > 0:19:03Still to come...

0:19:03 > 0:19:08What is our national coffee addiction doing to us?

0:19:08 > 0:19:11And would you know how to save someone who had drowned?

0:19:11 > 0:19:13But first...

0:19:17 > 0:19:20It's coming on now. Ah, yes!

0:19:20 > 0:19:23Every year, I suffer from attacks like this one...

0:19:24 > 0:19:27There's a bit of leaking going on in the eyes.

0:19:27 > 0:19:30..and so do a quarter of the UK population.

0:19:30 > 0:19:33It's hay fever.

0:19:33 > 0:19:37It's beginning to produce some quite unpleasant symptoms.

0:19:37 > 0:19:41Symptoms that are familiar to millions of us.

0:19:41 > 0:19:43At-choo!

0:19:44 > 0:19:48My throat and my ears kind of itch inside, if that's possible!

0:19:48 > 0:19:51Itchy eyes, erm, runny nose, congestion...

0:19:51 > 0:19:54It feels like you've got a very, very bad cold.

0:19:54 > 0:19:58So, if hay fever is such a problem for so many people,

0:19:58 > 0:20:00what's being done about it?

0:20:01 > 0:20:04The hay fever season starts around February,

0:20:04 > 0:20:07when trees like birch start to release pollen,

0:20:07 > 0:20:10which, for some people, is their main trigger.

0:20:10 > 0:20:13But for most of us, though, the peak is mid-summer,

0:20:13 > 0:20:17when the grasses really get going with their pollen.

0:20:17 > 0:20:20Hay fever happens because your body treats pollen

0:20:20 > 0:20:23as if it were some dangerous, invading parasite.

0:20:23 > 0:20:27Amongst other things, it releases chemicals called histamines.

0:20:27 > 0:20:31Unfortunately, histamines have some annoying side effects,

0:20:31 > 0:20:35as I'm going to demonstrate with these lovely stinging nettles.

0:20:35 > 0:20:37We all know that stinging nettles sting,

0:20:37 > 0:20:40but they also inject you with histamines.

0:20:40 > 0:20:43Right, let's give it a go.

0:20:43 > 0:20:45Agh! Ooh, yes, nice!

0:20:45 > 0:20:48Agh! That's painful.

0:20:48 > 0:20:50Very quickly, you see this area's going red

0:20:50 > 0:20:53and some nice big blobs are appearing.

0:20:53 > 0:20:58The histamines injected by the nettle cause inflammation and itching.

0:20:58 > 0:21:01But your body also produces its own histamines

0:21:01 > 0:21:04as part of its defence mechanism.

0:21:04 > 0:21:07When you have an allergic reaction to something like pollen,

0:21:07 > 0:21:10you are releasing them in the eyes and nose.

0:21:10 > 0:21:13It's as if there's been an attack by parasites,

0:21:13 > 0:21:18and one of their effects is annoying itchiness and runniness.

0:21:18 > 0:21:21The way to combat to the effects of histamine

0:21:21 > 0:21:24is, naturally enough, to take antihistamines.

0:21:26 > 0:21:28The antihistamine market is huge.

0:21:28 > 0:21:33We spend £72 million in the UK on antihistamine pills.

0:21:34 > 0:21:38Now, severe hay fever is really unpleasant,

0:21:38 > 0:21:40but antihistamines can also have side effects

0:21:40 > 0:21:44so it's vital to get the right treatment.

0:21:44 > 0:21:49Professor Angela Simpson has seen the dramatic effects of hay fever on children,

0:21:49 > 0:21:53especially noticeable when their performance is measured in exams.

0:21:53 > 0:21:56There's a very interesting study in children,

0:21:56 > 0:22:00because we've got natural experiments with public exams in June,

0:22:00 > 0:22:02right in the middle of the hay fever season,

0:22:02 > 0:22:06but the mocks are done in January, before the grass pollen season,

0:22:06 > 0:22:10and so you can look to see what factors predict children dropping a grade

0:22:10 > 0:22:15between their mock exam and their actual exam in June.

0:22:15 > 0:22:17Besides being a boy, which is a predictor,

0:22:17 > 0:22:20- the biggest predictor is having hay fever.- Right.

0:22:20 > 0:22:22But perhaps, more importantly,

0:22:22 > 0:22:26another important predictor is being treated with a sedating antihistamine for your hay fever.

0:22:26 > 0:22:31Your whole life can be transformed. You get a lower grade, you don't go to university...

0:22:31 > 0:22:34- Because you had hay fever that wasn't properly treated.- OK.

0:22:34 > 0:22:37So we're keen to make sure people are properly treated,

0:22:37 > 0:22:39and for us, that would be starting a nasal steroid,

0:22:39 > 0:22:42probably a couple of weeks before the onset of your symptoms.

0:22:42 > 0:22:47For you, being grass pollen allergic, May would be a good time to start your nasal steroid,

0:22:47 > 0:22:50to try and calm down inflammation in the nasal passages

0:22:50 > 0:22:53so you don't get the attacks of sneezing and the nasal stuffiness

0:22:53 > 0:22:56and the itchy eyes that impair your concentration.

0:22:56 > 0:23:02It could be the reason I failed that exam way back then was because of this!

0:23:02 > 0:23:04- Definitely.- Thank you. I have a perfect excuse!

0:23:05 > 0:23:08It's clearly important to ensure that if you do have hay fever,

0:23:08 > 0:23:11you treat it and treat it right.

0:23:12 > 0:23:14So nasal steroids get the thumbs-up.

0:23:14 > 0:23:18If you are taking antihistamines, do check on the back of the packet

0:23:18 > 0:23:21that they are the sort that won't make you feel drowsy.

0:23:21 > 0:23:25And don't forget to start taking the nasal sprays

0:23:25 > 0:23:29two weeks before your normal sneezing season to get full effect.

0:23:31 > 0:23:34But even with the best drugs and steroid sprays,

0:23:34 > 0:23:36many people still struggle to find a way

0:23:36 > 0:23:39to deal with their hay fever symptoms.

0:23:40 > 0:23:43I take pills and I've got a nasal spray. Eye drops...

0:23:43 > 0:23:46- And do those work? - Yes, er, usually kind of short-term

0:23:46 > 0:23:49and then they tend not to work after long-term use.

0:23:49 > 0:23:55I don't find that any antihistamines or nasal sprays actually make an awful lot of difference.

0:23:55 > 0:24:00My son has some prescription drugs, I don't know the names of them, but he gets them from the doctor.

0:24:00 > 0:24:02- And do they work? - Er, not wholly, no.

0:24:03 > 0:24:08Clearly, there's a need for better treatments for hay fever.

0:24:08 > 0:24:10I've come to find out about a new approach

0:24:10 > 0:24:13which could even get rid of the allergy for good.

0:24:13 > 0:24:15- Please, sit down.- Thank you.

0:24:15 > 0:24:20Professor Stephen Durham has been working on these rather unusual pills.

0:24:20 > 0:24:21Can I have a go?

0:24:21 > 0:24:26They're weird, aren't they? It's not like any pill I've ever encountered before.

0:24:26 > 0:24:29Is this essentially grass pollen mixed with sort of...

0:24:29 > 0:24:31It's a freeze-dried grass pollen.

0:24:31 > 0:24:33- Just pop it under your tongue.- OK.

0:24:36 > 0:24:37OK, is it -

0:24:37 > 0:24:40You shouldn't speak. Just hold down your tongue

0:24:40 > 0:24:43and just keep it there for two minutes.

0:24:44 > 0:24:47This pollen pill works a bit like a vaccine.

0:24:47 > 0:24:51By exposing yourself to pollen in regular small doses,

0:24:51 > 0:24:53your body learns not to react to it.

0:24:53 > 0:24:56It's a technique called immunotherapy.

0:24:56 > 0:25:00- Any sensation at all?- There was a sort of slight tingling, I thought.

0:25:00 > 0:25:02- Well, that's it. OK. - That was it?- Yes.

0:25:02 > 0:25:05So if I wanted to get rid of my hay fever forever,

0:25:05 > 0:25:09- it would just be a matter of taking one of those? - One of those a day for three years.

0:25:09 > 0:25:12Some 15 million people suffer from hay fever

0:25:12 > 0:25:16and approximately 80-85 percent of patients will benefit,

0:25:16 > 0:25:19so that's, I think, a very exciting development.

0:25:22 > 0:25:26It's quite a commitment, taking daily pills for three years.

0:25:26 > 0:25:29So, what do people think?

0:25:29 > 0:25:34- If you could take a pill, and there's a new one out there, which will get rid of it...- Yes.

0:25:34 > 0:25:37- ..but you have to take it every day for three years...- I'd take it.

0:25:37 > 0:25:41Three years? That's quite a... No, I'm willing to give it a go.

0:25:41 > 0:25:45I don't think I would, no. I don't think I would be prepared to take that,

0:25:45 > 0:25:48because every day for three years seems an awful long time

0:25:48 > 0:25:50for one month of discomfort.

0:25:50 > 0:25:52Yes, I would, actually, because, erm,

0:25:52 > 0:25:56if it solves the problem permanently, it's worth doing.

0:25:56 > 0:26:00These pollen pills are only available on prescription,

0:26:00 > 0:26:05but long-term clinical trials suggest they can be very effective

0:26:05 > 0:26:09and immunotherapy is also being trialled for other allergies.

0:26:09 > 0:26:12I think immunotherapy is an fascinating approach,

0:26:12 > 0:26:16which has wider uses than simply hay fever.

0:26:16 > 0:26:20I also think that when these pills come down in price,

0:26:20 > 0:26:23they will be more routinely prescribed.

0:26:23 > 0:26:27Visit our website at bbc.co.uk/trustme

0:26:27 > 0:26:32for more information about identifying the pollens you might be allergic to

0:26:32 > 0:26:35and about treatments for your hay fever.

0:26:41 > 0:26:44MUSIC: "Coffee & TV" by Blur

0:26:47 > 0:26:50Can I get a big filter coffee?

0:26:50 > 0:26:52If you're a fan of reading the health headlines,

0:26:52 > 0:26:56you'll probably be pretty confused about coffee.

0:26:56 > 0:27:01No-one seems to agree whether the 70 million cups of it that we drink every single day

0:27:01 > 0:27:03are doing us harm...

0:27:03 > 0:27:06..or good?

0:27:06 > 0:27:10There's a whole raft of health benefits proposed about caffeine and coffee,

0:27:10 > 0:27:15but for every health benefit, there often seems to be a contradictory risk.

0:27:16 > 0:27:18So, what's the real truth?

0:27:20 > 0:27:23Caffeine is found in a whole range of plants,

0:27:23 > 0:27:26from tea leaves in China to the cocoa beans of Mexico,

0:27:26 > 0:27:29and we've found many ways to get it into our diets.

0:27:29 > 0:27:32I've got seven things on this table and they all contain caffeine.

0:27:32 > 0:27:37I'm going to put them out in order, because I think it isn't obvious which one has the most.

0:27:37 > 0:27:42The least amount of caffeine is in this large glass of cola.

0:27:42 > 0:27:45With a little bit more, we've got a cup of normal tea.

0:27:46 > 0:27:51A bit more than the tea, a large bar of dark chocolate. That's 50 grams.

0:27:52 > 0:27:56More than the chocolate, a single espresso.

0:27:57 > 0:27:59Then we've got a standard energy drink.

0:27:59 > 0:28:01That's got quite a lot.

0:28:01 > 0:28:03And of the food and drink items,

0:28:03 > 0:28:06the one with the most amount of caffeine

0:28:06 > 0:28:09is a mug of filter coffee.

0:28:09 > 0:28:13But with more caffeine than all of them...

0:28:14 > 0:28:17..is a single dose of painkillers.

0:28:17 > 0:28:19These are Paracetamol Extra with caffeine in it.

0:28:19 > 0:28:25They've got more than four times the amount of caffeine than you find in a cola drink.

0:28:25 > 0:28:27# Coffee and TV... #

0:28:27 > 0:28:29Plants use caffeine as an insecticide,

0:28:29 > 0:28:32which doesn't sound like something we should be taking.

0:28:32 > 0:28:35In humans, caffeine's a powerful stimulant,

0:28:35 > 0:28:38used by millions of us every day to wake us up,

0:28:38 > 0:28:40help keep us alert and generally boost our concentration.

0:28:40 > 0:28:43# Coffee and TV... #

0:28:43 > 0:28:46The way caffeine works is, it increases the flow of adrenalin.

0:28:46 > 0:28:49Adrenalin is the hormone used for fight or flight,

0:28:49 > 0:28:54so it boosts your heart rate, your blood pressure and increases blood flow to your muscles.

0:28:54 > 0:28:58All these things combine to give you that much-needed kick.

0:28:58 > 0:29:01So, is that good or bad for us?

0:29:01 > 0:29:05Most studies show there's no harm in drinking caffeinated coffee,

0:29:05 > 0:29:07but new research does come out all the time,

0:29:07 > 0:29:12and if you've got high blood pressure or you're pregnant, you should be cautious.

0:29:12 > 0:29:15But caffeine isn't the whole story.

0:29:15 > 0:29:17Coffee's packed full of other ingredients

0:29:17 > 0:29:21and research into these often hits the headlines, too.

0:29:21 > 0:29:24If you go for the lighter roasts grades 1-2 -

0:29:24 > 0:29:29then coffee is fantastically rich in compounds called polyphenols.

0:29:29 > 0:29:34These are the beneficial chemicals found in what the media like to call "superfoods",

0:29:34 > 0:29:37and they have been shown to help blood flow in the heart and brain,

0:29:37 > 0:29:40protecting against strokes and dementia.

0:29:40 > 0:29:42Research is in its early stages,

0:29:42 > 0:29:46but a lightly-roasted coffee could eventually turn out to be good for you.

0:29:48 > 0:29:50At the moment, the only guidelines in the UK

0:29:50 > 0:29:56are that pregnant women should limit their daily intake to a maximum of 200mg of caffeine,

0:29:56 > 0:29:59that's the equivalent of two cups of filter coffee.

0:29:59 > 0:30:01For the rest of us, there's no clear-cut evidence

0:30:01 > 0:30:04that it's either overall good for us or overall bad for us.

0:30:04 > 0:30:09Until there is, I'm going to keep enjoying coffee whenever I feel like it.

0:30:16 > 0:30:20Earlier in the programme, we met the Hunter family, who are wearing pollution monitors

0:30:20 > 0:30:23to see how much pollution each one of them is exposed to

0:30:23 > 0:30:26during a typical day.

0:30:26 > 0:30:29Once soot and tiny particles get into our lungs,

0:30:29 > 0:30:31what happens to it there

0:30:31 > 0:30:34and what can be done to reduce exposure?

0:30:36 > 0:30:41I'm cycling through London, as I do most days, getting my lungs full of traffic fumes.

0:30:41 > 0:30:44And then it's time to cough it all up,

0:30:44 > 0:30:46with help from Dr Rossa Brugha.

0:30:46 > 0:30:49Go for it, big wet coughs. HE COUGHS & SPLUTTERS

0:30:49 > 0:30:52I can assure, you this is as unpleasant for me

0:30:52 > 0:30:54as it is for you!

0:30:57 > 0:30:59What we need is these nice big chunky bits,

0:30:59 > 0:31:01there and there.

0:31:01 > 0:31:04Rossa's making me cough up everything I can

0:31:04 > 0:31:07so I can see what's going on inside my lungs.

0:31:07 > 0:31:11He's got some misty salt solution to make my sputum more liquid.

0:31:11 > 0:31:15- I think we're done.- I think I'm beginning to feel a little faint!

0:31:15 > 0:31:17- Fair enough!- OK.

0:31:17 > 0:31:19So, what am I looking at here?

0:31:19 > 0:31:22You are now looking at cells that come from inside your lungs.

0:31:22 > 0:31:24You coughed up your sputum for us.

0:31:24 > 0:31:30This cell, you can see it's speckled with these black little... little particles here,

0:31:30 > 0:31:33probably soot from diesel engines.

0:31:34 > 0:31:36Despite legal controls,

0:31:36 > 0:31:39cars and trucks, particularly those with diesel engines,

0:31:39 > 0:31:43still produce large amounts of tiny bits of particulate matter,

0:31:43 > 0:31:44or PM.

0:31:44 > 0:31:48Too small to see and too small for our noses to filter out,

0:31:48 > 0:31:51they go deep inside our lungs.

0:31:52 > 0:31:55Fortunately, our lungs have defences,

0:31:55 > 0:32:01cells called macrophages, that can eat up these particles.

0:32:04 > 0:32:07The problem is that macrophages are slow workers -

0:32:07 > 0:32:09we speeded up this footage -

0:32:09 > 0:32:12so we have to be careful not to overload them.

0:32:15 > 0:32:18If you're at the traffic lights and a lorry starts off in a low gear

0:32:18 > 0:32:21and gives a big pile of cloud coming from the engine,

0:32:21 > 0:32:25your macrophages aren't going to be able to deal with all the particles you breathe in in one go.

0:32:25 > 0:32:28That stuff is going to sit on the lining of your lung,

0:32:28 > 0:32:32causing damage by stressing the lining of your lung fluid

0:32:32 > 0:32:35- and being generally bad for you. - OK. How bad?

0:32:35 > 0:32:39A report came out a couple of years ago, commissioned by the government,

0:32:39 > 0:32:42that said that 29,000 people a year die

0:32:42 > 0:32:45because of breathing in this stuff, this PM or soot.

0:32:45 > 0:32:48Or they equated it to losing about six months of your life

0:32:48 > 0:32:51- simply because of the quality of the air.- That's significant.

0:32:51 > 0:32:55We worry so much about clean water and clean food,

0:32:55 > 0:32:58but we're all breathing dirty air all the time.

0:32:58 > 0:33:0329,000 deaths a year is an astonishing figure.

0:33:03 > 0:33:07New research has shown that the tiny PM particles from diesel fumes

0:33:07 > 0:33:09can get into our blood stream from the lungs,

0:33:09 > 0:33:13and there they increase our risk of heart disease.

0:33:14 > 0:33:17But if we keep our pollution exposure low enough

0:33:17 > 0:33:21we give the macrophages in our lungs a chance to deal with a lot of it.

0:33:22 > 0:33:27Personal pollution monitors have been giving researchers real insights,

0:33:27 > 0:33:32so back in Lancaster, Rossa's hoping the Hunter family's results will help.

0:33:32 > 0:33:37It turns out that the person with the most dramatic pollution exposure was little Olivia.

0:33:37 > 0:33:41As Olivia arrives at school, she gets this huge spike in pollution exposure.

0:33:41 > 0:33:46- That's big?- That's big. It's bigger than anything we see from Mum or Dad during the day.

0:33:46 > 0:33:51Back indoors, not very much. And then she goes on a car journey, I think she goes to Brownies,

0:33:51 > 0:33:54and you see these spikes again when she's in the car with her mother.

0:33:54 > 0:33:57Rossa's research group have, again and again,

0:33:57 > 0:34:00found this same pattern of exposure in children.

0:34:00 > 0:34:04Getting through the school gates quickly is the key.

0:34:04 > 0:34:09At school, she has to go outside and run around, and we absolutely want her to do that,

0:34:09 > 0:34:12but there's things that expose children to air pollution that adults don't get,

0:34:12 > 0:34:17such as people letting their engines idle at the beginning and end of the day.

0:34:17 > 0:34:19That's the big spike, when she arrives,

0:34:19 > 0:34:22and there's presumably a load of cars outside with their engines idling.

0:34:23 > 0:34:28Olivia was exposed to twice as much pollution as her mother.

0:34:30 > 0:34:31Mum gets lower levels,

0:34:31 > 0:34:35but it's interesting to see what drives her exposure to pollution.

0:34:35 > 0:34:38In the morning, she walks the dog. She takes the car out three times in the day.

0:34:38 > 0:34:42Every time she takes the car out one, two, three

0:34:42 > 0:34:44she gets big spikes in exposure.

0:34:44 > 0:34:46ENGINES REV

0:34:46 > 0:34:50This is another common finding in Rossa's research.

0:34:51 > 0:34:53When you're driving, you are most at risk

0:34:53 > 0:34:57because you're directly in line with the exhaust from the car in front.

0:34:57 > 0:34:59If you close your air vents and windows

0:34:59 > 0:35:02and keep a little way behind the car in front,

0:35:02 > 0:35:06and you can dramatically reduce your pollution exposure.

0:35:07 > 0:35:10But most telling of all was Mark's data.

0:35:10 > 0:35:14Although he also gets a spike when given a lift to work in the car,

0:35:14 > 0:35:17he manages to avoid it in the evening.

0:35:17 > 0:35:19He walks home,

0:35:19 > 0:35:23so he doesn't get the pollution spike that you'd expect from being in a car or being in traffic.

0:35:23 > 0:35:26So, he actually gets less pollution walking home

0:35:26 > 0:35:29than he did being driven to work in the morning?

0:35:29 > 0:35:31It looks about half.

0:35:31 > 0:35:35Mark managed to reduce his pollution exposure walking home,

0:35:35 > 0:35:39because on the pavement you are not directly in line with the exhaust from another car.

0:35:39 > 0:35:44Being just a few metres away from the road, on the far side of the pavement,

0:35:44 > 0:35:48goes a long way to protecting you from airborne soot.

0:35:48 > 0:35:51People, I think, are often quite fatalistic about air pollution.

0:35:51 > 0:35:54They know it's there, they know it's affecting them,

0:35:54 > 0:35:56but they don't feel there's a huge amount they can do.

0:35:56 > 0:35:59I think it's quite obvious from Mark's trace

0:35:59 > 0:36:03that you can decrease your exposure to air pollution by changing the way that you behave.

0:36:04 > 0:36:07But what about all those hours we spend at home?

0:36:07 > 0:36:10Is there anything we can do to protect ourselves there?

0:36:10 > 0:36:13A team at the University of Lancaster claim

0:36:13 > 0:36:18that you can improve the quality of the air in your house simply by planting a tree outside.

0:36:18 > 0:36:21Can that really make a difference?

0:36:21 > 0:36:25It's the sort of claim that would need pretty good evidence to convince us,

0:36:25 > 0:36:28so surgeon Gabriel Weston has been setting up an experiment,

0:36:28 > 0:36:32along with the researcher responsible for the original idea,

0:36:32 > 0:36:34Professor Barbara Maher.

0:36:36 > 0:36:40We're installing a line of trees in the Hunter family's street.

0:36:40 > 0:36:42But they're not just any trees,

0:36:42 > 0:36:46they're specially-chosen silver birch trees.

0:36:46 > 0:36:49Barbara, we've got a busy, polluted road here.

0:36:49 > 0:36:51You're hoping that these trees

0:36:51 > 0:36:55might do a job of dusting the air or cleaning up the air in some way?

0:36:55 > 0:37:00We're here to see if these silver birch trees, specially chosen for the job,

0:37:00 > 0:37:03if they can make a big difference to the PM,

0:37:03 > 0:37:05the amount of PM in the atmosphere,

0:37:05 > 0:37:09and indeed inside the houses adjacent to this area, as well.

0:37:09 > 0:37:13We've chosen this tree particularly, we've chosen it for two reasons.

0:37:13 > 0:37:16The first reason is that the structure of the leaf

0:37:16 > 0:37:20makes it very, very good at removing particulates.

0:37:20 > 0:37:23It has ridges on it, it has hairs on it,

0:37:23 > 0:37:27so when the particles that are floating in the atmosphere, when the PM hits the leaf,

0:37:27 > 0:37:30the PM lodges on the leaf, it sticks to the leaf,

0:37:30 > 0:37:33and it's removed from the atmosphere. So that's one reason.

0:37:33 > 0:37:36The second reason, the tree itself is a very tolerant tree,

0:37:36 > 0:37:39so when it receives all this pollution,

0:37:39 > 0:37:42it doesn't get too stressed itself.

0:37:46 > 0:37:49There are hardly any leaves on our tiny little trees,

0:37:49 > 0:37:53but over two weeks, we're going to see if they afford any protection

0:37:53 > 0:37:58by monitoring the air inside eight houses on the Hunters' street.

0:37:58 > 0:38:02Four will be supposedly protected by our trees

0:38:02 > 0:38:04and the four neighbouring ones won't be.

0:38:04 > 0:38:07And we'll be measuring the levels of PM pollution in the air indoors

0:38:07 > 0:38:13by using the dust-attracting static of the residents' TV screens.

0:38:13 > 0:38:16We can come in, we clean off the TV screens

0:38:16 > 0:38:20so it's totally free of any PM before the start of the experiment.

0:38:20 > 0:38:25We come back after two weeks, we wipe another bit of the screen with the wet wipe

0:38:25 > 0:38:27and we measure the magnetic content,

0:38:27 > 0:38:30and that tells us about these iron-bearing particles

0:38:30 > 0:38:33that have come specifically from the vehicle outside.

0:38:33 > 0:38:36- Great, so this one's done.- This one's done. Let's go to the next house.

0:38:36 > 0:38:40Leaving the residents of the street with sparkling-clean screens

0:38:40 > 0:38:42and a new view from their windows,

0:38:42 > 0:38:46our work here is done for now.

0:38:46 > 0:38:51In two weeks' time, we'll be back to see how much PM has built up on the screens

0:38:51 > 0:38:55of the four houses with trees and the four without.

0:38:55 > 0:38:58We'll find out the results later in the programme.

0:39:09 > 0:39:13I work in a busy A&E, where I see patients who could be saved

0:39:13 > 0:39:18if more people had the confidence or knowledge to try first aid.

0:39:18 > 0:39:21You don't need to have a full medical training

0:39:21 > 0:39:24to be able to help someone who's in trouble.

0:39:24 > 0:39:28I want to share my skills with regular people up and down the country

0:39:28 > 0:39:32so that as many of us as possible know what to do in an emergency,

0:39:32 > 0:39:35before the paramedics arrive.

0:39:35 > 0:39:38I want to show you how to save a life.

0:39:39 > 0:39:42This time, I'm dealing with drowning.

0:39:42 > 0:39:45Over 400 people drown each year,

0:39:45 > 0:39:50most not in the sea, but in a lake, river or swimming pool.

0:39:50 > 0:39:53Would you know what do if you came across someone in trouble?

0:39:53 > 0:39:56Many people who drown are found by walkers,

0:39:56 > 0:40:00so I've come to Blackthorn in Oxfordshire to meet a rambling group,

0:40:00 > 0:40:03to teach them the skills to save a life.

0:40:03 > 0:40:07Dealing with a drowning casualty is a rescue of two parts.

0:40:07 > 0:40:11The first part is - don't become a casualty yourself.

0:40:11 > 0:40:12Don't get in the water.

0:40:12 > 0:40:15Do your best to get them out,

0:40:15 > 0:40:18use whatever is around you to try and hoick them out,

0:40:18 > 0:40:21but don't jump in yourself.

0:40:21 > 0:40:23The last thing anyone needs is another casualty,

0:40:23 > 0:40:27so stay calm and stay safe yourself.

0:40:27 > 0:40:32If you have managed to get them out of the water safely, shout for help,

0:40:32 > 0:40:35and then you can try the second part of the rescue -

0:40:35 > 0:40:38a few simple steps which could help them survive.

0:40:38 > 0:40:42The first thing you do is to try and rouse them,

0:40:42 > 0:40:43wake them up.

0:40:43 > 0:40:45Hello? Can you hear me? Can you hear me.

0:40:45 > 0:40:48Give their... Grab hold of their shoulders and give them a shake.

0:40:48 > 0:40:50ALL: Hello? Hello?

0:40:50 > 0:40:53If they're not waking up, the other thing you can do,

0:40:53 > 0:40:55a little pinch to the earlobe, OK?

0:40:55 > 0:40:57That sometimes does it.

0:40:57 > 0:41:02If they're still not responding, make sure their airway is clear.

0:41:02 > 0:41:05Lift their chins up and tilt their head back.

0:41:05 > 0:41:09That in itself could be enough.

0:41:09 > 0:41:12Next, check if they are breathing.

0:41:12 > 0:41:16We use the words, "Look, feel, listen," OK?

0:41:16 > 0:41:19Cheek down close to the mouth...

0:41:19 > 0:41:21..and look down the chest.

0:41:21 > 0:41:25Can you see it falling and rising?

0:41:25 > 0:41:31Can you feel any warm breath, or any kind of breath on your cheek?

0:41:31 > 0:41:34If not, call the emergency services

0:41:34 > 0:41:36and try mouth-to-mouth resuscitation.

0:41:36 > 0:41:38It's not as scary as it sounds.

0:41:38 > 0:41:42We need to give them five rescue breaths.

0:41:42 > 0:41:44Pinch the nose.

0:41:47 > 0:41:51Each breath... lasting for a second.

0:41:51 > 0:41:55When you do that, make sure you've taken a breath in,

0:41:55 > 0:41:59otherwise you'll be fainting over the patient!

0:42:00 > 0:42:03Then start CPR.

0:42:03 > 0:42:07Use both hands together, right in the middle of the chest,

0:42:07 > 0:42:11and with straight arms start pushing down twice a second,

0:42:11 > 0:42:15about five centimetres each time.

0:42:15 > 0:42:20These two things could get life-saving oxygen to the person's brain.

0:42:20 > 0:42:23If you are alone and without a mobile phone

0:42:23 > 0:42:26then don't leave the casualty before doing this.

0:42:26 > 0:42:30It's really important that you do these steps first

0:42:30 > 0:42:35before taking the time, a few minutes, to call 999.

0:42:35 > 0:42:37You know what to do, you can swap in.

0:42:37 > 0:42:39Once help is on its way,

0:42:39 > 0:42:44continue giving 30 chest compressions, followed by two rescue breaths,

0:42:44 > 0:42:46until they arrive.

0:42:46 > 0:42:48If the casualty starts breathing,

0:42:48 > 0:42:53the best thing to do is to put them into the recovery position.

0:42:53 > 0:42:56Move the arm closest to you to one side.

0:42:56 > 0:43:00Grab their other arm and place it by their cheek.

0:43:00 > 0:43:06Then, by pulling on the knee that's furthest away from you, roll them onto their side.

0:43:06 > 0:43:09The recovery position will keep the airway open.

0:43:09 > 0:43:10- Comfortable?- Of course!

0:43:10 > 0:43:14# Come on, baby, and rescue me... #

0:43:14 > 0:43:18If there is going to be any vomit or anything coming out of the mouth,

0:43:18 > 0:43:23it will come out this way and they won't choke on anything.

0:43:23 > 0:43:28This is a stable position to leave someone in whilst you go off to get help.

0:43:28 > 0:43:31Remember, if they are not breathing

0:43:31 > 0:43:34you have to initiate those five rescue breaths

0:43:34 > 0:43:37and start that one minute of CPR.

0:43:37 > 0:43:40Make sure that 999 has been dialled.

0:43:40 > 0:43:44And then continue CPR until help arrives.

0:43:44 > 0:43:49If you follow those steps you could ultimately save a life.

0:43:56 > 0:43:58Still to come...

0:43:58 > 0:44:01Does cracking your knuckles give you arthritis?

0:44:01 > 0:44:05And what happens in our tree experiment in Lancaster?

0:44:05 > 0:44:06Whoo! Whoa!

0:44:06 > 0:44:08I am utterly astonished.

0:44:15 > 0:44:20Throughout the series, I'm trying to get expert advice on the risks and benefits

0:44:20 > 0:44:24of some of the pills that we are all encouraged to take in our lifetime.

0:44:24 > 0:44:28After all, we take an estimated 40,000 of them,

0:44:28 > 0:44:30enough to fill a wheelbarrow.

0:44:30 > 0:44:33We take pills for allsorts of reasons.

0:44:33 > 0:44:37Sometimes it's just to treat a headache or perhaps an infection.

0:44:37 > 0:44:40But there are also treatments given on a long-term basis,

0:44:40 > 0:44:44and one of the most controversial of these is HRT -

0:44:44 > 0:44:46Hormone Replacement Therapy.

0:44:51 > 0:44:55HRT is taken by women who suffer symptoms around the menopause.

0:44:55 > 0:45:00It boosts their levels of the hormones oestrogen and progesterone, which fall at this time,

0:45:00 > 0:45:03and it can give a lot of benefits.

0:45:03 > 0:45:05But if you read the health pages of magazines,

0:45:05 > 0:45:10you'll have seen a lot of confusing information about its risks.

0:45:10 > 0:45:14- Are you thinking of HRT? - Not at this moment in time, no.

0:45:14 > 0:45:18I think my symptoms are mild and I'd rather wait until I was really desperate.

0:45:18 > 0:45:21If I read a bit more about it

0:45:21 > 0:45:24and I felt it would be of benefit to me in the future, I would take it, yes.

0:45:24 > 0:45:27- How long were you on HRT for? - For ten years.

0:45:27 > 0:45:29Would you have liked to have continued on it

0:45:29 > 0:45:32- or were you happy off it? - I was fine on it.

0:45:32 > 0:45:35For many years, women were sold the idea

0:45:35 > 0:45:39that taking HRT was the equivalent of the elixir of youth,

0:45:39 > 0:45:43and for decades sales absolutely soared.

0:45:43 > 0:45:46And then, about ten years ago, came a couple of studies

0:45:46 > 0:45:49which suggested that, far from being safe,

0:45:49 > 0:45:54long-term use of HRT was associated with increased risk of stroke,

0:45:54 > 0:45:56heart disease and breast cancer.

0:45:56 > 0:45:58Sales collapsed.

0:45:58 > 0:46:02So, were the fears about HRT justified?

0:46:03 > 0:46:08I'm going to hear the case from two experts, with very different views.

0:46:09 > 0:46:12Professor Klim McPherson of Oxford University

0:46:12 > 0:46:15studies the long-term effects of HRT.

0:46:15 > 0:46:19He was an author of one of the studies 10 years ago

0:46:19 > 0:46:22which revealed unexpected risks.

0:46:22 > 0:46:24So, should women take HRT?

0:46:24 > 0:46:27If women have symptoms which they want to get rid of,

0:46:27 > 0:46:29then they should probably think about taking HRT,

0:46:29 > 0:46:33but only as low a dose as possible and only as short a time as possible.

0:46:33 > 0:46:37- What about things like osteoporosis, then?- Magic! HRT is magic.

0:46:37 > 0:46:40It stops bone loss, you know, overnight basically,

0:46:40 > 0:46:44and continues to prevent bone loss, bone-density loss while you're taking it.

0:46:44 > 0:46:49But women at 50 don't really have much in the way of bone loss and fractures

0:46:49 > 0:46:51compared to women of 60, 70 and 80,

0:46:51 > 0:46:54and therefore, to get that benefit, you've got to take HRT for a long time,

0:46:54 > 0:46:5810, 15 years, which, given the risks, is out of the question.

0:46:58 > 0:47:02- What are the risks? - You get breast cancer more commonly, twice as commonly.

0:47:02 > 0:47:06The risk is 2 per thousand, per year. You go up to 4 per thousand, per year.

0:47:06 > 0:47:10You get an increased risk of ovarian cancer, clots of various kinds,

0:47:10 > 0:47:12strokes, DVTs and so on.

0:47:12 > 0:47:14What about things like heart disease?

0:47:14 > 0:47:19Well, we dug out all the trials that were submitted by manufacturers to the regulators,

0:47:19 > 0:47:22of which there were something like two or 300,

0:47:22 > 0:47:27and among those trials, there were several which had a massive increase in coronary heart disease,

0:47:27 > 0:47:29which presumably weren't published for that reason.

0:47:29 > 0:47:33- It is slightly shocking when you hear that, isn't it? - People thought we were bonkers.

0:47:33 > 0:47:38- Do you feel vindicated now? - Of course. Completely vindicated by the WHI trial in America,

0:47:38 > 0:47:43with 8,000 women given HRT and 8,000 women given placebo in a double blind trial,

0:47:43 > 0:47:45which showed the same results.

0:47:45 > 0:47:47Do you think that if you're currently on HRT,

0:47:47 > 0:47:52- you've been on HRT for five years, would you suggest coming off it? - Yes.

0:47:52 > 0:47:55If you haven't tried coming off it, it's very well worthwhile trying it.

0:47:55 > 0:48:00- Because?- Because your symptoms might not be there any more and you will no longer need it,

0:48:00 > 0:48:03and therefore, the risks will be ameliorated.

0:48:04 > 0:48:08Professor John Studd is a consultant gynaecologist,

0:48:08 > 0:48:13awarded the Royal Society of Medicine's Gold Medal for lifetime services.

0:48:13 > 0:48:18He has a very different opinion on the risks of HRT.

0:48:18 > 0:48:22There are about a million women in the UK on HRT at the moment.

0:48:22 > 0:48:25Do you think that figure is too low or too high?

0:48:25 > 0:48:27Well, it has fallen in the last ten years,

0:48:27 > 0:48:30therefore, I would like it to go back to normal levels.

0:48:30 > 0:48:36I would certainly like it higher, for the sake of women's health and women's future health.

0:48:36 > 0:48:38What about the argument that

0:48:38 > 0:48:42there is an increased risk of breast cancer from taking HRT,

0:48:42 > 0:48:44do you accept that?

0:48:44 > 0:48:48There may be a very small increase in breast cancer,

0:48:48 > 0:48:53but even that's disputed, and I certainly dispute it.

0:48:53 > 0:48:58Some experts are saying combined HRT increases the risk of breast cancer, doubles it.

0:48:58 > 0:49:02- Nobody said that.- Somebody said it just this morning to me!

0:49:02 > 0:49:05- Not even the Oxford people say that. - That's what he said.- It isn't true.

0:49:05 > 0:49:08- Klim McPherson said to me, it doubles it.- Not true.

0:49:08 > 0:49:11- He said it. - Well, I can tell you it's not true.

0:49:11 > 0:49:13- You absolutely deny that, do you? - Absolutely.

0:49:13 > 0:49:16There've been these two very controversial studies

0:49:16 > 0:49:19showing more heart attacks and more breast cancer

0:49:19 > 0:49:21and they've mostly been retracted,

0:49:21 > 0:49:24even, you know, by the investigators.

0:49:24 > 0:49:28I followed one of the investigators at a meeting last month,

0:49:28 > 0:49:31and he publicly apologised

0:49:31 > 0:49:33for the...

0:49:33 > 0:49:37the failure to analyse these data correctly.

0:49:37 > 0:49:41And he particularly made the point that you have in America

0:49:41 > 0:49:45these ten million or so women, 50 to 60,

0:49:45 > 0:49:48who, because of this scare, this false scare,

0:49:48 > 0:49:51have been denied the preventative aspect

0:49:51 > 0:49:54as regards osteoporosis,

0:49:54 > 0:49:56heart attacks, Alzheimer's, etcetera,

0:49:56 > 0:49:58because of this study.

0:49:58 > 0:50:03One third of all women get a fracture.

0:50:03 > 0:50:06You can prevent almost all of those,

0:50:06 > 0:50:10you can reduce the risk of heart attacks,

0:50:10 > 0:50:13you can prevent a lot of Alzheimer's.

0:50:13 > 0:50:15Why aren't you winning the argument, then?

0:50:15 > 0:50:20Because women are continuing, presumably, to not take the pills,

0:50:20 > 0:50:23they've decided HRT is too dangerous, they've given up.

0:50:23 > 0:50:28I have no doubt that once the facts become quite clear,

0:50:28 > 0:50:31that people will take up HRT again

0:50:31 > 0:50:35for removal of their symptoms and preventative medicine.

0:50:35 > 0:50:37Thank you.

0:50:39 > 0:50:42I'm not sure I've ever met two experts

0:50:42 > 0:50:46who disagree so profoundly on a subject.

0:50:46 > 0:50:48They are disputing the results of the same studies.

0:50:48 > 0:50:52It's impossible for the rest of us to know who is right

0:50:52 > 0:50:54and who is wrong.

0:50:54 > 0:50:57From the conversations I've had, this is what I've concluded...

0:50:57 > 0:51:00if you have severe menopausal symptoms,

0:51:00 > 0:51:05then the benefits of HRT in the short term are clear.

0:51:05 > 0:51:08The risks are small in absolute terms -

0:51:08 > 0:51:11an increased risk of breast cancer -

0:51:11 > 0:51:14but in the longer term those risks mount.

0:51:14 > 0:51:16But so do the benefits,

0:51:16 > 0:51:20including the reduced risk of osteoporotic fracture.

0:51:20 > 0:51:24In the end, it has to be an intensely personal choice,

0:51:24 > 0:51:27one that you have to make with your GP.

0:51:39 > 0:51:43Meanwhile, Lancastrians have been throwing more questions in our direction...

0:51:43 > 0:51:46Is it true that cracking your knuckles gives you arthritis?

0:51:46 > 0:51:48One for Chris

0:51:48 > 0:51:52One of my favourite pieces of research ever was done by Dr Donald Unger.

0:51:52 > 0:51:55For 50 years, he cracked the knuckles in his left hand

0:51:55 > 0:51:58and he didn't crack the knuckles in his right hand.

0:51:58 > 0:52:02Do you know what he found? No arthritis in either hand.

0:52:02 > 0:52:04And other, more rigorous studies

0:52:04 > 0:52:06have confirmed that the link to arthritis

0:52:06 > 0:52:09is just an old wives' tale.

0:52:10 > 0:52:12We've all heard joints crack

0:52:12 > 0:52:15and you might've wondered what exactly causes that sound.

0:52:15 > 0:52:16Well...?

0:52:16 > 0:52:19Doctors think that cracking sound is bubbles,

0:52:19 > 0:52:24forming and then disappearing in the fluid in our joints when we move them.

0:52:35 > 0:52:39For two weeks, this small stretch of the A6 in Lancaster

0:52:39 > 0:52:41has been home to an unusual experiment -

0:52:41 > 0:52:46to see if trees, even ones as small and flimsy as these,

0:52:46 > 0:52:49can help shield us from the harmful effects of PM pollution

0:52:49 > 0:52:51produced by traffic.

0:52:54 > 0:52:57In her lab at the University of Lancaster,

0:52:57 > 0:53:01Professor Barbara Maher is showing Gabriel some promising signs.

0:53:02 > 0:53:06Scanning electron microscope images of some leaves taken from the trees

0:53:06 > 0:53:09show that - lodged between the ridges and grooves -

0:53:09 > 0:53:12there are lots of particles.

0:53:12 > 0:53:15So this leaf that we're looking at, this dark leaf,

0:53:15 > 0:53:19would have been completely clean a couple of weeks ago,

0:53:19 > 0:53:22and this is after just two weeks on that heavy road,

0:53:22 > 0:53:25with all of that traffic exhaust being churned out?

0:53:25 > 0:53:28That's right. We chose the silver birch deliberately

0:53:28 > 0:53:32because our previous work has shown how efficient it is

0:53:32 > 0:53:34because of its roughness and its hairiness.

0:53:34 > 0:53:38We can actually see just how well the surface of the leaf

0:53:38 > 0:53:41provides all of this opportunity

0:53:41 > 0:53:44for the particles to be intercepted and to lodge

0:53:44 > 0:53:47and to be kept on the leaf surface.

0:53:47 > 0:53:51It's clear the pollution particles are sticking to the trees.

0:53:51 > 0:53:54When it rains, this will get washed away,

0:53:54 > 0:53:57leaving the leaves clean to collect more.

0:53:57 > 0:54:01But have the leaves on our trees actually made any difference at all

0:54:01 > 0:54:06to the amount of pollution that reached the houses and the residents inside?

0:54:06 > 0:54:11Barbara returns to collect the final measurements from inside the houses.

0:54:11 > 0:54:14The static TV screens and computer monitors

0:54:14 > 0:54:17that we left nice and clean a fortnight ago

0:54:17 > 0:54:20now get another wipe.

0:54:21 > 0:54:24The pollution from traffic tends to be rich in magnetic iron,

0:54:24 > 0:54:28so Barbara can simply measure the magnetic properties of each wet wipe

0:54:28 > 0:54:31and estimate how many particles there are on each

0:54:31 > 0:54:35so we can compare the pollution levels

0:54:35 > 0:54:37in the four houses with trees outside

0:54:37 > 0:54:40against those in the houses without.

0:54:44 > 0:54:47Barbara, when I first heard about this, I was extraordinarily sceptical.

0:54:47 > 0:54:50- You weren't expecting much? - Not at all.

0:54:50 > 0:54:52- OK.- So I'm dying to see the results!

0:54:52 > 0:54:54- The best thing to do, then, is to show you some data.- OK.

0:54:54 > 0:54:56You recall we did this interesting thing

0:54:56 > 0:55:01where we wiped the TV screens in the front room of all the houses along our street,

0:55:01 > 0:55:03our experimental street.

0:55:03 > 0:55:08These are the TV wipe data for the houses with no trees.

0:55:08 > 0:55:11So, will the levels behind our trees be lowered at all?

0:55:11 > 0:55:13These are the same data for...

0:55:13 > 0:55:16- Whoa!- ..the tree-lined streets.

0:55:16 > 0:55:18Well done! Wow!

0:55:18 > 0:55:21I am genuinely astonished.

0:55:21 > 0:55:25That is very, very, very impressive. I am utterly astonished.

0:55:25 > 0:55:30I was expecting no shift, or possibly a tiny shift, because they are little trees!

0:55:30 > 0:55:34- It's about a 50 or 60 percent reduction.- That is good!

0:55:34 > 0:55:36They have done a good job. Wow.

0:55:36 > 0:55:38Wow, good old silver birch!

0:55:38 > 0:55:39- That's it - - Who would've believed it?

0:55:39 > 0:55:44The trees are special. We knew birch would do a good job because of their leaves,

0:55:44 > 0:55:47- because of the nature of the leaves. - Right.

0:55:47 > 0:55:51An incredible 60 percent reduction in harmful particulates

0:55:51 > 0:55:54inside the houses, behind the little trees,

0:55:54 > 0:55:56more than halving the amount of pollution

0:55:56 > 0:55:59the people living inside were breathing in.

0:55:59 > 0:56:01..the fact it does something as impressive as that,

0:56:01 > 0:56:04with that few trees, that small...

0:56:04 > 0:56:08The line of trees is what's important. You don't need a forest or a continuous canopy.

0:56:08 > 0:56:12It's that edge that provides the interception of those particulates

0:56:12 > 0:56:14before they get into people's houses.

0:56:14 > 0:56:17That means the people inside hopefully are breathing

0:56:17 > 0:56:20half the amount they were breathing just because of the little trees.

0:56:20 > 0:56:23Just because that little row of green trees,

0:56:23 > 0:56:24that looked a bit like an art installation

0:56:24 > 0:56:28- but were doing a fantastic job of cutting the dust.- Wow!

0:56:32 > 0:56:35For the Hunters, and many of us who live on busy roads,

0:56:35 > 0:56:38these results are incredibly good news.

0:56:38 > 0:56:43I'm amazed that such a small thing makes such a big difference, really.

0:56:43 > 0:56:48Everybody that spotted the trees said, "What difference could they possibly make?"

0:56:48 > 0:56:50It is incredibly early days

0:56:50 > 0:56:53and they need to do lots more research,

0:56:53 > 0:56:55but I am very impressed.

0:56:55 > 0:56:58I think that, especially for the girls,

0:56:58 > 0:57:01it would be a good idea to clean the house pollution up a bit

0:57:01 > 0:57:03by getting some trees out.

0:57:03 > 0:57:05Good idea.

0:57:08 > 0:57:13Research continues into the best way to tackle traffic pollution.

0:57:14 > 0:57:18But it seems silver birch trees may have their place.

0:57:19 > 0:57:22I was really surprised by how much impact

0:57:22 > 0:57:25the silver birch trees had on the air pollution in the house,

0:57:25 > 0:57:29and since air pollution is clearly exacerbating heart disease -

0:57:29 > 0:57:32and heart disease is Britain's biggest killer -

0:57:32 > 0:57:37you can see that this is potentially a hugely important area of research.

0:57:37 > 0:57:41Certainly, if I lived on a busy street, I would want to see trees outside,

0:57:41 > 0:57:44and if I had a front garden, I would be out planting my own.

0:57:44 > 0:57:47That's it from us. I hope you have found it useful.

0:57:47 > 0:57:49We have certainly found it eye-opening.

0:57:52 > 0:57:55That's quite a shock. That is quite a shock.

0:57:57 > 0:58:00Standing badly like you are, it's dreadful!

0:58:00 > 0:58:02That's what you're not supposed to do!

0:58:02 > 0:58:04That's astonishing.

0:58:04 > 0:58:08# I just made an appointment For a special rendezvous

0:58:08 > 0:58:13# To see a man of miracles And all that he can do

0:58:13 > 0:58:18# I checked in at reception Put my hat into my lap...

0:58:18 > 0:58:21I feel really rude taking your strawberries. Go on.

0:58:21 > 0:58:24Whoo! Whoa! That is good!

0:58:24 > 0:58:26# Come over here And give me some medicine

0:58:26 > 0:58:28# Move a little closer So my head can spin

0:58:28 > 0:58:31# A little bit of potion Makes my fever go

0:58:31 > 0:58:33# Get it out of me like a volcano

0:58:33 > 0:58:36# Da-ba-da-be-di-be-da-be-du-doh-doh

0:58:36 > 0:58:38# Doc-tor, I want you

0:58:38 > 0:58:40# Mmm, my Doctor Wanna Do

0:58:40 > 0:58:42# I can't get over you

0:58:42 > 0:58:45# Doctor do anything That you wanna do

0:58:45 > 0:58:48# Doc-tor, I want you

0:58:48 > 0:58:50# Mmm, my Doctor Wanna Do

0:58:50 > 0:58:52# I can't get over you

0:58:52 > 0:58:55# Doctor do anything That you wanna do #

0:58:55 > 0:58:58Subtitles by Red Bee Media Ltd