Episode 3 Trust Me, I'm a Doctor

We're constantly being told how to live our lives.

But what's the health advice you can really trust?

In this series, we use our expertise to guide you...

..through the contradictions and the confusions.

We'll get to the heart of the debate...

..and ensure you get the information you need.

We're here when you don't know where to turn.

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.

This time, we're in Glasgow, doing a huge experiment -

to test whether vegetable oils are good for our hearts.

We'll be finding out if eating meat is bad for you,

testing whether beards are dangerously unhygienic...

Excuse me, sir, would you mind if I swabbed your beard?

..hearing from survivors on how to spot a killer disease

before it's too late,

and seeking the best remedy for painful mouth ulcers.

That's not the most pleasant thing in the world! Oh, my God!

Welcome to Glasgow, a vibrant, exciting city,

but also one where more people die of heart disease

than anywhere else in the UK.

We've come here to do a big experiment,

to see if changing just one thing about your diet

can give you the benefits of a Mediterranean lifestyle,

without you having to move to the Med.

In countries like France and Spain,

they live longer, and have lower levels of heart disease,

and many put it down to their diet.

It's full of vegetables, fish and less meat than we're used to.

But could it be that the key is actually simpler -

just one magic ingredient?

Olive oil.

Now, we consume a lot more than we used to,

but the amount we knock back

is nothing compared to our Mediterranean cousins.

The French consume about twice as much as us,

the Spanish 14 times as much,

and the Greeks a whopping 20 times as much.

The trouble is heart disease takes years to manifest,

and there's never been a way to test

whether one particular food can really make a difference...

until now.

Because here in Glasgow,

they've developed a brand-new scientific technique

that can do this for the first time.

And it centres on another golden liquid.

This is a flask of human urine -

my urine, to be precise.

It contains waste products from my body

but it's also, in its own way, medical gold.

as it contains information

about processes that are happening deep inside my body.

That information comes in the form of particular chemicals

in the urine - proteins - which the team can detect in the lab.

And what's really exciting is that they can work out

a protein fingerprint for different diseases.

-Hi there.

-Hello, Michael.

'The technique is called proteomics

'and it's being pioneered by Dr Bill Mullen.'

If we monitor the proteins in the urine,

we can monitor what's happening in the cells in the body.

So somebody who, for example, has got heart disease

will start to produce different proteins in their urine

to someone who has a healthy heart.

There will be a different fingerprint of these proteins

in their urine and we can detect that before the person actually

has any symptoms of the disease.

I guess it's very different from

measuring things like cholesterol in the blood

because cholesterol in the blood is basically just a risk factor.

It doesn't tell you whether you have heart disease,

-it just tells you you're at greater risk.

-That's correct, yes,

but when our proteomics fingerprint shows that you have heart disease,

we're actually measuring the disease itself,

not the risk of developing the disease.

This new technique can detect disease

before you have any symptoms at all.

It's so precise that over just a few weeks,

Bill thinks we can use it to measure

whether consuming olive oil, as the marketing suggests,

can improve heart health.

So his team in Glasgow are running a trial of 70 people

and I'm one of them.

I start by swapping my flask of urine for a bottle of olive oil.

Bill's team will test my urine along with the other volunteers'

to determine the health of our hearts.

And we'll have to take 20ml of the oil every day for six weeks.

-Any special tips?

-Well, it has to be consumed raw.

Cooking with it tends to degrade

the compounds that are meant to be good for you in it.

So the health message is that it's raw.

OK, raw, fine. I think I got the better of the exchange.

-Cheers, Michael.

-Cheers.

But there's a twist.

Half the people in the study are being given regular olive oil -

the other half, extra virgin.

I won't be told which I've got.

The more expensive extra virgin oil

has been claimed to be better for your heart than regular oil

because it doesn't go through any processing,

so it contains a lot more natural chemicals from the olive plant.

This study will be the first real test.

Now, I'm really looking forward to this,

but I'm also a bit sceptical,

because I think the benefits of the Mediterranean diet

come from the whole thing, not just from the olive oil.

Nonetheless, however, I'm going to add a couple of dessertspoons

to my daily diet and see what happens.

Compared to some of the things I've done in the name of science,

consuming olive oil is a pleasure!

On salad. On bread.

Or even just as it comes.

'And after six weeks, the scientists analyse everyone's urine again

'to see if taking the oil has made any difference.

'So, time for the results.'

-Ta-da!

-Time for the fun, yes.

Well, the good news is that

the results show there was a positive effect.

First, the results from those taking the extra virgin olive oil.

On average, the levels of particular proteins that signal heart disease

fell significantly over the six weeks.

That's a fantastic result in such a short period of time.

-Very pleasing.

-This is one of the beauties of this test,

that I think is really good for

measuring the effectiveness of food

in changing your health.

That is impressive.

'And what about the normal olive oil?

'Well, the results show

'it has exactly the same effect.

'It seems that any olive oil is good for you.'

I wondered if I was going to put on a bit of weight,

knocking back all that oil, but, actually, it made no difference.

Well, the 20ml of olive oil which is sort of the recommended amount

that you have, that's fine.

I would recommend no more than 20ml of olive oil a day,

and the best thing to do is replace fat in your diet with olive oil.

So we might finally have identified

at least one element of that famously healthy Mediterranean diet.

A little bit of olive oil a day can improve your heart health

in just a few weeks.

And it doesn't seem to matter which kind,

so you can save some money by choosing the regular sort

rather than that fancy bottle of extra virgin.

Cheers.

But olive oil isn't the only oil

that's marketed as being good for our hearts.

So later in the programme, we'll be teaming up with Bill again

to put some other supposedly healthy vegetable oils to the test.

But first, over to Dr Chris van Tulleken.

In recent years, a strange force has grown in power on Britain's streets.

The beard.

They seem to be everywhere these days.

But rumours abound that they might not be hygienic.

Recent reports have suggested they could be full of germs -

even poo.

So is that true?

Now, you probably know that every inch of you is covered with bacteria

and a good throng of the right microbes is essential

for our wellbeing - indeed, you can't live without them.

It's only if the wrong kinds of bacteria start to proliferate

that you get problems.

But what about beards?

Are we surrounding our mouths with giant microbial mats?

And if so, could it be doing us harm?

'OK, it's not me.

'This furry-faced doppelganger is my identical twin brother, Xand.

'I've always been slightly suspicious of him

'and his bearded ilk.

'His face mat may harbour all kinds of strange bacteria,

'but the fact is, we don't actually know.

'And being a doctor of infectious diseases,

'I, for one, want to get to the truth.'

So I'm going to have a furtle in some of the furry faces of Camden

using one of these.

This is a bacterial swap, and then we're going to grow out the bacteria

on this - a Petri dish covered in agar jelly.

Let's find some beards!

'I'd like to find out

'whether there are more bacteria on beards than on naked skin.'

Excuse me, sir, would you mind if I swabbed your beard?

'What we'll find is a bit of mystery.

'Research so far has been contradictory.

'A study from 2000 showed that

'bearded faces shed considerably more bacteria than naked skin.'

But a 2014 survey befriended the beard,

showing that they contained less Staphylococcus aureus.

That's the bacterium that puts the "SA" into MRSA,

the hospital superbug.

So, are beards unhygienic or not?

It's four weeks since I took my swabs.

And here at University College, London,

they've been incubated and analysed for bacteria by Dr Adam Roberts.

He's studied bacteria from the planet's poles

to the bottom of the sea, but beards are a new habitat, even to him.

So what did you find on the beards?

Well, a lot of different bacteria, actually.

These look disgusting.

There's many different bacteria on there.

We've got over 100 species.

-Are these bacteria?

-No, those are a couple of moulds.

-You don't normally expect moulds on skin.

-No.

There are many different reasons why there could be moulds in a beard.

We didn't go into it.

-Right, most of them don't bear thinking about!

-That's right.

It may sound disgusting, but of the bacteria that Adam identified,

almost all can be found on naked skin.

And while we did find one common to our small intestine,

it doesn't mean it came from poo, as the headlines suggested.

For those of us that are involved with beards -

we either have beards, or we kiss beards,

or we're involved in the beard community -

should we be worried?

Are there health and safety concerns

with beards that you have identified?

No. I don't think so.

So we don't have to be anxious about that?

There's nothing we've found which is alarming.

Nothing alarming,

and in fact, Adam has seen something potentially exciting in our samples.

When you get a competitive environment like a beard,

where there are many different bacteria, they fight for food,

resources and space, so they produce things like antibiotics

and you can see here, you've got halos

and that's what we're looking for.

The clear halo is a ring of death,

created by antibiotic chemicals

secreted by the bacteria in the middle,

killing everything around them.

It's the same thing that Alexander Fleming first noticed

when he discovered penicillin.

So that's a colony of a beard bug

-and around it, it's killed the other bacteria.

-That's right.

This is hugely exciting. Potentially an antibiotic.

Yes, and potentially, we could use it in medicine.

Adam still has a lot of research to do before we'll find out

whether Trust Me I'm A Doctor has discovered the next penicillin.

But it seems that there are no more nasties lurking in beards

than on naked skin.

So that's a relief - beards are completely safe.

And in fact, far from being dangerous,

they might actually be concealing the next generation of antibiotics.

Back in Glasgow,

surgeon Gabriel Weston is leading the next part of our big experiment.

We're using a brand-new technique

to test whether different vegetable oils are good for our hearts or not.

Earlier in the programme, we put olive oil to the test

and discovered that it really can improve our heart health.

We know now that adding just 20ml of raw olive oil

to what you eat every day can be really good for your heart.

But we want to go a step further

to discover if other oils can be beneficial, too.

The kinds of fats and oils we eat have long been a hot topic.

For decades, saturated fats, like butter and lard,

have been seen as the devil's work,

linked to high cholesterol and heart disease.

So we began to replace them with vegetable oils,

which contain healthier, unsaturated fats.

In fact, no matter which oil you choose,

it will be made up of three types of fat.

All vegetable oils contain a combination of polyunsaturated,

monounsaturated and saturated fats.

And for years now, the health benefits of each of these

have been the cause of much debate.

In the 1980s, we were bombarded with marketing for polyunsaturated fats,

like those in sunflower oil.

These were thought to lower our cholesterol

and be good for our hearts.

Then, in the 1990s,

the marketers began to sell us the Mediterranean dream, with olive oil.

This oil is rich in monounsaturates,

also thought to reduce cholesterol.

Today, another oil is getting a lot of hype - rapeseed.

Like olive oil, it's high in monounsaturates.

But which of these is really best for us?

To find out, we're going into oil in a big way.

So we've recruited 75 volunteers.

A third of them will get a six-week supply of rapeseed oil.

Another 25 will get sunflower oil.

And 25 of them will have no oils at all -

they're our control group and they'll carry on life as normal.

As before, none of the volunteers know which oil they're getting.

There's just one rule.

As with the olive oil, they're not allowed to cook with it,

as most of it would end up in the pan.

Instead, they need to take it raw.

20ml, or two dessertspoons full, a day.

Once again, Dr Bill Mullen from Glasgow University,

will analysing their urine at the beginning and end of the experiment

to see whether either of these oils

really does make a difference to our heart health.

Olive oil, at the moment, is the only one

that is really a health benefit out there.

We have rapeseed oil, which is also rich in monounsaturates,

so we think they're similar.

And we also have sunflower oil,

which is high in polyunsaturates

and there's good health claims around

that this may be beneficial, as well.

So, at this point in time,

we really don't know what the outcome's going to be.

So there's a real air of mystery to this that we're investigating.

It hasn't been done before like this.

And that's why we're doing the science,

to try and find out exactly what it is

that we can recommend to people to actually take.

And I notice here that you've got your oil with your lunch.

I'm wondering what your favourite tipple is?

Well, at this point in the study, we can't tell you.

And if I did, I'd have to kill you, then!

We'll find out how well these different oils

live up to their marketing later in the programme.

Previously on Trust Me, we asked you to help us find out

whether using duct tape on warts or verrucas was actually helpful.

Well, hundreds of you gave it a go and got in touch.

And it turns out that perhaps it is.

57% of people said they saw some reduction in the size of the warts,

particularly if they were big ones.

In fact, on average,

they went down by about a quarter over four weeks.

Now, this compares favourably with doing nothing at all

or, indeed, other forms of treatment.

So if you want to find out how to use duct tape

on your wart of verruca,

then go to our website...

And on our website, you can also ask us

any health questions you'd like answered.

Hundreds of people have done just that.

And our first question is...

What causes mouth ulcers

and how can I prevent or get rid of them?

One for Dr Saleyha Ahsan.

Mouth ulcers, or canker sores, are tiny.

But they can be so painful that they can stop you from eating

and even talking.

-Do you get them?

-No, but I used to.

Yeah, occasionally, from time to time.

I have one right now!

Let's have a look. I can see it, yeah.

Ulcers happen when a patch

of the top layer of skin in your mouth gets damaged,

leaving the pain sensors underneath more exposed.

Sometimes, the cause is obvious.

You're chewing away, you bite the inside of your cheek

and...hey, presto!

There's an ulcer.

But other times, they can seem to come out of nowhere

and even we doctors aren't always sure why they develop.

Some research indicates slight overactivity of the immune system

can be to blame and that some people get them

when they're tired and run-down.

So what can you do about them?

Although most ulcers will heal by themselves within a week,

there are some home remedies you can try to relieve the pain.

'Some people swear by chilli.'

OK... That's not the most pleasant thing in the world!

Chilli contains the chemical capsaicin.

This triggers our nerve sensors for heat.

But it's also thought to act as a natural painkiller.

Are you all right with it?

-Oh, yeah.

-Oh, my God, it's really hot, though. It's nice.

So mixing a bit of chilli with water

and dabbing it on your ulcer could help.

Maybe I didn't do it enough.

I think you did. I think you've given it a good... OK, right. OK.

Yeah, that's good.

But if you find chilli painful, don't persist with it.

There are some less fiery options.

Peppermint and eucalyptus contain chemicals

that trigger the nerve sensors for cold

and also seem to reduce the sensation of pain.

Whoa!

That's really minty.

It feels really airy inside my mouth.

You can buy them as essential oils,

but make sure you use them as directed on the label.

And if neither hot nor cold does it for you,

there are over-the-counter treatments,

containing the ingredients salicylate or lidocaine,

which can help relieve the pain.

Now, it's important to say that the methods we've mentioned so far

may help lessen the pain of an ulcer,

but none of them will help the ulcer to heal.

Yet there are a few things that can.

Salt has been known for a long time

to have mild anti-microbial properties.

So swishing your mouth with warm salt water

may help ulcers heal more quickly.

But adding bicarbonate of soda to your home-made mouthwash

might make it even more effective.

That's thought to be, in part, because it's alkaline,

which the bacteria in our mouth don't like -

although nor do I.

Now, none of these home remedies have been subject

to controlled scientific studies.

But the science does makes sense

and, anecdotally, they do seem to help.

If none of them work for you,

your doctor can prescribe more heavy-duty medical treatments,

which help ulcers heal more quickly.

Ask your GP or dentist what's best for you.

But if an ulcer takes more than two weeks to heal

or is bigger than a centimetre,

it could be something more serious.

So do get it checked by a doctor.

Although you can't stop ulcers from forming,

the good news is you can help lessen the pain

and possibly help them to heal faster.

Just choose the method that works for you

and stick with it until the ulcer's gone.

It's that time of year when the cold and damp

seem to bring out all our worst aches and pains.

In fact, one in eight of all GP appointments

are about pain in the joints.

So show me on the skeleton where you ache.

-Right underneath the kneecap.

-OK, yeah.

Knees and feet.

I've got a problem with my left shoulder,

kind of in-between the two bones here.

Sitting down. If I get up, then that's a struggle.

It's one of these things you just have to try and manage.

So why do our joints give us so much bother?

And what can we do about it?

In a healthy joint, the tips of the bones

are covered with a soft tissue called cartilage.

And in that joint space there, there's a fluid that's a lubricant

called synovial fluid.

It's a bit like oil in a hinge.

But if any of that system gets damaged,

that's when we get pain.

The most common cause of joint pain is arthritis.

And the most widespread form is osteoarthritis or OA.

It's caused by basic wear and tear.

The cartilage gets damaged

and when you're not using your joints, fluid leaks out.

So the less you move, the stiffer you get.

A staggering 8.75 million people seek help for OA every year.

We feel it mainly in our knees, our hips

and the small joints of our hands.

But there are things we can do to alleviate the symptoms,

or possibly even avoid them altogether.

To show you how, I've come to meet some folks

whose job puts them particularly at risk of OA...

hauliers.

The combination of heavy lifting

and long periods sitting still

can take its toll on the joints.

Tell me about your joints.

Aches, pains, anything at all?

Aches and pains in that finger and that finger.

If I touch anything, try and grip hold.

It's worse in the mornings.

I'm suffering with my knees. If I sit in the car for a long time

and then I go to get out, that causes me problems.

To diagnose OA, there are some classic signs to look out for.

The symptoms to look for

is pain within 30 minutes of waking up in the morning.

Like your knee pain...

Bad when you get up, gets gradually better.

The thing we need to do is to get the joint moving

and to strengthen the muscles around the joints.

And you can do this with some simple exercises.

So we get the socks. What we're going to do

is rest your hands on the arms of the chair

and squeeze the sock as tight as you can

and hold it for 30 seconds.

So we'll do this off and on with a 20-second rest.

You want to build up to doing this for about half an hour.

It's about strengthening those small muscles around the joint

and that's what improves joint pain.

Maybe it's nicest if you're sitting around on the sofa with the missus

watching the telly,

not to use your stinky socks

that you've been loading vehicles with all day.

Next up are the knees.

What could be more natural than lying on the floor with your doctor?

Bend the left knee, like that.

And then lift that right leg off the ground, a foot in the air.

And hold that for 20 to 30 seconds

and keep that muscle as tight as you can.

And relax. OK, and swap legs.

Simple exercises like these

can really help avoid or reduce the pain of OA.

But there's another form of arthritis

that's completely different.

Rheumatoid arthritis, or RA, affects around 700,000 people

and it has nothing to do with wear and tear.

Instead, the immune system attacks the soft tissues of the joint,

causing them to become inflamed and swollen.

It's estimated that as many as 300,000 of us

have RA without knowing.

But if you spot it early, you can stop it in its tracks.

There are medications available that can slow the condition

and minimise joint damage,

provided they're started within three months of the first symptoms.

So here's what to look out for. It's called the S-factor.

The first S is for stiffness.

Does your early-morning stiffness persist for more than 30 minutes

and sometimes into the day?

The second S is swollen.

Is there swelling around the joints and are they hot to touch?

And the final S is squeeze.

When you squeeze your joints, are they painful?

If the answer to all these questions is yes,

then you need to see your GP as soon as possible.

Because, if you catch RA early, you can stop its progress

and keep the disease in check.

But one of the biggest mysteries about arthritis

has never been solved.

And that is, does bad weather really make the pain worse?

Well, new research at the University of Manchester

could soon answer this age-old question,

with the help of you and your mobile phone.

The study is being led by Dr Will Dixon.

We've got an app that will allow people to report their joint pain

and at the same time as the patient's reporting,

we use the GPS signal that links to the local weather station

so that we can then look at the association between their joint pain

and the weather at that moment in time and exactly where they were.

OK, so if the phone doesn't move, it's usually cos that person

-is in pain and they're reporting more severe symptoms.

-Absolutely.

The accelerometer and the GPS track people's activity

-and that's of real importance.

-OK.

Because, if people have arthritis and their arthritis gets worse,

then, typically, their activity goes down.

In a rheumatology clinic,

I might see somebody every six months or once a year

and I don't know how they've done over that time.

But actually, if I have a system

whereby I can use the phone on in their pocket

to infer information about their activity,

then that would be great.

The app is now available for anyone to download,

allowing the team to gather data from across the country

in a way that's never been possible before.

It's hoped this will develop better treatments

for millions of sufferers.

This is a massive study and it's hoped that it will give new insight

into what causes joint pain, helping millions of people in the process.

There are links to the study on our website,

so if you have joint pain of any kind,

I strongly recommend that you go to the website and sign up.

Go to...

..where you can also find more exercises

to help avoid osteoarthritis.

Still to come...

..how much meat is safe to eat?

And can we drink alcohol when we're on medication?

But first...

Previously on Trust Me, I'm A Doctor,

we ran tests on herbal supplements available here in the UK

and we found that many of them are not what they say they are.

We discovered that many supplements sold without the "THR" mark,

that is a guarantee of quality,

actually contained little or none of the product advertised

and some even contained chemical contaminants.

If I look at all these packs on this table,

they're all very clear,

they have ingredients, they have a dosage.

I mean, they can't just be lying?

Well, I'm sorry to say,

I think some of the suppliers of food supplements,

yes, they are lying.

Well, we passed our findings on to the Food Standards Agency.

They have commissioned local authorities to run further tests.

They have taken more than 500 samples of supplements

and results of those tests are now being analysed

and should be published very soon.

We'll be putting the report on our website straightaway,

and the FSA will help local authorities to take action

against companies found to be selling fake or contaminated supplements.

To find out more, go to our website...

..where you have also been asking us your health questions.

How can I get rid of my tinnitus?

To investigate the phantom noises caused by tinnitus,

Gabriel Weston is stepping into a completely soundless room.

# It's oh, so quiet

# Ssh! #

It's not unusual if you find yourself

in a completely silent room to hear the odd noise in your head.

Buzzing, ringing, clicking, hissing.

Tinnitus is the term for

when these noises become obtrusive in everyday life.

And 10% of us will suffer from it at one point or another.

But why does tinnitus happen, and can we get rid of it?

Well, a new understanding of the condition

may help come up with solutions.

Up to 90% of cases are in people who are suffering from hearing loss,

either as part of the ageing process,

or because of exposure to loud music and noises.

And that has been a vital clue.

A new theory for why tinnitus happens

is that sensory cells in the ear

overcompensate for hearing loss by becoming more sensitive.

This turns up the volume on background noises

we wouldn't usually hear,

a bit like turning the gain up on an amplifier.

DISTORTED BUZZING

So if you suffer from tinnitus,

the first thing you should do is get your hearing checked.

You might find you need a hearing aid,

and this could help stop your ear overcompensating -

in effect, turn down the gain and get rid of unwanted noise.

But if that doesn't get rid of your tinnitus, then there is a way

to make it less intrusive -

listening to something else to tune it out.

One way to do this is to use a sound pillow at night,

to play music or sounds of nature as you go to sleep.

Other people swear by white noise.

Now this can be delivered to the ear via a generator

which is worn a bit like a hearing aid,

or by just switching your analogue radio in between stations.

But there could be more hope for some tinnitus sufferers.

Drugs are being developed

which may in the future reduce the unwanted noise

for those whose tinnitus is caused by inner-ear damage.

For now my advice would be,

be reassured that your tinnitus is highly unlikely to be dangerous.

Get your hearing tested.

And if your tinnitus is intrusive,

try some of the available therapies out there.

They really can make the difference

between tinnitus that gets on top of you

and tinnitus that you can really manage.

It's always difficult to know how best to be healthy.

We're told something is good for us.

Then too much is bad.

So what are the limits?

When can you have too much of a good thing?

This time, I'm looking at meat.

Now, is it a vital source of protein and other nutrients,

or would you be better off leaving it out of your diet entirely?

When it comes to meat, how much is too much?

I've come to hear the opinions of two leading experts

about the links between meat and health.

They have very different points of view.

Professor Robert Pickard

thinks meat plays an important part in a healthy diet.

There is no biological reason whatsoever

to be unduly concerned about red meat.

But Dr Valter Longo thinks any amount can be harmful.

I think it would be safest to go to no meat at all.

So how do they come to such different conclusions?

I want to hear their evidence. First up, Robert Pickard,

Emeritus Professor of Neurobiology at the University of Cardiff.

He's former Director General of the British Nutrition Foundation

and a member of the Meat Advisory Panel.

What do you think about the recent article in The Lancet

saying that processed meat definitely causes cancer

and that red meat probably does?

It's very important to distinguish between associations

and cause and effect mechanisms.

The evidence that it was based on shows associations

between people that eat certain quantities of red meat

and the incidence of disease, in particular, of course, cancer.

But we've got lots of studies to show that vegetarians

have the same incidence of colorectal cancer

as people that eat meat on a very regular basis.

So the science would indicate that there is nothing to worry about.

So why are there so many negative reports about red meat?

I really don't understand that,

because there is no biological reason whatsoever

to be unduly concerned about red meat.

I would eat red meat from pork, lamb or beef

probably two or three times a week.

It's the most nutritious food that we have on our plate,

and in fact, with a small amount of red meat

and a tiny one-inch cube of liver,

you would get all your vitamin and mineral requirements

just in one portion of food.

You'd only need to supplement it with a little bit of vitamin C.

In terms of quantities, then,

you are comfortable eating red meat two or three times a week?

How much?

If you could take a piece of fillet steak,

and you look at the palm of your hand,

and if you can imagine it fitting into the palm of your hand,

about a centimetre high,

then that's an appropriately moderate amount.

When people ask me about beef burgers,

which can be a similar shape and size,

I always have to remind them that a beef burger contains 30% more fat

than an equivalent weight of genuine fillet steak.

So in fact, a beef burger is TOO nutritious

to be eaten in large quantities by sedentary people.

So you would put processed meat into a different category to red meat?

Well, processed meat contains more fat,

and that can create a problem

because there is some indication that

a high intake of fat could have some carcinogenic properties,

and also if a meat has been preserved with nitrates or nitrites,

then of course, those can be carcinogenic.

Have you ever been tempted to become vegetarian?

No, because the biology has always been very clear to me

that after the age of 60, it becomes much more difficult

to absorb nutrients from the gut.

So I always say to people over 60 that red meat

is far more valuable to you than it was in your middle years,

because now you need extra concentrations

of vitamins and minerals

to cope with the fact that you're less efficient at absorbing them.

Are your views at all affected by funding?

Have you been funded by the meat industry?

No, but the Meat Advisory Panel

is funded by the Agriculture and Horticultural Development Board.

But my views are the views of a professional biologist,

and they represent other views

that professional biologists would generally have.

I would not do anything

that I believed to be contrary to the public interest.

So what would your broad advice to people be?

We've evolved over seven million years to eat an omnivorous diet.

Our gut is designed to treat both animal and plant foods.

So I would maintain a pretty steady supply

of animal proteins throughout life.

I'd make sure that it's slightly higher for children,

and it's particularly higher for adults over 60.

So Professor Pickard thinks we all need at least some meat

to stay healthy, and there is no strong evidence

to link eating meat with an increased risk of cancer.

Professor Valter Longo strongly disagrees.

He's Professor in Gerontology

at the University of Southern California.

He's shown a link between high protein -

especially from meat - and age-related diseases.

Your research suggests that too much protein

-is associated with accelerated ageing.

-Yes.

And is there a particular level which triggers off these processes?

Yes, and it turned out that people

that had over 20% of their calories coming from proteins

were at a much higher risk for a variety of diseases.

But does it matter where the protein comes from?

Yes, we believe that it does,

and the amino acid profile of, for example, plant-based proteins

is different from that of animal-based proteins.

And the red meat may in fact - we don't know yet -

but may in fact have the worst profile in general, right?

And we suspect that the type of amino acids that it contains

has the largest effect

and these growth factors that are so central for ageing and diseases.

Now do you think there's something particularly bad

-about processed meat?

-Yes.

The processed meat may contain other components - the fat -

and maybe some of the ingredients, maybe they're based on

the way the meat was processed or the way the animals were fed,

and those could have additional effects that makes it even worse.

Now you've said that eating large amounts of meat

is as bad for you as smoking.

Do you stick with that?

Yes, I mean, the statement was about the risk, right?

So when you look at the database of a number of diseases

in the United States, following thousands of people,

and you look at the risk

for the group having the highest protein intake,

and then you look in the same database for either smokers

or past smokers, the risk increase was very similar.

Isn't that rather peculiar,

since our ancestors have been eating red meat for millions of years?

Yeah, and this argument is...

I always hear this and it's just completely irrelevant,

and it's irrelevant because our ancestors lived to 55,

maybe, if they were lucky, they made it to 50, 55 years of age.

So what do you eat?

I eat a plant-based plus fish, so a pescatarian diet that is

low-protein, high-nourishment and generally low-carb.

I assume that... You know, you're obviously Italian,

that in your childhood you must have eaten quite a lot of these foods.

Yeah, actually, we spend a lot of time going round the world

asking people what they eat now, centenarians especially,

and what they used to eat,

and it turns out that when you ask centenarians,

particularly Italians, they almost never ate red meat.

Now realistically you're not going to persuade people worldwide

to give up eating meat, it's extremely unlikely.

What do you think people should do?

I think that, if you can do it, as it happened for smoking,

then it's best to go down to very little or nothing.

I mean, it's interesting that we don't use the system

that we already use in a courtroom,

where you have to have evidence from many different sides, right,

then you put it all together and at the end, you have a verdict.

So you think basically the verdict should be, meat, guilty?

Absolutely yes.

The verdict right now is meat guilty,

and then you can always appeal,

and with the appeal, we will see,

but I feel pretty good about the case, yeah.

So Professor Longo is convinced that eating lots of protein,

particularly from meat, is bad for us and can cause cancer.

After hearing the evidence on both sides, it's time for me

to decide on my verdict for meat.

Now having listened to my two experts, I am, if anything,

a little bit more confused than I was.

But I think something which is really clear,

processed meat is bad for you.

If you really want to live a long time,

then probably your best bet is to go for Professor Longo's approach,

which is essentially fish and vegetables.

But most of us are human.

I still enjoy my steak, and so I think it's pretty safe,

if you stick to the government guidelines,

which are 70 grams, on average, a day.

That is not very generous, it's a piece of meat about the size

of my palm, and about one centimetre thickness.

There are some conditions, like heart disease, where most people are aware

of the signs and symptoms.

But there is a condition which kills over 30,000 people every year,

which people are not really aware of.

That is a shame, because if they were, many lives could be saved.

Over to Dr Saleyha Ahsan.

This little-known killer is called sepsis.

It can strike any of us at any time,

but its early signs can be difficult to spot.

But now survivors of the condition are sharing their experiences

so that we can all learn what to look out for.

And across the nation,

doctors and campaigners are working to raise awareness of sepsis

so that more lives can be saved.

Sepsis causes around eight million deaths worldwide every year,

and 37,000 of those happen here in the UK.

That's more than breast, bowel and prostate cancer combined,

yet very few people have ever heard of it,

and fewer still understand it.

You may have heard it called septicaemia, or blood poisoning,

but it isn't actually an infection.

It is caused when the immune system reacts to an infection

in a way that's abnormal and dangerous.

My daughter Tilly had sepsis.

Her body shut down.

I woke up three weeks later, I couldn't lift my hands.

I couldn't feel my legs.

I couldn't speak, either.

I just wondered what had happened to me. How did this happen?

The trigger for sepsis can be as simple as a cut finger.

But in a matter of days, even just hours,

it can develop into a catastrophic attack

that threatens the body's own tissues and organs.

I was 20.

I didn't understand it because I do quite a lot of sport,

I'm mostly fit and healthy.

It didn't make any sense in my head that I'd become so sick so quickly.

If sepsis isn't recognised early

and treated quickly,

it can lead to shock, organ failure and death.

And those lucky enough to survive

may have to live with amputations and lasting health problems.

I survived, but at the cost of my right leg below the knee,

all the fingers on my left hand

and the second and third digits of the fingers on my right hand.

Any of us can get sepsis,

and it can be triggered by any kind of infection, even minor.

Yet it can be surprisingly difficult to spot.

So listening to survivors can help us all learn

what symptoms to look out for.

It came on really, really suddenly -

I woke up in the middle of the night feeling very cold

but kind of sweaty and feverish and shaking a bit,

and I thought, "Oh, this is great. Great, I've got flu(!)"

It started off with flu-like symptoms -

temperature, shivering.

About three days later I started getting stomach bug symptoms

as well, so I had quite bad sickness and diarrhoea.

Sepsis often starts with intense flu-like symptoms,

but as it gets more severe,

it reduces the blood supply to major organs,

leading to some more distinctive symptoms.

For me it was the shivering and the shaking, just...

I had absolutely no control over it.

I was legitimately worried

I was going to end up chipping quite a few teeth just because I was...

my teeth were chattering.

You're trying to take in as much air as you can

and it's like there isn't anywhere for that air to go

so you can't breathe in any more.

I got very confused.

I think it may be that confusion

that alerted my husband to get a doctor.

My wife just said I was delirious, confused,

and, er, she just dialled 999 right away.

Mandy, you'd noticed that Tilly hadn't been wetting her nappies.

I don't think it was particularly,

erm, something that stuck out in my mind,

but actually it should have been.

If I'd had some information,

I might have picked up on earlier and said, "This isn't right."

Symptoms like these are signs that some of the body's organs,

such as the lungs, brain and kidneys,

are being starved of oxygen and are going into failure.

I noticed a mottled rash all over my body.

It was a rash that I'd never really seen before.

A rash like this is caused by capillaries, tiny blood vessels,

shutting down, and blood leaking into the tissues under the skin.

With me, it sort of progressed and sort of spread

over my entire body, erm, there's a photo of it here.

Also you can see the swelling of my body from not passing any fluid.

At this stage, Patrick's life was hanging in the balance.

In fact, all our survivors were close to death

by the time they reached hospital.

And some were instinctively aware of the danger -

a feeling that shouldn't be ignored.

At one point I was on my knees

and I really thought I was going to die.

Er, looking back, it was as if my insides were being crushed.

This kind of direct feedback from people who've survived sepsis

has been used to compile a list of six common red-flag symptoms.

In babies and young children,

some of these symptoms will present differently.

In babies, you won't notice that they've got slurred speech,

but you might notice that they're irritable,

not feeding and not engaging.

This makes children, like Tilly, particularly vulnerable.

We couldn't really rouse her from her sleep,

and her skin had gone mottled.

I tried to give her a bottle and she wouldn't take it,

so at that point we literally put her in the car,

and then we had to drive 80 miles down to Southampton

where they've got a paediatric intensive care unit,

and from that point it sort of snowballed,

and they said that she might not make it

because she had sepsis and she was in septic shock.

I've never heard of sepsis, didn't know where to turn.

Didn't know where to get information.

Although close to death when she was brought into hospital,

thanks to a doctor's speedy diagnosis, Tilly survived.

I probably hold them a bit closer than I would otherwise

but, you know, I feel so lucky, so lucky.

Gosh, I want to give you a hug!

'One thing that everyone in our group had in common

'was a lack of existing knowledge about sepsis.

'That's something I want to help change.'

I think the most important thing is for people to consider sepsis.

It's that fine line in that sort of first period of recognition

which is the most important,

because you can save a life or a limb,

or psychological damage to someone,

and that's the most important thing

so it's getting people to really consider it.

Testimony like this from patients can make us all more aware of sepsis

and improve recognition and treatment.

It's something I'm personally passionate about,

so, please, go to our website at...

..for more information,

and spread the word about sepsis to help save lives.

Now, something that confuses a lot of people is,

when you're on medication, what food and drink should you avoid?

Like alcohol. As a doctor, I'm always asked,

can people drink booze when they're taking medicines?

Or could that end up being a lethal cocktail?

In fact, it's thought that drinking alcohol while taking medicine

is a factor in up to a quarter of all A&E visits.

You might think that antibiotics are the biggest culprit,

but rather surprisingly, most nowadays don't require abstinence.

Other drugs, though, can be a problem.

You should never take alcohol with medicines that make you drowsy

because alcohol also makes you drowsy.

But there are other medicines that change the way that alcohol

is broken down and they can increase this toxic by-product that you get

when you drink alcohol called acetaldehyde,

and give you a thing called a flushing syndrome,

where you can vomit, go bright red in the face,

and it can dangerously increase your heart rate.

So alcohol is something to be avoided

unless you're absolutely certain that the drug you are on

is safe when you take it.

Alcohol isn't the only culprit, though -

lots of foods can cause problems too.

One of the most surprising offenders is grapefruit!

It's the iconic healthy breakfast, isn't it?

What could possibly be harmful about a grapefruit?

Well, in fact, when scientists were studying the effect of alcohol

on blood pressure medicines back in the 1980s,

they disguised the taste of alcohol

in the studies with grapefruit juice,

and what they found out was that the grapefruit

had a far bigger effect

on the medication dose than the alcohol did,

and in some cases it actually tripled the dose

of blood pressure medicine.

This happens because grapefruit contain a chemical that messes up

the normal breakdown of drugs in your body.

This is particularly true for cholesterol drugs like statins.

If you take one statin pill a day,

but you also drink a glass of grapefruit,

what you'll end up with in your bloodstream

is the equivalent of taking 13 statin pills.

And that can really, really dangerous.

It's not all statins, though,

so always check with your doctor, nurse or pharmacist.

Now, as if the dangers of grapefruit weren't enough,

there are some other foods to look out for.

If you're taking a blood-thinning medicine to prevent clots,

like warfarin, vegetables like kale, spinach, broccoli,

salad leaves and cabbage can be a bit of a problem.

Even green tea and liver, because all of these things contain

high levels of vitamin K,

and vitamin K can help promote blood clotting,

so they effectively mean you need more of that anti-clotting drug.

But don't go eliminating healthy green veg from your diet

if you're on blood thinners - just eat them in small, regular amounts

to avoid a big vitamin K boost.

Finally - liquorice!

Black liquorice contains a chemical

that can cause your potassium levels to fall.

Low potassium levels may lead to high blood pressure,

irregular heart rhythms and even heart failure.

So if you're on heart or blood pressure medicines

it might be best to stick it to the stick.

Now, no-one could possibly remember all the different

drug and food interactions, it's way too complicated.

The thing to remember is, check with your doctor,

check with your pharmacist, and always read the packet.

Back in Glasgow, we're coming to the end of our big six-week experiment.

75 volunteers have been helping us test

different types of vegetable oil,

to see if they are good for our hearts, as olive oil is.

I found it a bit daunting -

it's quite a lot of oil to consume every day.

I found the easiest thing to do was make porridge in the microwave,

stir in the oil and it blended in quite nicely.

I stirred it into soup or cooked pasta.

Sometimes if I forgot about it I downed it like a shot,

which was my least favourite option,

followed by orange juice

or something that would cut through the oil.

One group of volunteers took 20ml a day of sunflower oil,

high in polyunsaturated fats.

Another group took rapeseed oil, high in monounsaturates.

We wanted to find out whether either of these

could match the heart benefits of olive oil.

After using a new technique that involves analysing proteins

in our volunteers' urine, Dr Bill Mullen has the results.

-Hi. Good to see you.

-Nice to see you too.

So, what was the verdict?

The sunflower oil, which is the one that's rich in polyunsaturates

which allegedly have a protective effect against cholesterol,

showed no change in our biomarker for heart disease.

So, after all the marketing

for polyunsaturates and sunflower goodness,

there's no evidence in this experiment

that it's good for our hearts.

But what about rapeseed oil, high in monounsaturates, instead?

When we looked at the one that was high in monounsaturates,

which was closer to what we believe olive oil is,

again there was no change in that on our biomarker for heart disease.

A real surprise, then.

Rapeseed oil, which has fewer saturated fats

and almost as many monounsaturated fats as olive oil,

should, according to the latest theories,

have been at least as good for us as olive oil.

But according to this test, it's not.

So to find the secret of olive oil, it's back to the drawing board.

We've shown that polyunsaturates and the monounsaturates

that are in rapeseed oil and in sunflower oil

seem to have no effect on our cardiovascular disease biomarker.

So really it must be more complex

than just simply the amount of monounsaturates in an oil,

or the amount of polyunsaturates in an oil.

So we should be sceptical of the marketing messages about oils.

As ever, it's not as simple as they suggest.

But the good news is that we have shown

that olive oil really is good for us.

It turns out that this ancient golden liquid

really does hold the key to a healthier heart -

and we've found nothing to match it.

Now, the key to exactly why it does that is still a mystery.

But the take-home message is,

take a couple of spoonfuls of this every day,

doesn't matter whether it's the expensive extra virgin option

or the cheaper stuff, as long as it's raw, and not cooked.

That's it from Glasgow.

Next time we're in Derby, testing out new ways

to help you stick to your health resolutions,

trying out the supplement that might make you drink less alcohol,

and unveiling the new discovery that could help us all lose weight.

That's just amazing.

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# Mm, my doctor, wanna do

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# Doctor, do anything that you wanna do... #