Episode 3 Trust Me, I'm a Doctor


Episode 3

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

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

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

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..through the contradictions and the confusions.

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

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..and ensure you get the information you need.

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

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I'm Michael Mosley. In this series,

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I'm joined by a team of doctors.

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Together, we'll cut through the hype,

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the headlines and the health claims.

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This is Trust Me I'm A Doctor.

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

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to test whether vegetable oils are good for our hearts.

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

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testing whether beards are dangerously unhygienic...

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

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

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before it's too late,

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and seeking the best remedy for painful mouth ulcers.

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

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Welcome to Glasgow, a vibrant, exciting city,

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but also one where more people die of heart disease

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than anywhere else in the UK.

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We've come here to do a big experiment,

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to see if changing just one thing about your diet

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can give you the benefits of a Mediterranean lifestyle,

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without you having to move to the Med.

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In countries like France and Spain,

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

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and many put it down to their diet.

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

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But could it be that the key is actually simpler -

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just one magic ingredient?

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Olive oil.

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

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but the amount we knock back

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is nothing compared to our Mediterranean cousins.

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The French consume about twice as much as us,

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the Spanish 14 times as much,

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and the Greeks a whopping 20 times as much.

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The trouble is heart disease takes years to manifest,

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and there's never been a way to test

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

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until now.

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Because here in Glasgow,

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they've developed a brand-new scientific technique

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that can do this for the first time.

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And it centres on another golden liquid.

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This is a flask of human urine -

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my urine, to be precise.

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It contains waste products from my body

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

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as it contains information

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about processes that are happening deep inside my body.

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That information comes in the form of particular chemicals

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

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

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a protein fingerprint for different diseases.

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-Hi there.

-Hello, Michael.

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'The technique is called proteomics

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

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If we monitor the proteins in the urine,

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

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So somebody who, for example, has got heart disease

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will start to produce different proteins in their urine

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to someone who has a healthy heart.

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There will be a different fingerprint of these proteins

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

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has any symptoms of the disease.

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I guess it's very different from

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measuring things like cholesterol in the blood

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

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

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

-That's correct, yes,

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

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we're actually measuring the disease itself,

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not the risk of developing the disease.

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This new technique can detect disease

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before you have any symptoms at all.

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

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Bill thinks we can use it to measure

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whether consuming olive oil, as the marketing suggests,

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can improve heart health.

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

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and I'm one of them.

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

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

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to determine the health of our hearts.

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

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-Any special tips?

-Well, it has to be consumed raw.

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Cooking with it tends to degrade

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

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So the health message is that it's raw.

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

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-Cheers, Michael.

-Cheers.

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But there's a twist.

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

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the other half, extra virgin.

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

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The more expensive extra virgin oil

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

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because it doesn't go through any processing,

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

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This study will be the first real test.

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Now, I'm really looking forward to this,

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but I'm also a bit sceptical,

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because I think the benefits of the Mediterranean diet

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

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

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to my daily diet and see what happens.

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

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consuming olive oil is a pleasure!

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On salad. On bread.

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Or even just as it comes.

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

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

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'So, time for the results.'

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-Ta-da!

-Time for the fun, yes.

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Well, the good news is that

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the results show there was a positive effect.

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

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

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fell significantly over the six weeks.

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

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-Very pleasing.

-This is one of the beauties of this test,

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that I think is really good for

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measuring the effectiveness of food

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in changing your health.

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That is impressive.

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'And what about the normal olive oil?

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'Well, the results show

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'it has exactly the same effect.

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

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

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

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

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that you have, that's fine.

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

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

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So we might finally have identified

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at least one element of that famously healthy Mediterranean diet.

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

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in just a few weeks.

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And it doesn't seem to matter which kind,

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so you can save some money by choosing the regular sort

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rather than that fancy bottle of extra virgin.

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Cheers.

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But olive oil isn't the only oil

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that's marketed as being good for our hearts.

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

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

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But first, over to Dr Chris van Tulleken.

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

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The beard.

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They seem to be everywhere these days.

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But rumours abound that they might not be hygienic.

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Recent reports have suggested they could be full of germs -

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even poo.

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So is that true?

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

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and a good throng of the right microbes is essential

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

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

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that you get problems.

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But what about beards?

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Are we surrounding our mouths with giant microbial mats?

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And if so, could it be doing us harm?

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'OK, it's not me.

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

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'I've always been slightly suspicious of him

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'and his bearded ilk.

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

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

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'And being a doctor of infectious diseases,

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

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

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using one of these.

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

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on this - a Petri dish covered in agar jelly.

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Let's find some beards!

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'I'd like to find out

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

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

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

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'Research so far has been contradictory.

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'A study from 2000 showed that

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

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But a 2014 survey befriended the beard,

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showing that they contained less Staphylococcus aureus.

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

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the hospital superbug.

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So, are beards unhygienic or not?

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It's four weeks since I took my swabs.

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And here at University College, London,

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

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He's studied bacteria from the planet's poles

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

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So what did you find on the beards?

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Well, a lot of different bacteria, actually.

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These look disgusting.

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There's many different bacteria on there.

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We've got over 100 species.

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-Are these bacteria?

-No, those are a couple of moulds.

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-You don't normally expect moulds on skin.

-No.

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

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We didn't go into it.

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

-That's right.

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

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almost all can be found on naked skin.

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

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

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For those of us that are involved with beards -

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we either have beards, or we kiss beards,

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or we're involved in the beard community -

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should we be worried?

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Are there health and safety concerns

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with beards that you have identified?

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No. I don't think so.

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

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

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Nothing alarming,

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

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When you get a competitive environment like a beard,

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

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resources and space, so they produce things like antibiotics

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and you can see here, you've got halos

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and that's what we're looking for.

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The clear halo is a ring of death,

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created by antibiotic chemicals

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secreted by the bacteria in the middle,

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killing everything around them.

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It's the same thing that Alexander Fleming first noticed

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when he discovered penicillin.

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So that's a colony of a beard bug

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

-That's right.

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This is hugely exciting. Potentially an antibiotic.

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

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

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

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

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than on naked skin.

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

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And in fact, far from being dangerous,

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they might actually be concealing the next generation of antibiotics.

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Back in Glasgow,

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

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We're using a brand-new technique

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

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

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and discovered that it really can improve our heart health.

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

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

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But we want to go a step further

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to discover if other oils can be beneficial, too.

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

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For decades, saturated fats, like butter and lard,

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have been seen as the devil's work,

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linked to high cholesterol and heart disease.

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So we began to replace them with vegetable oils,

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which contain healthier, unsaturated fats.

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In fact, no matter which oil you choose,

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it will be made up of three types of fat.

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All vegetable oils contain a combination of polyunsaturated,

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monounsaturated and saturated fats.

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

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have been the cause of much debate.

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

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like those in sunflower oil.

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These were thought to lower our cholesterol

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and be good for our hearts.

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Then, in the 1990s,

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

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This oil is rich in monounsaturates,

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also thought to reduce cholesterol.

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

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Like olive oil, it's high in monounsaturates.

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But which of these is really best for us?

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

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So we've recruited 75 volunteers.

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

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Another 25 will get sunflower oil.

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And 25 of them will have no oils at all -

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

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

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There's just one rule.

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

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as most of it would end up in the pan.

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Instead, they need to take it raw.

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20ml, or two dessertspoons full, a day.

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Once again, Dr Bill Mullen from Glasgow University,

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

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to see whether either of these oils

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really does make a difference to our heart health.

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Olive oil, at the moment, is the only one

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that is really a health benefit out there.

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

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so we think they're similar.

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And we also have sunflower oil,

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which is high in polyunsaturates

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and there's good health claims around

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that this may be beneficial, as well.

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So, at this point in time,

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

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

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It hasn't been done before like this.

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

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to try and find out exactly what it is

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that we can recommend to people to actually take.

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

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I'm wondering what your favourite tipple is?

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

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

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We'll find out how well these different oils

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live up to their marketing later in the programme.

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

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

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

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And it turns out that perhaps it is.

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

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particularly if they were big ones.

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In fact, on average,

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they went down by about a quarter over four weeks.

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Now, this compares favourably with doing nothing at all

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or, indeed, other forms of treatment.

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

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on your wart of verruca,

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then go to our website...

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And on our website, you can also ask us

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any health questions you'd like answered.

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Hundreds of people have done just that.

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And our first question is...

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What causes mouth ulcers

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and how can I prevent or get rid of them?

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One for Dr Saleyha Ahsan.

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Mouth ulcers, or canker sores, are tiny.

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

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and even talking.

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-Do you get them?

-No, but I used to.

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Yeah, occasionally, from time to time.

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I have one right now!

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

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Ulcers happen when a patch

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

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leaving the pain sensors underneath more exposed.

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Sometimes, the cause is obvious.

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

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and...hey, presto!

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There's an ulcer.

0:19:010:19:02

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

0:19:020:19:05

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

0:19:050:19:09

Some research indicates slight overactivity of the immune system

0:19:100:19:15

can be to blame and that some people get them

0:19:150:19:18

when they're tired and run-down.

0:19:180:19:20

So what can you do about them?

0:19:200:19:21

Although most ulcers will heal by themselves within a week,

0:19:220:19:26

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

0:19:260:19:30

'Some people swear by chilli.'

0:19:300:19:32

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

0:19:320:19:34

Chilli contains the chemical capsaicin.

0:19:340:19:37

This triggers our nerve sensors for heat.

0:19:370:19:40

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

0:19:400:19:44

Are you all right with it?

0:19:440:19:46

-Oh, yeah.

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

0:19:460:19:48

So mixing a bit of chilli with water

0:19:480:19:51

and dabbing it on your ulcer could help.

0:19:510:19:53

Maybe I didn't do it enough.

0:19:530:19:54

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

0:19:540:19:58

Yeah, that's good.

0:19:580:19:59

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

0:19:590:20:03

There are some less fiery options.

0:20:030:20:05

Peppermint and eucalyptus contain chemicals

0:20:050:20:08

that trigger the nerve sensors for cold

0:20:080:20:11

and also seem to reduce the sensation of pain.

0:20:110:20:15

Whoa!

0:20:150:20:16

That's really minty.

0:20:160:20:18

It feels really airy inside my mouth.

0:20:180:20:20

You can buy them as essential oils,

0:20:200:20:23

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

0:20:230:20:26

And if neither hot nor cold does it for you,

0:20:270:20:29

there are over-the-counter treatments,

0:20:290:20:31

containing the ingredients salicylate or lidocaine,

0:20:310:20:35

which can help relieve the pain.

0:20:350:20:37

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

0:20:370:20:42

may help lessen the pain of an ulcer,

0:20:420:20:45

but none of them will help the ulcer to heal.

0:20:450:20:48

Yet there are a few things that can.

0:20:480:20:51

Salt has been known for a long time

0:20:510:20:53

to have mild anti-microbial properties.

0:20:530:20:56

So swishing your mouth with warm salt water

0:20:560:20:59

may help ulcers heal more quickly.

0:20:590:21:01

But adding bicarbonate of soda to your home-made mouthwash

0:21:010:21:06

might make it even more effective.

0:21:060:21:08

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

0:21:080:21:11

which the bacteria in our mouth don't like -

0:21:110:21:14

although nor do I.

0:21:140:21:16

Now, none of these home remedies have been subject

0:21:160:21:19

to controlled scientific studies.

0:21:190:21:21

But the science does makes sense

0:21:210:21:23

and, anecdotally, they do seem to help.

0:21:230:21:27

If none of them work for you,

0:21:270:21:29

your doctor can prescribe more heavy-duty medical treatments,

0:21:290:21:33

which help ulcers heal more quickly.

0:21:330:21:35

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

0:21:350:21:39

But if an ulcer takes more than two weeks to heal

0:21:390:21:42

or is bigger than a centimetre,

0:21:420:21:44

it could be something more serious.

0:21:440:21:47

So do get it checked by a doctor.

0:21:470:21:49

Although you can't stop ulcers from forming,

0:21:490:21:52

the good news is you can help lessen the pain

0:21:520:21:55

and possibly help them to heal faster.

0:21:550:21:59

Just choose the method that works for you

0:21:590:22:01

and stick with it until the ulcer's gone.

0:22:010:22:04

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

0:22:180:22:20

seem to bring out all our worst aches and pains.

0:22:200:22:23

In fact, one in eight of all GP appointments

0:22:250:22:27

are about pain in the joints.

0:22:270:22:29

So show me on the skeleton where you ache.

0:22:290:22:32

-Right underneath the kneecap.

-OK, yeah.

0:22:320:22:34

Knees and feet.

0:22:340:22:35

I've got a problem with my left shoulder,

0:22:350:22:38

kind of in-between the two bones here.

0:22:380:22:40

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

0:22:400:22:43

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

0:22:430:22:45

So why do our joints give us so much bother?

0:22:470:22:50

And what can we do about it?

0:22:500:22:53

In a healthy joint, the tips of the bones

0:22:530:22:57

are covered with a soft tissue called cartilage.

0:22:570:22:59

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

0:22:590:23:02

called synovial fluid.

0:23:020:23:04

It's a bit like oil in a hinge.

0:23:040:23:06

But if any of that system gets damaged,

0:23:060:23:09

that's when we get pain.

0:23:090:23:10

The most common cause of joint pain is arthritis.

0:23:110:23:15

And the most widespread form is osteoarthritis or OA.

0:23:150:23:19

It's caused by basic wear and tear.

0:23:190:23:23

The cartilage gets damaged

0:23:230:23:25

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

0:23:250:23:28

So the less you move, the stiffer you get.

0:23:290:23:33

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

0:23:330:23:38

We feel it mainly in our knees, our hips

0:23:380:23:42

and the small joints of our hands.

0:23:420:23:43

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

0:23:430:23:47

or possibly even avoid them altogether.

0:23:470:23:49

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

0:23:520:23:54

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

0:23:540:23:57

hauliers.

0:23:570:23:59

The combination of heavy lifting

0:23:590:24:02

and long periods sitting still

0:24:020:24:03

can take its toll on the joints.

0:24:030:24:06

Tell me about your joints.

0:24:060:24:09

Aches, pains, anything at all?

0:24:090:24:10

Aches and pains in that finger and that finger.

0:24:100:24:12

If I touch anything, try and grip hold.

0:24:120:24:15

It's worse in the mornings.

0:24:150:24:16

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

0:24:160:24:19

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

0:24:190:24:22

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

0:24:230:24:28

The symptoms to look for

0:24:280:24:29

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

0:24:290:24:33

Like your knee pain...

0:24:330:24:34

Bad when you get up, gets gradually better.

0:24:340:24:37

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

0:24:370:24:40

and to strengthen the muscles around the joints.

0:24:400:24:43

And you can do this with some simple exercises.

0:24:430:24:47

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

0:24:470:24:49

is rest your hands on the arms of the chair

0:24:490:24:51

and squeeze the sock as tight as you can

0:24:510:24:54

and hold it for 30 seconds.

0:24:540:24:57

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

0:24:570:24:59

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

0:24:590:25:02

It's about strengthening those small muscles around the joint

0:25:020:25:05

and that's what improves joint pain.

0:25:050:25:08

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

0:25:080:25:11

watching the telly,

0:25:110:25:12

not to use your stinky socks

0:25:120:25:13

that you've been loading vehicles with all day.

0:25:130:25:16

Next up are the knees.

0:25:170:25:20

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

0:25:200:25:23

Bend the left knee, like that.

0:25:230:25:27

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

0:25:270:25:31

And hold that for 20 to 30 seconds

0:25:310:25:35

and keep that muscle as tight as you can.

0:25:350:25:37

And relax. OK, and swap legs.

0:25:370:25:39

Simple exercises like these

0:25:400:25:42

can really help avoid or reduce the pain of OA.

0:25:420:25:46

But there's another form of arthritis

0:25:460:25:48

that's completely different.

0:25:480:25:50

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

0:25:500:25:55

and it has nothing to do with wear and tear.

0:25:550:25:58

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

0:25:580:26:02

causing them to become inflamed and swollen.

0:26:020:26:05

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

0:26:070:26:09

have RA without knowing.

0:26:090:26:12

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

0:26:120:26:16

There are medications available that can slow the condition

0:26:160:26:19

and minimise joint damage,

0:26:190:26:21

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

0:26:210:26:25

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

0:26:250:26:28

The first S is for stiffness.

0:26:280:26:31

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

0:26:310:26:34

and sometimes into the day?

0:26:340:26:36

The second S is swollen.

0:26:360:26:37

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

0:26:370:26:41

And the final S is squeeze.

0:26:410:26:43

When you squeeze your joints, are they painful?

0:26:430:26:47

If the answer to all these questions is yes,

0:26:470:26:49

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

0:26:490:26:51

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

0:26:510:26:55

and keep the disease in check.

0:26:550:26:57

But one of the biggest mysteries about arthritis

0:26:570:27:00

has never been solved.

0:27:000:27:02

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

0:27:020:27:07

Well, new research at the University of Manchester

0:27:070:27:10

could soon answer this age-old question,

0:27:100:27:12

with the help of you and your mobile phone.

0:27:120:27:16

The study is being led by Dr Will Dixon.

0:27:160:27:20

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

0:27:200:27:24

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

0:27:240:27:26

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

0:27:260:27:30

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

0:27:300:27:34

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

0:27:340:27:38

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

0:27:380:27:41

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

-Absolutely.

0:27:410:27:44

The accelerometer and the GPS track people's activity

0:27:440:27:48

-and that's of real importance.

-OK.

0:27:480:27:49

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

0:27:490:27:52

then, typically, their activity goes down.

0:27:520:27:54

In a rheumatology clinic,

0:27:540:27:56

I might see somebody every six months or once a year

0:27:560:27:59

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

0:27:590:28:01

But actually, if I have a system

0:28:010:28:04

whereby I can use the phone on in their pocket

0:28:040:28:06

to infer information about their activity,

0:28:060:28:08

then that would be great.

0:28:080:28:10

The app is now available for anyone to download,

0:28:120:28:15

allowing the team to gather data from across the country

0:28:150:28:18

in a way that's never been possible before.

0:28:180:28:21

It's hoped this will develop better treatments

0:28:220:28:24

for millions of sufferers.

0:28:240:28:25

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

0:28:270:28:30

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

0:28:300:28:34

There are links to the study on our website,

0:28:340:28:36

so if you have joint pain of any kind,

0:28:360:28:38

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

0:28:380:28:41

Go to...

0:28:420:28:44

..where you can also find more exercises

0:28:460:28:48

to help avoid osteoarthritis.

0:28:480:28:51

Still to come...

0:28:570:28:58

..how much meat is safe to eat?

0:28:590:29:02

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

0:29:020:29:05

But first...

0:29:050:29:06

Previously on Trust Me, I'm A Doctor,

0:29:090:29:12

we ran tests on herbal supplements available here in the UK

0:29:120:29:16

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

0:29:160:29:19

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

0:29:210:29:26

that is a guarantee of quality,

0:29:260:29:27

actually contained little or none of the product advertised

0:29:270:29:31

and some even contained chemical contaminants.

0:29:310:29:35

If I look at all these packs on this table,

0:29:350:29:37

they're all very clear,

0:29:370:29:39

they have ingredients, they have a dosage.

0:29:390:29:41

I mean, they can't just be lying?

0:29:410:29:43

Well, I'm sorry to say,

0:29:430:29:45

I think some of the suppliers of food supplements,

0:29:450:29:48

yes, they are lying.

0:29:480:29:50

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

0:29:500:29:53

They have commissioned local authorities to run further tests.

0:29:530:29:57

They have taken more than 500 samples of supplements

0:29:570:30:01

and results of those tests are now being analysed

0:30:010:30:03

and should be published very soon.

0:30:030:30:04

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

0:30:040:30:08

and the FSA will help local authorities to take action

0:30:080:30:12

against companies found to be selling fake or contaminated supplements.

0:30:120:30:17

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

0:30:170:30:20

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

0:30:210:30:25

How can I get rid of my tinnitus?

0:30:250:30:27

To investigate the phantom noises caused by tinnitus,

0:30:290:30:32

Gabriel Weston is stepping into a completely soundless room.

0:30:320:30:36

# It's oh, so quiet

0:30:360:30:39

# Ssh! #

0:30:390:30:41

It's not unusual if you find yourself

0:30:410:30:44

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

0:30:440:30:49

Buzzing, ringing, clicking, hissing.

0:30:490:30:52

Tinnitus is the term for

0:30:520:30:53

when these noises become obtrusive in everyday life.

0:30:530:30:57

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

0:30:570:31:01

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

0:31:010:31:06

Well, a new understanding of the condition

0:31:070:31:09

may help come up with solutions.

0:31:090:31:12

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

0:31:120:31:17

either as part of the ageing process,

0:31:170:31:19

or because of exposure to loud music and noises.

0:31:190:31:23

And that has been a vital clue.

0:31:230:31:25

A new theory for why tinnitus happens

0:31:270:31:30

is that sensory cells in the ear

0:31:300:31:32

overcompensate for hearing loss by becoming more sensitive.

0:31:320:31:37

This turns up the volume on background noises

0:31:370:31:40

we wouldn't usually hear,

0:31:400:31:41

a bit like turning the gain up on an amplifier.

0:31:410:31:45

DISTORTED BUZZING

0:31:450:31:47

So if you suffer from tinnitus,

0:31:470:31:48

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

0:31:480:31:52

You might find you need a hearing aid,

0:31:520:31:54

and this could help stop your ear overcompensating -

0:31:540:31:57

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

0:31:570:32:02

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

0:32:020:32:05

to make it less intrusive -

0:32:050:32:07

listening to something else to tune it out.

0:32:070:32:10

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

0:32:100:32:13

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

0:32:130:32:17

Other people swear by white noise.

0:32:170:32:19

Now this can be delivered to the ear via a generator

0:32:190:32:22

which is worn a bit like a hearing aid,

0:32:220:32:25

or by just switching your analogue radio in between stations.

0:32:250:32:29

But there could be more hope for some tinnitus sufferers.

0:32:310:32:34

Drugs are being developed

0:32:340:32:36

which may in the future reduce the unwanted noise

0:32:360:32:39

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

0:32:390:32:42

For now my advice would be,

0:32:420:32:44

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

0:32:440:32:48

Get your hearing tested.

0:32:480:32:51

And if your tinnitus is intrusive,

0:32:510:32:53

try some of the available therapies out there.

0:32:530:32:56

They really can make the difference

0:32:560:32:59

between tinnitus that gets on top of you

0:32:590:33:02

and tinnitus that you can really manage.

0:33:020:33:05

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

0:33:140:33:17

We're told something is good for us.

0:33:180:33:20

Then too much is bad.

0:33:200:33:22

So what are the limits?

0:33:220:33:24

When can you have too much of a good thing?

0:33:240:33:27

This time, I'm looking at meat.

0:33:290:33:30

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

0:33:300:33:34

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

0:33:340:33:37

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

0:33:370:33:41

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

0:33:420:33:45

about the links between meat and health.

0:33:450:33:48

They have very different points of view.

0:33:480:33:51

Professor Robert Pickard

0:33:510:33:52

thinks meat plays an important part in a healthy diet.

0:33:520:33:56

There is no biological reason whatsoever

0:33:560:33:59

to be unduly concerned about red meat.

0:33:590:34:01

But Dr Valter Longo thinks any amount can be harmful.

0:34:010:34:06

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

0:34:060:34:10

So how do they come to such different conclusions?

0:34:100:34:14

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

0:34:140:34:17

Emeritus Professor of Neurobiology at the University of Cardiff.

0:34:170:34:22

He's former Director General of the British Nutrition Foundation

0:34:220:34:25

and a member of the Meat Advisory Panel.

0:34:250:34:28

What do you think about the recent article in The Lancet

0:34:280:34:33

saying that processed meat definitely causes cancer

0:34:330:34:37

and that red meat probably does?

0:34:370:34:39

It's very important to distinguish between associations

0:34:390:34:43

and cause and effect mechanisms.

0:34:430:34:45

The evidence that it was based on shows associations

0:34:450:34:49

between people that eat certain quantities of red meat

0:34:490:34:52

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

0:34:520:34:58

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

0:34:580:35:02

have the same incidence of colorectal cancer

0:35:020:35:05

as people that eat meat on a very regular basis.

0:35:050:35:08

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

0:35:080:35:12

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

0:35:120:35:17

I really don't understand that,

0:35:170:35:19

because there is no biological reason whatsoever

0:35:190:35:22

to be unduly concerned about red meat.

0:35:220:35:24

I would eat red meat from pork, lamb or beef

0:35:240:35:28

probably two or three times a week.

0:35:280:35:30

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

0:35:300:35:35

and in fact, with a small amount of red meat

0:35:350:35:39

and a tiny one-inch cube of liver,

0:35:390:35:41

you would get all your vitamin and mineral requirements

0:35:410:35:45

just in one portion of food.

0:35:450:35:47

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

0:35:470:35:50

In terms of quantities, then,

0:35:500:35:52

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

0:35:520:35:56

How much?

0:35:560:35:57

If you could take a piece of fillet steak,

0:35:570:36:00

and you look at the palm of your hand,

0:36:000:36:03

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

0:36:030:36:06

about a centimetre high,

0:36:060:36:08

then that's an appropriately moderate amount.

0:36:080:36:11

When people ask me about beef burgers,

0:36:110:36:15

which can be a similar shape and size,

0:36:150:36:17

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

0:36:170:36:21

than an equivalent weight of genuine fillet steak.

0:36:210:36:26

So in fact, a beef burger is TOO nutritious

0:36:260:36:30

to be eaten in large quantities by sedentary people.

0:36:300:36:34

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

0:36:340:36:37

Well, processed meat contains more fat,

0:36:370:36:40

and that can create a problem

0:36:400:36:42

because there is some indication that

0:36:420:36:45

a high intake of fat could have some carcinogenic properties,

0:36:450:36:50

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

0:36:500:36:54

then of course, those can be carcinogenic.

0:36:540:36:57

Have you ever been tempted to become vegetarian?

0:36:570:37:00

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

0:37:000:37:04

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

0:37:040:37:08

to absorb nutrients from the gut.

0:37:080:37:10

So I always say to people over 60 that red meat

0:37:100:37:13

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

0:37:130:37:18

because now you need extra concentrations

0:37:180:37:21

of vitamins and minerals

0:37:210:37:22

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

0:37:220:37:27

Are your views at all affected by funding?

0:37:270:37:29

Have you been funded by the meat industry?

0:37:290:37:32

No, but the Meat Advisory Panel

0:37:320:37:35

is funded by the Agriculture and Horticultural Development Board.

0:37:350:37:39

But my views are the views of a professional biologist,

0:37:390:37:43

and they represent other views

0:37:430:37:45

that professional biologists would generally have.

0:37:450:37:49

I would not do anything

0:37:490:37:51

that I believed to be contrary to the public interest.

0:37:510:37:55

So what would your broad advice to people be?

0:37:550:37:58

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

0:37:580:38:03

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

0:38:030:38:08

So I would maintain a pretty steady supply

0:38:080:38:11

of animal proteins throughout life.

0:38:110:38:14

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

0:38:140:38:16

and it's particularly higher for adults over 60.

0:38:160:38:22

So Professor Pickard thinks we all need at least some meat

0:38:220:38:26

to stay healthy, and there is no strong evidence

0:38:260:38:28

to link eating meat with an increased risk of cancer.

0:38:280:38:32

Professor Valter Longo strongly disagrees.

0:38:320:38:35

He's Professor in Gerontology

0:38:350:38:37

at the University of Southern California.

0:38:370:38:39

He's shown a link between high protein -

0:38:390:38:42

especially from meat - and age-related diseases.

0:38:420:38:47

Your research suggests that too much protein

0:38:470:38:49

-is associated with accelerated ageing.

-Yes.

0:38:490:38:51

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

0:38:510:38:54

Yes, and it turned out that people

0:38:540:38:56

that had over 20% of their calories coming from proteins

0:38:560:39:00

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

0:39:000:39:04

But does it matter where the protein comes from?

0:39:040:39:06

Yes, we believe that it does,

0:39:060:39:09

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

0:39:090:39:13

is different from that of animal-based proteins.

0:39:130:39:16

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

0:39:160:39:18

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

0:39:180:39:21

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

0:39:210:39:25

has the largest effect

0:39:250:39:27

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

0:39:270:39:31

Now do you think there's something particularly bad

0:39:310:39:33

-about processed meat?

-Yes.

0:39:330:39:36

The processed meat may contain other components - the fat -

0:39:360:39:41

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

0:39:410:39:44

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

0:39:440:39:49

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

0:39:490:39:53

Now you've said that eating large amounts of meat

0:39:530:39:57

is as bad for you as smoking.

0:39:570:40:00

Do you stick with that?

0:40:000:40:01

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

0:40:010:40:06

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

0:40:060:40:10

in the United States, following thousands of people,

0:40:100:40:13

and you look at the risk

0:40:130:40:15

for the group having the highest protein intake,

0:40:150:40:18

and then you look in the same database for either smokers

0:40:180:40:22

or past smokers, the risk increase was very similar.

0:40:220:40:25

Isn't that rather peculiar,

0:40:250:40:26

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

0:40:260:40:31

Yeah, and this argument is...

0:40:310:40:33

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

0:40:330:40:36

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

0:40:360:40:40

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

0:40:400:40:44

So what do you eat?

0:40:440:40:46

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

0:40:460:40:51

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

0:40:510:40:55

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

0:40:550:40:58

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

0:40:580:41:01

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

0:41:010:41:05

asking people what they eat now, centenarians especially,

0:41:050:41:08

and what they used to eat,

0:41:080:41:09

and it turns out that when you ask centenarians,

0:41:090:41:11

particularly Italians, they almost never ate red meat.

0:41:110:41:14

Now realistically you're not going to persuade people worldwide

0:41:140:41:17

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

0:41:170:41:20

What do you think people should do?

0:41:200:41:22

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

0:41:220:41:26

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

0:41:260:41:30

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

0:41:300:41:34

that we already use in a courtroom,

0:41:340:41:37

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

0:41:370:41:40

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

0:41:400:41:43

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

0:41:430:41:46

Absolutely yes.

0:41:460:41:48

The verdict right now is meat guilty,

0:41:480:41:51

and then you can always appeal,

0:41:510:41:53

and with the appeal, we will see,

0:41:530:41:56

but I feel pretty good about the case, yeah.

0:41:560:41:58

So Professor Longo is convinced that eating lots of protein,

0:41:580:42:02

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

0:42:020:42:07

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

0:42:070:42:11

to decide on my verdict for meat.

0:42:110:42:15

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

0:42:150:42:18

a little bit more confused than I was.

0:42:180:42:20

But I think something which is really clear,

0:42:200:42:22

processed meat is bad for you.

0:42:220:42:24

If you really want to live a long time,

0:42:240:42:27

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

0:42:270:42:31

which is essentially fish and vegetables.

0:42:310:42:34

But most of us are human.

0:42:340:42:35

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

0:42:350:42:39

if you stick to the government guidelines,

0:42:390:42:42

which are 70 grams, on average, a day.

0:42:420:42:44

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

0:42:440:42:48

of my palm, and about one centimetre thickness.

0:42:480:42:51

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

0:43:020:43:06

of the signs and symptoms.

0:43:060:43:08

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

0:43:080:43:12

which people are not really aware of.

0:43:120:43:15

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

0:43:150:43:19

Over to Dr Saleyha Ahsan.

0:43:190:43:21

This little-known killer is called sepsis.

0:43:210:43:25

It can strike any of us at any time,

0:43:250:43:29

but its early signs can be difficult to spot.

0:43:290:43:32

But now survivors of the condition are sharing their experiences

0:43:320:43:37

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

0:43:370:43:41

And across the nation,

0:43:410:43:42

doctors and campaigners are working to raise awareness of sepsis

0:43:420:43:46

so that more lives can be saved.

0:43:460:43:49

Sepsis causes around eight million deaths worldwide every year,

0:43:490:43:54

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

0:43:540:43:59

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

0:43:590:44:03

yet very few people have ever heard of it,

0:44:030:44:06

and fewer still understand it.

0:44:060:44:09

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

0:44:090:44:13

but it isn't actually an infection.

0:44:130:44:15

It is caused when the immune system reacts to an infection

0:44:150:44:19

in a way that's abnormal and dangerous.

0:44:190:44:22

My daughter Tilly had sepsis.

0:44:220:44:24

Her body shut down.

0:44:260:44:28

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

0:44:280:44:33

I couldn't feel my legs.

0:44:330:44:36

I couldn't speak, either.

0:44:360:44:38

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

0:44:380:44:41

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

0:44:430:44:46

But in a matter of days, even just hours,

0:44:460:44:49

it can develop into a catastrophic attack

0:44:490:44:52

that threatens the body's own tissues and organs.

0:44:520:44:56

I was 20.

0:44:560:44:57

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

0:44:570:45:00

I'm mostly fit and healthy.

0:45:000:45:01

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

0:45:010:45:06

If sepsis isn't recognised early

0:45:080:45:11

and treated quickly,

0:45:110:45:12

it can lead to shock, organ failure and death.

0:45:120:45:16

And those lucky enough to survive

0:45:160:45:18

may have to live with amputations and lasting health problems.

0:45:180:45:23

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

0:45:230:45:26

all the fingers on my left hand

0:45:260:45:28

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

0:45:280:45:31

Any of us can get sepsis,

0:45:320:45:34

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

0:45:340:45:38

Yet it can be surprisingly difficult to spot.

0:45:380:45:42

So listening to survivors can help us all learn

0:45:420:45:46

what symptoms to look out for.

0:45:460:45:48

It came on really, really suddenly -

0:45:480:45:50

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

0:45:500:45:54

but kind of sweaty and feverish and shaking a bit,

0:45:540:45:56

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

0:45:560:45:59

It started off with flu-like symptoms -

0:45:590:46:02

temperature, shivering.

0:46:020:46:04

About three days later I started getting stomach bug symptoms

0:46:040:46:07

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

0:46:070:46:10

Sepsis often starts with intense flu-like symptoms,

0:46:110:46:15

but as it gets more severe,

0:46:150:46:16

it reduces the blood supply to major organs,

0:46:160:46:20

leading to some more distinctive symptoms.

0:46:200:46:22

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

0:46:220:46:25

I had absolutely no control over it.

0:46:250:46:26

I was legitimately worried

0:46:260:46:28

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

0:46:280:46:31

my teeth were chattering.

0:46:310:46:33

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

0:46:330:46:34

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

0:46:340:46:37

so you can't breathe in any more.

0:46:370:46:38

I got very confused.

0:46:380:46:40

I think it may be that confusion

0:46:400:46:42

that alerted my husband to get a doctor.

0:46:420:46:44

My wife just said I was delirious, confused,

0:46:440:46:47

and, er, she just dialled 999 right away.

0:46:470:46:50

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

0:46:500:46:55

I don't think it was particularly,

0:46:550:46:57

erm, something that stuck out in my mind,

0:46:570:47:00

but actually it should have been.

0:47:000:47:03

If I'd had some information,

0:47:030:47:04

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

0:47:040:47:08

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

0:47:080:47:13

such as the lungs, brain and kidneys,

0:47:130:47:15

are being starved of oxygen and are going into failure.

0:47:150:47:19

I noticed a mottled rash all over my body.

0:47:190:47:21

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

0:47:210:47:24

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

0:47:240:47:29

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

0:47:290:47:33

With me, it sort of progressed and sort of spread

0:47:330:47:35

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

0:47:350:47:38

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

0:47:380:47:41

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

0:47:410:47:45

In fact, all our survivors were close to death

0:47:450:47:49

by the time they reached hospital.

0:47:490:47:51

And some were instinctively aware of the danger -

0:47:510:47:54

a feeling that shouldn't be ignored.

0:47:540:47:56

At one point I was on my knees

0:47:560:47:58

and I really thought I was going to die.

0:47:580:48:00

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

0:48:000:48:04

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

0:48:040:48:08

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

0:48:080:48:14

In babies and young children,

0:48:290:48:31

some of these symptoms will present differently.

0:48:310:48:34

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

0:48:340:48:37

but you might notice that they're irritable,

0:48:370:48:40

not feeding and not engaging.

0:48:400:48:43

This makes children, like Tilly, particularly vulnerable.

0:48:430:48:48

We couldn't really rouse her from her sleep,

0:48:480:48:51

and her skin had gone mottled.

0:48:510:48:52

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

0:48:520:48:55

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

0:48:550:48:59

and then we had to drive 80 miles down to Southampton

0:48:590:49:02

where they've got a paediatric intensive care unit,

0:49:020:49:06

and from that point it sort of snowballed,

0:49:060:49:08

and they said that she might not make it

0:49:080:49:11

because she had sepsis and she was in septic shock.

0:49:110:49:15

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

0:49:150:49:17

Didn't know where to get information.

0:49:170:49:20

Although close to death when she was brought into hospital,

0:49:200:49:23

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

0:49:230:49:29

I probably hold them a bit closer than I would otherwise

0:49:290:49:32

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

0:49:320:49:36

Gosh, I want to give you a hug!

0:49:360:49:39

'One thing that everyone in our group had in common

0:49:400:49:43

'was a lack of existing knowledge about sepsis.

0:49:430:49:46

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

0:49:460:49:49

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

0:49:490:49:52

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

0:49:520:49:55

which is the most important,

0:49:550:49:57

because you can save a life or a limb,

0:49:570:49:59

or psychological damage to someone,

0:49:590:50:02

and that's the most important thing

0:50:020:50:03

so it's getting people to really consider it.

0:50:030:50:06

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

0:50:060:50:11

and improve recognition and treatment.

0:50:110:50:15

It's something I'm personally passionate about,

0:50:150:50:18

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

0:50:180:50:19

..for more information,

0:50:220:50:24

and spread the word about sepsis to help save lives.

0:50:240:50:28

Now, something that confuses a lot of people is,

0:50:360:50:39

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

0:50:390:50:43

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

0:50:430:50:47

can people drink booze when they're taking medicines?

0:50:470:50:50

Or could that end up being a lethal cocktail?

0:50:500:50:52

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

0:50:540:50:57

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

0:50:570:51:01

You might think that antibiotics are the biggest culprit,

0:51:010:51:05

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

0:51:050:51:09

Other drugs, though, can be a problem.

0:51:100:51:12

You should never take alcohol with medicines that make you drowsy

0:51:130:51:16

because alcohol also makes you drowsy.

0:51:160:51:18

But there are other medicines that change the way that alcohol

0:51:180:51:22

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

0:51:220:51:26

when you drink alcohol called acetaldehyde,

0:51:260:51:28

and give you a thing called a flushing syndrome,

0:51:280:51:30

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

0:51:300:51:32

and it can dangerously increase your heart rate.

0:51:320:51:34

So alcohol is something to be avoided

0:51:340:51:36

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

0:51:360:51:40

is safe when you take it.

0:51:400:51:42

Alcohol isn't the only culprit, though -

0:51:420:51:45

lots of foods can cause problems too.

0:51:450:51:47

One of the most surprising offenders is grapefruit!

0:51:470:51:52

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

0:51:520:51:54

What could possibly be harmful about a grapefruit?

0:51:540:51:57

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

0:51:570:52:01

on blood pressure medicines back in the 1980s,

0:52:010:52:03

they disguised the taste of alcohol

0:52:030:52:05

in the studies with grapefruit juice,

0:52:050:52:07

and what they found out was that the grapefruit

0:52:070:52:10

had a far bigger effect

0:52:100:52:11

on the medication dose than the alcohol did,

0:52:110:52:13

and in some cases it actually tripled the dose

0:52:130:52:16

of blood pressure medicine.

0:52:160:52:17

This happens because grapefruit contain a chemical that messes up

0:52:170:52:20

the normal breakdown of drugs in your body.

0:52:200:52:23

This is particularly true for cholesterol drugs like statins.

0:52:230:52:26

If you take one statin pill a day,

0:52:260:52:28

but you also drink a glass of grapefruit,

0:52:280:52:30

what you'll end up with in your bloodstream

0:52:300:52:32

is the equivalent of taking 13 statin pills.

0:52:320:52:36

And that can really, really dangerous.

0:52:360:52:38

It's not all statins, though,

0:52:380:52:40

so always check with your doctor, nurse or pharmacist.

0:52:400:52:44

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

0:52:480:52:50

there are some other foods to look out for.

0:52:500:52:53

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

0:52:530:52:55

like warfarin, vegetables like kale, spinach, broccoli,

0:52:550:52:59

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

0:52:590:53:02

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

0:53:020:53:05

high levels of vitamin K,

0:53:050:53:07

and vitamin K can help promote blood clotting,

0:53:070:53:11

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

0:53:110:53:15

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

0:53:150:53:19

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

0:53:190:53:23

to avoid a big vitamin K boost.

0:53:230:53:25

Finally - liquorice!

0:53:270:53:29

Black liquorice contains a chemical

0:53:290:53:31

that can cause your potassium levels to fall.

0:53:310:53:34

Low potassium levels may lead to high blood pressure,

0:53:340:53:37

irregular heart rhythms and even heart failure.

0:53:370:53:40

So if you're on heart or blood pressure medicines

0:53:410:53:44

it might be best to stick it to the stick.

0:53:440:53:47

Now, no-one could possibly remember all the different

0:53:480:53:51

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

0:53:510:53:54

The thing to remember is, check with your doctor,

0:53:540:53:56

check with your pharmacist, and always read the packet.

0:53:560:53:59

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

0:54:100:54:15

75 volunteers have been helping us test

0:54:150:54:18

different types of vegetable oil,

0:54:180:54:21

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

0:54:210:54:25

I found it a bit daunting -

0:54:260:54:28

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

0:54:280:54:30

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

0:54:300:54:34

stir in the oil and it blended in quite nicely.

0:54:340:54:37

I stirred it into soup or cooked pasta.

0:54:370:54:41

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

0:54:410:54:44

which was my least favourite option,

0:54:440:54:46

followed by orange juice

0:54:460:54:47

or something that would cut through the oil.

0:54:470:54:49

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

0:54:510:54:55

high in polyunsaturated fats.

0:54:550:54:58

Another group took rapeseed oil, high in monounsaturates.

0:54:580:55:02

We wanted to find out whether either of these

0:55:020:55:05

could match the heart benefits of olive oil.

0:55:050:55:08

After using a new technique that involves analysing proteins

0:55:090:55:12

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

0:55:120:55:16

-Hi. Good to see you.

-Nice to see you too.

0:55:170:55:20

So, what was the verdict?

0:55:200:55:22

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

0:55:220:55:26

which allegedly have a protective effect against cholesterol,

0:55:260:55:30

showed no change in our biomarker for heart disease.

0:55:300:55:34

So, after all the marketing

0:55:340:55:36

for polyunsaturates and sunflower goodness,

0:55:360:55:39

there's no evidence in this experiment

0:55:390:55:41

that it's good for our hearts.

0:55:410:55:43

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

0:55:430:55:48

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

0:55:480:55:52

which was closer to what we believe olive oil is,

0:55:520:55:56

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

0:55:560:56:01

A real surprise, then.

0:56:020:56:04

Rapeseed oil, which has fewer saturated fats

0:56:040:56:07

and almost as many monounsaturated fats as olive oil,

0:56:070:56:10

should, according to the latest theories,

0:56:100:56:13

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

0:56:130:56:16

But according to this test, it's not.

0:56:160:56:19

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

0:56:190:56:24

We've shown that polyunsaturates and the monounsaturates

0:56:240:56:28

that are in rapeseed oil and in sunflower oil

0:56:280:56:31

seem to have no effect on our cardiovascular disease biomarker.

0:56:310:56:35

So really it must be more complex

0:56:350:56:39

than just simply the amount of monounsaturates in an oil,

0:56:390:56:43

or the amount of polyunsaturates in an oil.

0:56:430:56:46

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

0:56:460:56:50

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

0:56:500:56:55

But the good news is that we have shown

0:56:550:56:58

that olive oil really is good for us.

0:56:580:57:01

It turns out that this ancient golden liquid

0:57:010:57:05

really does hold the key to a healthier heart -

0:57:050:57:07

and we've found nothing to match it.

0:57:070:57:10

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

0:57:100:57:15

But the take-home message is,

0:57:150:57:17

take a couple of spoonfuls of this every day,

0:57:170:57:20

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

0:57:200:57:23

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

0:57:230:57:27

That's it from Glasgow.

0:57:400:57:41

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

0:57:410:57:44

to help you stick to your health resolutions,

0:57:440:57:48

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

0:57:480:57:52

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

0:57:520:57:56

That's just amazing.

0:57:560:57:58

# I just made an appointment for a special rendezvous

0:58:070:58:11

# To see a man of miracles and all that he can do

0:58:110:58:16

# Doctor, I want you

0:58:210:58:24

# Mm, my doctor, wanna do

0:58:240:58:26

# I can't get over you

0:58:260:58:28

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

0:58:280:58:31

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