Episode 4

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2:00:00 > 2:00:00TRUST ME I'M A DOCTOR FKR A470Y/03 BRD492018

0:00:28 > 0:00:33We're constantly being told how to live our lives,

0:00:33 > 0:00:36but what's the health advice you can really trust?

0:00:40 > 0:00:44In this series, we use our expertise to guide you

0:00:44 > 0:00:48through the contradictions and the confusions.

0:00:55 > 0:00:57We'll get to the heart of the debate.

0:00:59 > 0:01:02And ensure you get the information you need.

0:01:09 > 0:01:12We're here when you don't know where to turn.

0:01:15 > 0:01:19I'm Michael Mosley. In this series, I'm joined by a team of doctors -

0:01:19 > 0:01:22together, we'll cut through the hype,

0:01:22 > 0:01:26the headlines and the health claims.

0:01:26 > 0:01:28This is Trust Me, I'm A Doctor.

0:01:32 > 0:01:35'It's the end of January and most of us

0:01:35 > 0:01:39'have started to let our new year health resolutions slip, so in this

0:01:39 > 0:01:43'programme, we're going to test some cunning tricks to make them stick.'

0:01:43 > 0:01:45Good looking guy. I'd trust him.

0:01:45 > 0:01:48'Plus, we reveal the herbal supplement that could help

0:01:48 > 0:01:50'you drink less.

0:01:50 > 0:01:52'We'll find out why chocolate

0:01:52 > 0:01:54'and ice cream could help some lose weight...'

0:01:54 > 0:01:59- That just makes you think about food in a totally new way.- Absolutely.

0:01:59 > 0:02:03'..whether running outdoors or on a treadmill is better for you.

0:02:03 > 0:02:07'And why the key to a good night's sleep might be pineapple.'

0:02:07 > 0:02:10Ha-ha! This, I can't believe!

0:02:10 > 0:02:12New year is traditionally the time

0:02:12 > 0:02:14when we decide we're going to get in shape,

0:02:14 > 0:02:17we're going to do that exercise, go on the diet,

0:02:17 > 0:02:20take the cake out of the trolley and put it back on the shelf.

0:02:20 > 0:02:23The problem is these resolutions rarely last.

0:02:26 > 0:02:28By now, near the end of January, many of us

0:02:28 > 0:02:32will have given up our healthy new year's resolutions and by the

0:02:32 > 0:02:36end of the year, the figure will have risen to a shocking 80%.

0:02:36 > 0:02:38We're here to help change all that.

0:02:38 > 0:02:41When it comes to new year's resolutions, the themes remain

0:02:41 > 0:02:46the same every year - broadly, eat better, do more exercise.

0:02:46 > 0:02:50We know what we want to do, broadly we know how to do it,

0:02:50 > 0:02:53the question is - how do we do it in a way that lasts?

0:02:53 > 0:02:56How do we motivate ourselves to keep on going?

0:02:56 > 0:03:00To find out, we're going to run a whole range of different

0:03:00 > 0:03:03experiments throughout this programme to discover some

0:03:03 > 0:03:06new tricks that could help us all stick to our resolutions

0:03:06 > 0:03:08and improve our health.

0:03:09 > 0:03:11To designs our tests,

0:03:11 > 0:03:15we've assembled a team of behaviour experts at the Shard in London.

0:03:16 > 0:03:20'Claire McDonald and Ed Gardner are leading our brainstorm.'

0:03:20 > 0:03:24If it said, "After you've eaten these nachos, you really need to

0:03:24 > 0:03:29"go for an hour run," then that might be something we could explore.

0:03:29 > 0:03:32'It all comes down to understanding why we believe the way we do.'

0:03:32 > 0:03:35Why do you think it is that people just find it incredibly

0:03:35 > 0:03:38difficult to stick to resolutions?

0:03:38 > 0:03:40There's lots of reasons and I think one of them

0:03:40 > 0:03:44is related to what is pulling us to behave in a different way,

0:03:44 > 0:03:48so it's easier to be inactive or eat more unhealthily,

0:03:48 > 0:03:50then we're probably more likely to do that.

0:03:50 > 0:03:52And we get distracted quite a lot.

0:03:52 > 0:03:54The way our homes are built, the way we run our lives,

0:03:54 > 0:03:59they're not always set up to help us act out that new behaviour

0:03:59 > 0:04:03and if we are going to do it, we've got to change the way we live.

0:04:03 > 0:04:07'So it's not that we lack the will to be healthier, it's just hard

0:04:07 > 0:04:11'to alter our lifestyles in ways that really stick.

0:04:11 > 0:04:12'But we want to change that.

0:04:12 > 0:04:15'So we've come to Derby to test some of Ed

0:04:15 > 0:04:18'and Claire's ideas on how people can stay motivated.

0:04:22 > 0:04:23'For our first experiment,

0:04:23 > 0:04:29'we've recruited 36 volunteers who all work here at Derby University.'

0:04:29 > 0:04:30Morning, all. Hi there.

0:04:30 > 0:04:33'Like most of us, they want to be a bit more active,

0:04:33 > 0:04:36'but find it hard to motivate themselves.'

0:04:36 > 0:04:39Are you kind of conscious of sitting quite a lot during the day?

0:04:39 > 0:04:40Yeah, definitely.

0:04:40 > 0:04:43I tried one of the fitness bands for a while and it kind of vibrated

0:04:43 > 0:04:44when I'd sat for too long.

0:04:44 > 0:04:48Do you classify yourselves as active or a bit inactive?

0:04:48 > 0:04:51- A bit inactive.- I'm not very active at all, I'm afraid.

0:04:51 > 0:04:53I'm trying, but...

0:04:53 > 0:04:56'We're hoping to turn trying into triumphing.'

0:04:56 > 0:05:00We're asking our volunteers to put a bit more activity,

0:05:00 > 0:05:03a bit more oomph into their daily lives.

0:05:03 > 0:05:06And we're dividing them into three groups

0:05:06 > 0:05:09because we want to test out three very different motivational

0:05:09 > 0:05:13techniques and see which, if any of them, works.

0:05:15 > 0:05:18'All three groups are being given the sort of information

0:05:18 > 0:05:22'we hear all the time - take lunchtime strolls, get

0:05:22 > 0:05:26'off the bus a stop early, and take the stairs, rather than the lift.

0:05:26 > 0:05:30'But our experiment is about how well they stick to this more

0:05:30 > 0:05:32'active lifestyle.

0:05:32 > 0:05:36'So each group will try a different technique to remain motivated.

0:05:36 > 0:05:39'Group one are the control group.

0:05:39 > 0:05:42'They're just getting the usual familiar health messages.

0:05:42 > 0:05:45'Group two will be our competitors.

0:05:45 > 0:05:47'They'll be competing for prizes

0:05:47 > 0:05:50'and will get regular feedback on their progress.

0:05:50 > 0:05:53'Group three are the collaborators.

0:05:53 > 0:05:55'We're giving them a team target

0:05:55 > 0:05:57'which they have to achieve together.'

0:05:57 > 0:06:00Now, with the control group, essentially,

0:06:00 > 0:06:03they're kind of like the rest of us. They've got some information,

0:06:03 > 0:06:06the standard sort of government information.

0:06:06 > 0:06:08Do you expect that to make any difference?

0:06:08 > 0:06:10I think we might see some kind of increase, yeah,

0:06:10 > 0:06:13because we are providing them with prompts, but it is the kind

0:06:13 > 0:06:16of standard prompts that we know and are given on a daily basis,

0:06:16 > 0:06:19so information alone is not enough to change behaviour.

0:06:19 > 0:06:22So I think we might see some kind of small increase, but potentially

0:06:22 > 0:06:24not as great an increase as we see within the other groups.

0:06:24 > 0:06:28Why did you choose the different approaches in the other two groups?

0:06:28 > 0:06:32There's well established, I guess, findings that competition can improve people's

0:06:32 > 0:06:36productivity and performance, so we're seeing whether or not it works in this office environment.

0:06:36 > 0:06:40With cooperation, again, there's lots of evidence around, the role of social proof,

0:06:40 > 0:06:44so actually if you see other people doing similar things to you,

0:06:44 > 0:06:47or if people provide you with encouragement

0:06:47 > 0:06:50or support in order to reach a particular goal,

0:06:50 > 0:06:52then people are much more likely to commit.

0:06:52 > 0:06:55I do like this. The uncertainty is quite fun.

0:06:55 > 0:06:58It'll be very interesting to see which one wins. You think it'll be tight.

0:06:58 > 0:07:01I think it'll be tight between the cooperation

0:07:01 > 0:07:02and the competition, yeah.

0:07:02 > 0:07:05- OK, I'm going for competition.- OK.

0:07:05 > 0:07:09Over the past week, we've gathered our volunteers'

0:07:09 > 0:07:11baseline activity levels.

0:07:11 > 0:07:14Now, we'll be keeping track over their progress over the next

0:07:14 > 0:07:17four weeks with pedometers and apps to see which group is

0:07:17 > 0:07:21the most successful at sticking to a more active lifestyle.

0:07:21 > 0:07:25Will the urge to beat rivals or the dread of letting

0:07:25 > 0:07:28a group down keep them more motivated?

0:07:29 > 0:07:32We'll find out later in the programme.

0:07:43 > 0:07:47Now, many of us make a resolution to cut back on alcohol.

0:07:47 > 0:07:49A heroic few are attempting a dry January,

0:07:49 > 0:07:53something that requires a supreme act of willpower.

0:07:53 > 0:07:56But for those of us with the more modest aim of just cutting

0:07:56 > 0:08:00back a bit on the booze, could there be an easier way?

0:08:00 > 0:08:03Well, some brand new research coming from the United States

0:08:03 > 0:08:08suggests that an ancient Chinese remedy might be able to help.

0:08:08 > 0:08:11Surgeon Gabriel Weston's going to find out more.

0:08:11 > 0:08:15This tablet is made from the root of the kudzu plant,

0:08:15 > 0:08:19a type of vine native to South East Asia,

0:08:19 > 0:08:22and there are some intriguing new studies that suggest that

0:08:22 > 0:08:27taking it can help us reduce our alcohol consumption without us

0:08:27 > 0:08:30even realising it.

0:08:30 > 0:08:32It's a plant with a long history,

0:08:32 > 0:08:35as Professor Elizabeth Williamson explains.

0:08:35 > 0:08:39The ancient traditional uses, going back for 2,000 years, were for

0:08:39 > 0:08:42coughs and colds and flu, also for blood pressure,

0:08:42 > 0:08:45high blood pressure, hypertension, angina, quite a lot of things like

0:08:45 > 0:08:50that, but it also has a long history of use for preventing alcohol abuse.

0:08:50 > 0:08:53And what's its effectiveness against all those things?

0:08:53 > 0:08:57It's used routinely in China for people with heart conditions

0:08:57 > 0:09:01and that's been extensively tested. As far as the alcohol's concerned,

0:09:01 > 0:09:04the history of that is documented back as far as 600 AD.

0:09:06 > 0:09:08And it's not just ancient tradition.

0:09:08 > 0:09:12There's some new scientific research that suggest kudzu might be

0:09:12 > 0:09:15effective in curbing alcohol consumption.

0:09:15 > 0:09:18But does that mean we should all start buying it?

0:09:19 > 0:09:22I must admit I'm doubtful.

0:09:22 > 0:09:24Sure, there are some tantalising

0:09:24 > 0:09:27and reputable studies from Harvard no less,

0:09:27 > 0:09:32but these were conducted on lone drinkers in laboratory conditions,

0:09:32 > 0:09:35hardly equivalent to a boozy night out.

0:09:35 > 0:09:39What we want to do is test kudzu in the wild,

0:09:39 > 0:09:42so to speak, with a real life scenario

0:09:42 > 0:09:44for the very first time.

0:09:45 > 0:09:48We've recruited a group of volunteers from companies

0:09:48 > 0:09:53in Reading willing to have two nights out in the name of science.

0:09:53 > 0:09:55Two hours ago, we gave them all pills.

0:09:55 > 0:09:58Some of them got kudzu and others a placebo.

0:09:58 > 0:10:01None of them knows which they've taken.

0:10:01 > 0:10:04Now, they're going to have access to our bar for 90 minutes

0:10:04 > 0:10:08and can have their choice of beer, wine or spirits,

0:10:08 > 0:10:12and we're monitoring how much each person consumes.

0:10:12 > 0:10:16In America, studies have shown that taking kudzu makes people

0:10:16 > 0:10:20drink more slowly and so drink less. This is thought to happen

0:10:20 > 0:10:24because of a group of active molecules known as isoflavones

0:10:24 > 0:10:27and the theory is that these isoflavones help deliver

0:10:27 > 0:10:31alcohol to the brain more quickly,

0:10:31 > 0:10:34so people feel its effects sooner

0:10:34 > 0:10:36and hence, slow down.

0:10:38 > 0:10:40But will this work in the real world?

0:10:40 > 0:10:44One week later, our volunteers are back at the pub to repeat

0:10:44 > 0:10:45the experiment.

0:10:45 > 0:10:49Those who had the placebo last time have been given kudzu this time

0:10:49 > 0:10:51and vice versa.

0:10:51 > 0:10:55Again, they don't know which pills they've taken and we're monitoring

0:10:55 > 0:10:59how many units they're drinking to see if the kudzu has any effect.

0:11:03 > 0:11:05So, what do our volunteers think?

0:11:05 > 0:11:08I felt like I was actually slowing down, compared to last week.

0:11:08 > 0:11:10Pretty similar, really. Yeah.

0:11:10 > 0:11:12- So no dramatic difference for you? - No, not really.- OK.

0:11:12 > 0:11:15Well, tonight, I didn't really want to drink as much,

0:11:15 > 0:11:18but I don't know whether that was because I wanted to or

0:11:18 > 0:11:20whether because it's just cos of the drugs, I don't know.

0:11:20 > 0:11:25So, guys, I've got the secret results in the envelope here.

0:11:25 > 0:11:29When you were drinking as a group without kudzu,

0:11:29 > 0:11:33just with a placebo, you had seven units per person

0:11:33 > 0:11:36and when you took the kudzu, you had

0:11:36 > 0:11:405.5 units per person, which means

0:11:40 > 0:11:44that overall, you drank about 20% less when you took the supplement.

0:11:44 > 0:11:46It's a result.

0:11:48 > 0:11:53I'm both surprised and encouraged by the results of our test.

0:11:53 > 0:11:57I really didn't expect the kudzu to make such a substantial

0:11:57 > 0:12:01difference, but before you rush out to buy kudzu extract,

0:12:01 > 0:12:04it's a case of buyer beware.

0:12:04 > 0:12:07Our test and those in the US involved each person taking

0:12:07 > 0:12:11over 500mg of the active ingredient.

0:12:11 > 0:12:14But we couldn't find any brands of kudzu available that had

0:12:14 > 0:12:18the Government's THR mark that guarantees that they contain

0:12:18 > 0:12:20what they say on the label.

0:12:20 > 0:12:24We had to have ours laboratory tested to get the right doses

0:12:24 > 0:12:27and they didn't contain the amount they said on the packet.

0:12:27 > 0:12:32Maddeningly, then, there isn't yet a reliable product on the market.

0:12:32 > 0:12:36But it's an enticing prospect, one that could make it easier to

0:12:36 > 0:12:39stick to our resolutions and cut back on the booze.

0:12:49 > 0:12:53Eating healthily, losing weight, these are all good resolutions.

0:12:53 > 0:12:56The trouble is we're all different and it's unlikely that

0:12:56 > 0:13:00a single diet is going to work just as well in everyone.

0:13:00 > 0:13:04Dr Saleyha Ahsan has been to Israel to look at some really impressive

0:13:04 > 0:13:08new research which suggests for the first time it is possible to

0:13:08 > 0:13:10develop a truly personalised diet.

0:13:13 > 0:13:17Some people can eat exactly what they want

0:13:17 > 0:13:20and they never put on any weight, whereas others just need to

0:13:20 > 0:13:24look at food and they're piling on the pounds.

0:13:24 > 0:13:28'For years, we were told that this couldn't be true, that those

0:13:28 > 0:13:33'who put on weight were secretly eating more, or exercising less.'

0:13:33 > 0:13:35That smells gorgeous!

0:13:35 > 0:13:37'Then we started to blame our genes.

0:13:37 > 0:13:41'But now there's a new discovery which can explain this phenomenon

0:13:41 > 0:13:44'and crucially, could help us all become healthier

0:13:44 > 0:13:48'and slimmer without counting calories.'

0:13:49 > 0:13:52A team here in Israel have found that different people do

0:13:52 > 0:13:55react differently to different types of food

0:13:55 > 0:13:58and what they've found is that it's not

0:13:58 > 0:14:01so much to do with our genes, but our gut bacteria.

0:14:02 > 0:14:05All of us have thousands of different microbes

0:14:05 > 0:14:09living in our gut. They're key to how we process food.

0:14:09 > 0:14:13And this new research suggests that our own personal

0:14:13 > 0:14:16combination of bacteria can make a real difference.

0:14:18 > 0:14:21'To find out how, I'm going to become

0:14:21 > 0:14:26'part of a huge trial that's being carried out on 1,000 volunteers.

0:14:26 > 0:14:29'First, I have to give a poo or a stool sample

0:14:29 > 0:14:32'and I'm being fitted with a glucometer, a device which

0:14:32 > 0:14:36'will measure my blood sugar levels constantly for the next week.'

0:14:36 > 0:14:37Are you ready?

0:14:37 > 0:14:41'When we eat, our blood sugar levels go up,

0:14:41 > 0:14:45'but if they go up too high and too quickly in a spike, this can

0:14:45 > 0:14:49'increase our risk of putting on weight and type 2 diabetes.

0:14:49 > 0:14:52'Some foods have long been thought particularly bad at causing

0:14:52 > 0:14:56'blood sugar spikes, but the researchers here now think

0:14:56 > 0:15:00'those foods are different for each of us, as Dr Eran Segal explains.'

0:15:00 > 0:15:05If we can understand which foods for individuals in particular

0:15:05 > 0:15:07spike their blood sugar levels,

0:15:07 > 0:15:10then we might be able to recommend for them

0:15:10 > 0:15:13personally tailored diets that would achieve a normalised blood

0:15:13 > 0:15:16glucose levels in these individuals.

0:15:16 > 0:15:19So, why do you need a stool sample from me?

0:15:19 > 0:15:22From the stool, we can actually extract the collection of gut

0:15:22 > 0:15:25microbes that live there.

0:15:25 > 0:15:28There's been many different studies showing the very intimate

0:15:28 > 0:15:32relationships between us and our gut microbes.

0:15:32 > 0:15:35If you take gut microbes from an overweight person

0:15:35 > 0:15:38and from a lean person and you transplant them into mice,

0:15:38 > 0:15:42the one who receives the gut microbes of the overweight

0:15:42 > 0:15:46person will increase his body weight and become obese very quickly,

0:15:46 > 0:15:49compared to the other who on the same exact diet will

0:15:49 > 0:15:51actually not gain weight.

0:15:51 > 0:15:55Oh, my gosh! Wow!

0:15:55 > 0:15:58'Each one of us has our own unique set of gut bacteria

0:15:58 > 0:16:02'and the theory is that this explains why different foods cause

0:16:02 > 0:16:04'sugar spikes in different people.

0:16:04 > 0:16:08'So I'm going to put that to the test.'

0:16:08 > 0:16:11So I'm all kitted out now in exactly the same way as all the other

0:16:11 > 0:16:15hundreds of people involved in the team's study.

0:16:15 > 0:16:19They've got a sample of my gut bacteria and this little monitor

0:16:19 > 0:16:23will be keeping an eye on my blood sugar levels throughout the week.

0:16:24 > 0:16:26'Another volunteer, Leila,

0:16:26 > 0:16:29'is starting the same experiment alongside me.

0:16:29 > 0:16:33'We're the same sex and age and for the next week,

0:16:33 > 0:16:35'we're going to do and eat all the same things.

0:16:36 > 0:16:40'But both of us have different gut microbes,

0:16:40 > 0:16:44'so will this make us respond differently to the same foods?

0:16:44 > 0:16:48'A week of careful monitoring will tell us.'

0:16:48 > 0:16:49Go to sleep. OK. There we go.

0:16:58 > 0:17:01The next morning, Leila and I start the experiment.

0:17:01 > 0:17:05'We're going to be following how our blood sugar levels react

0:17:05 > 0:17:07'throughout the day to the same foods,

0:17:07 > 0:17:10'using finger prick tests that give an instant result.'

0:17:12 > 0:17:15- Right. Breakfast. I'm actually hungry.- I'm starving.

0:17:15 > 0:17:19'The researchers have given us a really exciting breakfast -

0:17:19 > 0:17:21'four slices of white bread.

0:17:21 > 0:17:23'This, according to the textbooks...'

0:17:23 > 0:17:24Ow!

0:17:24 > 0:17:27'..should cause us both a rapid spike in blood sugar levels.'

0:17:27 > 0:17:29Mine's 99.

0:17:29 > 0:17:3188. Quite a big difference, though, isn't it?

0:17:31 > 0:17:36So, I'm having a little bit of a... On my graph, it'll be going up.

0:17:36 > 0:17:39'So, I had the expected spike. Not good for me.

0:17:39 > 0:17:43'But Leila's blood sugar remained at a lower, healthier level.'

0:17:43 > 0:17:46# Me and you just singin' on the train,

0:17:46 > 0:17:48# Me and you listening to the rain... #

0:17:48 > 0:17:52'Over the next week, we'll continue to test our bodies' reactions

0:17:52 > 0:17:55'to a whole range of common foods to find out

0:17:55 > 0:17:58'which give each of us a bad sugar spike and which don't.'

0:17:58 > 0:18:02I'm allowed to eat ice cream and I have to say,

0:18:02 > 0:18:06after a hot morning's work, it's delicious.

0:18:06 > 0:18:10And then we'll work out whether I'm ever allowed to have it again!

0:18:10 > 0:18:13I'm going to make the most of it for now.

0:18:13 > 0:18:14'From our results,

0:18:14 > 0:18:18'the researchers will be able to relate our gut bacteria to the

0:18:18 > 0:18:21'foods that give us a bad sugar spike and give us

0:18:21 > 0:18:25'each a personalised diet plan to avoid them.

0:18:25 > 0:18:28'But the team here think they can do even more than that.

0:18:28 > 0:18:33'As Dr Eran Elinav, the project's other lead researcher, explains -

0:18:33 > 0:18:37'they believe we can actually change our gut bacteria,

0:18:37 > 0:18:40'giving us a healthier response to food.'

0:18:41 > 0:18:45Eran, how can you actually change your gut bacteria?

0:18:45 > 0:18:48So there's several ways which are under intense

0:18:48 > 0:18:51research at our labs and nutrition is the strongest

0:18:51 > 0:18:55influencer of the composition of and function of the gut microbes

0:18:55 > 0:18:58so if we take, for example, an extreme situation in which

0:18:58 > 0:19:03a person is eating meat and now he becomes a vegetarian.

0:19:03 > 0:19:06And we have done such experiments in our labs.

0:19:06 > 0:19:09You can measure the gut microbes and, within days,

0:19:09 > 0:19:12there will be a dramatic, very reproducible change

0:19:12 > 0:19:15both in the composition and the function of the gut microbes.

0:19:15 > 0:19:18- You're training your gut microbes. - Absolutely.

0:19:18 > 0:19:20This is exactly like training your muscles.

0:19:20 > 0:19:24It is training your other organ, which is our gut microbes.

0:19:24 > 0:19:27- I mean, this is just so exciting. - I am super excited.

0:19:27 > 0:19:31This field and these findings are what keeps...gets me up at night!

0:19:32 > 0:19:34The idea that food affects us

0:19:34 > 0:19:38so differently and that we can alter that effect is brand-new to me.

0:19:38 > 0:19:42I'd accepted the view that some foods gave all of us

0:19:42 > 0:19:46a sugar spike and others didn't but, during this week,

0:19:46 > 0:19:50I've already begun to see hints that this isn't quite true.

0:19:50 > 0:19:54So I'm really looking forward to seeing what the entire picture

0:19:54 > 0:19:57looks like with all of my results.

0:19:57 > 0:20:00I'll be getting my personalised diet results a bit later

0:20:00 > 0:20:05in the programme, seeing what it does for me, and finding

0:20:05 > 0:20:08out more about the implications of this research for all of us.

0:20:17 > 0:20:21Another common resolution is to get more sleep.

0:20:21 > 0:20:23We all know how good it is for us,

0:20:23 > 0:20:25but if we have real problems sleeping,

0:20:25 > 0:20:28it can be a very hard nut to crack.

0:20:28 > 0:20:30But we've got some new tricks you can try.

0:20:30 > 0:20:32Over to Dr Chris van Tulleken.

0:20:35 > 0:20:39I'm a lousy sleeper and it's getting worse as I get older.

0:20:39 > 0:20:41You know, I wake up in the middle of the night more,

0:20:41 > 0:20:42then I'm tired during the day,

0:20:42 > 0:20:45so I have a nap, usually through something important,

0:20:45 > 0:20:48that stresses me out, then I can't get to sleep at night.

0:20:48 > 0:20:50It's a really lousy pattern.

0:20:50 > 0:20:54Getting into bad sleeping habits can have serious effects on our brains.

0:20:54 > 0:20:56So how can we break them?

0:20:56 > 0:20:59To put our theories to the test, we found a place where

0:20:59 > 0:21:03there are plenty of people suffering from problems sleeping -

0:21:03 > 0:21:05a retirement village.

0:21:05 > 0:21:08As we get older, problems with sleep get worse.

0:21:08 > 0:21:12Time we went to bed, between 10 and 11, I was wide awake again.

0:21:12 > 0:21:16And it would be three, four and five o'clock before I'd go to sleep,

0:21:16 > 0:21:18tossing and turning.

0:21:18 > 0:21:22I've started recently getting up four or five times a night.

0:21:22 > 0:21:25Sometimes I'd be wide awake at two o'clock in the morning.

0:21:25 > 0:21:29And I wouldn't go to bed till six o'clock, seven o'clock.

0:21:29 > 0:21:31These are classic patterns of bad sleep.

0:21:31 > 0:21:33And whether you're stressed

0:21:33 > 0:21:36or getting older, the cause is the same.

0:21:36 > 0:21:40It's down to your hormones, especially one called melatonin.

0:21:40 > 0:21:43This hormone should naturally be released into our brain

0:21:43 > 0:21:46when night falls, making us feel drowsy.

0:21:46 > 0:21:49Dr Manny Bagary explains.

0:21:49 > 0:21:51This is a melatonin curve of a young adult.

0:21:51 > 0:21:54As you can see, round about seven o'clock,

0:21:54 > 0:21:58the melatonin levels start to increase up until about three,

0:21:58 > 0:22:01four o'clock in the morning, at which they peak

0:22:01 > 0:22:03and then start to decrease.

0:22:03 > 0:22:06And melatonin is the hormone that puts me to sleep.

0:22:06 > 0:22:09Yeah, it helps you to go to sleep.

0:22:09 > 0:22:11OK, why does our sleep get worse as we get older?

0:22:11 > 0:22:13So, as we get older,

0:22:13 > 0:22:16the peak in melatonin often comes a little bit earlier,

0:22:16 > 0:22:19so we tend to sleep a little bit earlier

0:22:19 > 0:22:22and we also tend to wake up a little bit earlier.

0:22:23 > 0:22:26'So to tackle our volunteers' problems

0:22:26 > 0:22:30'we're going to start by measuring their melatonin levels.

0:22:30 > 0:22:34'Charmingly, we collected their spit at regular intervals

0:22:34 > 0:22:36'throughout the day until they fall asleep.'

0:22:36 > 0:22:37Thanks a lot(!)

0:22:39 > 0:22:43We're also tracking their sleep patterns through watches that

0:22:43 > 0:22:46monitor their movements and through detailed diaries.

0:22:47 > 0:22:50After a week, Manny analyses our volunteers' data.

0:22:50 > 0:22:53For some, it's clear from their melatonin patterns

0:22:53 > 0:22:55that their body clocks are all wrong.

0:22:57 > 0:23:00Tony shows a classic pattern for older people,

0:23:00 > 0:23:03with his melatonin peaking too early, around 8pm,

0:23:03 > 0:23:05sending him napping.

0:23:05 > 0:23:09But his melatonin then drops again when he should be going to bed.

0:23:11 > 0:23:16Billy, instead, has very low levels all night and can't get to sleep.

0:23:16 > 0:23:19And then it suddenly peaks in the early morning,

0:23:19 > 0:23:22which is when he finds himself finally dropping off.

0:23:25 > 0:23:28'We, though, have researched a whole raft of ways that might help

0:23:28 > 0:23:31'get their body clocks back on track,

0:23:31 > 0:23:35'boosting melatonin at the right times and helping with sleep.

0:23:35 > 0:23:38'And I've prepared each of our volunteers

0:23:38 > 0:23:40'a Trust Me sleeping bag with instructions.'

0:23:40 > 0:23:42- There you go.- Cheers.

0:23:42 > 0:23:46'The regime, surprisingly, starts in the morning.'

0:23:46 > 0:23:48That's the last thing I need!

0:23:48 > 0:23:50'They're not allowed to lie in.

0:23:50 > 0:23:56'They must get up and open the curtains to get bright sunlight.

0:23:56 > 0:23:58'Sunlight helps set the body clock,

0:23:58 > 0:24:00'suppressing melatonin production in the brain.

0:24:00 > 0:24:04'This should help make them alert for the day.

0:24:04 > 0:24:07'Caffeine in the morning is fine, but not after 3pm.'

0:24:07 > 0:24:09Decaf tea.

0:24:09 > 0:24:12'Afternoon naps are strictly forbidden.

0:24:12 > 0:24:15'The supper menu - a few unusual things to try,

0:24:15 > 0:24:19'even though there's less evidence for them.'

0:24:19 > 0:24:21Pineapples actually contain melatonin.

0:24:21 > 0:24:23It's a bit of a long shot

0:24:23 > 0:24:25as to whether or not they'll put you to sleep, but if you're

0:24:25 > 0:24:28desperate and you like pineapple, well, it might be worth a go.

0:24:29 > 0:24:32Oh, wonderful.

0:24:32 > 0:24:34'And there are other melatonin-containing alternatives

0:24:34 > 0:24:39'such as rice, walnuts, sweetcorn,

0:24:39 > 0:24:41'banana, orange and a warm, milky drink.

0:24:43 > 0:24:46'After supper, it's no alcohol and complete darkness.'

0:24:46 > 0:24:49What's this? A sleep mask.

0:24:49 > 0:24:52'Even the blue-tinted light from computer screens

0:24:52 > 0:24:55'and TVs can suppress melatonin that should be being released

0:24:55 > 0:24:58'into their brains and helping put them to sleep.

0:25:01 > 0:25:04'Our volunteers have agreed to stick to this routine for a week

0:25:04 > 0:25:08'whilst we continue to monitor their sleep and melatonin levels.

0:25:08 > 0:25:10'So how have they got on?'

0:25:10 > 0:25:13I pretty well liked what was in the bag.

0:25:13 > 0:25:15I'm a very happy bunny.

0:25:15 > 0:25:19I really did lay off having coffee in the evening.

0:25:19 > 0:25:22I did try to take my half-glass of hot milk

0:25:22 > 0:25:25and I think that made a difference, too.

0:25:25 > 0:25:28So, Manny, what were the results?

0:25:28 > 0:25:29The results were very interesting.

0:25:29 > 0:25:32Most people seemed to get better but those changes really

0:25:32 > 0:25:34seemed to come through towards the end of the week.

0:25:34 > 0:25:36And three people got significantly better.

0:25:37 > 0:25:40For example, at the start, Kerry's melatonin levels

0:25:40 > 0:25:42were very low through the night,

0:25:42 > 0:25:44linked to her problems sleeping.

0:25:44 > 0:25:48But now her cycle has returned to normal.

0:25:48 > 0:25:51I tried doing the things that were on the list.

0:25:51 > 0:25:52I ate the foods at the right time.

0:25:52 > 0:25:54I'm going to make sure that she doesn't drink

0:25:54 > 0:25:58- as much coffee any more. She does. - And the wine.- Can't stop the wine.

0:25:58 > 0:26:01- No, no, the wine can be medicinal, but coffee, no.- Ooh!

0:26:01 > 0:26:06And Beryl's sleeping patterns show that she woke up fewer times each night.

0:26:06 > 0:26:11One of the articles you gave us and told us was to block out light.

0:26:11 > 0:26:14And I did that, and that was a great help.

0:26:14 > 0:26:17Some of the other things we tried were rather experimental,

0:26:17 > 0:26:20but others have good scientific backing behind them

0:26:20 > 0:26:24and some of them, at least, seem to have had an effect.

0:26:24 > 0:26:28The results based on one week's intervention are very impressive.

0:26:28 > 0:26:30We would expect improvements to bed in

0:26:30 > 0:26:33over a period of six to eight weeks.

0:26:33 > 0:26:35Is anyone going to keep up any

0:26:35 > 0:26:38of the advice or interventions that we have given?

0:26:38 > 0:26:40Yes, because it helped.

0:26:40 > 0:26:43Instead of three, four, five o'clock in the morning,

0:26:43 > 0:26:45I can go to sleep now straightaway.

0:26:45 > 0:26:49I think we are definitely sleeping better

0:26:49 > 0:26:54because of what we have learned, what we have been shown.

0:26:54 > 0:26:57There is evidence that better melatonin patterns

0:26:57 > 0:26:59and sleep might do all our brains good, too,

0:26:59 > 0:27:01helping keep us sharp.

0:27:02 > 0:27:04You know, I think a lot of us just accept,

0:27:04 > 0:27:06as we get older and we get more stressed,

0:27:06 > 0:27:10we're just never going to sleep that well again, but there is this what

0:27:10 > 0:27:13I think of as a kind of bundle of changes you can make in your life.

0:27:13 > 0:27:16These might help restore your melatonin and sleep patterns

0:27:16 > 0:27:21so that you don't just feel better, your mind will stay sharper, too.

0:27:21 > 0:27:25There's information about all the tricks you can try to sort

0:27:25 > 0:27:30out your body clock and melatonin levels on our website...

0:27:41 > 0:27:44The hardest thing about getting healthier isn't knowing what

0:27:44 > 0:27:47to do, it's actually going out and doing it and then sticking to it.

0:27:47 > 0:27:51And that's why we've set off a whole array of experiments here in Derby

0:27:51 > 0:27:55to see which, if any, help people achieve their health goals.

0:27:58 > 0:27:59Morning, all!

0:27:59 > 0:28:01'In the university offices,

0:28:01 > 0:28:04'36 volunteers have set out to get more active.

0:28:04 > 0:28:09'We're testing whether competing with each other or cooperating to

0:28:09 > 0:28:12'achieve a group target is better to keep them motivated.

0:28:13 > 0:28:16'My resolution, though, is around food.

0:28:16 > 0:28:21'Whenever it's there, I'm tempted to eat it, especially if it's sugary.

0:28:21 > 0:28:25'So how can I get better at resisting temptation?

0:28:25 > 0:28:27'Well, there is research that suggests

0:28:27 > 0:28:30'a few simple tricks might make a big difference.'

0:28:33 > 0:28:37Experts from Cornell University in the United States have done

0:28:37 > 0:28:41some absolutely fascinating research looking at the links

0:28:41 > 0:28:45between our weight and the foods we leave lying out on the surface.

0:28:45 > 0:28:48And based on studies in hundreds of kitchens,

0:28:48 > 0:28:50they've come up with some golden rules

0:28:50 > 0:28:52of what to do and what not to do.

0:28:55 > 0:28:58First, put all food out of sight...

0:28:59 > 0:29:01..apart from fruit.

0:29:02 > 0:29:06What the experts found was that people weighed more on average

0:29:06 > 0:29:09if they kept things like biscuits, fizzy drinks,

0:29:09 > 0:29:13crisps and even cereal on their kitchen counters, whereas those

0:29:13 > 0:29:17with just fruit on the counter were more likely to weigh less.

0:29:17 > 0:29:20The trick here is to avoid temptation altogether.

0:29:20 > 0:29:24What I'm doing is out of sight and out of mind.

0:29:24 > 0:29:27But, in reality, I am such a chocoholic that I'd actually have

0:29:27 > 0:29:32to give this to my wife to hide, otherwise I would go and eat it.

0:29:32 > 0:29:34Next, reorder your cupboards.

0:29:34 > 0:29:37It turns out we are all naturally a bit lazy and are three times

0:29:37 > 0:29:41more likely to eat the first foods we see than the fifth one.

0:29:41 > 0:29:44So put healthier foods first.

0:29:44 > 0:29:47And take vegetables out of the drawers at the bottom of the fridge

0:29:47 > 0:29:49and put them where you can see them.

0:29:52 > 0:29:55Then there's the eating itself.

0:29:55 > 0:29:57When I cook a family meal like a casserole, I would normally

0:29:57 > 0:30:01leave it on the kitchen table for people to help themselves.

0:30:01 > 0:30:04Well, it turns out this is actually a really bad idea.

0:30:04 > 0:30:07In studies we have found that, if you leave

0:30:07 > 0:30:12the casserole on the stove, then people will actually 20% less.

0:30:12 > 0:30:14Why? Well, we don't just eat when we're hungry,

0:30:14 > 0:30:16we eat what is in front of us.

0:30:16 > 0:30:20So if you leave it over there, then people are far less likely to

0:30:20 > 0:30:23help themselves to unnecessary seconds, or even thirds.

0:30:25 > 0:30:28The trick is to understand that we naturally tend

0:30:28 > 0:30:32to go for the easy option and make that the healthy option.

0:30:33 > 0:30:36Which is all very well in the privacy of our own homes,

0:30:36 > 0:30:39but what happens when we head out shopping?

0:30:41 > 0:30:44'There, it seems, the whole world is designed to make us

0:30:44 > 0:30:48'buy more food, and often less healthy food.

0:30:48 > 0:30:52'Well, behaviour expert Claire McDonald has some tricks for us

0:30:52 > 0:30:53'to try there too.'

0:30:53 > 0:30:56The shopping environment has been designed to help us

0:30:56 > 0:31:00conveniently move around a store in a kind of mindless fashion.

0:31:00 > 0:31:04A fog head. You'll have the similar items week in, week out,

0:31:04 > 0:31:08and how they get into your basket isn't necessarily choice,

0:31:08 > 0:31:10it's just repetition, habits.

0:31:10 > 0:31:13We get into a way of shopping.

0:31:14 > 0:31:18'And she's unearthed some possible ways of breaking those bad habits.

0:31:18 > 0:31:21'But they require rather unusual experiments

0:31:21 > 0:31:24'at an obliging local supermarket.

0:31:24 > 0:31:27'Firstly, can we be nudged into healthy habits

0:31:27 > 0:31:30'if caught at the right moment...'

0:31:30 > 0:31:32Good-looking guy! I'd trust him.

0:31:32 > 0:31:37'..with unexpected messages and reminders at the right time?'

0:31:37 > 0:31:41We're going to remind people as they go round the store,

0:31:41 > 0:31:44so they don't get lost in the kind of mind space of shopping.

0:31:44 > 0:31:46They're going to be prompted continually.

0:31:46 > 0:31:49So by putting a prompt right by the fruit and veg,

0:31:49 > 0:31:52you can act upon the message as you receive it.

0:31:52 > 0:31:54So, soon there could become more cut-outs of me

0:31:54 > 0:31:57- scattered all over the country! - A terrifying thought.

0:31:57 > 0:31:59An army of Michaels across the country

0:31:59 > 0:32:01telling you to eat fruit and veg.

0:32:01 > 0:32:03And we're also testing a new theory,

0:32:03 > 0:32:07that what we eat just before we shop will influence our buying habits.

0:32:07 > 0:32:10We've probably all suffered from shopping while hungry,

0:32:10 > 0:32:14but how about shopping while eating?

0:32:14 > 0:32:17Over the next few weeks we're going to monitor the sales of fruit

0:32:17 > 0:32:19and vegetables in this shop

0:32:19 > 0:32:22and see if our interventions have made any difference.

0:32:22 > 0:32:24If they have, and even if they haven't,

0:32:24 > 0:32:27we should learn some valuable lessons.

0:32:28 > 0:32:32'And when the results came in, they were encouraging.

0:32:32 > 0:32:34'Compared with similar stores,

0:32:34 > 0:32:38'this one had an 8% increase in vegetable sales over six weeks.

0:32:38 > 0:32:41'It seems that reminders at the crucial time really helped.

0:32:41 > 0:32:45'And when we encourage people to eat clementines before shopping,

0:32:45 > 0:32:48'clementine sales went through the roof.

0:32:48 > 0:32:50'Not a surprise to marketeers, perhaps,

0:32:50 > 0:32:52'but something we could turn to our advantage.'

0:32:52 > 0:32:54Thank you!

0:32:54 > 0:32:57'So when you're hitting the food shops, use your own psychology.

0:32:57 > 0:33:01'Don't go snacking on chocolate and crisps just beforehand

0:33:01 > 0:33:03'if you want to avoid buying more junk.

0:33:03 > 0:33:06'And use the power of the timely reminder.

0:33:06 > 0:33:09'You don't need a life-size cut-out of me.

0:33:09 > 0:33:12'A note to self on shopping list should do it.'

0:33:23 > 0:33:26'Earlier in the programme I was in Israel...'

0:33:26 > 0:33:28Are you ready?

0:33:28 > 0:33:32'..taking part in a new study that promises to revolutionise

0:33:32 > 0:33:34'the way we think about foods.

0:33:34 > 0:33:37'The researchers there believe that what's good for one person

0:33:37 > 0:33:39'can be bad for another

0:33:39 > 0:33:43'because of differences in the bacteria we all have in our guts.

0:33:43 > 0:33:47'If true, this could change diet advice for ever.

0:33:50 > 0:33:54'To put it to the test, both I and another volunteer, Leila,

0:33:54 > 0:33:57'ate exactly the same things for a week.

0:33:57 > 0:33:59'The researchers analysed how those

0:33:59 > 0:34:02'foods affected our blood sugar

0:34:02 > 0:34:04'levels and how this in turn related

0:34:04 > 0:34:07'to different bacteria in our gut.

0:34:07 > 0:34:11'Dr Eran Segal is about to reveal our results.'

0:34:11 > 0:34:16Basically, we have analysed everything that you ate.

0:34:16 > 0:34:21So there are certain items that we identified as being good,

0:34:21 > 0:34:22and good in the sense

0:34:22 > 0:34:24that they do not raise your blood sugar levels much.

0:34:24 > 0:34:29- OK.- And we can put that into categories of things that are...

0:34:29 > 0:34:32I'm already seeing things that I love that are on the bad!

0:34:32 > 0:34:34Oh, no!

0:34:34 > 0:34:36Cereal, grapes, tomato soup

0:34:36 > 0:34:39and sushi all turn out to give me

0:34:39 > 0:34:41a bad spike in blood sugar levels,

0:34:41 > 0:34:45increasing my risk of type 2 diabetes and putting on weight.

0:34:45 > 0:34:47I thought I was being healthy.

0:34:47 > 0:34:52I thought, "Right, I've got grapes. I'll just snack on grapes."

0:34:52 > 0:34:55And as I've been doing that I've actually been contributing

0:34:55 > 0:34:58to my glucose levels spiking and getting fatter.

0:34:58 > 0:35:04But cola, ice cream, chocolate and croissants are all on my GOOD list.

0:35:04 > 0:35:06It's all very surprising.

0:35:06 > 0:35:10- I haven't bought a loaf of bread for years.- Really?

0:35:10 > 0:35:11I can't believe that.

0:35:11 > 0:35:13'And compared to mine,

0:35:13 > 0:35:15'Leila's results

0:35:15 > 0:35:16'just go to show

0:35:16 > 0:35:18'how different individuals are.

0:35:18 > 0:35:20'Several foods, like croissants,

0:35:20 > 0:35:23'bananas and nuts, pasta and pizza,

0:35:23 > 0:35:24'had opposite effects

0:35:24 > 0:35:26'on the two of us.

0:35:26 > 0:35:27'And this means that standard

0:35:27 > 0:35:29'healthy eating advice

0:35:29 > 0:35:31'is doing some of us

0:35:31 > 0:35:32'no good at all.'

0:35:32 > 0:35:33Wow!

0:35:33 > 0:35:35I'm so surprised.

0:35:35 > 0:35:38This is showing you the results on two individuals,

0:35:38 > 0:35:41but we've tested close to 1,000 individuals.

0:35:41 > 0:35:44And, for example, if a dietician tells somebody

0:35:44 > 0:35:46to eat wholegrain rice,

0:35:46 > 0:35:49and we see that many people actually spike for rice

0:35:49 > 0:35:50and they don't know it,

0:35:50 > 0:35:54then that advice can actually have harmful effects in the long run.

0:35:54 > 0:35:56Yeah.

0:35:56 > 0:35:59'But the team think that knowing our gut microbes could help.'

0:35:59 > 0:36:04When comparing you and Leila, we actually found very big

0:36:04 > 0:36:08differences in your microbiome composition.

0:36:08 > 0:36:10Leila has a good bacterial composition

0:36:10 > 0:36:12that is much more diverse.

0:36:12 > 0:36:14- She's got more colours. - More colours.

0:36:14 > 0:36:15And in general, more colours

0:36:15 > 0:36:20and more diversity of gut bacteria is a good thing to have.

0:36:20 > 0:36:24So if I follow the diet that you've given me,

0:36:24 > 0:36:28- then I could end up with a more colourful pie chart.- You might.

0:36:28 > 0:36:32And then perhaps, after altering your good bacteria,

0:36:32 > 0:36:36your response to foods might actually improve overall

0:36:36 > 0:36:39and your glucose metabolism might improve overall.

0:36:39 > 0:36:41'These results are fascinating

0:36:41 > 0:36:45'and clearly I have to try what the researchers are suggesting.'

0:36:45 > 0:36:46Looking ahead -

0:36:46 > 0:36:49and I am so excited about this -

0:36:49 > 0:36:52I'm going to stick to the good food diet, I'm going

0:36:52 > 0:36:56to avoid the bad food diet and then we're going to re-test

0:36:56 > 0:37:01for my gut bacteria to see if there's been any difference.

0:37:01 > 0:37:04And according to Eran, there should be.

0:37:05 > 0:37:10So for two weeks, it's out with the red foods and in with the green.

0:37:11 > 0:37:15Meanwhile, back in Israel, the team are analysing my gut bacteria

0:37:15 > 0:37:18in stool samples I send them.

0:37:18 > 0:37:20Now it's time to find out what they've seen.

0:37:24 > 0:37:27- Hi, how are you doing, guys? - Good.- We're good.

0:37:27 > 0:37:31What I'm dying to know is, how were my results?

0:37:31 > 0:37:36Your microbiome configuration dramatically changed.

0:37:36 > 0:37:39And in most aspects it changed for the better.

0:37:39 > 0:37:44We saw that certain bacteria that are typically associated with

0:37:44 > 0:37:48- a risk for obesity and diabetes became lower.- Really?

0:37:48 > 0:37:52We can see that certain bacteria that are associated with

0:37:52 > 0:37:57- improved glucose tolerance, they actually went up.- That's amazing.

0:37:57 > 0:38:03- And actually over a really short space of time.- Absolutely.

0:38:04 > 0:38:07The results are incredibly promising.

0:38:07 > 0:38:08If I keep to the personalised diet,

0:38:08 > 0:38:11my gut bacteria should

0:38:11 > 0:38:13continue to change.

0:38:13 > 0:38:15My health should improve

0:38:15 > 0:38:17and I may even lose some weight.

0:38:17 > 0:38:20This research is truly revolutionary

0:38:20 > 0:38:23and has the potential to transform

0:38:23 > 0:38:24our health in the future.

0:38:26 > 0:38:29I'm so excited by what I've just been told.

0:38:29 > 0:38:33In the space of just a few weeks, I've managed to change my own

0:38:33 > 0:38:35gut microbiome profile.

0:38:35 > 0:38:38This experience is going to change my life,

0:38:38 > 0:38:43and I hope in the future it will help other people too.

0:38:43 > 0:38:48The team in Israel are now working on a way to allow anyone to

0:38:48 > 0:38:52send in a stool sample and get a personalised diet plan in return.

0:38:55 > 0:38:59And they are currently running a study over a year to see how

0:38:59 > 0:39:03long you need to stay on the diet to maintain the healthy changes

0:39:03 > 0:39:04in your gut bacteria.

0:39:05 > 0:39:08There are more details on our website at...

0:39:17 > 0:39:21Still to come, could your scales really be lying to you?

0:39:21 > 0:39:24And is there such a thing as too much exercise?

0:39:24 > 0:39:26But first...

0:39:30 > 0:39:33For those of us whose resolution is to get more exercise,

0:39:33 > 0:39:36running is a very popular option.

0:39:36 > 0:39:39But is there really any difference between treadmill running

0:39:39 > 0:39:41and outdoor running?

0:39:41 > 0:39:43And which one is better for our body?

0:39:46 > 0:39:49I'm going to try pounding the pavement

0:39:49 > 0:39:51and toiling on the treadmill to find out.

0:39:55 > 0:39:59First, does one of them get me fitter than the other?

0:39:59 > 0:40:02Well, there's a decent chance you're burning more calories

0:40:02 > 0:40:04if you're out in the open air.

0:40:04 > 0:40:08Running outside actually uses up more energy than

0:40:08 > 0:40:10running at the same speed on a treadmill.

0:40:10 > 0:40:13This is largely due to wind resistance,

0:40:13 > 0:40:16which you just don't get running indoors.

0:40:16 > 0:40:20However, a study conducted at the University of Exeter shows

0:40:20 > 0:40:23that you can easily compensate for this in the gym

0:40:23 > 0:40:26simply by setting your treadmill to a 1% gradient.

0:40:26 > 0:40:29But there's also the issue of perception.

0:40:29 > 0:40:33A study from 2012 found that the treadmill can

0:40:33 > 0:40:35distort our perception of speed.

0:40:35 > 0:40:38When participants were asked to match their outdoor running speed

0:40:38 > 0:40:42on a treadmill, they ended up running significantly slower.

0:40:42 > 0:40:45This suggests that not only do we work harder

0:40:45 > 0:40:49when we're running outside, we don't even realise we're doing it.

0:40:49 > 0:40:52So if running edges it in terms of work rate,

0:40:52 > 0:40:56what method is safest for our bodies?

0:40:56 > 0:41:01When it comes to injuries, there are fewer hazards to treadmill running.

0:41:04 > 0:41:07But there are also some surprising drawbacks.

0:41:08 > 0:41:11Repetition of the same movement can put us at a grater risk

0:41:11 > 0:41:15of wearing out joint or ligaments and ending up with an injury.

0:41:15 > 0:41:19When we run, each foot hits the ground about 1,000 times per mile,

0:41:19 > 0:41:22leading to a lot of wear and tear.

0:41:22 > 0:41:24So if you use a treadmill,

0:41:24 > 0:41:28where you're performing the same action again and again,

0:41:28 > 0:41:32it's a good idea to mix it up a bit by varying the speed and incline.

0:41:34 > 0:41:38This is less of an issue in the great outdoors.

0:41:38 > 0:41:41When you run outdoors, especially if you go off-road,

0:41:41 > 0:41:45each step is likely to be different because of the uneven

0:41:45 > 0:41:49and varied terrain, and this can actually strengthen the ligaments,

0:41:49 > 0:41:55activate a variety of muscles and even teach the body better balance.

0:41:58 > 0:42:01Studies have also shown that exercising outdoors

0:42:01 > 0:42:05is good for the mind and for lowering stress and blood pressure.

0:42:06 > 0:42:09Plus there are the advantages of exposure to the sunshine

0:42:09 > 0:42:12and therefore to vitamin D,

0:42:12 > 0:42:15although in Britain that clearly can't be guaranteed.

0:42:15 > 0:42:18For strength, fitness and well-being,

0:42:18 > 0:42:21outdoor running clearly has the edge and it costs nothing.

0:42:21 > 0:42:25But if you prefer the treadmill, make sure you take advantage

0:42:25 > 0:42:30of all its features to up the energy levels and ring the changes.

0:42:31 > 0:42:34But when you're enthusiastically getting your exercise,

0:42:34 > 0:42:38can you overdo it? Is there such a thing as too much exercise?

0:42:38 > 0:42:42The current government guidelines for adults are

0:42:42 > 0:42:44150 minutes of moderate exercise a week.

0:42:44 > 0:42:48But is this the best amount for us or just the minimum?

0:42:48 > 0:42:50Michael is finding out.

0:42:50 > 0:42:53I've come to hear the opinions of two of the world's leading

0:42:53 > 0:42:57experts on exercise and they have very different views.

0:42:59 > 0:43:02In the blue corner is Professor Sanjay Sharma.

0:43:02 > 0:43:05He thinks the guidelines are spot on.

0:43:05 > 0:43:09150 minutes, let's call it max 200 minutes per week,

0:43:09 > 0:43:13is enough for the welfare of the general population.

0:43:13 > 0:43:17And in the red corner is Professor Alejandro Lucia.

0:43:17 > 0:43:20He thinks we should be doing much more.

0:43:21 > 0:43:25Maybe 450 minutes per week would be ideal.

0:43:25 > 0:43:29I want to find out why they have such different views.

0:43:29 > 0:43:34First up, Professor Sanjay Sharma from St George's Hospital, London.

0:43:34 > 0:43:37He is the medical director for the London Marathon.

0:43:37 > 0:43:42He's convinced there is such a thing as too much exercise.

0:43:42 > 0:43:46Over the last two decades or so, there has been emerging evidence

0:43:46 > 0:43:51that in some individuals too much exercise may be deleterious

0:43:51 > 0:43:55to an individual who otherwise had a normal heart.

0:43:55 > 0:44:00Postulations are that too much exercise may cause the atrium,

0:44:00 > 0:44:01the top chamber of the heart,

0:44:01 > 0:44:04to stretch or to even become inflamed

0:44:04 > 0:44:07and scarred, such that the electrical circuit through it

0:44:07 > 0:44:11doesn't work very well, which is called atrial fibrillation.

0:44:11 > 0:44:14Now, some people would say this is only going to happen in people

0:44:14 > 0:44:18who already have some sort of pre-existing weakness or disease,

0:44:18 > 0:44:23that you can't make a good heart bad by doing exercise.

0:44:23 > 0:44:28Well, we took 172 veteran athletes, mean age about 52,

0:44:28 > 0:44:32we compared them with matched individuals who lead a healthy lifestyle.

0:44:32 > 0:44:37We found that our athletes, 15% of our athletes,

0:44:37 > 0:44:41had scarring in the heart muscle compared to none of our controls.

0:44:41 > 0:44:4543% of our athletes had furring up of the arteries compared with

0:44:45 > 0:44:47only 23% of our controls.

0:44:47 > 0:44:51So I don't think for one second that the more you exercise,

0:44:51 > 0:44:54- the longer you will live. - What would you recommend?

0:44:54 > 0:44:55I would say 30 minutes a day,

0:44:55 > 0:44:59equating to 150 minutes per week.

0:44:59 > 0:45:03This has been derived from very large studies of 45,000 males.

0:45:03 > 0:45:07And that kind of gives you probably the sort of optimal health benefits.

0:45:07 > 0:45:10I do believe this 150 to 200 minute cut-off

0:45:10 > 0:45:14that we're talking about is enough to give you at least

0:45:14 > 0:45:16three additional years of life.

0:45:16 > 0:45:20If we packaged exercise up into a pill, it would be considered

0:45:20 > 0:45:23as a miracle pill, because there is no other therapy that's been

0:45:23 > 0:45:27invented yet that quite has the benefits of exercise.

0:45:27 > 0:45:29I should also say that these benefits

0:45:29 > 0:45:30go beyond the cardiovascular system.

0:45:30 > 0:45:34Exercising reduces the risk of cancer of the colon,

0:45:34 > 0:45:38cancer of the prostate, it retards the ageing process,

0:45:38 > 0:45:40and it is an antidepressant.

0:45:40 > 0:45:41And what would you recommend?

0:45:41 > 0:45:44If you were going for a single form of exercise, what would it be?

0:45:44 > 0:45:46I would say a brisk walk.

0:45:46 > 0:45:49A brisk walk can be done any time, you don't have to pay

0:45:49 > 0:45:53to go to the gym, it can be performed anywhere, anyplace

0:45:53 > 0:45:55and it's enjoyable.

0:45:56 > 0:45:59Professor Sharma clearly believes that, although exercise is

0:45:59 > 0:46:03great for our health, there is such a thing as too much.

0:46:03 > 0:46:04But is he right?

0:46:05 > 0:46:09Professor Alejandro Lucia has carried out studies into the health

0:46:09 > 0:46:14of elite athletes and authored more than 350 scientific papers.

0:46:14 > 0:46:17Now, the standard recommendations are that we should be doing

0:46:17 > 0:46:21150 minutes of moderately vigorous exercise every week.

0:46:21 > 0:46:23How much do you think we should really be doing

0:46:23 > 0:46:26if we want to get optimal benefits?

0:46:26 > 0:46:32I will say that...maybe 450 minutes per week would be ideal.

0:46:32 > 0:46:34450 minutes a week is a lot!

0:46:34 > 0:46:37I mean, that's almost 70 minutes a day.

0:46:37 > 0:46:39How much do you do?

0:46:39 > 0:46:43I do indoor cycling two or three times a week fairly intensively

0:46:43 > 0:46:47and then I ride my bike for four to five hours on Sundays.

0:46:47 > 0:46:48- Four to five hours?- Yeah.- OK.

0:46:48 > 0:46:51- And then...- That's impressive!

0:46:51 > 0:46:54So do you think you can damage a healthy heart

0:46:54 > 0:46:55by doing too much exercise?

0:46:55 > 0:47:01I don't think that intense exercise, even at the highest level,

0:47:01 > 0:47:06if done properly, should damage a previously healthy heart.

0:47:06 > 0:47:11So you frequently hear about people dropping dead in a marathon.

0:47:11 > 0:47:13Yeah, there was

0:47:13 > 0:47:18a NICE study done by American researchers a few years ago.

0:47:18 > 0:47:21They analysed data from 10 million runners who ran

0:47:21 > 0:47:26marathons and half marathons in the US in the last decade.

0:47:26 > 0:47:29And they found that the incidence of sudden cardiac death

0:47:29 > 0:47:31was fairly low.

0:47:31 > 0:47:36And, when it happened, it always did in the less prepared runners

0:47:36 > 0:47:38and during the second half of the race.

0:47:38 > 0:47:42These people had never even done a half marathon before

0:47:42 > 0:47:45and they had an underlying cardiac condition,

0:47:45 > 0:47:48which had remained unrecognised until that moment.

0:47:48 > 0:47:52So Professor Sharma would argue that, if you do a lot of exercise,

0:47:52 > 0:47:57then you can cause permanent damage to your heart. What do you say?

0:47:57 > 0:48:00We did a couple of studies, the cohort was fairly small

0:48:00 > 0:48:04on former world champions in marathons or Tour de France cyclists

0:48:04 > 0:48:09and we didn't see any type of deleterious affect with MRI.

0:48:09 > 0:48:12There was a good balance between the muscle mass

0:48:12 > 0:48:14and the size of the cavities of the heart.

0:48:14 > 0:48:18But is there any real evidence that elite athletes actually live

0:48:18 > 0:48:19longer than the rest of us?

0:48:19 > 0:48:22Yeah, they do live longer than the rest of us,

0:48:22 > 0:48:25especially those who have participated in endurance sports.

0:48:25 > 0:48:30For instance, there was a study published on

0:48:30 > 0:48:34almost 100 cyclists who finished the Tour de France

0:48:34 > 0:48:37and they lived quite longer than the general population.

0:48:37 > 0:48:41Doctor Lucia sees government guidelines

0:48:41 > 0:48:43as a bare minimum, not a target.

0:48:43 > 0:48:47And he thinks there is no limit to how much exercise we can do.

0:48:47 > 0:48:51As long as we are healthy, we will never damage our bodies.

0:48:51 > 0:48:54Now it's my turn to decide, after hearing their evidence,

0:48:54 > 0:48:56what I believe.

0:48:56 > 0:48:59Now, everyone agrees that exercise is a good thing,

0:48:59 > 0:49:00but how much is too much?

0:49:00 > 0:49:04Well, having listened to our experts, I am inclined to think

0:49:04 > 0:49:09that around 30 minutes of moderate exercise done most days of the week,

0:49:09 > 0:49:13that's 150 to 180 minutes, is enough for most people.

0:49:13 > 0:49:17And if you go on really hard for a long period of time, there is

0:49:17 > 0:49:20a small but significant risk that you'll damaged not just

0:49:20 > 0:49:23your joints but also your heart.

0:49:36 > 0:49:39There's nothing more depressing than climbing onto the scales

0:49:39 > 0:49:43after a week of dedicated dieting and seeing that your weight has

0:49:43 > 0:49:47stayed exactly the same or, worse still, seems to have increased.

0:49:49 > 0:49:52This can undermine all of our good intentions and leave us

0:49:52 > 0:49:55reaching for the cake tin in despair.

0:49:55 > 0:49:58But what if these disappointing results

0:49:58 > 0:50:00aren't always what they seem?

0:50:00 > 0:50:04What if it's the way that we are weighing ourselves

0:50:04 > 0:50:05that's the problem?

0:50:05 > 0:50:08Let's say you're trying to hit a sensible weight loss target

0:50:08 > 0:50:12of half a kilogram a week. Sounds simple enough, but...

0:50:12 > 0:50:15over the course of a single day,

0:50:15 > 0:50:18our weight can fluctuate by as much as one or two kilograms.

0:50:19 > 0:50:23'This is mainly due to things like eating, drinking, exercising

0:50:23 > 0:50:25'and going to the toilet.

0:50:25 > 0:50:28'So if you want an accurate measurement of weight loss,

0:50:28 > 0:50:30'here's what you should do.

0:50:30 > 0:50:33'Ideally weigh yourself naked.'

0:50:33 > 0:50:36- I'm not taking my jeans off! - No, no, don't worry about that.

0:50:36 > 0:50:38- Is that where you're normally at? - Yep.

0:50:38 > 0:50:40Step on.

0:50:40 > 0:50:44That's great, even with shoes and coat on. Right, your turn.

0:50:44 > 0:50:46'Always use the same scales.'

0:50:46 > 0:50:49- Happy, sad?- Not surprised.- OK.

0:50:50 > 0:50:54'You should also make sure you place the scales on the same hard surface.

0:50:54 > 0:50:58'Carpet can make a surprising difference.'

0:50:58 > 0:51:00I know always my weight.

0:51:00 > 0:51:01OK.

0:51:03 > 0:51:04Right.

0:51:05 > 0:51:07Go.

0:51:12 > 0:51:15The reason that these scales are reading differently is

0:51:15 > 0:51:17because the base is sinking into the carpet,

0:51:17 > 0:51:21which means the carpet fibres are supporting some of the weight.

0:51:23 > 0:51:26- That's nicer.- That's nicer!

0:51:26 > 0:51:29A lot nicer. Like 10... Yeah, 10 kilos.

0:51:29 > 0:51:31Wow, wow.

0:51:31 > 0:51:36For accurate results, weigh yourself every day at the same time.

0:51:36 > 0:51:39Then, at the end of the week, calculate the average.

0:51:40 > 0:51:44After a few weeks, you will have an accurate track of your weight.

0:51:46 > 0:51:50A recent study in the US found that people who weigh themselves

0:51:50 > 0:51:54every day are more likely to achieve their weight goal.

0:51:54 > 0:51:59But if a daily weigh-in is a bit off-putting, do it weekly instead.

0:51:59 > 0:52:01Choose the same day every week

0:52:01 > 0:52:04and then calculate the average over each month.

0:52:06 > 0:52:08So next time you step onto the scales

0:52:08 > 0:52:11and get a nasty surprise, don't lose heart.

0:52:11 > 0:52:14One-off measurements don't reflect your true progress.

0:52:14 > 0:52:19Instead, keep going. Your hard work will pay off over time.

0:52:30 > 0:52:31Paracetamol is in the news.

0:52:31 > 0:52:35We take it for everything, from toothache to pulled muscles.

0:52:35 > 0:52:38But recent headlines claim that, for back pain,

0:52:38 > 0:52:40it's no better than a sugar pill.

0:52:40 > 0:52:43They're reporting on a big study in a major scientific journal.

0:52:43 > 0:52:46So what does this mean? Over to Chris.

0:52:46 > 0:52:49The truth is, paracetamol has always been a bit of a mystery.

0:52:49 > 0:52:53We've never been exactly sure how it kills pain.

0:52:53 > 0:52:56And it turns out now that perhaps the reason we don't understand how

0:52:56 > 0:53:00it works for things like back pain is because it might not work at all.

0:53:00 > 0:53:04But for back pain, maybe that shouldn't be such a surprise.

0:53:05 > 0:53:08We've known for a long time that paracetamol is not as effective

0:53:08 > 0:53:12as anti-inflammatories at treating painful conditions where the

0:53:12 > 0:53:17painful area is inflamed, like arthritis or a painful wound.

0:53:17 > 0:53:20We also know it doesn't work very well

0:53:20 > 0:53:24when pain is coming from the nerve itself, so things like sciatica.

0:53:24 > 0:53:29And that might explain why it's not very effective for back pain,

0:53:29 > 0:53:33because much back pain is due to inflammation and nerve pain.

0:53:34 > 0:53:37Perhaps more importantly, though, there's another caution

0:53:37 > 0:53:40about paracetamol, that there are questions about its safety

0:53:40 > 0:53:43if you take it in the long term in relatively high doses,

0:53:43 > 0:53:45something that you might be tempted to do if you have

0:53:45 > 0:53:46a longer-term back pain.

0:53:47 > 0:53:50But the good news is that paracetamol is probably still

0:53:50 > 0:53:53effective for things like post-operative pain,

0:53:53 > 0:53:59headaches, dental pain and of course it treats fever very effectively.

0:53:59 > 0:54:01So don't be put off paracetamol completely.

0:54:01 > 0:54:04Just use it sparingly and for the right things.

0:54:04 > 0:54:07As for back pain, the National Institute for Clinical Excellence,

0:54:07 > 0:54:10NICE, are reviewing their recommendations

0:54:10 > 0:54:13and they'll consider this evidence when they report back.

0:54:13 > 0:54:16In the meantime, if you have back pain or want to try something

0:54:16 > 0:54:19different, there are drug alternatives.

0:54:19 > 0:54:22But more importantly, there's exercise and physiotherapy

0:54:22 > 0:54:26and you can speak to your GP about how to do those things best.

0:54:36 > 0:54:39Back in Derby, it's the end of their big experiment.

0:54:40 > 0:54:44For four weeks, our 36 volunteers have been trying to stick

0:54:44 > 0:54:49to the resolution to get more active using different types of motivation.

0:54:49 > 0:54:50One group, our control,

0:54:50 > 0:54:54received nothing more than regular public health advice.

0:54:54 > 0:54:56The second group were competing

0:54:56 > 0:54:58against each other for prizes.

0:54:59 > 0:55:01And the third group had a collective

0:55:01 > 0:55:03target to aim for together.

0:55:04 > 0:55:08It seems some of them certainly found motivation.

0:55:08 > 0:55:10Erm, use the stairs, never catch the lift.

0:55:10 > 0:55:13Where I'd normally e-mail people, I would try and go and see them.

0:55:13 > 0:55:15We had one day where we decided we just try

0:55:15 > 0:55:18and do as many stairs as possible, so we started at the bottom floor,

0:55:18 > 0:55:22up to the ninth, back down again for as many times as we could go.

0:55:22 > 0:55:25But which group increased their activity the most?

0:55:25 > 0:55:29Experts Claire McDonald and Ed Gardner have been monitoring all

0:55:29 > 0:55:33their steps and their stair-climbing and totting up the winners.

0:55:33 > 0:55:35First up, the control group.

0:55:35 > 0:55:39Over the four weeks, their average activity levels

0:55:39 > 0:55:43stayed pretty constant, just a 3% overall improvement.

0:55:43 > 0:55:46The co-operators were much more active throughout

0:55:46 > 0:55:49the experiment, a 16% improvement.

0:55:49 > 0:55:51And finally the competitors,

0:55:51 > 0:55:54well, they were similar to the co-operators

0:55:54 > 0:55:57until the final week, when they had a burst of activity,

0:55:57 > 0:56:01giving them a 30% overall improvement.

0:56:01 > 0:56:04But then we looked at individual scores.

0:56:04 > 0:56:08Although the competitive group contained the two tops scorers,

0:56:08 > 0:56:11response from the rest of the group was more mixed.

0:56:13 > 0:56:16These patterns give Ed and Claire a fascinating insight

0:56:16 > 0:56:19into our psychology.

0:56:19 > 0:56:22One of the things that we found was that those in the competitive

0:56:22 > 0:56:25group appear to be increasing in the number of steps they were taking

0:56:25 > 0:56:28from week to week, so they were improving on a week by week basis,

0:56:28 > 0:56:31whereas those in the control and the cooperative groups

0:56:31 > 0:56:34stayed relatively stable, so they just stayed flat over time.

0:56:34 > 0:56:36So the people who are in the different groups,

0:56:36 > 0:56:39they could see what other people in the groups were doing?

0:56:39 > 0:56:42So the competitive group, yeah, they were told their position,

0:56:42 > 0:56:44I guess, or their rank within their group each week.

0:56:44 > 0:56:47Right, so as you slipped down the rankings, you might have said,

0:56:47 > 0:56:49"Right, I'm going to improve," or something like that?

0:56:49 > 0:56:52That's the idea - those below the normal, below the average,

0:56:52 > 0:56:54should show or realise they need to improve

0:56:54 > 0:56:55compared to the rest of the group.

0:56:55 > 0:56:57That's what you find in the competitive group.

0:56:57 > 0:57:00Whereas in the cooperative group, even those below the norm,

0:57:00 > 0:57:01they're all in it together,

0:57:01 > 0:57:05therefore actually people remain relatively stable.

0:57:05 > 0:57:08So understanding a bit of psychology can help us

0:57:08 > 0:57:10all stick to our resolutions.

0:57:10 > 0:57:13I tend to go for the stairs now just by default, really.

0:57:13 > 0:57:17- I don't think I've taken a lift since we started.- It's very helpful.

0:57:17 > 0:57:20I think if you try to do things on your own,

0:57:20 > 0:57:23you tend to slip back into your old ways.

0:57:24 > 0:57:26Doing things in a group is key.

0:57:26 > 0:57:30It's social pressure that motivates us to stick to our resolutions

0:57:30 > 0:57:32and not give up.

0:57:32 > 0:57:35Now, certainly our activity experiment suggested that

0:57:35 > 0:57:37involving other people is incredibly helpful,

0:57:37 > 0:57:39probably because it's more enjoyable

0:57:39 > 0:57:44and that means you're more likely to stick to it long-term.

0:57:44 > 0:57:47For some people, competing with each other seems to be best.

0:57:47 > 0:57:50For others, it's being in a cooperative group.

0:57:51 > 0:57:55But whichever suits you personally, use that knowledge and any other

0:57:55 > 0:57:59tricks from the series if you want to make yourself healthier.

0:58:01 > 0:58:04Get the most benefit for the least effort...

0:58:06 > 0:58:08..by exercising at the right time...

0:58:11 > 0:58:13..and eating at the right time...

0:58:17 > 0:58:21..knowing a few things to avoid in your life...

0:58:21 > 0:58:25- It's a shocking result. - It really, really is shocking.

0:58:25 > 0:58:27..and a few things to get a bit more of.

0:58:27 > 0:58:31The wider the hips, the more healthy you are.

0:58:40 > 0:58:42That's it from Derby and this series of Trust Me,

0:58:42 > 0:58:45though we will be back later in the year.

0:58:45 > 0:58:47In the meantime, why don't you go and visit our website...

0:58:51 > 0:58:54..where you can find out a lot more about everything

0:58:54 > 0:58:57covered in this series and also sign up for some experiments.

0:59:02 > 0:59:07# I just made an appointment for a special rendezvous

0:59:07 > 0:59:13# To see a man of miracles and all that he can do

0:59:17 > 0:59:20# Doctor, I want you

0:59:20 > 0:59:22# Mmm, my doctor, wanna do

0:59:22 > 0:59:26# I can't get over you, Doctor, do anything that you wanna do. #