Episode 2 Trust Me, I'm a Doctor


Episode 2

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When it comes to our health it seems everyone has an opinion

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and everyone has an agenda.

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

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We're here to weigh up the evidence and use our expertise

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to guide you...

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Through the contradictions and the confusions.

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We do the research no one else has done.

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And put your health at the heart of what we do...

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to ensure that you get the information that you need.

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We're here when you want to know the latest findings,

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and not just the latest fads.

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I'm Michael Mosley.

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In this series I'm joined by a team of doctors.

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Together, we'll cut through the hype, the headlines

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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 Worcester, running a big experiment to find

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out, is going gluten-free really good for us?

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I get hypnotised to discover if this could be the next big thing

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in medicine.

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We reveal the tiny implant which could switch off

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rheumatoid arthritis.

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I have my life back.

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For those of us unsteady on our feet, we reveal the secret

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to better balance.

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And does stretching our muscles before exercise

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actually do any good?

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But first...

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Welcome to the historic city of Worcester.

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The British Medical Association was founded here over 180 years ago.

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We're here, however, to do an experiment to find

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out what the effects of going gluten-free are.

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Over to Dr Chris van Tulleken.

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We now spend about ?180 million a year avoiding gluten,

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with an estimated 8.5 million of us is going gluten-free

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in the last year or so.

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Gluten is a protein found in grains like wheat, rye and barley,

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and foods that many of us take for granted like bread

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and pasta are full of it.

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Giving it up isn't straightforward.

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So who exactly should consider making the sacrifice?

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Well, there are a small number of people who have to avoid gluten.

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About 1% of people have a condition called coeliac disease.

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When they eat gluten their immune system is stimulated in such

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a way that it ends up attacking their own bodies.

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This damages the intestines and limits the body's ability

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to absorb nutrients.

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Coeliac disease can be diagnosed with a biopsy from the intestines

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and then it is a lifetime of avoiding gluten for sufferers.

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There are a few other people for whom gluten-free is a short cut

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to knowing something is free from wheat.

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A tiny proportion of people, around a tenth of 1%,

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are allergic to wheat and going gluten-free is a good way

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of avoiding it.

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Now, if these people eat wheat, within minutes, they have an immune

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response similar to hay fever, sneezing, itching and rashes.

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In rare cases they can have a more severe anaphylactic reaction

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which can be fatal.

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But apart from those who need to avoid these foods,

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there is a significant proportion of the population who have

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voluntarily gone gluten-free.

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In fact, about 15% of people think it is healthier for them

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or they have some sort of intolerance to gluten,

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giving gut symptoms like bloating and wind.

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But are they right?

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For some doctors, gluten intolerance is controversial.

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Patients describe digestive symptoms after eating gluten.

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But on testing they have no abnormality with their immune system

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or their guts.

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So it doesn't appear to be an allergy or coeliac disease.

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The question is, are these people hypochondriacs or are they suffering

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with something that science has yet to describe?

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To find out, we've come to Worcester to run an experiment.

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We're going to see just what effect a gluten-free diet has an 60 people,

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some of whom think they might have a gluten intolerance,

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and others who don't believe it exists.

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If I have a pizza I know about it the next day!

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So bloating, wind?

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More of a sicky feeling, as if you've eaten something dodgy.

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OK.

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Because I've had IBS for over 20 years, I thought this would be

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an opportunity to take part in a proper experiment and to see

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whether I could alleviate some of the bloating and noise...

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Nausea.

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And noise!

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Noisea!

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I joined up in the hope that I would be proven that cynicism rules.

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Why?

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I think I'm allergic to nothing.

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But they won't be gluten-free all the time.

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Although they are being asked to cut out all gluten from their diet

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for the next six weeks, we are supplying them

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with some special pasta.

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This is normal pasta, full of gluten.

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And this is gluten-free pasta.

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Each day of the trial, every volunteer will eat a pasta meal,

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but at no point will they know whether the pasta they are eating

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contains gluten or is gluten-free.

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So all our volunteers will have weeks when they are gluten-free

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and weeks when they are eating gluten but they won't know when,

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nor will the scientists.

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Before the trial starts, we check that none of the volunteers

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actually have coeliac disease or a wheat allergy because we know

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that they will have a reaction to the pasta.

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We want to find out if gluten could affect other people

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without these conditions, so we will be asking everyone

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to record any symptoms they have every fortnight,

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and we will be taking regular blood samples to examine their

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immune system and look for markers of gut inflammation.

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Do some people really suffer gut trouble when they eat gluten,

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and is there a blood test which could confirm if this

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intolerance is real?

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We don't really know what to expect from this trial.

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First of all, we should be able to pin down

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whether the people who claim

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they get symptoms when they eat gluten really do, because of course

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they won't know when they are eating it and when they are not.

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And secondly, we hope that our blood tests should be able to shed some

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light on what is going on in our volunteers' bodies.

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Do those people who get symptoms also show a reaction on their blood

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tests for their immune system and their gut inflammation?

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And finally, could it be that gluten is affecting all of us badly?

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We'll find out the results later in the programme.

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Like many of us, my vision has never been perfect.

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As I get older, it's getting worse.

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Now, most of us don't worry about our eyesight until things

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start to go wrong.

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What can we all do to prevent problems and perhaps even

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improve our eyesight as we get older?

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I've come to Waterford in south-east Ireland to find out

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about some ground-breaking research which suggests what we eat

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could make a difference.

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To discover why, I need to look right to the back of my eye

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as Professor John Nolan explains.

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What we are looking at here, Michael, is an image

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at the back of your eye, an area known as the retina which is

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basically responsible for vision.

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Now, the centre part of the retina is known as the macula.

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And the macula is very important because it is where about 90%

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of our vision is mediated from.

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The macula is protected by special coloured pigments.

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These act as a sunscreen for the eyes to block

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harmful UV light.

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It is thought they are a key part of good eyesight.

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So the researchers here believe that if we boost our pigments, we might

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be able to boost our vision too.

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Pigments in your macula which protect your eyes

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against sunlight come from food, in particular from leafy green

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spinach, kale, bright red peppers and from the yellow yolk of eggs.

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If we eat enough of the right kinds of foods, the theory is

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we end up with three key chemicals in our blood.

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Lutein, zeaxanthin and meso-zeaxanthin.

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If the theory is right, these should make their way

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from our blood to our macula and improve our eyesight.

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To find out if this theory is true, we got a group of ten volunteers

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here in Waterford, and me.

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Every day for the next five weeks, our volunteers will drink a daily

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smoothie made of a special recipe.

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It's not really long enough to expect any improvement

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in their eyesight, but we will be able to test a crucial first stage,

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whether their daily smoothie can boost

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the pigment compounds in their blood.

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I hear the kiwi takes away the amount of kale!

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I want to take part in this experiment as well, but I'm

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going to test a different way to get these crucial chemicals.

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One that is also the subject of research.

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I'm going to be taking some supplements

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and see what effect that has.

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The supplements have concentrated amounts of the three

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key pigment chemicals.

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I'm testing whether these instant high levels will really make

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a difference to my eyesight.

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I'm going to be taking the supplements for 12 weeks.

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At the beginning and end I'm having my eyes tested.

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They'll measure the levels of the pigment chemicals in my eye,

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and also test every aspect of my eyesight, from my perception

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of detail and colour, to my night vision.

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Meanwhile, over in Ireland, our smoothie-sucking volunteers

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are having their blood tested to see if they now have high levels

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of the all-important chemicals.

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So how did we all get on?

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Firstly, our volunteers.

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After five weeks of the smoothie diet, the levels of one of the three

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key chemicals in their blood, lutein was significantly boosted.

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It is not long enough to see the effects on their eyesight

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but research into this is ongoing.

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More is already known about the effect of supplements

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which can deliver a controlled dose of chemicals into the blood.

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So, how have I fared after my 12 week regime?

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After a thorough re-test of my eyes, it is results time.

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The results are interesting, in fact we could

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significantly increase your macula pigment levels.

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So the chemicals definitely went into my eyes and the pigment

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significantly increased.

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But would that make any real difference to my eyesight?

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When we look at your contrast sensitivity measures,

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we can see at the end of the experiment your vision now

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is greatly enhanced.

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So my levels of these vital pigments all went up?

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Yes.

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And my vision improved pretty much across the board?

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Yes.

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I can now see objects that are significantly smaller

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and fainter than I could before.

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I also notice colours more vividly, particularly yellows and blues.

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The most important change though is in my night vision.

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I can see much finer detail in the dark.

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It's an outstanding result, but that's not all.

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John and his team have come across something unexpected that

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could have an even greater impact on our health.

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It's recently been found in studies of people

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It's recently been found in studies of people with Alzheimer's disease

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that there is an unforeseen link to these compounds.

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What is really striking is that the subjects that had

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the high amount of macula pigment have significantly better cognitive

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performance when compared to the subjects with low levels.

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So the idea here is the macula pigment may in fact be a very

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important measure of the risk about sinus disease.

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important measure of the risk of Alzheimer's disease.

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It may be that detecting high levels of these chemicals means that people

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are getting a healthy diet, rich in fruit and vegetables

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which is as good for the brain as it is for the eyes.

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So it seems, many of us could improve our eyesight simply

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by eating more of these colourful plant chemicals.

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But although a healthy diet is important, the research suggests

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for once it is cheaper and more effective simply

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to take supplements.

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Check that they contain lutein, zeaxanthin and meso-zeaxanthin.

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Now, on the whole, I'm not a fan of supplements.

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I would much rather people got their nutrients from real food.

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But in this example I can see that as well as eating lots more leafy

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green vegetables and red peppers, there might be a case

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for having supplements.

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It utterly depends on your personal circumstances.

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To find out more, do visit our website.

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When we took about improving our health, the first things

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that spring to mind are normally diet and exercise.

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But as Dr Saleyha Ahsan has been finding out, there is something

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which is equally as important.

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Balance, it's one of the most underrated aspects

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of our health and fitness.

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Balancing helps improve our core which acts

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as our body's inner stabiliser.

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When you do that you improve your posture and coordination,

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and that helps us avoid injury.

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But, like our muscle strength, if you don't use it,

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you will lose it.

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Well done!

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So, what can we do to improve our own sense of balance?

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Well, the first thing is to work out how good or bad your own balance is,

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and there is a really easy way to test it.

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Simply, close your eyes, lift one of your feet about six

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inches off the ground and time how long you can balance.

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Our brain relies heavily on what our eyes see to keep us steady,

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but there are other parts of the body involved.

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Our inner ear has a series of tubes and chambers containing fluid

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and works a bit like a spirit level.

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While our muscles

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are constantly sending signals to the brain to help us orientate.

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The average time you should be able to stand on one leg with your eyes

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closed declines with age.

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If you're under 40, it's about 15 seconds.

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If you're 65, it's around four.

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But if you're struggling, there are some simple

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things you can do to help.

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I've come to Dumfries to try a set of exercises that have been proven

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to help get any of us back into balance, with

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Professor Dawn Skelton, from Glasgow Caledonian University.

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Push yourself up nice and slowly.

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OK?

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Take a couple of steps backwards.

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Only a couple.

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Pull your bottom in, cos it's sticking out.

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LAUGHTER.

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The idea is that by lessening the amount of contact you have

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with the floor or by looking away from where you normally would,

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you're making your brain work harder to keep you balanced, training it.

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And the more you do this, the better your brain becomes

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at keeping you upright.

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Curl your toes up towards your nose.

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OK?

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Penguin walking.

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Three little steps.

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On your heels.

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That wobbliness is good because that means that your brain

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is having to work at getting everything to work together,

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and that will improve your balance.

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10-15 minutes a day and I guarantee, within three to four weeks,

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you'll feel a big difference in your balance.

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It's that quick.

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In Glasgow, these and similar exercises have been recommended

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for the over-65s and it's made a huge impact, helping reduce

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hospital admissions due to falls by a third.

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But they can improve your balance at any age and they're

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easy to do at home.

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Other activities known to help our balance,

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posture and core strength are dancing, tai chi and yoga.

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Now, balance exercises are quite simple to do,

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but the key is to integrate them into our everyday lives.

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You might never walk the tightrope, but you could soon be seeing

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improvements to your health.

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You'll find the demonstrations of all the balance

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exercises on our website.

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In Worcester, our 60 volunteers are back to have their bloods taken.

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So far, half of them have been gluten-free for two weeks.

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Half of them have been secretly given pasta containing gluten.

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We're recording any symptoms they notice and analysing

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their blood to see whether these match changes in their

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immune system and gut.

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They'll be back in a few weeks' time, after swapping

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to the opposite diet, when we'll retest them.

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We're hoping to discover whether gluten is having a real

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and measurable effect on any of them.

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Now, gluten, of course, isn't the only foodstuff

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that people worry about.

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There are companies out there flogging tests that apparently

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will tell you if you're allergic or, at least, intolerant

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to a whole range of things - from apples to yeast,

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from meat to tea.

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They cost between ?10 and ?300.

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And with allergies on the rise, we're buying a lot of them.

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But do they really work?

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I'm going to try out a few and find out.

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The tests you can buy on the High Street and online vary

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in what they claim to analyse.

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And they'll use anything from a piece of hair to a drop

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of blood to diagnose your problem.

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One tubeful of Mosley blood.

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They promise a healthier you as a result, because the consumption

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of certain foods can have profound effects on the physical and mental

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health of susceptible individuals.

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The results from the different tests tell me that I

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have an intolerance to - amongst other things -

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walnuts, durum wheat, maple syrup, eggs, Mountain Juniper,

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corn, even parsley and dill.

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Another test tells me that I do have food intolerances,

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but I'd have to stump up another ?284 to discover what they are.

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So should I be worried and pay up?

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To find out, I'm meeting allergist Dr Adam Fox,

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from Guy's and St Thomas' Hospital.

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First up, allergies.

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I took one test that claimed to measure my immune system's

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antibodies and it said I had no allergies, although I was actually

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suffering from hayfever.

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What was happening here?

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It's very easy to misinterpret the tests and that test only has

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value if it's done together with the medical history.

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So doing it in isolation, as a screening test -

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which is what lots of parents and patients do -

0:19:430:19:45

waste of time.

0:19:450:19:47

So if this isn't a useful test to do on its own,

0:19:470:19:51

only if you have clear symptoms of analogy such as itching

0:19:510:19:53

and sneezing would your doctor do a test, and for specific likely

0:19:530:19:56

causes.

0:19:560:20:01

And as for the quite expensive allergy test that can apparently be

0:20:010:20:03

done from a hair sample?

0:20:030:20:08

We know that has no scientific validity.

0:20:080:20:10

You can actually hear the quacking coming out of the box

0:20:100:20:13

with something like that!

0:20:130:20:14

So a firm 'no' to any home testing for allergy.

0:20:140:20:17

They need proper medical interpretation.

0:20:170:20:20

How about the test kits for intolerances?

0:20:200:20:23

These are, as we know from our big experiment,

0:20:230:20:25

very difficult to diagnose.

0:20:250:20:27

Intolerances are different.

0:20:270:20:29

They don't involve the immune system.

0:20:290:20:31

They can be unpleasant, but they're never really dangerous.

0:20:310:20:33

For example, lactose intolerance is extremely common,

0:20:330:20:36

so people don't have the enzyme in their gut that breaks down

0:20:360:20:39

the lactose that you find in milk.

0:20:390:20:44

And as a result, when they drink milk, they'll get an upset tummy,

0:20:440:20:47

they'll get diarrhoea and bloating.

0:20:470:20:49

One of the intolerance test kits I used claimed to measure

0:20:490:20:51

an antibody in the blood called IgG.

0:20:510:20:54

It told me I had potential intolerances to wheat,

0:20:540:20:56

rice and milk.

0:20:560:21:00

But Adam has me do the same test again to demonstrate a point.

0:21:000:21:05

IgG is one of the naturally occurring antibodies produced

0:21:050:21:07

by our immune system.

0:21:070:21:09

In fact, they have a very, very important role

0:21:090:21:11

in protecting us from infection.

0:21:110:21:14

They're also produced in response to any number of things that

0:21:140:21:17

you take into your body.

0:21:170:21:21

So if you eat lots of food, your body will be recognising that

0:21:210:21:24

it's food, it will be producing IgG antibodies to it.

0:21:240:21:26

And those IgG antibodies won't really be doing

0:21:260:21:28

anything in particular.

0:21:280:21:29

OK, so it isn't an indication of sickness or disease?

0:21:290:21:32

It's never been shown to be a useful indicator of disease in any way.

0:21:320:21:37

And to illustrate that, my results on this exact same test

0:21:370:21:40

today are different from when I took it previously.

0:21:400:21:42

The levels of IgG in my blood simply indicate what I've been

0:21:420:21:45

eating recently, not whether it was doing me any harm.

0:21:450:21:51

Eggs, it suggested quite strongly here, whereas eggs sort of,

0:21:510:21:53

you know, are very weak according to this one here.

0:21:530:21:57

Yes, and I'm sure if you did this test every day,

0:21:570:22:00

it would come up a little bit differently because your levels

0:22:000:22:03

of any antibody are going to fluctuate from one

0:22:030:22:05

day to the next.

0:22:050:22:06

So Adam's view on these home test kits is clear.

0:22:060:22:08

Across the world, the societies that represent allergists,

0:22:080:22:10

gastroenterologists, are very clear that these tests

0:22:100:22:12

do not have a place in diagnosis.

0:22:120:22:18

So although the kits may accurately measure IgG, that's of no use.

0:22:180:22:22

There is no scientifically valid home test for food intolerances.

0:22:220:22:27

Now, this isn't just about money.

0:22:270:22:29

Eliminating basics like eggs, wheat and dairy from your diet

0:22:290:22:31

is not a good idea, particularly if you're a child.

0:22:310:22:38

It should only really be done if there's a proven need.

0:22:380:22:43

And ideally, under medical supervision.

0:22:430:22:44

If you suspect you or your child has a food allergy, then visit your GP

0:22:440:22:48

to be properly tested for that specific foodstuff.

0:22:480:22:50

If you think you have an intolerance, then the best thing

0:22:500:22:52

you can do is to try and eliminate it from your diet,

0:22:520:22:55

to see whether or not that makes a difference.

0:22:550:23:05

Exactly as our volunteers at the university have

0:23:080:23:10

been doing with gluten.

0:23:100:23:11

And we'll see what differences that made to them later in the programme.

0:23:110:23:18

Still to come: The device that can switch off rheumatoid arthritis.

0:23:190:23:24

And the results of our experiment.

0:23:240:23:27

Should we all go gluten-free?

0:23:270:23:29

But first...

0:23:290:23:31

There are plenty of gadgets out there that are designed to help

0:23:310:23:35

you monitor your health, but are they value for money,

0:23:350:23:38

or do they simply generate unnecessary worry?

0:23:380:23:42

We've invited GP Dr Zoe Williams to investigate.

0:23:420:23:45

One of the commonest things I do as a GP is take people's blood

0:23:450:23:49

pressure using one of these.

0:23:490:23:53

But there are lots of problems with doing that here

0:23:530:23:56

in the consultation room because no matter how unintimidating

0:23:560:23:58

I try to be, sometimes, the patients may feel a bit stressed.

0:23:580:24:06

Now, my blood pressure reading is a bit on the high side just now.

0:24:060:24:10

That's because, frankly, I'm being intimidated by this lot.

0:24:100:24:12

So would we actually be better off measuring our own

0:24:120:24:14

blood pressure at home?

0:24:140:24:21

There's a wide variety of monitors available,

0:24:210:24:22

anything from ?10 to ?150.

0:24:220:24:23

You'll all have slightly different machines, but this is what we use

0:24:230:24:26

here in the surgery.

0:24:260:24:27

Our blood pressure is worth keeping an eye on.

0:24:270:24:30

If it's high, it can damage our blood vessels and put

0:24:300:24:32

a strain on the heart and this can lead to heart failure,

0:24:320:24:35

strokes and other problems as well.

0:24:350:24:36

The measurement is made up of two numbers, the highest and lowest

0:24:360:24:39

pressure your blood exerts throughout every beat of your heart.

0:24:390:24:42

The higher one is known as systolic blood pressure and the lower number

0:24:420:24:45

is the diastolic pressure, and that's the pressure

0:24:450:24:47

between the heartbeats.

0:24:470:24:49

So we've got your reading now, Andre, and the result

0:24:490:24:51

is pretty good.

0:24:510:24:52

So your systolic is 126.

0:24:520:24:54

We want that to be ideally between 80 and 130,

0:24:540:24:57

so yours is fine.

0:24:570:25:01

And the diastolic should be between 70 and 90.

0:25:010:25:04

So yours is absolutely fine, which is great, especially in this

0:25:040:25:07

slightly unusual environment.

0:25:070:25:11

Compared to the professional kit, then, how accurate are the sorts of

0:25:110:25:14

home monitors that we can all buy?

0:25:140:25:22

We've bought two common brands that fit on the upper arm

0:25:220:25:24

and they both compared well against the professional equipment.

0:25:240:25:27

88...

0:25:270:25:28

Mmm, quite close.

0:25:280:25:29

And two wrist monitors.

0:25:290:25:30

These are harder to use as the monitor needs to be held

0:25:300:25:32

at the level of the heart, but one performed very well.

0:25:320:25:35

126 over 84, exactly the same!

0:25:350:25:36

Wow!

0:25:360:25:39

Whilst the other was inaccurate every time.

0:25:390:25:43

So the reading is 139 over 92, which actually means

0:25:430:25:45

you've got abnormal blood pressure.

0:25:450:25:47

Yeah.

0:25:470:25:49

I'd feel worried if I was at home and I saw that.

0:25:490:25:52

Some monitors have been independently tested

0:25:520:25:54

and deemed accurate, and we have details on our website.

0:25:540:25:59

Most of the machines that you can buy over-the-counter

0:25:590:26:01

are actually quite good, but if you're buying

0:26:010:26:03

from a pharmacist, it might be worth just asking them

0:26:030:26:06

to check your machine against their calibrated

0:26:060:26:07

machine so you know you can trust the results.

0:26:070:26:11

But if you're going to measure your own blood pressure,

0:26:110:26:14

you have to know how to do it properly, so here's

0:26:140:26:16

our Trust Me guide.

0:26:160:26:18

Whether you're sitting, standing or lying down

0:26:180:26:20

will make a difference.

0:26:200:26:22

If you're talking or even if you have your legs crossed.

0:26:220:26:27

So you should be sitting, back supported, the pressure cuff

0:26:270:26:29

at the height of your heart, legs crossed, breathing

0:26:290:26:31

normally and not talking.

0:26:310:26:38

at the height of your heart, legs uncrossed, breathing

0:26:380:26:40

normally and not talking.

0:26:400:26:41

Your blood pressure also varies throughout the day,

0:26:410:26:43

so you should take it at the same time each day.

0:26:430:26:46

Take it twice, one minute apart, over four days to get

0:26:460:26:49

an average reading.

0:26:490:26:50

After meals, it can be variable as your body sends blood

0:26:500:26:52

to the gut for digestion.

0:26:520:26:53

And some food and drinks will also affect it,

0:26:530:26:56

as some of our volunteers found through their day.

0:26:560:26:58

Around midday, it started to get really quite high.

0:26:580:27:00

That's, I think, because I had some coffee.

0:27:000:27:05

And if you don't want to buy a home monitor, doctors' surgeries

0:27:050:27:07

and pharmacies often have monitors in public areas to use.

0:27:070:27:10

So measuring your blood pressure at home, then,

0:27:100:27:12

is a good idea.

0:27:120:27:15

But remember, your blood pressure goes up and down all the time

0:27:150:27:18

so if you get the occasional high reading, don't worry.

0:27:180:27:21

If your blood pressure is a bit high, there are lots of things that

0:27:210:27:24

you can do to help bring it down.

0:27:240:27:26

So exercise is one of them.

0:27:260:27:28

Just 20 minutes a day of brisk walking really helps

0:27:280:27:30

to bring it down.

0:27:300:27:31

And then dietary changes.

0:27:310:27:33

So reducing your alcohol intake and increasing the potassium intake

0:27:330:27:36

by eating more vegetables.

0:27:360:27:38

And if that doesn't work, then please do go and see your doctor.

0:27:380:27:42

It seems like every day, we read about so-called 'alternative

0:27:510:27:53

therapies' that claim to do things like relieve pain,

0:27:530:27:58

cure addiction or improve our mental health.

0:27:580:28:01

In this series, we're asking - can any of them really help us?

0:28:010:28:05

This time, we're looking at hypnosis.

0:28:050:28:09

Now, hypnosis has a long and colourful history and its fans

0:28:090:28:11

claim it can cure everything from depression through to phobias.

0:28:110:28:18

Critics, however, say it's nothing more than a cheap parlour trick.

0:28:180:28:21

I'm going to delve into the debate, try hypnosis for myself, and then

0:28:210:28:24

speak to a world-renowned expert.

0:28:240:28:29

I want to get to the truth and decide - should I try hypnosis?

0:28:290:28:35

I'm not convinced that hypnosis is really a state of altered

0:28:350:28:37

consciousness, or that people aren't just pretending,

0:28:370:28:39

so I want to see if I can be hypnotised.

0:28:390:28:44

I'm about to give you some instructions that will help

0:28:440:28:46

you to relax and gradually to enter a state of hypnosis.

0:28:460:28:49

Taking me through the procedure is Professor David Oakley,

0:28:490:28:51

a clinical psychologist who uses hypnosis to help people

0:28:510:28:54

with mental health conditions like depression and anxiety.

0:28:540:29:00

Your breathing is becoming slower and regular.

0:29:000:29:04

Not everyone can be hypnotised, so the first thing David

0:29:040:29:06

is going to try and do is put me into a state of focused attention

0:29:060:29:10

and then test how suggestible I am.

0:29:100:29:13

Pay attention only to my voice and only to such things as I may

0:29:130:29:17

call to your attention.

0:29:170:29:19

Now he gives me a series of suggestions to see if I perceive

0:29:190:29:22

them as real.

0:29:220:29:25

Please extend your left arm straight out in front of you.

0:29:250:29:30

Up in the air, just beginning to get very heavy.

0:29:300:29:34

Heavier and heavier, as though a weight were pulling

0:29:340:29:36

the hand and arm down.

0:29:360:29:38

A little bit down.

0:29:380:29:40

More and more down.

0:29:400:29:41

It gets heavier and heavier and goes down more and more.

0:29:410:29:45

If I were here to give up smoking or lose weight,

0:29:450:29:48

David would use hypnosis alongside other therapies to help me.

0:29:480:29:52

But today, it's just a test of how suggestible I am.

0:29:520:29:57

You haven't noticed that a fly has been buzzing around you and it's

0:29:570:30:00

going round and round your head.

0:30:000:30:01

Go ahead and get rid of it if you want to.

0:30:010:30:03

It's a weird experience.

0:30:090:30:11

I still feel conscious, yet compelled to follow

0:30:110:30:13

David's suggestions.

0:30:130:30:16

The power of these suggestions can be used to help a person

0:30:160:30:19

tackle their fears or negative thoughts or behaviour.

0:30:190:30:23

You will not awaken until I ask you to do so.

0:30:230:30:30

To test how powerful the suggestions can be, David now suggests

0:30:300:30:33

I write some sentences, as if I'm being controlled

0:30:330:30:35

by someone else.

0:30:350:30:38

The sentence begins, "the woman."

0:30:380:30:41

Now.

0:30:410:30:47

It's an eerie sensation.

0:30:480:30:52

Three, two, one, wide-awake and fully alert.

0:30:520:30:59

Blimey, I didn't even know I was writing this.

0:30:590:31:03

It was an involuntary movement.

0:31:030:31:07

It didn't feel directly it was something I was controlling.

0:31:070:31:10

It felt like something was being done to me,

0:31:100:31:14

rather than I was doing which was quite strange.

0:31:140:31:16

To my surprise, hypnosis felt very real, but is there something

0:31:160:31:19

going on in the brain that can be measured?

0:31:190:31:22

Here at Kings College London, they have spent months repeating

0:31:220:31:25

the writing test with volunteers in an MRI scanner.

0:31:250:31:35

As I count, you will feel yourself going down...

0:31:350:31:41

Like me, the volunteers are asked to write

0:31:410:31:43

as if they were being controlled by someone else.

0:31:430:31:46

Their brain scans are then compared to scans taken when they are asked

0:31:460:31:50

to pretend this is happening.

0:31:500:31:58

The study is overseen by Dr Eamonn Walsh.

0:31:580:32:01

When we asked our participants just to pretend that someone

0:32:010:32:04

was controlling their right hand as they wrote, we see a classic

0:32:040:32:10

signature of activation in the front and back of the brain.

0:32:100:32:13

This pattern is totally different from the activation we saw

0:32:130:32:15

when it was suggested that someone else is controlling

0:32:150:32:18

your hand movements as you write.

0:32:180:32:28

This would suggest that in the hypnotised state,

0:32:280:32:29

your volunteers were absolutely convinced that someone had

0:32:290:32:31

taken over their brain.

0:32:310:32:32

Yes.

0:32:320:32:34

It's very striking!

0:32:340:32:36

So the suggestion under hypnosis really does change the patterns

0:32:360:32:39

of activity in your brain.

0:32:390:32:41

It proves hypnosis isn't a trick.

0:32:410:32:43

It's real.

0:32:430:32:45

That is, I must admit, very impressive, isn't it?

0:32:450:32:48

Certainly, as a piece of evidence.

0:32:480:32:51

Seeing the power of hypnosis in the brain is fascinating,

0:32:510:32:54

but does that mean it's useful?

0:32:540:32:57

While it's used by trained experts to treat certain mental conditions,

0:32:570:33:01

can it really help you lose weight or quit smoking?

0:33:010:33:04

To find out, I'm going to speak to another member of the team,

0:33:040:33:08

Dr Quinton Deeley, consultant psychiatrist

0:33:080:33:10

at the Maudsley Hospital at Kings College London.

0:33:100:33:13

So what sort of conditions would you recommend or suggest

0:33:130:33:16

to people that they might like to go and explore hypnosis for?

0:33:160:33:26

The kind of conditios where it is being recommended is in conditions

0:33:310:33:34

like irritable bowel syndrome.

0:33:340:33:37

There is some evidence and recommendation to augment

0:33:370:33:39

weight loss and use for analgesia, pain relief, for example in labour.

0:33:390:33:44

There is a role for the use of suggestion in hypnosis in,

0:33:440:33:47

for example, cognitive behavioural therapy for depression.

0:33:470:33:49

There are some studies and practitioners which relate to that.

0:33:490:33:52

The difficulty we have is there is likely to be a lot

0:33:520:33:55

of individual variability to these types of interventions,

0:33:550:33:59

so if we are making a general recommendation to the public

0:33:590:34:06

as a whole, we still don't have a well conducted

0:34:060:34:09

as a whole, we still don't have a well conducted large-scale trial.

0:34:090:34:14

So there is something real going on in the brain,

0:34:140:34:19

potentially very useful, but it is slightly frustrating to be

0:34:190:34:21

able to pin it down?

0:34:210:34:22

I think it's a fair judgment.

0:34:220:34:24

Clearly, it is being advertised for smoking cessation,

0:34:240:34:33

I found very little evidence at all that it works in those cases,

0:34:330:34:36

and you could spend a lot of money and not get much result.

0:34:360:34:39

Is that broadly accurate?

0:34:390:34:40

I think that's an accurate summary.

0:34:400:34:41

At the moment, we still don't have the evidence

0:34:410:34:51

for the effectiveness of hypnotic intervention for smoking to make it

0:35:000:35:03

a strongly recommended treatment.

0:35:030:35:03

And how do you go about finding somebody who is a decent hypnotist?

0:35:030:35:07

Ideally, the practitioner should have training

0:35:070:35:08

in a recognised health profession.

0:35:080:35:09

So, for example, they should be a qualified psychologist,

0:35:090:35:11

or possibly another health profession.

0:35:110:35:13

And they are part of a professional organisation, regulatory body

0:35:130:35:15

to which they are accountable and which exercises

0:35:150:35:17

supervision over what they do.

0:35:170:35:18

So when is hypnosis useful?

0:35:180:35:21

Well, there is some evidence it is useful for treating pain

0:35:210:35:24

associated with irritable bowel and also with childbirth.

0:35:240:35:27

But in most other areas, the jury is still out.

0:35:270:35:30

So, should I have hypnosis?

0:35:300:35:33

I think it utterly depends on your personal circumstances.

0:35:330:35:36

Are you suggestible?

0:35:360:35:39

What sort of condition is it you are trying to get treated?

0:35:390:35:42

And most of all, who is going to be doing the hypnosis.

0:35:420:35:46

To find out more, do visit our website.

0:35:460:35:50

There are a number of serious diseases like multiple sclerosis

0:35:570:36:00

or rheumatoid arthritis, which happen when somebody's

0:36:000:36:04

immune system begins to attack their own body.

0:36:040:36:07

These conditions are you hard to treat.

0:36:070:36:14

These conditions are really hard to treat.

0:36:140:36:16

But a chance discovery is helping to rewrite our understanding of how

0:36:160:36:19

the immune system works and could help millions.

0:36:190:36:21

Surgeon Gabriel Weston has been investigating.

0:36:210:36:25

As a surgeon, I am always excited to find out about new medical

0:36:260:36:29

developments, but this time it is particularly special.

0:36:290:36:34

It is a treatment that's come from a breakthrough in understanding

0:36:340:36:37

how our bodies work.

0:36:370:36:39

When the body's damaged, the classic response is inflammation.

0:36:390:36:44

You'll know this from the redness and swelling you see

0:36:440:36:47

when you hurt yourself.

0:36:470:36:49

But it also happens in hidden parts of the body.

0:36:490:36:52

In autoimmune disease, where the body's immune system goes

0:36:520:36:55

wrong, and attacks your own cells, the damage this causes can trigger

0:36:550:36:58

inflammation in all sorts of parts of the body,

0:36:580:37:04

leading to disability, pain and illness.

0:37:040:37:09

The main treatment options for autoimmune diseases until now

0:37:090:37:13

have either been anti-inflammatory drugs like steroids to deal

0:37:130:37:16

with the symptoms of the damage, or severely dampening sufferers'

0:37:160:37:20

entire immune system is to stop the attack.

0:37:200:37:23

But at New York's Feinstein Institute, Dr Kevin Tracey

0:37:230:37:27

was studying the problem of inflammation and had

0:37:270:37:30

a moment of breakthrough.

0:37:300:37:33

He realised that signals controlling the immune system were being carried

0:37:330:37:38

by the nervous system which gave rise to a new idea.

0:37:380:37:43

What if we could use our nerves to control the immune system

0:37:430:37:47

and treat disease?

0:37:470:37:49

That was a real sort of eureka moment.

0:37:490:37:52

Nerves work by carrying electrical information to the end of the nerve.

0:37:520:37:56

At the end of the nerve, the nerve releases molecules,

0:37:560:37:59

neurotransmitters, which then instruct the cells next to the nerve

0:37:590:38:04

ending to change their behaviour.

0:38:040:38:08

And theoretically, you could have a device that targets

0:38:080:38:11

the activity of that nerve to just work for a very

0:38:110:38:14

short period of time, only in the place where the disease is.

0:38:140:38:19

That idea really for me, was the birth of bio-electronic medicine.

0:38:190:38:23

I think that some drugs that are used today,

0:38:230:38:27

will be replaced by very small devices that will target nerves.

0:38:270:38:33

The result was a world first, a device that could be implanted

0:38:330:38:37

beside a nerve that could send signals to control

0:38:370:38:39

the immune system.

0:38:390:38:42

The only way to find out if it would work,

0:38:420:38:45

was to try it in a handful of brave patients, and I've come

0:38:450:38:48

to California to see what they were given.

0:38:480:38:55

An implant that could be attached along the vagus nerve in the neck

0:38:550:38:58

which connects the brain to our major organs.

0:38:580:39:00

This device was implanted into patients as part

0:39:000:39:04

of the very first trial to set out whether the basic concept

0:39:040:39:07

would work.

0:39:070:39:11

This battery here is inserted under the skin

0:39:110:39:15

a bit like a pacemaker, and it is connected to this

0:39:150:39:19

lead with this electrode here which coils around the vagus.

0:39:190:39:23

The electrode stimulates the nerve for about a minute a day,

0:39:230:39:30

at a level which is optimal for regulating the inflammatory

0:39:300:39:32

response, but not so high that it interrupts the other really

0:39:320:39:35

important functions of the vagus nerve.

0:39:350:39:39

Amongst the first people to test this implant were a group

0:39:390:39:43

of patients in Amsterdam with severe rheumatoid arthritis.

0:39:430:39:48

In this disease, information is caused when the immune system

0:39:480:39:52

produces too many inflammatory molecules, including one called TNF.

0:39:520:39:58

Researchers hope that by targeting specific fibres in the vagus nerve

0:39:580:40:02

which control TNF production, they could lower levels

0:40:020:40:05

and reduce inflammation.

0:40:050:40:08

One of the patients taking part in the trial was Monique.

0:40:080:40:12

I couldn't walk from one side of the room to the other

0:40:120:40:15

side of the room.

0:40:150:40:18

It took a long time to go downstairs and put my clothes on,

0:40:180:40:21

and take a shower.

0:40:210:40:24

I was the whole day at home.

0:40:240:40:27

I didn't work any more.

0:40:270:40:31

Monique, could you show me how you use the device?

0:40:310:40:34

Yes, this is the magnet.

0:40:340:40:37

I do it on this way.

0:40:370:40:39

It is going now.

0:40:390:40:41

You will hear it maybe on my voice.

0:40:410:40:44

A little vibration on my voice.

0:40:440:40:48

I can hear it.

0:40:480:40:49

Yes!

0:40:490:40:51

And now, now it's gone.

0:40:510:40:54

How big a difference has this made to your life?

0:40:540:40:57

The first thing I recognised was my energy.

0:40:570:40:59

I had more energy to do more things.

0:40:590:41:03

So I can walk, I cycle more.

0:41:030:41:07

I have started with work again.

0:41:070:41:10

Dr Koopman, what do you make of Monique today,

0:41:100:41:12

assessing her, how is she doing?

0:41:120:41:15

For me there is nothing to detect, to show there

0:41:150:41:17

is any sign of arthritis.

0:41:170:41:21

You can see in her hands there has been arthritis,

0:41:210:41:24

but it has, at least for now, it has died down.

0:41:240:41:28

I don't see myself like a patient who has arthritis.

0:41:280:41:32

I don't think about it any more.

0:41:320:41:35

I have my life back as before I got arthritis.

0:41:350:41:39

Monique is now been using the device for three years

0:41:390:41:43

but Dr Frieda Koopman has the results of the trial as a whole.

0:41:430:41:47

How many patients were there in the trial?

0:41:470:41:50

In total there were 17.

0:41:500:41:52

What did you find?

0:41:520:41:54

About two thirds of the patients had clinical response,

0:41:540:41:57

so less swelling and also less painful joints.

0:41:570:42:01

You could see at the same time that TNF was going down,

0:42:010:42:04

and during the study there was a moment that we would stop

0:42:040:42:07

stimulations and then we saw the patients getting a little bit

0:42:070:42:10

worse, but also the TNF was going up.

0:42:100:42:13

And also the anti-inflammatory effect of the stimulation

0:42:130:42:16

was no longer there.

0:42:160:42:19

Of course, TNF is only one part of the problem

0:42:190:42:22

in rheumatoid arthritis.

0:42:220:42:25

But the results of this trial are really promising,

0:42:250:42:29

and what is even more exciting is that the technology involved

0:42:290:42:31

is only going to get better.

0:42:310:42:36

Here in California, the company which developed Monique's implant

0:42:360:42:40

are already working on a new model and it's tiny.

0:42:400:42:44

CEO Anthony Arnold explains how it works.

0:42:440:42:54

The device is a micro regulator we call it.

0:42:540:43:01

A surgeon would implant the device just above the collarbone.

0:43:010:43:03

Would that have any wires or batteries attached to it

0:43:030:43:06

which would also be under the skin?

0:43:060:43:07

Not at all.

0:43:070:43:08

It is entirely self-contained.

0:43:080:43:09

The battery is in it.

0:43:090:43:11

There are no wires.

0:43:110:43:13

The stimulating leads are built into the device so there is no need

0:43:130:43:16

for multiple components.

0:43:160:43:18

How long do you think it might be before this device can actually be

0:43:180:43:23

in necks doing the job it can do?

0:43:230:43:28

Could be four years in Europe, five years in the US,

0:43:280:43:33

assuming everything goes smoothly, and there are no unusual findings.

0:43:330:43:35

It's not just rheumatoid arthritis that could ultimately benefit

0:43:350:43:37

from this technology.

0:43:370:43:40

The vagus nerve is like a transatlantic telephone wire,

0:43:400:43:43

with maybe 100,000 individual telephone lines, and each

0:43:430:43:47

of those has a specific job, and the challenge for

0:43:470:43:50

bio-electronic medicine is to ask what is that fibre doing,

0:43:500:43:56

and how can we control that fibre to the therapeutic benefit of that

0:43:560:43:59

patient with this disease?

0:43:590:44:02

That is the opportunity for the future of medicine.

0:44:020:44:06

What I've seen in the US and here in Amsterdam has absolutely

0:44:090:44:12

blown me away, and it is clear that this rheumatoid arthritis trial

0:44:120:44:15

is just the beginning.

0:44:150:44:19

I wouldn't be at all surprised if in the near future,

0:44:190:44:22

we start seeing bioelectronics being used to treat a whole range

0:44:220:44:26

of previously very difficult to manage medical conditions.

0:44:260:44:31

Most people think that stretching is important when we exercise.

0:44:410:44:46

Do you normally stretch before exercise?

0:44:460:44:49

I do a little bit of stretching, yes.

0:44:490:44:51

Why do you do it?

0:44:510:44:52

I do it because I feel it will stave off injury.

0:44:520:44:56

I feel like I can actually use all my muscles to

0:44:560:44:59

the extent that I need to.

0:44:590:45:02

So the consensus is, we should stretch.

0:45:020:45:05

The idea is it will reduce your risk of injury and improve

0:45:050:45:08

your performance.

0:45:080:45:09

People believe this, but is it actually true?

0:45:090:45:12

Time for me to find out.

0:45:120:45:14

Agh!

0:45:140:45:19

I'm going to do an experiment on myself under the guidance

0:45:190:45:22

of biomechanist Dr Polly McGuigan.

0:45:220:45:27

Firstly, a baseline measure of my muscle power -

0:45:270:45:29

how high I can jump.

0:45:290:45:35

Then - how flexible am I?

0:45:350:45:37

Now, will stretching improve these measures?

0:45:370:45:42

Ooh, blimey.

0:45:420:45:43

Am I supposed to experience pain there?

0:45:430:45:45

You do expect to be able to feel it.

0:45:450:45:47

I can certainly feel it.

0:45:470:45:48

Good.

0:45:480:45:49

Now it's time to re-do exactly the same test to see if all those

0:45:490:45:52

structures had any effect.

0:45:520:45:57

stretches had any effect.

0:45:570:45:58

Polly has the answer.

0:45:580:45:59

OK, so after all that strenuous and slightly painful stretching,

0:45:590:46:02

what were the results?

0:46:020:46:03

Starting with flexibility, you did become more flexible

0:46:030:46:04

after the stretches.

0:46:040:46:05

OK.

0:46:050:46:08

For a given level of force, that muscle tension unit stretched

0:46:080:46:10

a little bit more.

0:46:100:46:11

After the stretching, I was able to extend my knee

0:46:110:46:14

by an extra 90 degrees.

0:46:140:46:16

by an extra 9 degrees.

0:46:160:46:18

My calves were almost 20% less stiff.

0:46:180:46:21

So how did stretching improve my flexibility?

0:46:210:46:25

There is an argument that over a long period of time,

0:46:250:46:27

if you stretch a muscle, you actually do physically

0:46:270:46:30

make it longer.

0:46:300:46:36

But probably, the strongest argument for an immediate effect like we saw

0:46:360:46:39

today is that you just become a little bit more tolerant to that

0:46:390:46:42

degree of stretch and, therefore, you can push yourself a bit further.

0:46:420:46:45

So stretching did make me more flexible, but the key question is,

0:46:450:46:48

does it actually make me a better athlete?

0:46:480:46:53

Time for my jumping results.

0:46:530:46:56

What about power?

0:46:560:46:58

Well, power had the opposite effect.

0:46:580:47:01

Your jump height went down after the stretching.

0:47:010:47:03

It didn't feel like it.

0:47:030:47:04

I mean, I actually felt more limber and

0:47:040:47:06

I was shouting well!

0:47:060:47:07

Yes!

0:47:070:47:08

And I was jumping to the full extent

0:47:080:47:10

of my strength.

0:47:100:47:11

Yeah.

0:47:110:47:14

In fact, my jump height was 20% lower.

0:47:140:47:16

So why does stretching actually harm my performance?

0:47:160:47:21

If things become a bit more stretchy, a bit more compliant,

0:47:210:47:25

the speed with which you can transmit force from the muscle

0:47:250:47:33

which is generating the force to your skeleton, which is producing

0:47:330:47:36

the movement, decreases a bit.

0:47:360:47:38

So stretching makes you less powerful, but what about

0:47:380:47:40

protecting you from injury?

0:47:400:47:41

The vast majority of the research suggests that there is no effect

0:47:410:47:47

on injury risk of stretching before you exercise.

0:47:470:47:50

It's not going to reduce your risk of getting injured.

0:47:500:47:53

Because I imagine that when you stretch, you're

0:47:530:47:55

going to warm up the muscles, and warming up the muscles

0:47:550:47:58

is a good thing.

0:47:580:47:59

Warming up the muscles is a good thing, definitely.

0:47:590:48:01

A muscle will produce more force after it's warmed up a little bit.

0:48:010:48:04

But stretching is not the best way to warm up.

0:48:040:48:07

It's better just to do gentle light exercise.

0:48:070:48:12

So stretching is useful to stay flexible, especially

0:48:120:48:15

as we get older, but not to help your exercise.

0:48:150:48:19

If you're doing any sort of exercise which involves power -

0:48:190:48:24

such as jumping or perhaps sprinting - then doing this sort

0:48:240:48:27

of stretching really isn't going to help.

0:48:270:48:29

Instead, if for example you want to go for a run,

0:48:290:48:32

then what you should do beforehand is go for a stroll, speed it up,

0:48:320:48:36

maybe do a little bit of jogging.

0:48:360:48:37

What this will do is, it will increase the blood flow

0:48:370:48:42

to the muscles that will warm them up and also improve efficiencies.

0:48:420:48:47

In fact, if you do this sort of exercise, the evidence is that it

0:48:470:48:50

will improve your performance.

0:48:500:48:53

When we talk about the signs and symptoms of ill-health,

0:48:590:49:02

we often focus on the physical, but mental illness is

0:49:020:49:04

also incredibly common.

0:49:040:49:07

So what should we be looking out for?

0:49:070:49:09

Over to Saleyha.

0:49:090:49:10

One in four people in the UK will be affected by mental health problems,

0:49:140:49:17

one of the most common of which is depression.

0:49:170:49:22

All too often, depression isn't recognised as a genuine health

0:49:220:49:25

condition or is dismissed as trivial, but it's far more

0:49:250:49:27

than feeling low or unhappy for a few days.

0:49:270:49:33

Depression is a real illness, with real symptoms and real dangers.

0:49:330:49:41

It's a medical condition which can creep up on any of us and its causes

0:49:410:49:45

are many and varied.

0:49:450:49:47

But the most common trigger is a traumatic life event

0:49:470:49:51

like losing a loved-one, going through a stressful situation

0:49:510:49:53

at work, or experiencing a serious physical illness.

0:49:530:50:01

Many people find it difficult to be open about having the condition,

0:50:010:50:04

for fear of seeming weak.

0:50:040:50:07

But Lol, Sarah, Richard and Cath - who have all been diagnosed

0:50:070:50:10

with depression - are happy to talk about their experiences to help us

0:50:100:50:13

all recognise the red-flag symptoms.

0:50:130:50:17

My moods were dropping.

0:50:170:50:19

My behaviours were erratic and quite unpredictable.

0:50:190:50:22

I eventually noticed that my normal behaviours,

0:50:220:50:26

my normal character and personality, had gone.

0:50:260:50:29

I'd really start spiralling down and feeling like

0:50:290:50:31

an impostor, you know?

0:50:310:50:32

I never felt I was quite good enough.

0:50:320:50:36

I'd be waking up once or twice in the night.

0:50:360:50:38

I was having thoughts about, have I done this, have I done that?

0:50:380:50:41

I need to get to work to sort this out.

0:50:410:50:43

I was questioning myself and being self-critical,

0:50:430:50:45

which I wouldn't normally be.

0:50:450:50:47

I just shut myself away, just not interested in anything

0:50:470:50:50

whatsoever, and just wanted to curl up in a ball and just stay

0:50:500:50:53

in my own bubble, so to speak.

0:50:530:50:58

Although people can have very different experiences of depression,

0:50:580:51:01

these are all common signs and symptoms,

0:51:010:51:02

and there are others to look out for.

0:51:020:51:09

Among them, there's a constant flow of negative thoughts

0:51:090:51:11

and low self-esteem.

0:51:110:51:14

People can also suffer from physiological symptoms

0:51:140:51:16

like changes in their eating or sleeping pattern, or feeling

0:51:160:51:18

like their energy levels are so low.

0:51:180:51:25

Sometimes, it's the people around us who notice the change

0:51:250:51:28

in our behaviour.

0:51:280:51:30

My children actually pointed it out because they'd ask me

0:51:300:51:32

for something and I'd bite their head off for it,

0:51:320:51:34

not meaning to.

0:51:340:51:38

And it was at that point, I said, right, I've got to go to my GP

0:51:380:51:42

and get this sorted.

0:51:420:51:42

I tried to mask it.

0:51:420:51:44

And then on this particular day, I was so emotional and my manager

0:51:440:51:47

said, look, you're clearly not well.

0:51:470:51:49

We've seen this for a long time, we've been seeing the signs.

0:51:490:51:52

I think tomorrow, you need to go and see a doctor.

0:51:520:51:55

And that was almost like a weight had been lifted off my shoulder.

0:51:550:51:58

I know it's a cliche, but...

0:51:580:52:00

If you do experience some of these symptoms every day for two weeks

0:52:000:52:03

or more, then visit your doctor, as there are many forms of treatment

0:52:030:52:07

and therapy to help you recover.

0:52:070:52:12

One of the things that they might prescribe you is CBT,

0:52:120:52:15

cognitive behavioural therapy.

0:52:150:52:20

CBT is a talking therapy.

0:52:200:52:22

It helps you to identify negative thoughts and gives

0:52:220:52:25

you coping strategies on how to deal with them.

0:52:250:52:28

I found it...

0:52:280:52:31

I found it quite useful.

0:52:310:52:35

It kind of gave me a different outlook, to look at things

0:52:350:52:38

in a different way.

0:52:380:52:39

It kind of shed a lot of light on different things.

0:52:390:52:42

Some people find self-help techniques effective.

0:52:420:52:44

Mindfulness is a big one for me, and meditation.

0:52:440:52:48

I do that every day and I swear by it.

0:52:480:52:51

Your GP may also suggest a course of antidepressant medication.

0:52:510:52:55

They've been a life-saver for me because they keep me buoyed up

0:52:550:52:58

so that I'm able to function and able to get to the point

0:52:580:53:01

where I can start to recover properly.

0:53:010:53:09

But whatever therapy is prescribed, it's important not to give up hope.

0:53:090:53:14

If you're a man in particular, or a young man, not to feel it's

0:53:140:53:18

a sign of weakness and to not feel stigmatised by having depression.

0:53:180:53:25

Certainly, don't shy away from it.

0:53:250:53:27

And also, talk about it to either friends,

0:53:270:53:29

family or go to your GP.

0:53:290:53:32

Ring up the NHS.

0:53:320:53:35

You know, I would say to them everyone's got their mental health

0:53:350:53:38

as much as we have physical health, so why not talk about it

0:53:380:53:41

in the same way that you would if you had

0:53:410:53:43

a terrible cold?

0:53:430:53:47

As an A doctor, one of the hardest parts of the job is losing a patient

0:53:470:53:50

due to a preventable cause, and that includes mental

0:53:500:53:53

health illnesses.

0:53:530:53:57

So if you or someone you know is suffering

0:53:570:53:59

from depressive symptoms, don't ignore them.

0:53:590:54:02

Getting help and the right treatment can save lives.

0:54:020:54:06

Don't suffer in silence.

0:54:060:54:10

If you want more information, go to our website...

0:54:100:54:12

Back in Worcester, our trial into going gluten-free

0:54:290:54:31

is coming to an end.

0:54:310:54:34

Our volunteers all cut out gluten for six weeks.

0:54:340:54:36

But we secretly slipped each of them gluten containing pasta for two

0:54:360:54:39

weeks during that time.

0:54:390:54:44

Not even the researchers knew when each person had their gluten

0:54:440:54:46

until the results were analysed.

0:54:460:54:48

But some of our volunteers thought they could tell which weeks

0:54:480:54:51

they were eating gluten just from the way they felt,

0:54:510:54:54

and they generally preferred being gluten-free.

0:54:540:55:02

Do you feel better off gluten or on gluten?

0:55:020:55:04

I definitely felt a difference.

0:55:040:55:05

And my teenage son has noticed a difference

0:55:050:55:07

in the digestive system.

0:55:070:55:08

In YOUR digestive system?

0:55:080:55:09

Yes.

0:55:090:55:10

He said to me, "Mum, you're not gluten-free

0:55:100:55:12

anymore, are you?"

0:55:120:55:13

And the rest, I'll leave to your imagination!

0:55:130:55:15

My eyes are clear and my skin is clear and my bloat has gone down.

0:55:150:55:18

It's been a really interesting experience, yeAH.

0:55:180:55:22

It's been a really interesting experience, yes.

0:55:220:55:23

Why?

0:55:230:55:24

Well, I have to say, I was a cynic.

0:55:240:55:27

Were you?

0:55:270:55:27

Yes, but I may convert now.

0:55:270:55:30

Yes, but I'm a convert now.

0:55:300:55:32

But anecdotes aren't scientific, so we asked people to record

0:55:320:55:34

their symptoms each fortnight.

0:55:340:55:35

Once the experiment was over, we then looked up who'd been given

0:55:350:55:38

gluten when and compared their symptoms on the different diets.

0:55:380:55:41

And actually, those that recorded gut symptoms like bloating

0:55:410:55:45

and nausea reported fewer when they were truly gluten-free.

0:55:450:55:47

And they did suffer significantly more in the weeks

0:55:470:55:50

we slipped them gluten.

0:55:500:55:52

We also recorded things like tiredness and skin health.

0:55:520:55:55

And here, there was no significant difference between gluten

0:55:550:55:57

and gluten-free weeks.

0:55:570:56:01

So what do our volunteers and the scientific team

0:56:010:56:03

make of these results?

0:56:030:56:09

Over to Justine, from the University of Worcester.

0:56:090:56:11

First of all, thank you very much for taking part.

0:56:110:56:13

I'm now going to hand you to Justine, our expert,

0:56:130:56:16

to give the results - which are pretty interesting.

0:56:160:56:18

So the symptom questionnaire data that we've got is showing

0:56:180:56:20

a statistically significant difference and a benefit

0:56:200:56:22

for following a gluten-free diet.

0:56:220:56:25

So in a sense, from your point of view as a scientist,

0:56:250:56:28

that is an important result?

0:56:280:56:29

Yes.

0:56:290:56:30

So people are feeling better.

0:56:300:56:32

And we have anecdotally asked people if they're going to continue

0:56:320:56:34

with the gluten-free diet and out of the 50 people who completed,

0:56:340:56:37

we think seven are going to return to eating normally and the rest

0:56:370:56:40

of the people have indicated that they will either

0:56:400:56:42

restrict their gluten or follow a gluten-free diet,

0:56:420:56:44

so that's quite significant.

0:56:440:56:50

So going gluten-free helped a lot of people's guts feel better,

0:56:500:56:54

but was this mirrored by changes in their immune system

0:56:540:56:57

or gut inflamation?

0:56:570:56:59

Could there be a medical test to help classify gluten

0:56:590:57:01

intolerance as a condition?

0:57:010:57:06

Well, when we looked at their blood test results, there was no

0:57:060:57:09

significant change in either their immune markers or information

0:57:090:57:11

markers when they went gluten-free or when they had gluten secretly

0:57:110:57:13

reintroduced into their diets.

0:57:130:57:20

Nor were there any differences between those who recorded suffering

0:57:200:57:23

a lot of symptoms when eating gluten and those who didn't.

0:57:230:57:29

But that doesn't matter to those who feel better.

0:57:290:57:32

Bryony, what was your experience of the experiment like?

0:57:320:57:34

Really good.

0:57:340:57:35

Was it?

0:57:350:57:36

Yes, really good.

0:57:360:57:37

I'm going to stay gluten-free now.

0:57:370:57:38

You're going to stay gluten-free?

0:57:380:57:39

Yes, 100%.

0:57:390:57:41

A lot more energy.

0:57:410:57:43

I'm exercising a lot more now.

0:57:430:57:46

The bloating's gone and I've lost some weight as well, so brilliant.

0:57:460:57:49

Now, it's possible that our volunteers could taste

0:57:490:57:52

the difference in the pastas and that this influenced them.

0:57:520:57:55

Perhaps simply thinking they were cutting out the gluten

0:57:550:57:57

was enough to make them feel better.

0:57:570:57:59

Or maybe gluten was doing something to their bodies that we just didn't

0:57:590:58:02

pick up with the blood markers that we looked at.

0:58:020:58:05

It could be, for example, that gluten affected some

0:58:050:58:07

people's gut bacteria badly.

0:58:070:58:10

Now, if you're going to exclude gluten from your diet, you should

0:58:100:58:13

take the appropriate medical advice.

0:58:130:58:16

But the good news is that all the tools are readily

0:58:160:58:18

and cheaply available for anyone to try this out on.

0:58:180:58:21

That's it from Worcester.

0:58:300:58:32

Next time: We're coming from Newcastle, where we're doing

0:58:320:58:35

a big experiment to see whether turmeric can help

0:58:350:58:37

protect us against cancer.

0:58:370:58:41

We'll also be revealing the secret behind glucosamine pills.

0:58:410:58:45

And investigating the current craze for mindfulness.

0:58:450:58:50

There's a brand-new way to stay

0:59:170:59:18

on top of the Premier League action.

0:59:180:59:20

We look ahead to the weekend's fixtures,

0:59:200:59:22

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