Episode 1

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0:00:04 > 0:00:05When it comes to our health,

0:00:05 > 0:00:10it seems everyone has an opinion and everyone has an agenda.

0:00:10 > 0:00:12But what's the health advice you can really trust?

0:00:16 > 0:00:19We're here to weigh up the evidence

0:00:19 > 0:00:21and use our expertise to guide you...

0:00:23 > 0:00:25Through the contradictions and the confusions.

0:00:28 > 0:00:30We do the research no-one else has done.

0:00:32 > 0:00:35And put your health at the heart of what we do.

0:00:36 > 0:00:39We listen to the questions you want answered.

0:00:43 > 0:00:46And ensure you get the information you need.

0:00:50 > 0:00:54We're here when you want to know the latest findings.

0:00:54 > 0:00:56And not just the latest fads.

0:00:59 > 0:01:00I'm Michael Mosley.

0:01:00 > 0:01:02In this series, I'm joined by a team of doctors.

0:01:04 > 0:01:06Together, we'll cut through

0:01:06 > 0:01:10the hype, the headlines and the health claims.

0:01:10 > 0:01:13This is Trust Me I'm A Doctor.

0:01:17 > 0:01:20Hello, and welcome to a new series of Trust Me I'm A Doctor.

0:01:20 > 0:01:23This time we're coming from Inverness in the Highlands,

0:01:23 > 0:01:26where we're carrying out a fascinating experiment

0:01:26 > 0:01:30to see if consuming probiotics will change your gut bacteria

0:01:30 > 0:01:33and maybe even improve your health.

0:01:33 > 0:01:38We'll also be finding out, can we lose weight while we sleep?

0:01:39 > 0:01:43And can red wine really help us live longer?

0:01:43 > 0:01:44We'll just have one more.

0:01:44 > 0:01:46One more small one.

0:01:47 > 0:01:49I'll discover how to beat the winter blues.

0:01:51 > 0:01:56We'll witness a UK first, a UK surgery using 3-D printing.

0:01:56 > 0:01:57I can see his heart!

0:01:57 > 0:02:01And we'll find out if going decaf is dangerous.

0:02:01 > 0:02:03But first...

0:02:07 > 0:02:10When it comes to losing weight, there are really two methods.

0:02:10 > 0:02:13There's dieting and there's exercise.

0:02:13 > 0:02:17I've come across reports that exercise makes us hungrier

0:02:17 > 0:02:20and more likely to snack on unhealthy treats afterwards,

0:02:20 > 0:02:22undoing all our good work.

0:02:22 > 0:02:25So, we might be better off sticking to dieting.

0:02:26 > 0:02:27But is that true?

0:02:28 > 0:02:32To find out, over the next two days we're running a study

0:02:32 > 0:02:34with the University of Bath.

0:02:34 > 0:02:38We've enlisted sports scientist Dr Javier Gonzales

0:02:38 > 0:02:40and recruited ten hungry volunteers

0:02:40 > 0:02:43who are getting ready to diet or exercise.

0:02:43 > 0:02:45Yeah, I think exercising will make you hungrier.

0:02:45 > 0:02:48I think after a few hours, the hunger will definitely kick in.

0:02:48 > 0:02:50I just think dieting always makes me hungry.

0:02:50 > 0:02:52Because when you've been exercising, you know,

0:02:52 > 0:02:54it takes your mind off your hunger.

0:02:56 > 0:02:59First, we find out how hungry everyone in the group is

0:02:59 > 0:03:00on a typical day.

0:03:00 > 0:03:04They all do no exercise and eat the same amount of food for breakfast.

0:03:06 > 0:03:07Over the next three hours,

0:03:07 > 0:03:10they all rate how hungry they feel on a questionnaire.

0:03:10 > 0:03:13And we're doing some blood tests to get some baseline measurements

0:03:13 > 0:03:15as a control.

0:03:16 > 0:03:19On day two, we split them into two groups.

0:03:19 > 0:03:21Diet and exercise.

0:03:24 > 0:03:29Before breakfast, the exercise group are burning off 500 calories.

0:03:29 > 0:03:33Which is between ten and 18 laps, depending on their body weight.

0:03:33 > 0:03:35Great stuff. Keep pushing.

0:03:38 > 0:03:42Meanwhile, our dieters are engaged in much more restful activities.

0:03:50 > 0:03:52Great job.

0:03:57 > 0:04:02Breakfast time, and it's the dieters' turn to suffer.

0:04:02 > 0:04:04They get 500 calories less to eat.

0:04:05 > 0:04:09Over the next three hours, we're testing which group gets hungrier.

0:04:09 > 0:04:11Again, they rate how hungry they feel.

0:04:12 > 0:04:15Just hold that there for me.

0:04:15 > 0:04:16And we repeat the blood test.

0:04:16 > 0:04:19We're looking at the levels of a hormone called ghrelin.

0:04:23 > 0:04:24Why are you focusing on ghrelin?

0:04:24 > 0:04:27There are many hormones that influence appetite.

0:04:27 > 0:04:29Many of these are secreted by our gut.

0:04:29 > 0:04:31The interesting thing about ghrelin

0:04:31 > 0:04:34is it's the only one we know of that stimulates appetite.

0:04:34 > 0:04:36All of the other hormones seem to suppress appetite.

0:04:36 > 0:04:39And when you have higher ghrelin, what does that mean?

0:04:39 > 0:04:41So, more ghrelin equals more hunger.

0:04:41 > 0:04:44OK. And what we're going to be looking at

0:04:44 > 0:04:47is whether exercise, or dieting, affects it more.

0:04:47 > 0:04:50When I do exercise, I feel hungrier.

0:04:50 > 0:04:54You may perceive that, but we'll find out today.

0:04:54 > 0:04:57- If that's true. OK.- Yeah.

0:04:57 > 0:04:59Once Javier's analysed the data,

0:04:59 > 0:05:03we gather to find out what he's discovered.

0:05:03 > 0:05:04OK. Results time.

0:05:04 > 0:05:07- What did you find? - Let's have a look.

0:05:07 > 0:05:09Wahey!

0:05:09 > 0:05:11So, these are the self-reported

0:05:11 > 0:05:13ratings of your appetite,

0:05:13 > 0:05:16compared to your control conditions.

0:05:16 > 0:05:17So, on average,

0:05:17 > 0:05:19the diet group felt hungrier,

0:05:19 > 0:05:21compared to the exercise group.

0:05:21 > 0:05:22Did you all feel hungry afterwards?

0:05:22 > 0:05:24- Very hungry.- Super hungry.

0:05:24 > 0:05:25Very hungry. Yeah.

0:05:25 > 0:05:27So, there were no exceptions in this group?

0:05:27 > 0:05:29- No.- No.- OK. I must admit,

0:05:29 > 0:05:32I was surprised by how big a difference it was

0:05:32 > 0:05:33between these two groups.

0:05:33 > 0:05:35And did people feel less hungry?

0:05:35 > 0:05:38Yeah, so I felt really, really hungry before the run in the morning.

0:05:38 > 0:05:40But then, after the run,

0:05:40 > 0:05:41I didn't feel particularly hungry

0:05:41 > 0:05:45and, actually, I wasn't nearly as hungry as I'd been before.

0:05:45 > 0:05:49So, on average, the dieters felt hungrier than the exercises.

0:05:49 > 0:05:52But what about their levels of hunger hormone ghrelin?

0:05:54 > 0:05:55First, the exercise group.

0:05:55 > 0:05:59On the left is their ghrelin level on the control day.

0:05:59 > 0:06:05On the right, the level on the day they burned 500 calories by running.

0:06:05 > 0:06:07We've got the exercise group, where you can see

0:06:07 > 0:06:09there's not much difference in ghrelin concentrations,

0:06:09 > 0:06:11compared to control.

0:06:11 > 0:06:14But for the dieters who consumed 500 calories less,

0:06:14 > 0:06:16it's a different story.

0:06:16 > 0:06:19Poor old dieters getting less calories there

0:06:19 > 0:06:21and their ghrelin levels going up

0:06:21 > 0:06:25and it's shouting at you, "Feed me! Feed me!"

0:06:25 > 0:06:29What's interesting is, it's completely consistent with your questionnaire.

0:06:29 > 0:06:31- Yes.- So, if you do the exercise,

0:06:31 > 0:06:32it's going to give you lots of benefits,

0:06:32 > 0:06:34It's not necessarily going to increase your appetite.

0:06:34 > 0:06:37- Yeah.- Anyway, I think you've all been patient long enough.

0:06:37 > 0:06:39Please tuck in.

0:06:39 > 0:06:40Hooray!

0:06:43 > 0:06:46So, the good news is that our study adds to a body of research

0:06:46 > 0:06:51which suggests that doing exercise is not going to make you hungrier.

0:06:51 > 0:06:54So, if you combine it with a little bit of calorie restriction,

0:06:54 > 0:06:58there's a very good chance that you will not only get healthier,

0:06:58 > 0:07:00but you will also lose weight.

0:07:00 > 0:07:02That is a win-win.

0:07:11 > 0:07:14Now, it's always a struggle to cut back on the good things in life,

0:07:14 > 0:07:16not least the booze.

0:07:16 > 0:07:18Do we really have to?

0:07:18 > 0:07:20Over to Dr Chris van Tulleken.

0:07:23 > 0:07:25Many of us have the evidence of lived experience

0:07:25 > 0:07:28that alcohol makes you clever, charming

0:07:28 > 0:07:30and more attractive to the opposite sex.

0:07:30 > 0:07:34Unfortunately, there is the more powerful evidence of robust science

0:07:34 > 0:07:37which says that even small amounts of alcohol are pretty bad for you.

0:07:37 > 0:07:40But there is one drink which claims to be an exception.

0:07:43 > 0:07:44Red wine.

0:07:45 > 0:07:47We're endlessly bombarded with news reports telling us

0:07:47 > 0:07:50it might be just a little virtuous.

0:07:53 > 0:07:56It's a part of the Mediterranean diet

0:07:56 > 0:07:58which is meant to make you live longer.

0:07:58 > 0:08:01We know that it's not the alcohol that's responsible

0:08:01 > 0:08:04for the supposed health benefits of red wine.

0:08:04 > 0:08:06But could there be something else in here

0:08:06 > 0:08:09that offsets the harm caused by the alcohol?

0:08:09 > 0:08:11Red wine is thought to be good for you

0:08:11 > 0:08:14because it's made using the grape skin,

0:08:14 > 0:08:18which contains a family of chemicals called polyphenols.

0:08:18 > 0:08:21These have been the source of intense study for decades

0:08:21 > 0:08:23and one has been probed more than most.

0:08:24 > 0:08:26Resveratrol.

0:08:26 > 0:08:28Now, we've known about this chemical for a long time,

0:08:28 > 0:08:33but it wasn't until the 1990s that it was discovered in red wine.

0:08:33 > 0:08:35So, why has it got scientists so excited?

0:08:37 > 0:08:40This is an East African killifish.

0:08:40 > 0:08:42Let's call him Arthur.

0:08:42 > 0:08:44Arthur is a handsome beast,

0:08:44 > 0:08:46but sadly, his time on this Earth is short.

0:08:46 > 0:08:48Just a few months.

0:08:48 > 0:08:51But that's useful for scientists who study longevity.

0:08:52 > 0:08:56So, the scientists ran an experiment to see if giving resveratrol to fish

0:08:56 > 0:08:58like Arthur made them live longer.

0:08:58 > 0:09:02What they found was that the fish in the experiment given the resveratrol

0:09:02 > 0:09:05lived up to 40% longer.

0:09:05 > 0:09:09Now, that's pretty astonishing if you're an African killifish.

0:09:09 > 0:09:11What you'll find if you read beyond those headlines

0:09:11 > 0:09:12that say something like,

0:09:12 > 0:09:15"A glass of red wine a day keeps the doctor away,"

0:09:15 > 0:09:17is that at the bottom of the article, it will say

0:09:17 > 0:09:20that the experiments were actually done on a fish like Arthur,

0:09:20 > 0:09:22a worm, a fruit fly,

0:09:22 > 0:09:24or sometimes just cells in a dish.

0:09:27 > 0:09:29So, although the research may be promising,

0:09:29 > 0:09:31it doesn't amount to evidence

0:09:31 > 0:09:34that red wine may have health benefits that means you and I

0:09:34 > 0:09:35will live any longer.

0:09:38 > 0:09:41And even if we do one day discover that resveratrol has a significant

0:09:41 > 0:09:43beneficial effect on people,

0:09:43 > 0:09:46there's still a catch when it comes to getting it from wine.

0:09:46 > 0:09:47This is a glass of Pinot noir,

0:09:47 > 0:09:50it happens to be from the Yarra Valley in Australia.

0:09:50 > 0:09:53Now, Pinot noir is a light red with low acidity,

0:09:53 > 0:09:57medium tannins and some of the highest levels of resveratrol

0:09:57 > 0:09:59of any wine in the world,

0:09:59 > 0:10:01at about 10mg per litre.

0:10:01 > 0:10:04Unfortunately, though, most of the studies on resveratrol

0:10:04 > 0:10:07have been done using capsules, like this.

0:10:07 > 0:10:10And in order to get as much resveratrol out of my wine

0:10:10 > 0:10:12as there is in this capsule,

0:10:12 > 0:10:15I would need to drink all of these bottles here.

0:10:15 > 0:10:17So, I'd better get going.

0:10:20 > 0:10:24So, despite many years of research, we're still not entirely sure

0:10:24 > 0:10:27what lies behind red wine's healthy reputation.

0:10:28 > 0:10:31And it may well be that we've been looking at it the wrong way.

0:10:35 > 0:10:38When drunk in moderation as part of the Mediterranean diet,

0:10:38 > 0:10:40red wine accompanies nutrient-rich foods,

0:10:40 > 0:10:43like fruits, vegetables, fish and nuts.

0:10:43 > 0:10:46And the evidence suggests that it's the diet taken as a whole

0:10:46 > 0:10:49that leads to a longer, healthier life.

0:10:52 > 0:10:54Now, having one small glass of red wine with food

0:10:54 > 0:10:57is not going to do you any harm, but you have to ask yourself honestly,

0:10:57 > 0:10:59when was the last time you did that?

0:10:59 > 0:11:02If you're anything like me, you have one glass over dinner

0:11:02 > 0:11:04and then probably another glass over dinner,

0:11:04 > 0:11:05then you finish off the bottle

0:11:05 > 0:11:08in front of the television with dessert.

0:11:08 > 0:11:11So, sadly, red wine is not some kind of delicious medicine

0:11:11 > 0:11:13where the more you drink, the better it is for you.

0:11:14 > 0:11:17I will just have one more.

0:11:17 > 0:11:18One more small one.

0:11:28 > 0:11:29SNEEZE

0:11:30 > 0:11:34Every year in the UK, we spend over £700 million

0:11:34 > 0:11:37on probiotic products that promise to improve

0:11:37 > 0:11:41our health by enhancing the mix of bacteria in our gut.

0:11:44 > 0:11:48More and more research is showing how our gut bacteria

0:11:48 > 0:11:52influence every aspect of our health.

0:11:52 > 0:11:55And yet, there is still so much that we don't know

0:11:55 > 0:11:57about this inner ecosystem.

0:11:58 > 0:12:00If you believe the hype,

0:12:00 > 0:12:04our gut bacteria can help tackle a dizzying array of disorders.

0:12:04 > 0:12:08From poor digestion and bowel diseases to allergies, acne,

0:12:08 > 0:12:10obesity, and even mental health problems.

0:12:13 > 0:12:17Popular probiotic products say they can alter

0:12:17 > 0:12:19our gut bacteria for the better.

0:12:19 > 0:12:21But do they actually work?

0:12:22 > 0:12:25Probiotics are essentially supposed to work

0:12:25 > 0:12:27in the opposite way to antibiotics.

0:12:27 > 0:12:31Instead of killing harmful bacteria, it it's claim they add

0:12:31 > 0:12:34new, beneficial bacteria to the complex swamp of microbes

0:12:34 > 0:12:37that already live in our intestine.

0:12:38 > 0:12:40However, there's a catch.

0:12:40 > 0:12:42Before the bacteria in probiotic products

0:12:42 > 0:12:44can change our gut for the better,

0:12:44 > 0:12:47they have to survive the perilous journey

0:12:47 > 0:12:49through the acid bath that is our stomach

0:12:49 > 0:12:51and set up home in the intestines.

0:12:53 > 0:12:56How well they can really do this is a hot topic right now

0:12:56 > 0:13:00and is exactly the kind of thing that Trust Me likes to test.

0:13:00 > 0:13:03So, with the help of NHS Highlands,

0:13:03 > 0:13:06we've enrolled 30 residents of Inverness

0:13:06 > 0:13:10who are going to volunteer their guts in the name of science.

0:13:10 > 0:13:14We split our volunteers into three groups.

0:13:14 > 0:13:17They'll be helping us test a market leading probiotic

0:13:17 > 0:13:19against some alternatives.

0:13:21 > 0:13:22All closely scrutinised

0:13:22 > 0:13:26by Dr Adele Costabile of Roehampton University.

0:13:28 > 0:13:31Our first group will be taking a daily dose

0:13:31 > 0:13:35of a top-selling probiotic yoghurt, available in most supermarkets.

0:13:36 > 0:13:39Products like these are specially formulated to contain

0:13:39 > 0:13:43particular bacteria strains thought to be beneficial.

0:13:43 > 0:13:47This yoghurt contains just one specific bacteria.

0:13:47 > 0:13:50One specific bug that can help your gut

0:13:50 > 0:13:52to make a little bit healthier.

0:13:52 > 0:13:56However, some researchers claim these drinks don't work.

0:13:57 > 0:14:01They think our stomach acid, which kills off harmful bacteria,

0:14:01 > 0:14:04is also killing the good bacteria in these products.

0:14:04 > 0:14:08So, will our volunteers see any difference?

0:14:08 > 0:14:12Our next group are trying a different type of probiotic.

0:14:12 > 0:14:14A fermented milk drink called kefir.

0:14:14 > 0:14:18It's long been a traditional part of the diet in Central Asia,

0:14:18 > 0:14:21but it's recently started to appear in our supermarkets.

0:14:22 > 0:14:26This stuff naturally contains dozens of strains of live bacteria,

0:14:26 > 0:14:29way more than the familiar yoghurt drinks.

0:14:29 > 0:14:33Kefir has been in our diet for several hundred years.

0:14:33 > 0:14:38It doesn't contain only one species, but contains more bacteria,

0:14:38 > 0:14:39plus some yeast.

0:14:40 > 0:14:43But does having more bacteria make it more likely

0:14:43 > 0:14:46that some will survive our stomach acid?

0:14:46 > 0:14:50In four weeks' time, we should see if these bacteria

0:14:50 > 0:14:54have managed to make a new home for themselves within your gut.

0:14:55 > 0:14:58But to avoid the problem of stomach acid altogether,

0:14:58 > 0:15:02our final group will try a different way to boost their gut bacteria.

0:15:02 > 0:15:04Instead of taking a probiotic,

0:15:04 > 0:15:08they'll be given what's called prebiotic diet -

0:15:08 > 0:15:10foods that contain a type of fibre

0:15:10 > 0:15:13that the good bacteria already in our gut thrive on.

0:15:13 > 0:15:17It's a fibre that can target the good guys

0:15:17 > 0:15:22that are already down there in your digestive system.

0:15:23 > 0:15:25The prebiotic fibre we're going to test

0:15:25 > 0:15:29is one that's readily available in common veg.

0:15:29 > 0:15:30It's called inulin

0:15:30 > 0:15:34and it's found in leeks, onions, garlic, asparagus

0:15:34 > 0:15:36and Jerusalem artichokes.

0:15:38 > 0:15:42I got the inulin. Soup is the way to go, maybe some stir-fries.

0:15:42 > 0:15:44I don't know. I think variety's the thing, isn't it?

0:15:44 > 0:15:47I got kefir, which I've never heard of before.

0:15:47 > 0:15:49So, I'm interested to see what it tastes like.

0:15:49 > 0:15:51I got the yoghurt drink.

0:15:51 > 0:15:54The advert says that they did you good, so I tried them.

0:15:54 > 0:15:56I didn't notice any difference.

0:15:56 > 0:15:57So, that's why I'm doing this trial,

0:15:57 > 0:15:59because I want to know, do they work or not?

0:16:03 > 0:16:05Before our volunteers start the experiment,

0:16:05 > 0:16:08we're taking urine and stool samples

0:16:08 > 0:16:11which will allow us to test the volume and variety

0:16:11 > 0:16:13of their existing bacteria.

0:16:14 > 0:16:17In four weeks' time, we will test our volunteers again

0:16:17 > 0:16:19to see if there've been any changes to their guts.

0:16:28 > 0:16:31Many of us would like to be able to cut back on our calories,

0:16:31 > 0:16:33but we find it hard to do.

0:16:33 > 0:16:36GP Dr Zoe Williams has been investigating

0:16:36 > 0:16:40a surprising way to do this without even noticing.

0:16:43 > 0:16:45When it comes to keeping our weight in check,

0:16:45 > 0:16:48we naturally turn to diet and exercise,

0:16:48 > 0:16:52but intriguing research suggests that there may be an easier way.

0:16:52 > 0:16:56Surprisingly, getting enough sleep could make all the difference.

0:16:59 > 0:17:00On a cold, dark night,

0:17:00 > 0:17:03we've invited four volunteers into the Kent countryside.

0:17:03 > 0:17:06We're going to test a recent research claim

0:17:06 > 0:17:11that suggests the amount they sleep will affect how much they eat.

0:17:11 > 0:17:13So, we're giving them something that will keep them up all night.

0:17:16 > 0:17:17Oh, my God!

0:17:17 > 0:17:19The hairs!

0:17:21 > 0:17:23Oh, it's holding my finger, look.

0:17:28 > 0:17:31These pretend babies are designed to cry a lot.

0:17:31 > 0:17:33I can't do it!

0:17:33 > 0:17:37We've told our volunteers that we're looking into sleep,

0:17:37 > 0:17:40so they have no idea that we're really going to measure

0:17:40 > 0:17:43how their lack of sleep affects their food intake.

0:17:45 > 0:17:47I'm going to be watching their progress with sleep expert

0:17:47 > 0:17:50Dr Denise Robertson from the University of Surrey.

0:17:51 > 0:17:54Sleep interacts with every other aspect of your life.

0:17:54 > 0:17:58So, sleep is going to affect your ability to make good food choices,

0:17:58 > 0:18:01your ability to, sort of, resist snacks.

0:18:04 > 0:18:06It's bedtime for our volunteers.

0:18:07 > 0:18:09But not for long.

0:18:09 > 0:18:10BABY CRYING

0:18:17 > 0:18:21A bad night's sleep disrupts two key hormones that play a role in hunger.

0:18:21 > 0:18:25One, we heard about earlier in programme, ghrelin.

0:18:25 > 0:18:27You see an increase in ghrelin.

0:18:27 > 0:18:31And ghrelin is a hormone that's been linked to food intake.

0:18:31 > 0:18:32It drives your hunger.

0:18:32 > 0:18:35The other has the opposite effect, signalling when we're full.

0:18:35 > 0:18:37It's called leptin.

0:18:37 > 0:18:40At the same time, you'd see a suppression of leptin

0:18:40 > 0:18:43and leptin is a satiety signal.

0:18:43 > 0:18:46- OK.- So the combination of hunger going up, satiety going down,

0:18:46 > 0:18:49you'd expect them to feel physically more hungry.

0:18:51 > 0:18:53The morning after the night before.

0:18:54 > 0:18:57This is the thirstiest baby in the world.

0:18:59 > 0:19:03I've had, maybe, three or four hours' sleep.

0:19:10 > 0:19:14For breakfast, we laid on a spread of healthy and not-so-healthy foods.

0:19:15 > 0:19:17Look, the granola's going down well.

0:19:17 > 0:19:19- Yeah.- And the pastries are very popular.

0:19:19 > 0:19:22What you would expect is things like pain au chocolat, for example,

0:19:22 > 0:19:24because it's high-fat, it's high sugar,

0:19:24 > 0:19:28you could almost expect to see them going back for seconds or thirds

0:19:28 > 0:19:29if they were sleep deprived.

0:19:29 > 0:19:31Rather than hitting the bananas and the apples.

0:19:31 > 0:19:34As a comparison, we also gave our volunteers a night

0:19:34 > 0:19:36of normal, undisturbed sleep

0:19:36 > 0:19:39and, again, in the morning, counted the calories.

0:19:39 > 0:19:42Knowing the calorie content of each food,

0:19:42 > 0:19:45Denise is using our footage to tot up each person's total.

0:19:45 > 0:19:48And it's time for the results.

0:19:48 > 0:19:50Hi, guys. It's good news.

0:19:50 > 0:19:52You're all very good parents, except for one person.

0:19:54 > 0:19:56- Ronan.- We knew it!

0:19:56 > 0:19:58But we're not really interested in that,

0:19:58 > 0:20:01because that's not really what we were looking at, at all.

0:20:01 > 0:20:04They were actually monitoring how much you ate.

0:20:04 > 0:20:08Because we're interested to know if the amount of sleep you get

0:20:08 > 0:20:10affects how much food you put on your plate.

0:20:10 > 0:20:15- Mm.- OK.- And what we found is Ellie and Bertie, you had quite a...

0:20:15 > 0:20:16quite a difference in your sleep.

0:20:16 > 0:20:19You were losing three and a half or four hours.

0:20:19 > 0:20:24You did respond to the sleep loss, actually, you ate considerably more.

0:20:24 > 0:20:26You just let yourself go for it.

0:20:26 > 0:20:31Overall, Ellie ate 57 calories more at breakfast when she was tired.

0:20:31 > 0:20:34While Bertie ate 108 calories more.

0:20:34 > 0:20:36Eating 100 extra calories every day

0:20:36 > 0:20:40is enough to make you put on 5kg in weight over a year.

0:20:40 > 0:20:44Ronan barely slept a wink and whilst he didn't eat more,

0:20:44 > 0:20:47he did choose more sugary foods.

0:20:47 > 0:20:50But the person who got the most sleep responded rather differently.

0:20:50 > 0:20:53Howie, you managed to sleep quite well.

0:20:53 > 0:20:54- Yeah.- Even with the baby.

0:20:54 > 0:20:56- I was.- You just ignored her.

0:20:56 > 0:20:59No, I didn't ignore her.

0:21:01 > 0:21:03Interestingly, after his good night's sleep,

0:21:03 > 0:21:06Howie's eating habits were unaffected.

0:21:06 > 0:21:10These experiences are consistent with an analysis by King's College London

0:21:10 > 0:21:15that reviewed dozens of smaller studies involving sleep and appetite.

0:21:15 > 0:21:18It showed that although not everyone is affected in the same way,

0:21:18 > 0:21:21on average, getting less than seven hours of sleep night led to people

0:21:21 > 0:21:23eating significantly more overall.

0:21:24 > 0:21:27These guys are going to go back home where they don't have babies.

0:21:27 > 0:21:29What can they do to make sure that they have a good night's sleep?

0:21:29 > 0:21:32You would have blackout blinds.

0:21:32 > 0:21:34You would make sure the room wasn't too hot.

0:21:34 > 0:21:39You'd want to take out the laptop, the tablet, the mobile phone.

0:21:39 > 0:21:41I guess one way of thinking about it

0:21:41 > 0:21:45is that the bedroom is for two things and two things only.

0:21:45 > 0:21:46One of those is sleep and...

0:21:46 > 0:21:49You can probably work out the other one.

0:21:49 > 0:21:51Although Ronan looks confused.

0:21:55 > 0:21:57So, if you're struggling with your weight,

0:21:57 > 0:21:59then it's well worth considering not just your diet and exercise,

0:21:59 > 0:22:03though they're important, but also think about how much sleep you're getting.

0:22:03 > 0:22:05Aim for at least seven hours per night

0:22:05 > 0:22:07and not only will you feel better,

0:22:07 > 0:22:10but you'll be more able to resist those sugary treats.

0:22:12 > 0:22:15For information on how to get a better night's sleep, visit...

0:22:26 > 0:22:29Lots of you have been sending in your health questions.

0:22:29 > 0:22:32And we've been getting you answers.

0:22:32 > 0:22:35What is gout and what can I do to avoid it?

0:22:39 > 0:22:42Gout is actually a form of arthritis

0:22:42 > 0:22:43causing pain in the joints,

0:22:43 > 0:22:45and it's on the increase,

0:22:45 > 0:22:49thought to be due to an ageing population and rising obesity.

0:22:49 > 0:22:53It currently affects around a million people in the UK.

0:22:54 > 0:22:56Gout can affect any joint,

0:22:56 > 0:22:59but typically it starts here, in the big toe.

0:22:59 > 0:23:03Now, what causes it is the build-up of a substance called uric acid.

0:23:04 > 0:23:06And if your kidneys don't clear it,

0:23:06 > 0:23:10then you get deposition of crystals in the joints.

0:23:10 > 0:23:13And that's what causes all the pain and inflammation.

0:23:14 > 0:23:17But research has shown that there are things

0:23:17 > 0:23:20you can do to help avoid developing it.

0:23:20 > 0:23:22Now, gout is associated with being overweight,

0:23:22 > 0:23:24which is perhaps why it's becoming more common.

0:23:24 > 0:23:28The particularly bad form of fat is the visceral fat

0:23:28 > 0:23:32you get around your gut, which seems to block the clearance of uric acid.

0:23:32 > 0:23:34The good news is, if you lose weight

0:23:34 > 0:23:37then you'll see a rapid improvement in your gout.

0:23:39 > 0:23:41But there are also specific foods and drinks to avoid

0:23:41 > 0:23:43if you're prone to gout.

0:23:43 > 0:23:47Any drinks with lots of sugar, even fruit juices, are out.

0:23:47 > 0:23:52Instead, you should drink plenty of good old-fashioned water.

0:23:53 > 0:23:56Alcohol can raise uric acid levels too.

0:23:56 > 0:24:00And some foods contain a high level of proteins called purines,

0:24:00 > 0:24:02which our body breaks down into uric acid.

0:24:03 > 0:24:06Red meats and poultry are OK in moderation,

0:24:06 > 0:24:09but it's best to avoid seafood and gamey meat.

0:24:10 > 0:24:13On the other hand, skimmed milk, water and low-fat yoghurt

0:24:13 > 0:24:15actually seem to help.

0:24:15 > 0:24:18Along with plenty of fruit and veg, of course.

0:24:19 > 0:24:23If you do develop gout in a joint, rest and ice can help.

0:24:23 > 0:24:26Anti-inflammatories, like ibuprofen or naproxen,

0:24:26 > 0:24:29can reduce inflammation and pain.

0:24:29 > 0:24:31Aspirin's OK in low doses,

0:24:31 > 0:24:34but if you're taking more than 75mg a day,

0:24:34 > 0:24:37it can actually increase your uric acid levels.

0:24:37 > 0:24:40Your GP can give more advice and treatment options.

0:24:41 > 0:24:44Your doctor may decide to inject your joint with steroids

0:24:44 > 0:24:48or perhaps give you medication to balance out the uric acid levels.

0:24:48 > 0:24:52Either way, hopefully it'll get you back on your feet and pain-free.

0:25:01 > 0:25:04Now and again, a new bit of technology emerges

0:25:04 > 0:25:08in a completely unrelated field, like engineering or design,

0:25:08 > 0:25:11which has the potential to transform an area of medicine.

0:25:11 > 0:25:15Surgeon Gabriel Weston has been following one such story

0:25:15 > 0:25:19and has witnessed an operation, the first of its kind in the UK.

0:25:21 > 0:25:26Edward Evans had always been a keen sportsman and coach.

0:25:26 > 0:25:29But one day, seven years ago, when he was 54,

0:25:29 > 0:25:33he began to experience a pain that would change his life.

0:25:33 > 0:25:37I come down on most Sundays to watch my sons play rugby,

0:25:37 > 0:25:39and on this particular Sunday,

0:25:39 > 0:25:43I started to feel a dull ache in the centre of the chest.

0:25:43 > 0:25:49What Edward was feeling was a rare infection that had taken hold in his sternum -

0:25:49 > 0:25:52the bone at the centre of his ribcage.

0:25:52 > 0:25:54This made him extremely unwell.

0:25:55 > 0:25:59Doctors had no option to remove his sternum.

0:25:59 > 0:26:02Replacing it with an implant wasn't an option at the time

0:26:02 > 0:26:07because any foreign body inserted when Edward was already so ill

0:26:07 > 0:26:09carried a high risk of further infection.

0:26:10 > 0:26:16All the surgeons could do was cover the gap with some of Edward's own muscle,

0:26:16 > 0:26:19leaving his heart and lungs so vulnerable

0:26:19 > 0:26:21that a blow to his chest could be fatal.

0:26:23 > 0:26:25I was playing five-a-side up until that point,

0:26:25 > 0:26:27teaching the boys to play rugby on and off.

0:26:28 > 0:26:30So, that... Stopped doing that.

0:26:30 > 0:26:31And I miss it.

0:26:34 > 0:26:36I like to keep active.

0:26:36 > 0:26:38I want to keep fit. I want to cycle, I want to walk.

0:26:39 > 0:26:43In my mind, there's a massive correlation

0:26:43 > 0:26:48between keeping fit and feeling strong and feeling old.

0:26:49 > 0:26:52Edward could continue to live without a sternum,

0:26:52 > 0:26:56but his vulnerability is limiting his quality of life.

0:26:57 > 0:27:00Over time, his body has recovered from the infection,

0:27:00 > 0:27:03which means that surgery would be less risky.

0:27:03 > 0:27:07And he's been offered a new kind of implant

0:27:07 > 0:27:09that's never been tried in the UK.

0:27:09 > 0:27:13Normally, the only option for people like this

0:27:13 > 0:27:16would be an implant made out of mesh and cement.

0:27:16 > 0:27:20But what Edward's about to receive is completely different.

0:27:20 > 0:27:24It's a titanium sternum made especially for him

0:27:24 > 0:27:28and 3-D printed on the other side of the world.

0:27:30 > 0:27:32CT scans of Edward's chest

0:27:32 > 0:27:36have been sent to Anatomics in Melbourne, Australia.

0:27:36 > 0:27:40World leaders in the design and production

0:27:40 > 0:27:42of bespoke surgical implants.

0:27:42 > 0:27:45Their designs are loaded into the 3-D printer

0:27:45 > 0:27:48which has a chamber filled with powdered titanium

0:27:48 > 0:27:53and an electron beam which fuses the particles together, layer by layer.

0:27:55 > 0:27:58And now, it has printed Edward's new sternum.

0:28:00 > 0:28:02The loose powder is blown away,

0:28:02 > 0:28:04revealing the implant for the first time.

0:28:06 > 0:28:10The titanium is light, strong and rigid,

0:28:10 > 0:28:13and less susceptible to infection than cement.

0:28:16 > 0:28:18The finished sternum will be implanted

0:28:18 > 0:28:21at the Heartlands Hospital in Birmingham,

0:28:21 > 0:28:23by thoracic surgeon Mr Ehab Bishay.

0:28:24 > 0:28:28They, in fact, have reconstructed the defect

0:28:28 > 0:28:30to match completely what we took out.

0:28:30 > 0:28:33It will protect the underlying structures.

0:28:33 > 0:28:35The thing that we cannot tell you is

0:28:35 > 0:28:38whether it will improve your lung function,

0:28:38 > 0:28:40the mechanics of your breathing.

0:28:40 > 0:28:42- OK.- You're a pioneer.

0:28:43 > 0:28:48And hopefully, you'll show the advantages of something like that.

0:28:51 > 0:28:55The procedure begins with the plastic surgeon, Mr Khalil,

0:28:55 > 0:28:59taking down the muscle flap that was used to cover the defect

0:28:59 > 0:29:00several years ago.

0:29:01 > 0:29:05The structures that these gentlemen are operating up against

0:29:05 > 0:29:08are the very structures which keep us all alive.

0:29:09 > 0:29:11What Mr Khalil has already found

0:29:11 > 0:29:15is that the muscle has become very thin,

0:29:15 > 0:29:18so he's coming to the lung much more quickly than he'd anticipated.

0:29:20 > 0:29:22Once Mr Khalil is finished,

0:29:22 > 0:29:25Mr Bishay will perform the delicate task

0:29:25 > 0:29:27of fitting the new sternum into place.

0:29:27 > 0:29:31Normally, we would have to mould the cement ourselves, by hand,

0:29:31 > 0:29:35handling it. So, the risk of infection is increased.

0:29:35 > 0:29:38Here, you've got some that's ready-made, should slot in.

0:29:38 > 0:29:39You might not see that today,

0:29:39 > 0:29:42because, obviously, this is our first time using this technique,

0:29:42 > 0:29:44but I have faith in the fact

0:29:44 > 0:29:46that it's been reconstructed so precisely.

0:29:50 > 0:29:53In order for Mr Bishay to get the outside of the implant

0:29:53 > 0:29:56going over each rib head,

0:29:56 > 0:29:59he's had to ask his anaesthetic colleague

0:29:59 > 0:30:01to deflate the lung on purpose.

0:30:04 > 0:30:08Now, the implant will be tried in situ for the first time.

0:30:10 > 0:30:14There's an enormous amount of surgical skill and adjustment

0:30:14 > 0:30:17that comes into play, trying to make it perfectly fit,

0:30:17 > 0:30:20where it will hopefully stay for the rest of Edward's life.

0:30:26 > 0:30:27OK.

0:30:27 > 0:30:31At last, the perfect fit is achieved.

0:30:31 > 0:30:34It's an amazing thing to see and it's now just for Mr Bishay

0:30:34 > 0:30:36to fix it there with screws.

0:30:40 > 0:30:42Although the operation has gone smoothly,

0:30:42 > 0:30:47it remains to be seen how well the implant will function for Edward.

0:30:52 > 0:30:54Several weeks later,

0:30:54 > 0:30:58Edward has recovered from the procedure and it's time to find out.

0:31:01 > 0:31:02Throughout this process,

0:31:02 > 0:31:07Dr Nicola Oswald has been using motion capture and cameras

0:31:07 > 0:31:10to monitor Edward's breathing and movement.

0:31:10 > 0:31:13Past 100. Well done, keep going.

0:31:13 > 0:31:17So, has the implant made any difference?

0:31:17 > 0:31:19This was before surgery.

0:31:19 > 0:31:22And you can see when he takes a breath in,

0:31:22 > 0:31:26that the ribcage moves in rather than moving out, like you expect,

0:31:26 > 0:31:31- taking a deep breath.- How does that compare with the one after surgery?

0:31:33 > 0:31:36The overall shape of the chest looks more normal.

0:31:36 > 0:31:38Then when he takes a deep breath in there,

0:31:38 > 0:31:43the ribcage moves out in time with him breathing in and then back in,

0:31:43 > 0:31:44in time with him breathing out.

0:31:44 > 0:31:46So, it's gone back into synchrony again.

0:31:47 > 0:31:52These results are extremely encouraging and could pave the way

0:31:52 > 0:31:55towards even larger and more complicated implants.

0:31:58 > 0:32:02So, what's the main difference for you, Edward, now compared to before?

0:32:02 > 0:32:04I feel confident now.

0:32:05 > 0:32:08It feels like, probably, how I felt when my chest was...

0:32:08 > 0:32:10was normal.

0:32:10 > 0:32:14Whatever I do, simple or difficult, you know,

0:32:14 > 0:32:16I feel better doing it.

0:32:16 > 0:32:20I can fall over with confidence, basically.

0:32:20 > 0:32:21That's the truth!

0:32:34 > 0:32:38Coming up - how to spot an asthma attack and save a life.

0:32:38 > 0:32:43And can decaffeinated coffee actually be bad for you?

0:32:43 > 0:32:45But first...

0:32:45 > 0:32:49Four weeks ago, we started an experiment in Inverness to see if

0:32:49 > 0:32:51probiotic products are really the best way

0:32:51 > 0:32:54to improve the mix of healthy bacteria in your gut.

0:32:54 > 0:32:5830 volunteers have been trying one of the three options.

0:32:58 > 0:33:02Our first group have been taking a market-leading probiotic yoghurt drink.

0:33:02 > 0:33:06These drinks are formulated to contain one or two specific types

0:33:06 > 0:33:10of bacteria that manufacturers know to be beneficial.

0:33:10 > 0:33:12I was taking probiotic yoghurt.

0:33:12 > 0:33:13And how was that for you?

0:33:13 > 0:33:16Personally, I thought my health improved.

0:33:16 > 0:33:20Our second group have been taking a traditional drink called kefir,

0:33:20 > 0:33:23made by fermenting milk, which makes it naturally full of different types

0:33:23 > 0:33:25of live bacteria.

0:33:25 > 0:33:28It was quite an acquired taste to begin with, because it's very sour.

0:33:28 > 0:33:29But I got used to that.

0:33:29 > 0:33:33And our third group have been on what's called a prebiotic diet,

0:33:33 > 0:33:36rich in the type of fibre called inulin,

0:33:36 > 0:33:40thought to boost the good bacteria already in our gut.

0:33:40 > 0:33:42It was fine. It was a bit of a challenge on some days.

0:33:42 > 0:33:45I love leeks, I love artichokes, I love asparagus,

0:33:45 > 0:33:47but there's only so much you can eat in a day.

0:33:48 > 0:33:53Dr Adele Costabile now has the delightful job of analysing

0:33:53 > 0:33:55our volunteers' stool samples.

0:33:55 > 0:33:58This will reveal whether any of our methods have improved the mix of

0:33:58 > 0:34:01bacteria in our volunteers' guts.

0:34:01 > 0:34:03First, the probiotic yoghurt.

0:34:05 > 0:34:09This group saw a promising change in the levels of bacteria that had

0:34:09 > 0:34:10been linked to obesity.

0:34:10 > 0:34:12This is consistent with other,

0:34:12 > 0:34:15bigger studies that suggest a range of benefits,

0:34:15 > 0:34:18particularly in treating specific gut conditions.

0:34:19 > 0:34:24Next, the group who were on the diet rich in the fibre inulin.

0:34:24 > 0:34:26In our trial,

0:34:26 > 0:34:30this group saw a rise in one bacteria type known to be good for

0:34:30 > 0:34:32maintaining gut health.

0:34:32 > 0:34:36And this again is consistent with other studies that have shown inulin

0:34:36 > 0:34:38to be beneficial.

0:34:38 > 0:34:41But our most significant result was in the group

0:34:41 > 0:34:44taking the fermented milk drink, kefir.

0:34:44 > 0:34:49We saw for this group differences between before and after

0:34:49 > 0:34:51the four weeks' treatment.

0:34:51 > 0:34:54We saw a beneficial effect.

0:34:54 > 0:34:58Basically, the good guys down there in your gut,

0:34:58 > 0:35:01they were different compared with the beginning.

0:35:01 > 0:35:03This is something promising.

0:35:03 > 0:35:07Our kefir group saw a rise in a whole family of bacteria

0:35:07 > 0:35:09called lactobacillus.

0:35:09 > 0:35:12These bacteria are thought to be good for general gut health

0:35:12 > 0:35:15and they're known to help certain conditions,

0:35:15 > 0:35:18including traveller's diarrhoea and lactose intolerance.

0:35:20 > 0:35:24So, in our trial, amazingly, it was the fermented drink, kefir,

0:35:24 > 0:35:27that most of our volunteers had never even heard of before,

0:35:27 > 0:35:31that actually caused the most changes to their gut bacteria.

0:35:31 > 0:35:34I would actively be interested in trying the kefir drink,

0:35:34 > 0:35:36just to see the results of that.

0:35:36 > 0:35:38Andy, were you surprised by the results of the kefir?

0:35:38 > 0:35:42The fact that it was this fermented drink with maybe quite a variety

0:35:42 > 0:35:45of bacteria made me think it would have an affect.

0:35:47 > 0:35:49Now, the kefir was such a clear winner in our test

0:35:49 > 0:35:51that we want to find out more.

0:35:51 > 0:35:55What makes it so full of healthy bacteria, and are there other foods

0:35:55 > 0:35:57like it we should all be eating?

0:35:58 > 0:36:00This smells really nice.

0:36:00 > 0:36:02More on that later in the programme.

0:36:14 > 0:36:16The winter months can play havoc with our health.

0:36:16 > 0:36:21Colds, flu, joint pain and even heart attacks are more common.

0:36:21 > 0:36:24But is it also messing with our minds,

0:36:24 > 0:36:26giving us the winter blues?

0:36:26 > 0:36:31SAD, seasonal affective disorder, is also known as winter depression,

0:36:31 > 0:36:33but tends to come on during the winter months.

0:36:33 > 0:36:38Now, common symptoms include tiredness, low mood,

0:36:38 > 0:36:41a craving for carbs and weight gain.

0:36:41 > 0:36:44In some cases, it leads to severe depression.

0:36:46 > 0:36:50SAD was first recognised in the early 1980s.

0:36:50 > 0:36:54Since then, it has become an accepted medical condition

0:36:54 > 0:36:57and it makes the headlines most winters.

0:36:57 > 0:37:00A recent survey found a third of us think we might suffer from it.

0:37:01 > 0:37:03So, how do you know if you've got it?

0:37:03 > 0:37:05How do you treat it?

0:37:05 > 0:37:08Should I worry about SAD?

0:37:09 > 0:37:12Personally, I've not thought much about SAD,

0:37:12 > 0:37:15since I'm pretty sure it's something I've never experienced.

0:37:15 > 0:37:18But I'm putting that assumption to the test.

0:37:18 > 0:37:22I'm having my SAD potential assessed by Dr Brenda McMullen,

0:37:22 > 0:37:28a neurobiologist and psychiatrist from Copenhagen University Hospital.

0:37:28 > 0:37:29I start with a questionnaire,

0:37:29 > 0:37:33the basis of most mental health assessments.

0:37:33 > 0:37:36This asks about my mood and behaviour through the year.

0:37:36 > 0:37:38For a full diagnosis,

0:37:38 > 0:37:42it would usually be followed by an interview with a psychiatrist.

0:37:42 > 0:37:43So, what do my answers reveal?

0:37:45 > 0:37:49You mention in this that you have changes in all of the items that

0:37:49 > 0:37:52we look for in a person who suffers from seasonal affective disorder.

0:37:52 > 0:37:56So you say here you've experienced changes in the length of your sleep,

0:37:56 > 0:37:59in your appetite, in your weight,

0:37:59 > 0:38:02in your social activity and in your energy levels.

0:38:02 > 0:38:08It seems like you are feeling the best in August and July and you are

0:38:08 > 0:38:13feeling worse, gaining most weight, sleeping most in December.

0:38:13 > 0:38:16Yes. I was surprised when I started to fill it in,

0:38:16 > 0:38:18I started to realise I probably...

0:38:18 > 0:38:21I do have shades of seasonal affective disorder,

0:38:21 > 0:38:25which is something I hadn't really thought about before.

0:38:25 > 0:38:28Where would I fall in terms of the average, do you think?

0:38:28 > 0:38:31You are worse off than average.

0:38:31 > 0:38:33It's 11.

0:38:33 > 0:38:34A maximum of 24.

0:38:34 > 0:38:36So, you're in the middle range,

0:38:36 > 0:38:39but on average is probably closer to six or seven.

0:38:39 > 0:38:41How common is it?

0:38:41 > 0:38:43Seasonal affective disorder is not something

0:38:43 > 0:38:45that you either definitely have or do not have.

0:38:45 > 0:38:47It is a spectrum.

0:38:47 > 0:38:50So, many people would have some degree of seasonality,

0:38:50 > 0:38:52but not being depressed at all.

0:38:52 > 0:38:56And you would have probably 5% having a depression

0:38:56 > 0:38:59and maybe 5% having no symptoms at all.

0:39:00 > 0:39:04So, like a lot of people, I have some SAD symptoms.

0:39:04 > 0:39:08But I'm not amongst the small percentage who've been diagnosed

0:39:08 > 0:39:11with severe seasonal affective disorder.

0:39:11 > 0:39:14Those patients have been the subject of Brenda's research.

0:39:14 > 0:39:15Using brain scans,

0:39:15 > 0:39:18she noticed a difference in brain activity suggesting they were being

0:39:18 > 0:39:20deprived of serotonin,

0:39:20 > 0:39:25a chemical that is thought to regulate mood and appetite.

0:39:25 > 0:39:27Although we're not sure why this happens,

0:39:27 > 0:39:31it seems the seasons can affect us much more powerfully

0:39:31 > 0:39:32than I had realised.

0:39:32 > 0:39:34Now, that was a big surprise.

0:39:34 > 0:39:38I've known for a long time that I do not like dark, wet, wintry days,

0:39:38 > 0:39:41but I never imagined that I might have SAD.

0:39:41 > 0:39:45It certainly means I am intensely curious to find out more.

0:39:49 > 0:39:50To understand the condition better,

0:39:50 > 0:39:53I'm meeting Professor Anna Wirz-Justice

0:39:53 > 0:39:56from the University of Basel, Switzerland,

0:39:56 > 0:39:58who has been researching this condition for decades.

0:40:00 > 0:40:03So, what are the main theories about the causes of SAD?

0:40:03 > 0:40:06There are two aspects that are important.

0:40:06 > 0:40:10If we go back to basic biology of seasonality,

0:40:10 > 0:40:15it is the day length that triggers certain changes in physiology

0:40:15 > 0:40:16and behaviour.

0:40:16 > 0:40:19Hibernation in winter,

0:40:19 > 0:40:23adding weight, eating a lot more, sleeping longer.

0:40:23 > 0:40:26And the other one is that we don't get enough light

0:40:26 > 0:40:28to set the biological clock

0:40:28 > 0:40:31to synchronise our rhythms to 24 hours and, therefore,

0:40:31 > 0:40:33they drift later and later.

0:40:33 > 0:40:38And if you have a late clock, you are more vulnerable to depression.

0:40:38 > 0:40:40In what ways is light resetting the clock?

0:40:40 > 0:40:45The last 15 years has been a revolution in that a new kind of

0:40:45 > 0:40:49photoreceptor was found in the eye which is sensitive to light.

0:40:50 > 0:40:55These photoreceptors transmit directly to the biological clock

0:40:55 > 0:40:59in the brain - information that it's dawn or dusk,

0:40:59 > 0:41:01that it's light or dark.

0:41:01 > 0:41:02By having light in the morning,

0:41:02 > 0:41:06you are regularising all your rhythms in your body,

0:41:06 > 0:41:08they are all getting synchronised.

0:41:08 > 0:41:10Right, so it goes straight in there, just sort of...

0:41:10 > 0:41:13And goes, click! And says your biological clock is now awake

0:41:13 > 0:41:15and functioning.

0:41:15 > 0:41:18So, what sort of treatments are available for SAD?

0:41:18 > 0:41:22Light is the treatment of choice, of course.

0:41:22 > 0:41:25With or without antidepressants.

0:41:25 > 0:41:29And the third, the different psychological treatments.

0:41:29 > 0:41:33One of my main messages for anyone who suffers from the winter blues

0:41:33 > 0:41:35or from winter depression,

0:41:35 > 0:41:39is the easiest treatment would be a regular walk outside.

0:41:39 > 0:41:44Most of the studies show that light in the morning is better.

0:41:44 > 0:41:46So, if I just sit around my house,

0:41:46 > 0:41:49I'm not going to get it just from, sort of, overhead lighting

0:41:49 > 0:41:51- or things like that? - No, you are not.

0:41:51 > 0:41:54- You need special lamps. - You go outside.

0:41:54 > 0:41:56OK. It's cheaper.

0:41:56 > 0:41:58Is there any value in buying a light box?

0:41:58 > 0:42:01A light box is the most reliable method of treatment.

0:42:01 > 0:42:04You have it in your house and you sit in front of it

0:42:04 > 0:42:06for half an hour every day.

0:42:06 > 0:42:08So, have you seen a lot of lives transformed by light?

0:42:08 > 0:42:11A great many people.

0:42:11 > 0:42:14They finally have a diagnosis

0:42:14 > 0:42:18and they have a treatment that is fairly straightforward

0:42:18 > 0:42:21and it works rather quickly, within one or two weeks.

0:42:21 > 0:42:25And I think one of the important things for light therapy,

0:42:25 > 0:42:29you are treating yourself before you sink really into

0:42:29 > 0:42:31this winter depression.

0:42:33 > 0:42:36Speaking to our experts has been a real eye-opener.

0:42:36 > 0:42:40I was surprised to discover there was a spectrum of winter depression

0:42:40 > 0:42:42on which we might all find ourselves.

0:42:43 > 0:42:45So, should I worry about SAD?

0:42:45 > 0:42:47Well, it turns out I should.

0:42:47 > 0:42:50And should you worry about it? Well, that depends on whether

0:42:50 > 0:42:53you regularly get the winter blues or not.

0:42:53 > 0:42:56If you do, then the answer is simple.

0:42:56 > 0:42:58Light. Go out for a morning stroll,

0:42:58 > 0:43:00and it's important it is done in the morning,

0:43:00 > 0:43:03or invest in a light box.

0:43:03 > 0:43:05For more information,

0:43:05 > 0:43:09go to the Trust Me website where you can also try a questionnaire

0:43:09 > 0:43:11to see if you have any symptoms

0:43:11 > 0:43:13of seasonal affective disorder.

0:43:22 > 0:43:25If you do have health questions you've always wanted answered,

0:43:25 > 0:43:28then do send them to us via our website.

0:43:35 > 0:43:38I've heard that decaf coffee is full of the chemical

0:43:38 > 0:43:41used in the removal process, so it's best avoided.

0:43:41 > 0:43:43Is this true?

0:43:45 > 0:43:49These days, people are turning away from traditional coffee

0:43:49 > 0:43:51to decaffeinated options instead.

0:43:51 > 0:43:54Even in the case of posh coffees, like this one.

0:43:54 > 0:43:57And that's because some of them think that it is a healthier option.

0:43:57 > 0:43:59But is it?

0:43:59 > 0:44:03The first thing to look into is how decaf coffee is made.

0:44:03 > 0:44:06There have been reports in the media claiming that some of the methods

0:44:06 > 0:44:08used to remove the caffeine

0:44:08 > 0:44:10involved substances that are actually bad for us.

0:44:10 > 0:44:13All decaffeination methods start with this.

0:44:13 > 0:44:16The green, or unroasted coffee bean.

0:44:17 > 0:44:21Most methods use water to get the caffeine out of the bean.

0:44:21 > 0:44:23Then a chemical solvent is often used

0:44:23 > 0:44:26to get the caffeine out of the water.

0:44:26 > 0:44:30The solvent is then removed and the remaining water is dried off.

0:44:30 > 0:44:33There are two possible chemical solvents that can be used

0:44:33 > 0:44:37in this process - both of them, technically speaking, toxic.

0:44:37 > 0:44:38But by the time the process is complete,

0:44:38 > 0:44:42they're found at such vanishingly low levels that they are below

0:44:42 > 0:44:44the European regulated safe limit.

0:44:44 > 0:44:46But to avoid any solvents,

0:44:46 > 0:44:49there are other methods that some manufacturers use

0:44:49 > 0:44:50to remove the caffeine.

0:44:50 > 0:44:53One alternative uses a charcoal filter.

0:44:53 > 0:44:57Another uses carbon dioxide at extremely high pressures.

0:44:57 > 0:45:00So, you can choose solvent-free coffee if you want.

0:45:00 > 0:45:03But there's not any evidence that it's actually healthier.

0:45:03 > 0:45:07Now, coffee aficionados will tell you at great length, of course,

0:45:07 > 0:45:10that the method used to decaffeinate coffee can affect the taste.

0:45:10 > 0:45:13So if you really worry about these things, then I would be guided by

0:45:13 > 0:45:15your taste buds and don't sweat about the methods

0:45:15 > 0:45:17used to produce the coffee.

0:45:17 > 0:45:20There is, however, something else that you should be aware of

0:45:20 > 0:45:22if you're thinking of going decaf.

0:45:22 > 0:45:25Your decaf may not contain any chemical nasties,

0:45:25 > 0:45:27but you might be surprised to know

0:45:27 > 0:45:30that it probably does contain some caffeine.

0:45:30 > 0:45:32A 2006 study conducted in Florida

0:45:32 > 0:45:35found that nine out of the ten decafs they tested

0:45:35 > 0:45:38had at least some caffeine in them.

0:45:38 > 0:45:42So, the two-shot decaf latte that you're drinking might contain

0:45:42 > 0:45:45as much caffeine as a can of Coke.

0:45:45 > 0:45:48For most of us, though, if you're worried about what your

0:45:48 > 0:45:50daily cuppa's doing to your health,

0:45:50 > 0:45:53there's something other than caffeine

0:45:53 > 0:45:55you might want to think about.

0:45:55 > 0:45:58A cup of black coffee is virtually calorie free.

0:45:58 > 0:46:01Add milk and sugar, it goes up to about 50 calories.

0:46:01 > 0:46:04But by the time you're looking at one of these, a giant mocha latte,

0:46:04 > 0:46:07it can be up to 500 calories.

0:46:07 > 0:46:10The same as a big burger or a large piece of cake.

0:46:10 > 0:46:11So, caffeinated or not,

0:46:11 > 0:46:14you can enjoy a small cup with an easy conscience.

0:46:14 > 0:46:16But treat this as a treat.

0:46:27 > 0:46:30Asthma is one of those things we associate with childhood,

0:46:30 > 0:46:33yet one in 12 adults are also affected.

0:46:33 > 0:46:36We think of it as mild, and yet it can be life-threatening.

0:46:36 > 0:46:38Which is why it is so important

0:46:38 > 0:46:41to be able to recognise the signs and the symptoms.

0:46:41 > 0:46:44Over to Dr Saleyha Ahsan.

0:46:46 > 0:46:51There are over 5.5 million people with asthma in the UK and every year

0:46:51 > 0:46:55around 1,000 of them will lose their lives to an asthma attack.

0:46:55 > 0:46:57But if more people knew the warning signs,

0:46:57 > 0:46:59some of these deaths could be prevented.

0:47:00 > 0:47:03My brother has had asthma all his life.

0:47:03 > 0:47:07My father got it as an adult and has needed intensive care.

0:47:07 > 0:47:11His brother, my uncle, died of it.

0:47:12 > 0:47:17That's why I'm so keen to talk about the signs and symptoms of asthma,

0:47:17 > 0:47:22so that people can spot a dangerous attack quickly and save lives.

0:47:25 > 0:47:27Asthma is a condition that affects the airways,

0:47:27 > 0:47:30the tubes that carry air in and out of the lungs.

0:47:31 > 0:47:33If these become irritated,

0:47:33 > 0:47:36that can lead to inflammation of the airways,

0:47:36 > 0:47:39the muscles tighten and the tubes narrow.

0:47:39 > 0:47:42And this causes shortness of breath, wheezing,

0:47:42 > 0:47:46and it can even lead to a life-threatening asthma attack,

0:47:46 > 0:47:48needing hospitalisation.

0:47:53 > 0:47:55We still don't know what causes asthma in the first place,

0:47:55 > 0:47:57but for those who have it,

0:47:57 > 0:47:59there are many things that can trigger an episode.

0:48:03 > 0:48:05And even emotions and stress.

0:48:08 > 0:48:12Another surprisingly common trigger is exercise.

0:48:12 > 0:48:16But despite that, doctors actually recommend it for asthma,

0:48:16 > 0:48:19especially swimming, as it can calm and regulate breathing.

0:48:19 > 0:48:22So, I've come to an outdoor swimming club in Kent.

0:48:23 > 0:48:26I dipped my toe in and the water's freezing.

0:48:26 > 0:48:28A few of the members here have asthma.

0:48:28 > 0:48:32Describing their experiences help others recognise the symptoms.

0:48:32 > 0:48:34It feels like a tightening in your chest.

0:48:34 > 0:48:36It doesn't matter how many times you breathe in,

0:48:36 > 0:48:38or how deeply you breathe in.

0:48:38 > 0:48:40It stops you sleeping, I cough a lot in the night.

0:48:40 > 0:48:43My breath shortens and I think I'm not getting the air out of my lungs

0:48:43 > 0:48:46and, therefore, I find it hard to get the air back in again.

0:48:49 > 0:48:51To show the non-sufferers in the group

0:48:51 > 0:48:52what asthma actually feels like,

0:48:52 > 0:48:56we've set up a demonstration with the help of Dr John Dickinson

0:48:56 > 0:48:59and a device that impedes your breathing

0:48:59 > 0:49:01in a way that mimics asthma.

0:49:01 > 0:49:03When the non-asthmatics put this in their mouth,

0:49:03 > 0:49:05they'll find it pretty easy to breathe in...

0:49:05 > 0:49:08- Yeah.- But they'll find it pretty hard to breathe out and that's

0:49:08 > 0:49:09what happens in asthma.

0:49:09 > 0:49:12Just think how long it takes to empty your lungs,

0:49:12 > 0:49:13think about that asthma response.

0:49:13 > 0:49:15You can see how easy it is to get panicky

0:49:15 > 0:49:18when you're feeling like that, to start hyperventilating.

0:49:18 > 0:49:20That's horrible.

0:49:20 > 0:49:22That is actually horrible, because you can't get breath out

0:49:22 > 0:49:25- and you're already wanting to breathe back in.- Exactly.

0:49:25 > 0:49:28Feel how much longer it takes to breathe out.

0:49:28 > 0:49:30- What did you think?- It's hideous.

0:49:30 > 0:49:32- Yeah.- It's horrible.

0:49:32 > 0:49:34That's using all your muscles.

0:49:34 > 0:49:36That's huge exercise.

0:49:38 > 0:49:39You all right?

0:49:39 > 0:49:41- Horrible.- Yeah.- Yeah.

0:49:41 > 0:49:45I'm having a lot of sympathy and empathy for you guys right now.

0:49:45 > 0:49:46I really am.

0:49:46 > 0:49:50'Anyone who has asthma should always carry an inhaler,

0:49:50 > 0:49:54'a spray containing a muscle relaxant to open up the airways

0:49:54 > 0:49:55'and ease breathing.

0:49:55 > 0:49:57'If you see someone struggling with asthma,

0:49:57 > 0:50:01'you can assist by keeping them calm because this can help bring

0:50:01 > 0:50:03'their breathing under control.

0:50:03 > 0:50:06'But sometimes, if the symptoms continue,

0:50:06 > 0:50:08'things can become much more serious.'

0:50:08 > 0:50:13Every ten seconds, someone is having a life-threatening asthma attack.

0:50:14 > 0:50:16So, what are the warning signs?

0:50:16 > 0:50:20The person is extremely breathless, perhaps struggling to speak.

0:50:20 > 0:50:23Their symptoms are getting worse.

0:50:23 > 0:50:26Their asthma inhaler isn't helping.

0:50:26 > 0:50:29Children may complain of a tummy ache.

0:50:29 > 0:50:32If an asthma attack continues untreated,

0:50:32 > 0:50:38the lack of oxygen can be fatal, but there are things you can do to help.

0:50:38 > 0:50:42So, if someone is having an asthma attack, follow these instructions.

0:50:42 > 0:50:45Keep them and yourself calm.

0:50:46 > 0:50:48Sit them upright.

0:50:48 > 0:50:51Make sure that you've located their inhaler.

0:50:51 > 0:50:57Get them to take one puff of their inhaler every 30 to 60 seconds.

0:50:57 > 0:51:01It can feel like a long time in between, but it's the right thing.

0:51:03 > 0:51:05Repeat up to a maximum of ten puffs.

0:51:05 > 0:51:07Take another puff of that, please.

0:51:09 > 0:51:11Excellent, well done.

0:51:11 > 0:51:13If they didn't have their inhaler with them on the day,

0:51:13 > 0:51:16- what would you do then? - Call 999 straightaway.

0:51:16 > 0:51:18You should also call an ambulance

0:51:18 > 0:51:21if they don't feel better after ten puffs, or if they're a child.

0:51:23 > 0:51:26If, in an extreme situation, the patient stops breathing

0:51:26 > 0:51:30and their heart stops, you must start CPR immediately

0:51:30 > 0:51:32and don't stop until the ambulance arrives.

0:51:34 > 0:51:36Nice and easy.

0:51:36 > 0:51:37Nice and calm.

0:51:37 > 0:51:39If you have asthma,

0:51:39 > 0:51:43learn to recognise your triggers and always carry your inhaler.

0:51:43 > 0:51:48Make a plan with your GP of what to do if you have an asthma attack.

0:51:48 > 0:51:50And for the rest of us,

0:51:50 > 0:51:54we should learn to recognise the warning signs of an asthma attack,

0:51:54 > 0:51:56particularly for children.

0:51:56 > 0:51:58Wheezing, shortness of breath,

0:51:58 > 0:52:01they are unable to finish a sentence without having to breathe,

0:52:01 > 0:52:05and sometimes children complain of a tummy ache.

0:52:05 > 0:52:08For a list of symptoms and more, check out...

0:52:21 > 0:52:23Earlier in the programme,

0:52:23 > 0:52:27we did a big experiment to test three different ways to boost

0:52:27 > 0:52:29the good bacteria in our gut.

0:52:29 > 0:52:33The surprise winner was a little-known drink called kefir,

0:52:33 > 0:52:34made by fermenting milk.

0:52:37 > 0:52:41Having discovered in our trial that fermented foods worked best,

0:52:41 > 0:52:44we wanted to look at the subject in greater depth.

0:52:44 > 0:52:48What exactly is going on when food is fermented, and should we all

0:52:48 > 0:52:51be eating more of these foods?

0:52:51 > 0:52:53To find out, I first need to take a closer look.

0:52:54 > 0:52:59Fermentation is the process by which bacteria and yeast turn carbohydrate

0:52:59 > 0:53:03into things like gases, acids and alcohol.

0:53:03 > 0:53:06Now, we are familiar with the idea you need micro-organisms to produce

0:53:06 > 0:53:10your beer and wine, but until fridges were invented,

0:53:10 > 0:53:13it was actually one of the main ways to preserve foods.

0:53:13 > 0:53:18Fermented foods include pickled vegetables, cheese, chutneys,

0:53:18 > 0:53:22sourdough bread, soy sauce and drinks like kefir.

0:53:22 > 0:53:26And it turns out, they're surprisingly good for us because

0:53:26 > 0:53:29the way they're made encourages the growth of helpful bacteria.

0:53:34 > 0:53:39Anna, Simon and Gabba all regularly make fermented foods and drinks

0:53:39 > 0:53:41using traditional methods.

0:53:41 > 0:53:45Today, Anna is making some soft cheese and Kombucha,

0:53:45 > 0:53:47a fermented tea-based drink.

0:53:47 > 0:53:49I'm using the culture to make it.

0:53:49 > 0:53:53Simon is making sauerkraut - preserved white cabbage -

0:53:53 > 0:53:57and kefir, the milk-based drink that did so well in our trial.

0:53:57 > 0:54:00You just get these grains. Put them in with milk.

0:54:00 > 0:54:03And Gabba is making kimchi,

0:54:03 > 0:54:06a traditional Korean dish of fermented vegetables.

0:54:06 > 0:54:08When you try it, it's just fire!

0:54:10 > 0:54:11There are different methods,

0:54:11 > 0:54:14but a common one is to chop up vegetables and leave them

0:54:14 > 0:54:16in a salty liquid.

0:54:18 > 0:54:21Over time, the salt kills off the bad bacteria,

0:54:21 > 0:54:25allowing good bugs like lactobacillus to thrive.

0:54:28 > 0:54:32These bacteria produce lactic acid which preserves the vegetables

0:54:32 > 0:54:35and gives the food its distinctive flavour and aroma.

0:54:36 > 0:54:39Polish Korean kimchi. Here we go. Here.

0:54:42 > 0:54:44- Spicy.- It's spicy.

0:54:44 > 0:54:46Whaa... Ooh!

0:54:46 > 0:54:49But if you don't have time to ferment at home,

0:54:49 > 0:54:52these foods are increasingly available in supermarkets.

0:54:52 > 0:54:56I want to see how the amount of healthy bacteria in them compares.

0:54:56 > 0:54:59What we're going to do is we going to take these home-made fermented

0:54:59 > 0:55:02foods and we're also going to get the shop-bought equivalent.

0:55:02 > 0:55:06We're going to send them all off to a laboratory to be analysed.

0:55:06 > 0:55:07Now, I know which I prefer,

0:55:07 > 0:55:11from the point of view of smell, taste and texture,

0:55:11 > 0:55:15but it will be extremely interesting to see how the bacterial content

0:55:15 > 0:55:19of these foods compare to those which you can buy in the shops.

0:55:19 > 0:55:24Scientists at the University of Roehampton have placed samples from

0:55:24 > 0:55:26each product on petri dishes

0:55:26 > 0:55:29and are painstakingly counting any helpful bacteria that grow.

0:55:31 > 0:55:32To discuss the result,

0:55:32 > 0:55:36we brought in the leading expert in fermented food and gut bacteria,

0:55:36 > 0:55:41Dr Paul Cotter from the Teagasc Food Research Centre in Cork.

0:55:42 > 0:55:43So, what are the results showing?

0:55:43 > 0:55:48So, in the kimchi, the sauerkraut, cheese, kefir and Kombucha,

0:55:48 > 0:55:50from the home-made products in the blue,

0:55:50 > 0:55:52you're seeing quite high levels of bacteria,

0:55:52 > 0:55:55particularly lactobacillus bacteria.

0:55:55 > 0:55:57And in a commercially sourced products, you're only seeing

0:55:57 > 0:56:00those lactobacillus present in the kefir and Kombucha.

0:56:00 > 0:56:04These commercial providers presumably used a more traditional

0:56:04 > 0:56:07fermented food processing or preparation.

0:56:07 > 0:56:11Some commercially-produced foods will be pasteurised in order

0:56:11 > 0:56:13to make sure they're safe and to give them a long shelf life,

0:56:13 > 0:56:16But during that process, you're also killing the good bacteria

0:56:16 > 0:56:17along the way.

0:56:17 > 0:56:20Is there much evidence that lactobacillus, if you take it in

0:56:20 > 0:56:23the form of a preserved food, is actually good for your health?

0:56:23 > 0:56:26It depends on which lactobacillus are present.

0:56:26 > 0:56:30There are many different species and even within a particular species,

0:56:30 > 0:56:33there are different strains, some of which have good properties and others which don't.

0:56:33 > 0:56:36And I suppose that's why, in the case of probiotics,

0:56:36 > 0:56:39people will have studied an individual strain and know a lot about it.

0:56:39 > 0:56:42But by eating a fermented food with lots of different varieties,

0:56:42 > 0:56:46at least there's a chance that some of them in there will be good for you.

0:56:46 > 0:56:50So, for general good gut health and to acquire a range of helpful

0:56:50 > 0:56:54bacteria, fermented foods are an excellent way forward.

0:56:54 > 0:56:58And our tests suggest that you'll find more of these helpful bacteria

0:56:58 > 0:57:00in traditionally-made fermented foods.

0:57:00 > 0:57:02But if you want to make your own,

0:57:02 > 0:57:04then do follow a recipe and make sure your hands,

0:57:04 > 0:57:07jars and raw ingredients are clean.

0:57:07 > 0:57:10I think the key thing if you are making it at home is it's safe and

0:57:10 > 0:57:14you're not encouraging the growth of disease-causing or spoilage microbes.

0:57:14 > 0:57:19So, you need to have good-quality raw material, you need to have a recipe,

0:57:19 > 0:57:21correct ingredients,

0:57:21 > 0:57:24follow the recipe so that you're not storing it too long

0:57:24 > 0:57:26or at the wrong temperature.

0:57:26 > 0:57:28And I think in those circumstances,

0:57:28 > 0:57:30you can't go too far wrong.

0:57:33 > 0:57:35The biome, the gut bacteria,

0:57:35 > 0:57:38is clearly a really hot area of research and there is obviously

0:57:38 > 0:57:40still an awful lot that we need to learn.

0:57:40 > 0:57:44That said, I am convinced that fermented foods are good for the gut.

0:57:44 > 0:57:49In fact, I am going to go home now and make my own kefir.

0:57:58 > 0:58:00That's it from Inverness.

0:58:00 > 0:58:03Next time, we're in Walsall, where we're doing a really fascinating

0:58:03 > 0:58:06experiment to find out what the best ways are for you

0:58:06 > 0:58:08to boost your metabolism.

0:58:08 > 0:58:13We'll also investigate a hidden danger lurking in your rice

0:58:13 > 0:58:17and ask, do we really need to push our bodies to the limit?

0:58:19 > 0:58:21# My voice just cooed

0:58:21 > 0:58:24# My mind let loose

0:58:24 > 0:58:27# Mm, Dr Love

0:58:31 > 0:58:33# Doctor, I want you

0:58:33 > 0:58:36# Ooh, Doctor Wanna Do

0:58:36 > 0:58:38# I can't get over you

0:58:38 > 0:58:41# Dr do anything that ya Wanna Do

0:58:41 > 0:58:44# Doctor, I want you

0:58:44 > 0:58:46# Mm, my Doctor Wanna Do

0:58:46 > 0:58:48# I can't get over you

0:58:48 > 0:58:50# Dr do anything that ya Wanna Do. #