Episode 3 Trust Me, I'm a Doctor


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When it comes to our health,

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it seems everyone has an opinion and everyone has an agenda.

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But 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 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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We listen to the questions you want answered.

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And ensure you get the information 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,

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the headlines and the health claims.

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This is Trust Me, I'm A Doctor.

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Welcome to Liverpool.

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We're here to do a hugely ambitious experiment with

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Liverpool John Moores University, all about fish oils.

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Now, we know that fish oil is good for us,

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but what's the best way of getting it in our bodies?

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We'll also find out whether the plastics in food packaging

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are poisoning us.

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Why your sex affects how much fat you should eat.

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Basically, what we're saying is that women are better.

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We'll discover how this little patch could be the future

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of brain trauma treatment.

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How to spot the symptoms of an illness that can leave you blind.

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And how to overcome motion sickness.

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I think I'm going to go green, soon.

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But first, we're always hearing about how important

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omega-3 is for our health. Particularly our heart.

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And to make sure we get enough, we're encouraged to eat oily fish

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or take fish oil supplements.

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But how much difference do either of them really make to our health?

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Later on, we'll be doing a big experiment to find out.

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But before we start, Doctor Chris van Tulleken

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is going to take a closer look at supplements.

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The government recommends that we eat fish at least twice a week,

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with one portion being an oily fish like salmon or mackerel.

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However, in the UK, we don't eat anything like enough oily fish.

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It may be that people don't like the taste or the smell or perhaps they

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just don't know how to cook it, but, at any rate,

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lots of people prefer the convenience of fish oil supplements.

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These colourful capsules are one of Britain's best selling supplements.

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In 2010, we forked out about £140 million on them.

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But here on Trust Me, we know that you don't always

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get what you pay for.

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So, we've decided to put these popular pills to the test,

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to see if they're worthy of our hard-earned cash.

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Do they really contain what they say they do,

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and can they match the benefits that come from eating real fish?

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Oily fish are recommended because, well,

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people who eat them seem to live a bit longer,

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and that's because the fish are packed with nutrients,

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including omega-3 fatty acids.

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And these fish oils are meant to have a range of benefits,

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including preventing heart disease.

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Omega-3s help maintain healthy levels of fat

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in our blood and prevent blood clots.

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They're also a natural anti-inflammatory.

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But our bodies don't produce them,

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so we need to get them from external sources like certain plant oils,

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oily fish or supplements.

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There are different types of omega-3,

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but the two key ones for human health from fish

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are called EPA and DHA.

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Different health organisations suggest our combined daily intake of

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these fats should total between 200 and 450 mg.

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Popular supplements claim to meet this level, but do they?

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We're going to find out if the fish oil supplements contain what they

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say they do, especially those key fats, EPA and DHA, and we're going

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to test how fresh the oil in the supplements is,

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because rancid oil is not good.

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So, we've taken ten popular fish oil supplements

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and sent them to a lab for testing.

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The tests were carried out by Doctor Cristina Legido-Quigley

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from King's College London.

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The first thing we measured

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-was the amount of EPA and DHA in the supplements.

-OK.

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And it is thought that we should be eating from 200 to 450mg daily.

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And was there enough EPA and DHA in these tablets?

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-Yes. Here you have at least 200mg with all of the supplements.

-OK.

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So, this line is the 200 mg and all of them managed

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-to just get over that line?

-Yes.

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Our second test looked at whether the oil in the supplements

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had oxidised or gone rancid.

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We found that one of the supplements had values of oxidation

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-way above the limit.

-Was that because it had gone out of date?

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No, it still had 11 months to go.

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So, despite having 11 months left on its best-before date,

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one supplement we tested had gone rancid.

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All kinds of things can cause this over time, such as exposure to air,

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heat and light. So even if oil is good when it was manufactured,

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it could go rancid by the time you take it.

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There's evidence that rancid oils are bad for our health.

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And we also know that when oil oxidises, it starts breaking down.

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With fish oil supplements,

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that means the EPA and DHA are chemically altered,

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reducing the supposed benefits they provide.

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Finally, we ran a price comparison on the products we tested and the

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variation is shocking.

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So, you can see here that you could get

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your yearly amount for only £13.

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-For £13...

-£13.

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..you can get your whole year's worth with this brand?

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-Yes, that's right.

-Then what was the most?

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So, we have here this one, which would be more than £300 a year.

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So, the price difference ranges

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-from £13 a year to £304 a year?

-Mm-hmm.

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And it's exactly the same chemical constituents

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-in terms of the fats in the pills?

-Yes.

-Amazing.

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So, our tests showed that at least one of the supplements

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contained spoiled oil but, overall,

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the brands contained acceptable levels of EPA and DHA,

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albeit at wildly different prices.

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So, if you are going to buy fish oil supplements,

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there are a few things you can do to maximise your chances

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of getting the best from them.

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Look for accreditation badges, like this.

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Fish oils aren't medically regulated,

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but companies which seek accreditation

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are likely to have robust quality control in place.

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Make sure you check the label so you can choose a supplement

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with the longest possible shelf life.

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And store the supplements in a cool, dry, dark place,

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to minimise the chance of spoilage.

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Now, you might be convinced that the supplement that you take

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is a good one, but I'm afraid the jury is still very much out

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about whether or not fish oil supplements

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have the same health benefits as fresh fish,

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something we're pretty sure is good for you.

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But that is exactly the kind of thing that we like to put to

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the test on Trust Me, so that's what we're doing later -

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putting fish oil supplements and fresh fish head-to-head.

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Many of us are familiar with travel sickness,

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the scourge of family holidays, but what can you do about it?

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Over to Dr Saleyha Ahsan.

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I suffer from motion sickness myself and I dread situations like this.

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Travel sickness occurs when the brain receives conflicting messages

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from the eyes, which see motion,

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and the inner ear, which senses motion.

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The resulting confusion can cause various symptoms.

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The main symptoms of travel sickness that most of us will recognise are

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general feeling of discomfort, nausea and even vomiting,

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and some people might even experience headache,

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dizziness and cold sweats.

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So, what can you do about it?

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Over-the-counter medications like Hyoscine and antihistamines

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have good evidence behind them.

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But there's a drawback.

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They've both got side-effects.

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A common one is drowsiness.

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So, are there any drug-free alternatives?

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When I can't drink anything else, I can drink ginger ale.

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Many people swear by ginger,

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which has been used to prevent nausea for over 2,000 years,

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whereas others find acupressure bracelets helpful.

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But currently, there isn't strong evidence to prove that either works

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for motion sickness.

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I was told that if you're on a boat, if you look at the...

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keep focused on the horizon, that helps, but

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it's very difficult when you're going up and down

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and up and down!

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Looking at something stable, like the horizon, can help,

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by synchronising your vision and your movement.

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And studies have also shown that distracting yourself with music

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can make a difference.

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If, like me, you suffer from motion sickness,

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then it's worth trying all these techniques,

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but I've come across a recent report that suggests another technique

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that's easy, drug-free, effective and won't cost you a penny.

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I'm off to the University of Westminster to learn this trick from

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Professor John Golding.

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First, we have to establish my baseline level

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of motion sickness with this bizarre-looking chair.

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There's a sick bag here, which has never been used.

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I might be the first.

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This chair, combined with the instructions I'm following,

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is designed to take me to different levels of sickness.

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-ELECTRONIC VOICE:

-Rate symptoms.

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Two.

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Back.

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Return.

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Left.

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Return.

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-I feel sick.

-Right.

-OK, stop.

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Now that we've established the level at which I start feeling sick,

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John's going to talk me through a simple technique that might help me

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cope better next time.

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What's involved is gaining control,

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conscious control, of your breathing.

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The best way to do it is to understand what your

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natural frequency is,

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and then learn how to actually maintain that frequency.

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Why does that work and how does it work?

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There's a hard-wired reflex, or defence reflex,

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between respiration and nausea and vomiting,

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which means if I'm breathing, I'm not going to vomit, and equally,

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if I'm vomiting I'm going to close my breathing off.

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So, once I've worked out what my rhythm is,

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I've just got to focus on that and keep that going, is that right?

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Yes. Now it's up to you.

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OK, best of luck.

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Controlling your breathing while travelling isn't as easy

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as it sounds, as motion can disrupt your natural rhythm.

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But John's work suggests that maintaining that natural rhythm,

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despite the motion, can reduce nausea.

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Forward.

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Return.

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Just concentrate on your breathing.

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-Breath nice and steadily.

-Back.

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-Rate symptoms.

-One.

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One, OK.

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A few rounds in and my symptoms rating's already stayed lower

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for longer.

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-Rate symptoms.

-Two.

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Two, OK, doing fine.

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-Left.

-I feel sick.

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OK, keep your head upright, as still as possible.

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By the time I actually feel sick,

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I've lasted quite a bit longer than I did last time.

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-The breathing did help...

-Yeah.

-..because I focused on it,

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actually, and it did calm me down.

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Don't forget, it's a severe challenge.

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Under milder conditions,

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the breathing might be just enough to stave things off.

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If you suffer from travel sickness,

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I'd say it's well worth giving this breathing technique a go.

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As always,

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you can find more information on our website.

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Come back in an hour.

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I might be normal then.

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There's no shortage of advice in the media about the best ways to boost

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your immune system,

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but is any of this advice worth paying attention to?

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Over to surgeon Gabriel Weston.

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It's almost impossible these days to get away from products that,

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it's claimed, can boost our immune system,

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but I've always been a bit suspicious of such claims.

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Mostly because we're talking about one of the most complex aspects of

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the human body.

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The immune system is vastly complicated,

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consisting of hundreds of different kinds of cells that all do different

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jobs, whether recognising foreign invaders, carrying messages,

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devouring known bacteria or learning how to fight new enemies.

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To gain a rare view into this diverse system,

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I've come to Glasgow University.

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Professors Iain McInnes and Paul Garside

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are studying one of the key types of immune cell,

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white blood cells, using a laser microscope.

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It's actually very difficult to look at the immune system at work.

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Cardiologists can watch the heart beat with an echocardiogram.

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I don't have that immunological stethoscope, if you like,

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to really get into the detail of what the cells are doing.

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Think about somebody who develops glandular fever, for example.

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Within three or four days of getting that viral infection,

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they will generate in the order of seven billion cells.

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That's not far short of the world's total population.

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And that's why Paul and I have been working together to try and develop

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imaging techniques that allow us to see white blood cells in

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the real time, doing their job.

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Wow, so, not just white blood cells on a glass slide,

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but actually kind of in their dynamic function.

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Absolutely.

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This technology can reveal individual cells

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moving in real time.

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These are just two of the hundreds of cell types in the immune system.

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The green cells gather information and pass it on to the red cells,

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which will respond if needed.

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When the system is activated,

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you can see these interactions intensify.

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-It's amazing to see...

-Yeah, no, it's very exciting.

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-..the cells actually moving like that.

-Yeah, it's great fun.

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Isn't it? Really, really interesting.

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I think one of the most important things is how dynamic

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the immune system is,

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that the cells of your immune system move and talk to each other

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and they also all have conversations with the tissues within which they

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reside, so they will talk to the cells in your skin

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or the cells in your gut, and it's that integrated.

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And that's incredibly complex and we're only just beginning to scratch

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the surface of that.

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Because of this astonishing complexity,

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it's incredibly difficult to measure whether anything that's described as

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boosting the immune system can really make a difference.

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So, what do we know?

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To stay healthy, we need to get enough vitamins and minerals,

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and some studies have suggested that if we're deficient in, say,

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zinc or vitamin C,

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it can have a harmful effect on our immune response.

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But for most of us, that doesn't mean we need to take supplements.

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The truth is, if we're eating healthily,

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the vast majority of us will get all the vitamins and minerals we need in

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our diet and there's simply no evidence to suggest that taking

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extra amounts will enhance our disease-fighting powers.

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Studies have also looked at whether herbs, like Echinacea,

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can help our immune system,

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but there isn't yet enough good evidence to back up this connection.

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Probiotic products have also been linked to immune health,

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but the European Food Safety Authority has ruled that they can't

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claim to improve immune function,

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because of a lack of scientific proof.

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But there's something else that bothers me about all this.

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Even if we could boost our immune systems,

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is that something we really want to be doing?

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It seems to me that by concentrating so much on boosting,

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we're missing a vital point about the immune system -

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the importance of balance.

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There are as many off switches in the immune system

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as there are on switches.

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We tend to think of the on switches mainly,

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but those off switches are important.

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If they fail, overactive immunity could become a problem.

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That's where the immune system becomes confused and attacks our own

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tissues instead of invading organisms and germs.

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So, a healthy immune system is one that sits in balance.

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It's poised and ready to go.

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Think of a catapult.

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It's as if the elastic is pulled back and ready just to be released.

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That's how the immune system is set in health.

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What would you advise your kids or your wife or your relatives, if they

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said to you, "I really want to make sure that my immune function

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"is absolutely tiptop?" What would you say?

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I think the normal vitamins and minerals that we all take

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in a healthy, balanced diet are what you need.

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It's balance in your diet,

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it's balance in your lifestyle, and that balances your immune system.

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So, no quick fix magic wand waving, then?

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Not as far as I'm concerned, no.

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We're learning more about the immune system all the time,

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but there's still so much to discover.

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And its complexity means that it's unlikely to respond to any kind of

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quick fix.

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The immune system isn't a single entity,

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and to function properly it needs

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all of its elements to work together in perfect balance,

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so until there is some solid evidence that taking supplements can

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help us with this,

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I'm certainly not going to be wasting my money on any so-called

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immune-boosting products.

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Earlier on, Chris tested ten popular fish oil supplements and found that

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even the cheapest ones contain

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the levels of healthy omega-3 fats they claimed.

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But do the benefits of eating omega-3 really justify the hype?

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And if so, are supplements as effective as eating real fish?

0:18:500:18:54

To find out, we're setting up an experiment

0:18:540:18:56

with 60 people in Liverpool.

0:18:560:18:58

Our volunteers are going to start an eight-week trial,

0:18:590:19:02

testing the benefits of eating fresh fish versus supplements.

0:19:020:19:07

We're going to split our volunteers into three groups.

0:19:090:19:12

Group One will eat oily fish, like salmon or mackerel, twice weekly.

0:19:120:19:17

Group Two will take a supplement that, over the week,

0:19:170:19:19

will provide them with

0:19:190:19:21

the same amount of omega-3 as the oily fish group.

0:19:210:19:23

Our groups will be taking high

0:19:240:19:26

but safe levels of omega-3 fats to improve

0:19:260:19:29

the chances of seeing any changes in our eight-week study.

0:19:290:19:32

The third group will take a dummy pill

0:19:320:19:35

and they'll eat white fish,

0:19:350:19:37

which actually contains very little omega-3.

0:19:370:19:40

So, while they think they're getting omega-3,

0:19:400:19:42

they're actually our placebo group.

0:19:420:19:44

Before they start, we're doing a range of tests,

0:19:470:19:49

and one of the key things

0:19:490:19:51

we're looking at is something called the omega-3 index.

0:19:510:19:55

This is a measure of the levels of EPA and DHA in their blood.

0:19:550:20:00

It tells us what percentage of the fat in their cells

0:20:000:20:03

is actually made up of these health-boosting omega-3 fats.

0:20:030:20:07

A low omega-3 index is linked with an increased risk of heart attack,

0:20:090:20:13

stroke and diabetes.

0:20:130:20:15

At the end of the experiment,

0:20:150:20:17

we'll repeat all the tests and see if either the fish group or the

0:20:170:20:20

supplement-takers have seen any improvement.

0:20:200:20:23

Results coming up later in the programme.

0:20:230:20:25

If you have a burning health question

0:20:340:20:36

you've always wanted answered,

0:20:360:20:38

why not send it to us via the Trust Me website?

0:20:380:20:40

I'd like to know if there is a cure for restless leg syndrome.

0:20:460:20:50

Restless leg syndrome isn't jiggling your legs about when you're sitting,

0:20:520:20:55

it's very different.

0:20:550:20:57

To those who have experienced it, it's unmistakable and unpleasant.

0:20:570:21:00

Many of us have experienced a strange sensation

0:21:040:21:07

when we're resting, usually at night.

0:21:070:21:09

It's an irresistible urge to move your legs,

0:21:090:21:13

often accompanied by unpleasant feelings

0:21:130:21:15

like a crawling sensation under the skin.

0:21:150:21:17

Getting up and walking relieves it,

0:21:170:21:19

but it really disrupts sleep, bringing with it tiredness,

0:21:190:21:22

irritability and all the things that go with insomnia.

0:21:220:21:26

It's thought that one in ten people in the UK will suffer from

0:21:270:21:30

restless leg syndrome at some point in their life.

0:21:300:21:33

Research is still trying to pin down what causes it.

0:21:330:21:36

There's some evidence that it can be alleviated by drugs that boost the

0:21:370:21:40

level of a chemical in the brain

0:21:400:21:42

called dopamine, which affects movement.

0:21:420:21:45

Now, there are drugs you can take that boost dopamine levels, and they

0:21:450:21:47

can actually relieve symptoms or get rid of them completely,

0:21:470:21:50

but only for a while.

0:21:500:21:52

The problem with these drugs

0:21:520:21:53

is your body adapts and, so, within two years,

0:21:530:21:56

about a third of people will see their symptoms return.

0:21:560:21:58

If you are taking medication,

0:22:000:22:02

it's worth remembering that symptoms can suddenly disappear naturally,

0:22:020:22:06

so it's a good idea to take breaks from drug treatment to see if your

0:22:060:22:09

symptoms have cleared up on their own.

0:22:090:22:11

And recent research might account for why women are twice as likely

0:22:130:22:17

to suffer from it as men.

0:22:170:22:18

It seems that some sufferers may have low iron levels

0:22:180:22:21

in the parts of the brain

0:22:210:22:22

that control movement, and that these low iron levels may be due

0:22:220:22:26

to low iron levels in the blood overall.

0:22:260:22:28

And that might explain why restless leg syndrome is more common

0:22:280:22:31

when women become pregnant,

0:22:310:22:33

because they can become anaemic at the same time.

0:22:330:22:35

So, if you are a sufferer, it's worth going to your doctor,

0:22:350:22:37

getting a blood test, checking those iron levels and seeing if you need

0:22:370:22:41

a supplement.

0:22:410:22:43

Iron supplements must be prescribed by a doctor,

0:22:430:22:46

because it's important to get the levels just right.

0:22:460:22:49

But if your symptoms are mild enough, other things might help.

0:22:490:22:52

First, try to get a bit more exercise.

0:22:520:22:54

There's some evidence that that can help some sufferers.

0:22:540:22:57

Secondly, try and do everything you can to establish a regular sleeping

0:22:570:23:01

pattern, cutting down on caffeine and other stimulants at night.

0:23:010:23:04

But if your symptoms are really disrupting your sleep,

0:23:040:23:07

do make an appointment to go and see your doctor.

0:23:070:23:09

From time to time, most of us will eat far more

0:23:190:23:21

than we should in the way of fatty and sugary foods.

0:23:210:23:24

New research, however, suggest that overindulgence affects

0:23:240:23:28

men and women differently.

0:23:280:23:30

GP Dr Zoe Williams

0:23:300:23:32

has bravely volunteered herself as a subject to find out more.

0:23:320:23:36

As we saw earlier,

0:23:370:23:38

healthy fats and oils are an essential part of our diet,

0:23:380:23:42

but fat shouldn't make up more than about 30% of what we eat.

0:23:420:23:46

We all know that too much fat can cause issues with our weight

0:23:470:23:50

and our heart health.

0:23:500:23:52

But a new problem that's only just coming to light is that eating a lot

0:23:530:23:57

of fat can also affect how our bodies process other foods,

0:23:570:24:00

in particular, carbohydrates.

0:24:000:24:02

Scientists here at Liverpool are finding that just how bad it is may

0:24:040:24:08

be different depending on whether you're a man or a woman.

0:24:080:24:13

To find out more, I've come to meet the scientist behind the research,

0:24:130:24:17

Dr Matt Cocks of Liverpool John Moores University.

0:24:170:24:20

He's going to put both himself and me on a high-fat diet for a week,

0:24:200:24:25

to reveal how men and women differ.

0:24:250:24:27

This is for the whole week?

0:24:280:24:29

Yeah. So, this is your food for the week.

0:24:290:24:32

Everything you see on here, you need to eat.

0:24:320:24:34

-OK. Could've been worse.

-HE CHUCKLES

0:24:340:24:38

I see there's a lot of fat on the meat,

0:24:380:24:40

which I wouldn't normally eat the fat on the meat.

0:24:400:24:42

Fat's denser, more energy dense,

0:24:420:24:44

so you're actually going to eat maybe less food than you expected,

0:24:440:24:47

despite the fact you've got more calories.

0:24:470:24:50

There isn't a single fruit on there.

0:24:500:24:52

-This is literally it?

-This is it.

0:24:520:24:54

-We'll see how it goes.

-Yeah, we will.

-Give it my best shot.

0:24:540:24:59

Matt's been investigating how eating a diet high in fat, like this,

0:24:590:25:03

affects our ability to process carbs.

0:25:030:25:06

Carb-rich foods like bread and pasta

0:25:060:25:08

cause our blood sugar levels to rise, and that sugar is normally

0:25:080:25:12

either used as energy or stored as fat.

0:25:120:25:14

But Matt believes that eating a lot of fat interferes with these

0:25:150:25:20

processes, and causes the sugar to stay in our blood for longer,

0:25:200:25:22

which can be harmful and lead to type 2 diabetes.

0:25:220:25:26

So, while we're on our high-fat diet,

0:25:260:25:29

we'll have an occasional sugary drink, which will allow Matt to

0:25:290:25:31

measure what happens to our blood sugar levels.

0:25:310:25:35

Before the diet starts, a scanner measures our body fat.

0:25:350:25:39

Blood tests measure our blood sugar levels..

0:25:390:25:41

..and we'll wear a glucose monitor, so Matt can track how well

0:25:430:25:45

we control our blood sugar through the week.

0:25:450:25:49

Day three. Dinner time.

0:25:490:25:51

Over the next week, Matt and I gorge ourselves on fatty foods.

0:25:510:25:56

Really, really missing fruit.

0:25:560:25:58

And on two different days, we throw in a sugary drink.

0:25:580:26:02

I'm having my first sugar high!

0:26:020:26:03

One week later...

0:26:050:26:06

-Hi, Matt.

-How are you feeling?

0:26:060:26:08

..I'm back to see what impact the diet has had on our bodies.

0:26:080:26:12

173.

0:26:120:26:13

And whether there could be differences between men and women.

0:26:130:26:16

First, body fat.

0:26:170:26:19

Here, there's not much change.

0:26:190:26:22

Seven days eating all that fat hasn't made a significant difference

0:26:220:26:25

to the total body fat in either of us.

0:26:250:26:28

And this is what Matt has found in his previous research.

0:26:310:26:34

But things get really interesting when we look at how our bodies coped

0:26:350:26:39

with consuming sugar.

0:26:390:26:41

Like most women in Matt's research,

0:26:410:26:43

my ability to control my blood sugar levels didn't get any worse,

0:26:430:26:47

in fact, unusually, mine got slightly better.

0:26:470:26:50

But that's not the case with Matt.

0:26:500:26:53

When I finished the high-fat diet, so seven days later,

0:26:530:26:56

my control of blood sugar is actually...got 50% worse

0:26:560:27:00

than it was to start with.

0:27:000:27:02

-50%, wow.

-So...yeah, not good for me.

0:27:020:27:05

So, what that means is...

0:27:050:27:07

we need our bodies to deal with sugar in the blood

0:27:070:27:10

very quickly, to get rid of it because we don't want it to be

0:27:100:27:13

-there...

-Yeah.

-..and yours is only dealing with it half as well.

0:27:130:27:15

Yeah, that's what we seem to be saying.

0:27:150:27:17

Matt's response was extreme,

0:27:170:27:19

but his wider research confirms that men are significantly worse than

0:27:190:27:23

women at coping with high sugar levels when they eat lots of fat.

0:27:230:27:27

It does seem that, particularly if a man is having a very high-fat

0:27:270:27:30

diet, if they have sugar within that,

0:27:300:27:33

it could have a negative effect,

0:27:330:27:34

whereas maybe with the women who are on a high-fat diet,

0:27:340:27:37

it might be slightly less of a...

0:27:370:27:40

a kind of a bad thing to have that sugar every now and then.

0:27:400:27:43

OK, so, basically, what we're saying is that women are better.

0:27:430:27:46

It looks like it.

0:27:460:27:48

Our experiment is in line with Matt's wider research,

0:27:500:27:54

which reveals that eating a lot of fat has a significant effect on

0:27:540:27:58

men's ability to keep their blood sugar under control.

0:27:580:28:01

A key step in the development of type 2 diabetes.

0:28:010:28:04

So, what can you do about it?

0:28:060:28:08

Well, the best advice is don't overindulge in fatty foods.

0:28:080:28:13

If you do eat a lot of fat,

0:28:130:28:15

try to avoid eating carbs in the six hours afterwards,

0:28:150:28:18

as this is when the impact on your blood sugar is worst.

0:28:180:28:21

Be sparing with meals that combine a lot of fat with carbs,

0:28:220:28:25

like burger and chips or pizza.

0:28:250:28:27

But if you can't resist the urge, do some exercise after the meal,

0:28:300:28:33

because this will help use up the excess sugar

0:28:330:28:35

that's in your bloodstream.

0:28:350:28:37

Even just going for a walk can help open up those blood vessels,

0:28:370:28:41

which helps the glucose get to the muscles where it can be used.

0:28:410:28:44

And that might help to prevent long-lasting damage.

0:28:440:28:47

Coming up, the red flags we should all learn to recognise

0:28:550:28:58

that could save our eyesight.

0:28:580:29:00

And we reveal our fishy findings.

0:29:000:29:03

But first...

0:29:040:29:05

Previously on Trust Me,

0:29:070:29:09

we tested the effects of microwave cooking on vegetables,

0:29:090:29:12

and concluded it may actually be better than other cooking methods

0:29:120:29:16

at preserving some of the nutrients.

0:29:160:29:18

But some viewers spotted something that bothered them

0:29:180:29:21

in our cooking method.

0:29:210:29:23

Some of you wanted to know if it's safe to use clingfilm

0:29:230:29:27

in the microwave and, in particular,

0:29:270:29:29

if there's any danger of chemicals leaching out

0:29:290:29:32

and contaminating your food.

0:29:320:29:34

We thought this was well worth investigating,

0:29:340:29:37

so we decided to put some clingfilms to the test.

0:29:370:29:40

Plastics contain many different chemicals.

0:29:420:29:45

In fact, there are over 900 that are approved for use in food packaging,

0:29:450:29:50

and some of these can be tested to see if they migrate into our food.

0:29:500:29:54

So, we sent some PVC clingfilm labelled microwave-safe

0:29:550:29:59

to Dr Emma Bradley and her team at a laboratory

0:29:590:30:02

that specialises in this kind of testing.

0:30:020:30:05

Our PVC clingfilm contained a common chemical called ESBO,

0:30:060:30:11

which is made of soy bean oil.

0:30:110:30:13

Now, it's a plasticiser, and what that means is that it's

0:30:130:30:17

responsible for keeping the clingfilm flexible and stretchy.

0:30:170:30:21

ESBO is a good example of a chemical

0:30:230:30:25

that lab tests have shown can migrate into food.

0:30:250:30:29

So we wanted to see if it did this under cooking conditions

0:30:290:30:32

that replicated the worst possible real-life contact.

0:30:320:30:36

ESBO dissolves into fat,

0:30:360:30:40

so the scientists tested the clingfilm

0:30:400:30:42

with a couple of particularly fatty foodstuffs.

0:30:420:30:45

First, they microwaved it with spaghetti carbonara.

0:30:460:30:50

Then, for the ultimate test, they soaked it in olive oil,

0:30:500:30:54

another very fatty substance, before heating it.

0:30:540:30:58

And now we have the results.

0:30:580:30:59

In our first test,

0:31:020:31:03

when the clingfilm was microwaved with the carbonara,

0:31:030:31:07

there were no detectable levels of ESBO in the food.

0:31:070:31:11

But in our second test, when we heated the clingfilm with olive oil,

0:31:110:31:15

there were small amounts of ESBO in the olive oil.

0:31:150:31:19

But these levels were in line with legal limits.

0:31:190:31:22

Food safety authorities in Ireland

0:31:230:31:26

and North America advise not to

0:31:260:31:28

allow cling-film to touch food

0:31:280:31:30

when you're cooking, though the UK doesn't.

0:31:300:31:32

And interestingly, there seems to be no particular advantage in choosing

0:31:320:31:36

microwave-safe clingfilm.

0:31:360:31:38

If the packaging has no specific labelling,

0:31:380:31:41

it will have been tested to make sure it is safe for use in all

0:31:410:31:44

foreseeable kinds of contact with food.

0:31:440:31:46

So, if you do want to use clingfilm in your microwave,

0:31:480:31:51

rest assured that our tests didn't find anything

0:31:510:31:54

that breached EU limits.

0:31:540:31:56

But bear in mind one important rule when you're cooking -

0:31:560:32:00

keep your clingfilm and your food separate to minimise any risk

0:32:000:32:05

of chemicals leaching into your dinner.

0:32:050:32:07

I've been a medical journalist for many years.

0:32:180:32:21

Stories I've seen about plastics aren't limited to clingfilm

0:32:210:32:25

and microwaves.

0:32:250:32:26

Concern about plastics and the harm they might be doing us

0:32:260:32:29

is a much broader issue than that.

0:32:290:32:31

Plastic is everywhere.

0:32:320:32:34

A lot of our food comes wrapped in plastic.

0:32:340:32:37

Even things like tin cans have plastic lining.

0:32:370:32:42

Now, a lot of people have contacted us because they are concerned,

0:32:420:32:46

so I want to find out what, if anything,

0:32:460:32:48

is coming out of plastic into our food,

0:32:480:32:51

what effect is it having on our health,

0:32:510:32:54

should I worry about plastic?

0:32:540:32:57

Two chemicals you may have heard about are Bisphenol A, or BPA,

0:32:570:33:02

found in plastic food containers, and phthalates,

0:33:020:33:05

which help make plastic flexible.

0:33:050:33:07

Small amounts of these chemicals can migrate

0:33:090:33:12

from plastics into food and drink.

0:33:120:33:14

I wanted to find out how much is getting into me.

0:33:140:33:18

I sent off a urine sample so we could measure my levels of BPA

0:33:180:33:23

and phthalates.

0:33:230:33:24

Then I fasted for 24 hours and sent another sample, to see if avoiding

0:33:260:33:31

exposure to plastics in food made any difference.

0:33:310:33:34

After that, I ate a meal full of processed food,

0:33:350:33:38

that's been in close contact with plastics.

0:33:380:33:41

Not making me feel good. This is not what I would normally eat.

0:33:410:33:44

And then we measured my levels again.

0:33:440:33:47

What we found was that my levels dropped after my fast and rose again

0:33:470:33:52

after my meal, which shows that some of these chemicals are getting into

0:33:520:33:56

my body from my food and drink.

0:33:560:33:58

And this is true for all of us.

0:33:590:34:00

In fact, my baseline levels were in line with the UK average.

0:34:000:34:04

So, should we be worried?

0:34:050:34:08

I sent the results to two plastics experts with very different views.

0:34:080:34:12

Professor Andreas Kortenkamp, from Brunel University,

0:34:120:34:16

has some concerns about the chemicals in plastics.

0:34:160:34:19

The two things we've been looking at were

0:34:190:34:23

BPA and phthalates.

0:34:230:34:25

Why? What it is about them that worries you?

0:34:250:34:28

The levels you carry around with you are not dangerous,

0:34:280:34:32

but what we need to bear in mind is that some people,

0:34:320:34:35

for reasons we don't quite understand,

0:34:350:34:38

have very much higher levels

0:34:380:34:40

-and it is these who we need to protect.

-OK.

0:34:400:34:43

A different story is pregnant women.

0:34:430:34:45

It wouldn't be problematic for the women themselves,

0:34:450:34:49

but if they have a baby, it might be.

0:34:490:34:52

So, why is the foetus particularly at risk?

0:34:520:34:55

In foetal life, we have a roll of hormones.

0:34:550:34:58

Hormones programme development.

0:34:580:35:01

And phthalates interfere with this programming step.

0:35:010:35:04

They block, they drive down the synthesis

0:35:040:35:06

of the male sex hormone, so very relevant to male sexual development.

0:35:060:35:12

And we must be very careful

0:35:120:35:14

with any chemicals we are exposing mothers to

0:35:140:35:17

that might actually affect this programming.

0:35:170:35:20

But there are committees who exist to pore over the data, to make

0:35:200:35:24

judgments, to protect the public.

0:35:240:35:27

Do you think they're not doing their job?

0:35:270:35:28

The committees are doing their job, but what's missing

0:35:280:35:32

is a more effective implementation of measures.

0:35:320:35:35

But we haven't considered one other element.

0:35:350:35:38

We have a cocktail issue here.

0:35:380:35:41

What you define as tolerable exposure

0:35:410:35:43

for one chemical in isolation

0:35:430:35:45

will change as you take into account all the others.

0:35:450:35:49

The good news is that, currently,

0:35:490:35:51

there are moves ahead at the level of the

0:35:510:35:54

European Food Safety Authority,

0:35:540:35:56

to begin to think about ways how this can be done.

0:35:560:35:58

-Beginning to think?

-Yes.

0:35:580:36:00

OK, right.

0:36:000:36:01

So you don't accept the argument that science has progressed to

0:36:010:36:04

such a degree that

0:36:040:36:05

these sort of mistakes that we've seen in the past, with chemicals

0:36:050:36:10

where they're deemed to be safe and then they turned out not to be safe,

0:36:100:36:13

-that's just not going to happen?

-No, I don't think so.

0:36:130:36:16

So... Also, you see, our ability to evaluate

0:36:160:36:20

these chemicals properly, toxicologically,

0:36:200:36:23

cannot keep pace with the speed

0:36:230:36:26

with which industry turns out new chemicals and uses them.

0:36:260:36:30

So, the only option is better regulation.

0:36:300:36:33

For example, by restricting the use

0:36:330:36:36

of certain of these plasticiser chemicals in plastics.

0:36:360:36:40

I personally believe that we,

0:36:400:36:42

in the future, we won't be able to live without plastics,

0:36:420:36:45

so we have to make that safe.

0:36:450:36:46

My next expert is Dr Nick Plant,

0:36:490:36:51

a toxicologist at the University of Surrey.

0:36:510:36:54

He's part of the committee of toxicity

0:36:540:36:56

that advises on safe levels of these chemicals.

0:36:560:37:01

How do you assess the safety of these chemicals?

0:37:010:37:05

The really important tests are those done in animal models,

0:37:050:37:09

because they allow us to look at the whole-body effects of chemicals.

0:37:090:37:12

So, traditionally, what we do is to test these chemicals at a range

0:37:120:37:16

of doses. We would identify the level that you can give

0:37:160:37:20

to an animal that has no adverse effects,

0:37:200:37:23

no side-effects. Now, normally,

0:37:230:37:25

we would then go 100 times lower

0:37:250:37:27

than that to set what we call a tolerable daily intake.

0:37:270:37:31

Are you at all concerned about male foetuses?

0:37:310:37:33

Both BPA and the phthalates, we know in animal models

0:37:330:37:36

will cause effects on

0:37:360:37:39

reproduction and development.

0:37:390:37:41

But the level of exposure that you have to the chemicals means that

0:37:410:37:45

the risk to you is very, very low.

0:37:450:37:48

Is there a risk of the so-called cocktail effect?

0:37:480:37:51

We know that for certain chemicals, when you mix them together,

0:37:510:37:54

you can have a larger response,

0:37:540:37:56

so what we would do is we would use

0:37:560:37:58

the levels of the most potent chemical in that group,

0:37:580:38:02

so the most potent phthalate,

0:38:020:38:03

and we'd use that to make our safety level.

0:38:030:38:07

And that means even if there is some synergy going on,

0:38:070:38:10

we're still going to be within a level

0:38:100:38:12

that will be safe for human health.

0:38:120:38:13

Is there a possibility that actually we're missing something?

0:38:130:38:17

There is always the unknown unknowns.

0:38:170:38:19

And one of the key parts of regulation

0:38:190:38:22

is to keep levels of chemicals as low as reasonably practicable,

0:38:220:38:26

so we use them at the lowest level that we can.

0:38:260:38:29

If we want to have

0:38:290:38:32

good food containers, if we want to have safe intensive care units,

0:38:320:38:37

using tubing, then we have to have the plasticisers that will make that

0:38:370:38:41

tubing soft to allow us to deliver medicines,

0:38:410:38:43

so it's a risk that I think we have to accept to gain the benefits.

0:38:430:38:47

Why do you think this keeps on coming up over and over again?

0:38:470:38:51

It comes up because we don't have a clear answer.

0:38:510:38:55

And that naturally makes people concerned.

0:38:550:38:58

And, in fact, I believe that people should

0:38:580:39:01

always keep raising these things,

0:39:010:39:03

because if people keep discussing it, then we keep looking at ways of

0:39:030:39:07

reducing that exposure and therefore reducing the risk.

0:39:070:39:10

So, having heard both sides, should I worry about plastics?

0:39:110:39:15

As an adult, I'm not really troubled about my own exposure,

0:39:150:39:19

but there are concerns for unborn babies.

0:39:190:39:22

If you are worried,

0:39:220:39:23

you can choose products that are BPA and phthalate-free

0:39:230:39:26

and avoid cooking in plastics.

0:39:260:39:28

Visit the Trust Me website to find out more.

0:39:290:39:32

About one in three people who experience a serious trauma,

0:39:430:39:46

such as a car accident or being assaulted,

0:39:460:39:48

then suffer from post-traumatic stress disorder.

0:39:480:39:51

It can be really hard to treat.

0:39:510:39:54

Surgeon Gabriel Weston has been to California,

0:39:540:39:57

where they are testing some really novel techniques,

0:39:570:40:00

which involve stimulating the brain.

0:40:000:40:02

Post-traumatic stress disorder

0:40:040:40:06

is normally treated with talking therapies or medication.

0:40:060:40:09

But these don't work for everyone,

0:40:090:40:12

and the drugs involved can cause side-effects.

0:40:120:40:14

Here in California,

0:40:150:40:17

they're trialling a new approach to the way we treat mental illness.

0:40:170:40:20

And it all hinges on the complex inner workings of our brain.

0:40:210:40:25

Every day, as we go about our lives,

0:40:280:40:31

innumerable activities are going on in our brains.

0:40:310:40:34

Signals are travelling along complex networks of nerve cells,

0:40:340:40:38

neurons are firing and chemicals are reacting.

0:40:380:40:41

It's an intricate system that we still don't fully understand.

0:40:410:40:45

But one thing we do know is that these activities can be disrupted,

0:40:450:40:49

sometimes with devastating consequences.

0:40:490:40:52

Everything started when I got back on my second tour.

0:40:540:40:59

Armando was a US Marine who returned

0:40:590:41:01

from active service in Iraq with PTSD.

0:41:010:41:05

I was blown up by a suicide car bomb and, you know, there was...

0:41:050:41:09

..pieces of, you know, the hands and, you know, the...

0:41:110:41:16

jawbones and, you know, just pieces of the guy everywhere.

0:41:160:41:21

So, seeing something like that, I mean,

0:41:210:41:24

obviously, for some people, it has an effect on them.

0:41:240:41:28

I was real jumpy. Very paranoid.

0:41:280:41:31

Always checking that nobody was outside,

0:41:310:41:34

and I just could not, could not sleep.

0:41:340:41:36

Extreme or prolonged trauma can interfere with the brain's ability

0:41:380:41:42

to function normally.

0:41:420:41:44

What happens is that the brain gets caught in a state of hyperawareness

0:41:440:41:48

with communication networks, chemical reactions,

0:41:480:41:52

and the ability of the brain to process and store memory being

0:41:520:41:56

severely disrupted.

0:41:560:41:58

This is why PTSD sufferers can be left feeling anxious, agitated

0:41:580:42:03

and tormented by flashbacks.

0:42:030:42:06

But the new treatment being offered at

0:42:060:42:07

the University of California, Los Angeles

0:42:070:42:10

aims to relieve the symptoms.

0:42:100:42:12

Experts here are hoping to treat PTSD by targeting those areas

0:42:130:42:18

of the brain that have been altered by trauma.

0:42:180:42:22

The hope is that by applying electrical or magnetic stimulation

0:42:220:42:26

to these points,

0:42:260:42:28

they can reset brain activity and restore balance.

0:42:280:42:32

The name for this new approach is neuromodulation.

0:42:320:42:35

Dr Andrew Leuchter

0:42:370:42:39

is the director of the neuromodulation division.

0:42:390:42:42

We're treating the brain as though

0:42:440:42:47

it is a whole organ, and we're picking

0:42:470:42:50

particular critical hubs of this network,

0:42:500:42:53

and by introducing energy in specific ways,

0:42:530:42:57

we're able to change the way the network functions.

0:42:570:43:01

Which parts of the brain are involved in PTSD?

0:43:010:43:05

There are a few key areas that we've identified,

0:43:050:43:09

specifically the amygdala,

0:43:090:43:11

which allows us to process fear.

0:43:110:43:13

And the anterior cingulate, which is in the middle of the brain,

0:43:130:43:18

that determines how vigilant we are, and the prefrontal cortex,

0:43:180:43:22

which regulates mood and anxiety.

0:43:220:43:25

And by stimulating or inhibiting those areas,

0:43:250:43:29

we're able to reset how the brain's network functions.

0:43:290:43:33

There are a number of different neuromodulation methods

0:43:350:43:38

being studied here.

0:43:380:43:39

The first I'm going to look at is transcranial magnetic stimulation,

0:43:390:43:44

or TMS,

0:43:440:43:45

which uses electromagnetic pulses

0:43:450:43:47

to create small currents in parts of the brain.

0:43:470:43:51

The magnet is firing at ten pulses per second,

0:43:550:43:58

and it's introducing this repetitive burst of energy into the brain.

0:43:580:44:03

Depending on where we put the magnet,

0:44:040:44:07

over which part of the brain network we're stimulating,

0:44:070:44:10

we can relieve a number of different kinds of symptoms.

0:44:100:44:14

Magnetic stimulation has shown great potential in quietening down

0:44:140:44:18

the parts of the brain that are overactive in PTSD,

0:44:180:44:22

but it is not the only neuromodulation technique

0:44:220:44:24

being used here.

0:44:240:44:26

Another is electrical stimulation.

0:44:260:44:29

Dr Leuchter is also trialling something called

0:44:290:44:31

trigeminal nerve stimulation, or TNS.

0:44:310:44:35

Now, this takes advantage of a nerve called the trigeminal nerve,

0:44:350:44:38

which runs from the skin of the forehead directly into the brain.

0:44:380:44:42

And the great advantage of this technique is that patients can use

0:44:420:44:46

it in the comfort of their own homes.

0:44:460:44:48

All they need is this device,

0:44:500:44:52

which is being tested in a US Army-funded trial

0:44:520:44:55

where some patients get

0:44:550:44:56

the real thing and some get a placebo.

0:44:560:45:00

So, we just ask the patient to place it directly on the forehead.

0:45:000:45:05

Armando is one of the patients involved.

0:45:050:45:08

All subjects have to do is turn it on and go to sleep.

0:45:080:45:12

The patch on the forehead works by directly stimulating

0:45:140:45:17

the trigeminal nerve.

0:45:170:45:19

We use these very low energy,

0:45:200:45:23

high-frequency electrical impulses

0:45:230:45:26

that go in through the nerve and go to some of the deep brain areas

0:45:260:45:30

that help to regulate things like anxiety,

0:45:300:45:34

startle reflexes.

0:45:340:45:36

And what we're doing with these electrical signals

0:45:360:45:38

is essentially rebooting the network,

0:45:380:45:41

and we found that by doing that night after night

0:45:410:45:44

for a series of weeks, that we're able to eliminate

0:45:440:45:47

many of these troublesome anxiety and mood symptoms.

0:45:470:45:50

So, Armando, what does it feel like?

0:45:510:45:54

The main and most important thing would be my sleep.

0:45:540:45:56

I was averaging two to four hours

0:45:560:45:59

of sleep and now I'm getting a good six to...

0:45:590:46:01

..nine hours of sleep some days.

0:46:030:46:06

I'm not getting startled as easy.

0:46:060:46:08

And having a better attitude on life.

0:46:090:46:13

That's great. That's so great.

0:46:130:46:14

So far, Armando's response matches

0:46:160:46:18

results from an earlier trial, where the severity of PTSD symptoms

0:46:180:46:22

decreased and, for a quarter of the subjects,

0:46:220:46:25

actually went into remission.

0:46:250:46:27

How far do you think this will go in the future?

0:46:270:46:30

We're really just scratching the surface of what these

0:46:300:46:33

neuromodulation treatments can be used for.

0:46:330:46:36

We have treated successfully chronic pain,

0:46:360:46:39

obsessive compulsive disorder,

0:46:390:46:42

different kinds of anxiety syndromes and, interestingly enough,

0:46:420:46:46

even tinnitus - ringing in the ears.

0:46:460:46:48

And I think this is going to be the future of our specialty,

0:46:480:46:52

where we're going to be able to treat these illnesses

0:46:520:46:57

with very targeted energy treatments

0:46:570:46:59

that'll be largely devoid of side-effects.

0:46:590:47:01

I'm inspired by what I've ever seen here in LA,

0:47:040:47:07

and what's impressed me about neuromodulation

0:47:070:47:11

isn't so much the technology.

0:47:110:47:13

In fact, some of these devices are simple enough to be used at home,

0:47:130:47:17

but the fact that it provides a whole new therapy for a vast range

0:47:170:47:22

of different illnesses.

0:47:220:47:23

In the UK,

0:47:340:47:36

there are around 360,000 people

0:47:360:47:38

who are registered as blind or partially sighted.

0:47:380:47:42

Now, in many cases,

0:47:420:47:43

they have a disease and it's going to be progressive,

0:47:430:47:46

but there are also plenty of examples where

0:47:460:47:49

if you recognise the warning signs in time,

0:47:490:47:51

you can actually prevent someone from going blind.

0:47:510:47:55

Over to Dr Saleyha Ahsan.

0:47:550:47:57

I'm on my way to meet a group of patients to talk about a condition

0:47:580:48:02

that leads to around 3,000 people

0:48:020:48:04

losing some or all of their sight every year.

0:48:040:48:08

But if it's caught in time, vision can be saved.

0:48:080:48:11

As an A&E doctor,

0:48:110:48:12

I've seen first-hand what can happen when a disease called

0:48:120:48:16

giant cell arteritis is diagnosed too late.

0:48:160:48:20

That's why I'm joining a drive to help improve early management

0:48:200:48:24

and recognition and raise public awareness.

0:48:240:48:26

Giant cell arteritis, or GCA,

0:48:290:48:31

is a condition where the arteries become inflamed,

0:48:310:48:34

making it more difficult for blood to pass through them.

0:48:340:48:38

When it happens to the arteries supplying the optic nerve,

0:48:380:48:41

it can lead to blindness.

0:48:410:48:43

But if it's caught in time, vision can be saved.

0:48:430:48:47

The problem with GCA is that it can come on suddenly

0:48:470:48:50

and become dangerous very quickly.

0:48:500:48:53

And in some cases,

0:48:530:48:54

sight can be irreversibly lost within days or even hours.

0:48:540:49:00

It's really important that we recognise the red flag symptoms

0:49:000:49:03

so we can spot them and get treatment as early as possible.

0:49:030:49:08

GCA is more likely to affect adults

0:49:080:49:11

over 50 and is three times more common in women.

0:49:110:49:15

I began to get these severe headaches.

0:49:150:49:18

I also had jaw ache, neck ache,

0:49:180:49:21

ear ache and painful shoulders.

0:49:220:49:26

And these all got worse day by day by day.

0:49:260:49:28

My mobility became less.

0:49:280:49:31

Coming with lethargy and loss of appetite and loss of weight.

0:49:310:49:35

I was thinking, "Oh, it's going to be a migraine."

0:49:350:49:37

But it wasn't a migraine. It was like a cap of pain.

0:49:370:49:40

It was like my brain being squeezed.

0:49:400:49:44

My mother-in-law lost a lot of weight.

0:49:440:49:47

She was very, very low mood.

0:49:470:49:50

Very painful scalp.

0:49:500:49:52

Jaw pain, and when I say painful scalp,

0:49:520:49:56

brushing her hair became impossible.

0:49:560:49:59

The most common red flags are headaches,

0:49:590:50:02

especially at the temples,

0:50:020:50:04

tenderness of the scalp,

0:50:040:50:06

jaw pain and aches and pains.

0:50:060:50:09

But as the condition becomes more serious,

0:50:090:50:12

sufferers may start to experience problems with their vision.

0:50:120:50:16

She'd gone to put the TV on for her mum and she said,

0:50:160:50:18

"Oh, don't bother."

0:50:180:50:19

She said, "I can't see properly out of my left eye."

0:50:190:50:21

She said, "It's annoying me."

0:50:210:50:23

She had flashing lights in her eyes.

0:50:230:50:26

She uses her iPad a lot,

0:50:260:50:27

and she was like, "Oh, can you enlarge it for me?

0:50:270:50:30

"I can't see it any more."

0:50:300:50:32

One day, I had a sort of flash in one eye.

0:50:320:50:35

I actually lost the sight in this eye for about three minutes.

0:50:350:50:40

Just white.

0:50:400:50:42

Couldn't see anything with that eye.

0:50:420:50:44

At this stage,

0:50:440:50:45

sufferers should see a doctor immediately so that they can

0:50:450:50:47

be treated with steroids.

0:50:470:50:49

If they get these in time, it can save their sight.

0:50:490:50:53

They said, "Sit down there.

0:50:530:50:55

"Take your 70mg steroid straightaway."

0:50:550:50:58

"This is... You could lose your sight. This is serious."

0:51:000:51:03

Usually, patients have to remain on steroids for a few years,

0:51:030:51:07

but, over time, the dose can be reduced,

0:51:070:51:10

and after two to three years GCA may even disappear.

0:51:100:51:14

But if steroids aren't given in time,

0:51:140:51:17

the result can be catastrophic.

0:51:170:51:20

Within the four hours that we were in eye casualty, towards the end,

0:51:200:51:23

she reached round her chair

0:51:230:51:24

and grabbed my hand and she said, "Amanda, I can't see anything."

0:51:240:51:28

And she lost her sight that afternoon.

0:51:280:51:31

Listening to the stories of people who've experienced

0:51:310:51:34

giant cell arteritis has been incredibly moving,

0:51:340:51:38

and it's heartbreaking hearing about people who have lost their sight.

0:51:380:51:42

But the good news is that something is now being done to help prevent

0:51:420:51:47

vision loss from GCA.

0:51:470:51:49

At Southend Hospital, Professor Bhaskar Dasgupta

0:51:520:51:56

has been trialling a fast-track pathway for GCA,

0:51:560:51:59

where at-risk patients are immediately screened

0:51:590:52:02

using ultrasound.

0:52:020:52:03

What you see now is the picture of a normal temporal artery.

0:52:030:52:08

So, you can see the blood flow very nicely in the artery.

0:52:080:52:11

-So, what did it look like before?

-Let's have a look.

0:52:110:52:14

The inflamed vessel wall can be seen on both sides.

0:52:140:52:18

That dark band.

0:52:180:52:19

And that's called the halo sign.

0:52:190:52:20

-It's quite...

-It's very, very thick.

0:52:200:52:23

You see the halo sign.

0:52:230:52:25

It's quite clear. It's straight for treatment and you save their sight?

0:52:250:52:29

Indeed.

0:52:290:52:30

This system has already been saving patients' sight,

0:52:300:52:33

including that of Roger Kay.

0:52:330:52:35

I saw Professor Dasgupta,

0:52:360:52:39

and he recognised the condition immediately,

0:52:390:52:42

he did an ultrasound test,

0:52:420:52:44

and showed me on the screen that that's what it was.

0:52:450:52:48

The outcome was that it saved my eyesight.

0:52:480:52:52

I'm a very lucky man.

0:52:520:52:54

Professor Dasgupta, if I had £1 million, I'd give it to him.

0:52:540:52:58

The scheme in Southend has been so successful that it's now being

0:52:580:53:02

rolled out across the country,

0:53:020:53:04

meaning that future GCA patients

0:53:040:53:06

are far less likely to lose their sight.

0:53:060:53:08

And we can all help by learning

0:53:080:53:10

to recognise the early warning signs ourselves.

0:53:100:53:14

GCA isn't the only disease that can affect your vision,

0:53:140:53:18

but it is one where we have an excellent chance of stopping the

0:53:180:53:21

devastation of sight loss simply by spotting the red flags early.

0:53:210:53:27

So, if you have a bad headache with scalp tenderness, jaw pain,

0:53:270:53:32

or any visual disturbance, then go and see your doctor immediately.

0:53:320:53:36

It could save your sight.

0:53:360:53:38

Back in Liverpool, our eight-week trial

0:53:460:53:49

into the benefits of fish oils is coming to an end.

0:53:490:53:52

One group has been eating oily fish.

0:53:520:53:54

Another taking fish oil supplements.

0:53:540:53:57

And our third is a placebo group,

0:53:570:53:59

who have been taking a dummy pill and eating white fish,

0:53:590:54:02

which isn't rich in omega-3.

0:54:020:54:05

Blood tests have been analysed by Professor Graeme Close

0:54:050:54:08

and Dr Ellen Dawson from Liverpool John Moores University.

0:54:080:54:12

And our volunteers are keen to find out the results.

0:54:120:54:16

Well, I wanted to know whether it's beneficial to have supplements

0:54:180:54:21

because I'm getting to an age where I don't have tablets

0:54:210:54:24

and still play a lot of sport

0:54:240:54:25

and I want to know if I should be taking something.

0:54:250:54:28

-You had oily fish.

-Yeah, I did.

-And what did you make of that?

0:54:280:54:32

Um...not that fabulous,

0:54:320:54:34

but I managed to plough my way through it.

0:54:340:54:39

We wanted to find out whether fish

0:54:390:54:41

or supplements boosted our volunteers' levels

0:54:410:54:44

of healthy omega-3, and which were better.

0:54:440:54:47

So, we tested their omega-3 index.

0:54:480:54:51

This measures the fats in their blood and tells us what percent

0:54:510:54:55

are omega-3.

0:54:550:54:56

Having a low omega-3 index

0:54:560:54:58

is linked with heart disease and strokes.

0:54:580:55:00

So, time for the results.

0:55:020:55:04

Will eating the oily fish or taking the oily fish supplement have made

0:55:040:55:08

any difference?

0:55:080:55:10

When we look at this omega-3 index, we're interested in the percent.

0:55:100:55:14

8% omega-3 index gives us a low risk.

0:55:140:55:18

4%, medium,

0:55:180:55:20

and under 4% gives is a higher risk of cardiovascular disease.

0:55:200:55:24

So, at the start of the trial,

0:55:240:55:25

most people in this room were around about that 4% mark,

0:55:250:55:28

which puts you in the high to moderate risk

0:55:280:55:31

of a cardiovascular event.

0:55:310:55:33

-Was that a surprise to you?

-Yes.

0:55:330:55:36

All three of our groups started the trial with low levels of omega-3,

0:55:370:55:42

which puts them at increased risk of having a heart attack or stroke.

0:55:420:55:46

So, did the fish oil supplements make any difference?

0:55:460:55:50

When we look at both the omega-3 supplement group

0:55:500:55:53

and the oily fish group,

0:55:530:55:55

there was quite a marked increase in omega-3.

0:55:550:55:58

We can see that in both of our omega-3 interventions,

0:55:580:56:02

every single person had quite a good increase,

0:56:020:56:05

with many of you moving from the high-risk to the low-risk category.

0:56:050:56:09

Our placebo group showed a slight improvement,

0:56:100:56:13

perhaps because eating more white fish

0:56:130:56:15

made their diet more healthy.

0:56:150:56:17

Though it's not statistically significant.

0:56:170:56:20

But in our study, both the oily fish

0:56:200:56:22

and the supplement made a significant difference,

0:56:220:56:26

and this carries real health benefits.

0:56:260:56:29

The recent study suggested that people who presented

0:56:290:56:32

with the omega-3 profile greater than 6.5

0:56:320:56:37

had 90% fewer cardiovascular events than those

0:56:370:56:40

who presented with omega-3 profile less than three.

0:56:400:56:43

Both our oily fish and supplement group ended the trial above 6.5%.

0:56:450:56:50

Keep that up and both groups should cut their risk of diabetes,

0:56:500:56:55

stroke and heart attacks.

0:56:550:56:59

-What did you make of that?

-That was really interesting.

0:56:590:57:02

Yes, I didn't realise I was in the moderate to high-risk category.

0:57:020:57:05

And really interesting results. It's amazing what a difference can be

0:57:050:57:09

-made in such a short time.

-I will definitely eat more fish.

0:57:090:57:12

I'm really pleased with how it's come out.

0:57:120:57:14

I'll certainly be having a lot more fish, definitely.

0:57:140:57:17

And so will my family.

0:57:170:57:19

There's no doubt that eating two portions of oily fish a week is a

0:57:190:57:23

good option for getting your omega-3, and it's packed with other

0:57:230:57:27

healthy nutrients, too. If you'd rather take supplements,

0:57:270:57:30

choose an accredited brand

0:57:300:57:32

and make sure they contain more than

0:57:320:57:36

200mg of DEA and DHA combined.

0:57:360:57:39

But however you get your omega-3, make sure you do.

0:57:390:57:43

In just eight weeks, our volunteers boosted their levels.

0:57:430:57:47

I was really surprised by how many of those people started off with

0:57:490:57:52

such low levels of omega-3.

0:57:520:57:54

And I was really impressed by how

0:57:540:57:56

quickly eating the oily fish

0:57:560:57:58

or taking the supplements made a difference.

0:57:580:58:00

I'm a fan of oily fish and I will certainly continue to consume it.

0:58:000:58:04

That's it from Liverpool and this series of Trust Me.

0:58:140:58:16

We will be back later in the year.

0:58:160:58:18

In the meantime, why not visit our website,

0:58:180:58:21

where you can volunteer for experiments

0:58:210:58:23

and find out more about all the things we've covered in the series.

0:58:230:58:27

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