Episode 1 Trust Me, I'm a Doctor

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

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

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

through the contradictions and the confusions.

We do research no-one else has done

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

We listen to the questions you want answered,

and ensure you get the information you need.

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

and not the latest fads.

I'm Michael Mosley, and in this series I'm joined by a team of doctors.

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

and the health claims.

This is Trust Me, I'm A Doctor.

Hello and welcome to Trust Me, I'm A Doctor.

This time we're in Birmingham,

where we are carrying out a fascinating experiment,

seeing whether knocking back the fizzy drinks makes you eat more.

Also in the programme, we'll be finding out why the secret

to your new year fitness kick could be a cup of coffee...

..How a pioneering new technology could transform the lives of diabetics...

-There?

-Yeah.

-One, two, three.

..Why men go bald and what you can do about it.

But first...

Now, we all know that fizzy drinks are pretty bad for us.

The most popular brands contain around eight teaspoons of sugar

in a small tin. So we switch to healthier alternatives,

such as diet colas or perhaps sparkling water.

But are they really healthier?

Recent reports have suggested the sugar in fizzy drinks isn't

the only thing adding to your waistline.

It might also be the fizz itself.

Researchers at Birzeit University in Palestine,

found that rats given carbonated drinks ate more food

than rats given non-fizzy equivalents.

I do like sparkling water.

And I find it really, really unlikely that simply adding

a few bubbles to water could possibly make me hungrier.

But it is an interesting idea, so we thought we'd do an experiment.

We've recruited a group of volunteers to test

whether fizzy drinks make you feel hungrier than flat drinks,

and eat more as a result.

Running our study, from Aston University in Birmingham,

is Dr James Brown.

-Good morning, everybody.

-Morning.

The Palestinian researchers found that consuming fizzy drinks

lead to higher levels in the blood of a hormone called ghrelin,

which is secreted by the stomach when it's empty

to tell the brain "I'm hungry".

So we want to test levels of this hormone in our volunteers,

after a range of different fizzy and flat drinks.

We're also going to record the effect on appetite and food intake.

We're actually going to measure not just how much of the hunger hormone

they had, we're going to ask our volunteers,

"How hungry did you feel on that day?" So not just

a biological measure, but an actual measure of their hunger.

And then following on from that, we'll get them to keep a food diary,

so we'll measure how many calories they ate

in the hours following having each drink.

To make sure we have a level playing field,

our volunteers have all been asked to fast for ten hours.

And crucially, they have no idea what the experiment is about.

OK, then guys, do you want to come up?

To ensure that everyone starts the experiment with similar ghrelin levels,

we're giving each of them a delicious cheese sandwich

with exactly the same calories.

An hour later, each volunteer is given a soft drink,

allocated at random.

It's either a fizzy sugar drink, a flat sugar drink,

fizzy water, or flat water.

Ten minutes after their drink,

we take a blood sample to measure their ghrelin levels.

Over the next few days, our volunteers will come back

and repeat this for each of the different drinks.

I must admit, I'm putting my money at this moment in time

on the fact that it's going to be the sugar

and not the sparkles that make a difference, but...

OK. Well, we'll see.

Two weeks later, our volunteers have come back to Aston University

to find out exactly what they volunteered for.

-Hi, everyone.

-Hi.

Thank you very much for coming along.

So, very fond of cheese sandwiches now?

Looking forward to lunch?

As you probably guessed, we're interested in the drinks you were

given as opposed to the cheese sandwich you were given.

But it's not the sugar content in the drinks,

we're interested in the carbon dioxide.

We're interested in the fizziness of the drinks.

All the data has been analysed and now, it's time for the results.

What we found was actually really exciting.

We found that when you had a carbonated drink,

your hunger hormone, ghrelin,

was about 50% higher than when you had a non-carbonated drink.

Just bubbles. Who would have believed it?

Surprisingly, this increase in the production of ghrelin,

wasn't only seen after drinking sugary fizzy drinks.

There was also a slight effect in terms of the carbonated water.

So carbonated water, you were a little bit hungrier

than you were with still water, so this could be actually

that it's true of all drinks that are fizzy and not just

the kind of drinks that you buy in cans at the supermarket.

But it's not just levels of the hormone ghrelin that matters.

Crucially, it's how much food they actually consumed after the drink.

If you grouped together the carbonated drinks

and the non-carbonated drinks, you ate, on average, 120 calories more

after you had a carbonated drink

than you ate after you had a non-carbonated drink.

And that's a really significant finding.

And that will really add up.

I must say, I found it really surprising.

Absolutely genuinely surprising.

And I guess that's why we do the experiments,

and very grateful to you for taking part,

but why do bubbles have this affect?

There's two likely candidates. One is that

as you drink that carbonated drink and that carbon dioxide is released

in the stomach, that there are chemical receptors which

detect carbon dioxide and cause the cells at the top of

the stomach to release ghrelin, and it makes you feel hungry.

And the other possibility is it's a mechanical thing, that

the stomach bloats and stretches a little bit from that extra gas,

and again, that stimulates cells to release ghrelin.

Those are the best two possibilities in terms of mechanism.

So we're not saying that it's OK to drink flat sugary drinks.

No, I think that's really important.

Ideally, the take-home message from this is sadly and boringly,

that the healthiest option is probably still water.

-Still water, not sparkling water.

-Not sparkling water.

What a shame.

So it seems that the fizz in fizzy drinks really does make us

feel hungrier, and consequently, eat more calories.

And these surprising findings have certainly affected our volunteers.

I was really surprised with the result actually.

I expected quite the opposite to happen.

I expected the carbonation to actually make you more full.

I drink like a litre of fizzy water every day,

so I'm going to stop drinking that,

and I will move to still water.

What I love about making Trust Me,

is you come across this research which looks wildly unlikely,

look into it and, lo and behold, there really is something there.

Now this is early days, but it's another really good reason

why you should steer clear of the fizzy sweet stuff.

Now lots of us are constantly trying to get fitter.

GP and exercise expert Dr Zoe Williams has been

finding out about a surprising way to boost your performance.

We'd all love to run faster, jump higher, and pedal further.

But could the answer be as simple as a cup of coffee?

There's a fair amount of research out there on coffee and exercise.

And there's strong evidence to say that the caffeine in coffee

does, in fact, improve athletic performance.

But you won't get a benefit for every type of exercise,

and that's down to the way caffeine works.

Contrary to popular belief, it's not the increase in blood flow

to your muscles from making your heart pump faster.

In fact, the main benefit of caffeine

actually comes from something completely different.

Caffeine affects your workout by acting on your central nervous system.

As you exercise, your body produces a chemical called adenosine,

that makes you feel tired.

Caffeine blocks the adenosine receptors in your nerves,

like I'm blocking these balls.

So your brain perceives less pain and fatigue,

which means, you can keep going longer.

Ah!

And that means caffeine is especially useful

for one particular type of exercise - endurance sports.

So if you're into something like long-distance running, or cycling,

caffeine might help.

But only if you take the right amount.

There's a scientifically established but little-known sweet spot

optimal amount of caffeine to take.

It's 3mg per kilogram of body weight.

Well, that's all well and good, but how much is that really in cups of coffee?

And how do you know if you're getting the right amount?

For an average man or woman,

that's between one and two large cups of standard filter coffee.

If you don't like coffee, you also get caffeine in tea,

cola, chocolate, and sports drinks.

But their caffeine content is rarely stated on the label

so working out a precise dose from these products is not straightforward.

What's more, timing is everything.

Caffeine will go on working for a few hours after you've taken it,

but you need take it at least one hour before you exercise

to get the full benefits.

Controlling both the timing and the dose

to get your ideal caffeine boost is tricky.

But there's recently been a breakthrough.

The development of caffeine chewing gum.

Caffeine gum gives you much more control over the precise amount

and timing of your caffeine hit.

Chewing it delivers up to 85% of the caffeine to your bloodstream

in as little as five minutes.

Some premiership football teams are now chewing caffeine gum at half-time.

And the British sailing team have used it during their races.

But caffeine is no good for sports where hand-eye coordination is crucial,

like snooker, archery, or golf as it can make you jittery.

Caffeine can't be banned from professional sport because it's in

so many products, but the more you use it, the less benefit it has.

For the best possible effect,

rather than having caffeine before every workout,

save it as your secret weapon for that big race or that big event

and that way, you won't build up a tolerance to it.

Also, try to avoid caffeinated products for two or three days

before the big day, and you never know,

it might just give you that extra boost when you need it most.

Still to come, what is OCD

and what can you do about it?

And, the pioneering technology that could change the lives of diabetics.

But first...

There are many downsides to getting older,

but there's one thing that many men find particularly distressing -

losing their hair.

One, I think, for geneticist Dr Giles Yeo.

As a boy, yours truly had a head of thick black hair

that was always at the cutting edge of fashion.

It wasn't to last.

By my late teens, I noticed thinning and by my 30s,

I had little left on top.

Like many others, I had fallen victim to male pattern baldness -

a genetic condition that affects half of all men.

But although your genes are a major factor,

it's actually difficult to predict if you're going to go bald early

just because your dad did.

And that's because there are so many different genes involved.

Either way, what happens is that the follicles,

the little cavities where each hair grows, shrink over time.

So if it looks like you're starting to go bald,

what can you do about it?

We could follow the advice of a wealthy ancient Egyptians

who used to rub rhino fat into their head.

This is not rhino fat by the way.

Did it work? Of course not.

These days, there are lots of over-the-counter remedies

that claim to help, from caffeine shampoos to herbal supplements.

However, the scientific evidence on these is mixed.

So what DOES work?

Well, if you have the money you might opt for a hair transplant.

These can be very effective,

but at a price anywhere between £1,000 and £30,000,

it's more than I can afford.

Looks good, eh?

But if a hair transplant is not for your taste, or budget,

then you'll need a different solution.

If you go to your GP and tell them your hair loss is getting you down,

they'll most likely recommend one of two things.

The first is medication with an active ingredient called

Finasteride, that alters the levels of particular sex hormones.

Studies suggests it can trigger hair regrowth in about two thirds of men with baldness.

Also, you might have seen an advert for this stuff.

The active ingredient is called Minoxidil,

and the idea is you rub it into your scalp twice a day.

Researchers stumbled upon it in the 1950s when they're looking for

a treatment for high blood pressure.

Instead, it produced unexpected hair growth.

It's thought to work by increasing blood flow to the scalp,

which opens up the shrinking hair follicles.

Used properly, this can be effective in about 80% of users.

But it's a long-term commitment.

This product only works as long as you're using it,

and therein lies the rub.

Thank you.

The NHS won't pick up the bill for these two products.

You will have to pay.

And if you're using them every day,

you could be shelling out several hundred pounds a year.

So is there a cheaper alternative?

Well, there is some evidence that certain foods could be beneficial.

One study showed that a diet high in omega-3 gradually reduced hair loss.

Baldness has also been linked with iron deficiency,

so eating green leafy veg like spinach might help.

As well as eating the right foods, research indicates that exercising

more and reducing stress may well slow down your hair loss.

But perhaps we're actually looking a baldness in the wrong way.

There's some evidence that we needn't be quite so worried about it.

Some psychological studies looking into baldness have suggested that

bald men are seen as more educated, honest, virile,

so maybe bald is beautiful after all.

In this series of Trust Me,

we're going to explore some common mental health conditions.

In this programme, psychiatrist Dr Alain Gregoire,

is looking at OCD, obsessive-compulsive disorder.

So, what is it and what can you do about it?

OCD effects over half a million people in the UK.

It's a condition around which there are many popular misconceptions.

Most of us have used the expression, "I'm being a bit OCD,"

when we've gone back to check that the front door is locked,

but the reality for people with obsessive-compulsive disorder,

is very different and much more challenging.

In fact, the World Health Organization has ranked OCD

amongst the top ten most disabling health conditions worldwide.

So today, I'm meeting three people who have it.

Laura, Andy, and Jane.

Their experiences can help us all recognise OCD

and know how to deal with it.

Can you tell me how these difficulties began?

I came home from school one day, with a friend for tea,

and my mother had had a cerebral haemorrhage.

It was traumatic and that's when I started noticing

these strange behaviours. I used to have to tap the wall three times

before I left the classroom. Wanting to step on cigarette ends.

There was an overwhelming need to do it.

When I was at school, you would get homework given to you

in the morning, and the minute I had that homework, I had to do it.

I used to worry about things uncontrollably.

And I used to have constant ruminations about, you know,

"What if, what if, what if, what if?"

When I was 11, I got joint pains, migraines.

Things like ulceration and they couldn't quite diagnose what was wrong with me.

I started getting very scared of touching things,

because I kept thinking, like, where have I got this disease from?

And it was unfortunately a couple of years until I properly got diagnosed,

so within that couple of years, things just snowballed really.

Anxious intrusive thoughts like these are called obsessions.

And they can be accompanied by compulsions - ritualistic behaviours

that sufferers perform in the hope of finding relief.

When I wash things, I can't put them into a washing machine.

I have to wash every garment three times inside, three times outside.

And then I can put it in the washing machine.

Even things like leaving the room, I'd have to

physically grab something from behind me,

because if I didn't do this little ritual, I felt like I would die.

I remember driving along a road, just keeping things to myself,

looking in the rear-view mirror, and I couldn't see any cars.

All of a sudden, I had a flash, bang, "Did you cause an accident?"

And so, my first reaction was to pull over.

The relief provided by their compulsions is generally brief,

and often ends up reinforcing the obsession.

Friends and family,

I've started having thoughts that they're contaminated.

Anywhere that my contaminated members of my family and friends

have gone, becomes contaminated.

So at the moment the whole of Brighton is contaminated,

Heathrow Airport, parts of Bournemouth, Durham University.

I was scared to eat, I was scared to drink, I was scared to go outside.

I basically locked myself in my house and wouldn't leave.

Like many medical conditions, OCD can get worse if left untreated.

The first step is to recognise the condition.

There are some common thoughts or behaviours that the sufferer

often knows are irrational - an intense fear of causing harm

to oneself or others, intrusive thoughts or images,

dread of mess or contamination,

repetitive ritualistic behaviours.

OCD can be very difficult to spot, because sufferers may go to

great lengths to hide their symptoms because of feelings

and thoughts of guilt or shame or embarrassment.

Nobody at school knew.

Only my best friend, none of the teachers knew.

I was very secretive,

because I was ashamed of all the rituals I started performing.

Did you doubt whether you ought to go and get professional help?

Oh, yeah, I mean, you're not quite certain how society's going to

perceive it, and the other thing, which is the biggest risk,

is that people will start focusing on this issue that you've

dreamed up in your mind, which is not actually real,

and then giving it some gravity,

giving it some value, giving it some weight.

So if you think you know somebody who might have OCD,

what should you do about it?

It can be very difficult to raise the issue.

At the same time, it can be that crucial first step

on the road to treatment and recovery.

So I think you should talk to them about it,

in an understanding and non-judgemental way,

and that can mean inviting them to talk about it,

being there to listen,

and suggesting they get professional help if they need it.

It's important not to collude with their rituals though

as this can reinforce the OCD.

Instead, encourage them to seek treatment which can take many forms.

This can include psychological therapies designed to help them

confront and overcome their obsessions.

It might also include medication.

With the right support and the right help, you can manage it,

and you can live a life which is fulfilled and the important thing

is not to give up, not to give up.

Never be ashamed of who you are.

In fact, people who go through mental health illness day in day out

are probably more resilient than people who haven't.

You battle that every day, and you win every day.

The symptoms of OCD can be extremely distressing and even frightening

to the sufferer and to others, but it isn't a dangerous condition

and with expert help everybody can expect to improve.

There are more than four million diabetics here in the UK

and the numbers are rising every year.

If you have diabetes, then you're at increased risk of going blind,

having kidney failure or heart disease,

so there's a lot of interest in a pioneering new approach.

Surgeon Gabriel Weston investigates.

Until the age of 12, James was a healthy and active young boy.

But without warning, in the space of a few weeks, he became very unwell.

His clothes were dropping off him.

He stopped eating, he didn't want to do anything.

I think over the course of a weekend,

we both realised he was really not well at all.

Their GP took urine samples, which came back

with abnormally high sugar levels, a classic sign of diabetes.

In the UK, someone is diagnosed with Type 1 or Type 2 diabetes every two minutes.

That's nearly 800 people a day.

For most of us, sitting down to enjoy our lunch like this is

a relatively simple pleasure, even if like me, it's quite a greedy one.

But for diabetics, even this is potentially lethal, and that's

because their bodies can't correctly process the sugar in the food.

And too much or too little sugar in the bloodstream can,

in extreme cases, even lead to a life-threatening diabetic coma.

When you're healthy, your pancreas monitors the level

of glucose in your blood and releases just the right amount of the hormone insulin.

Insulin acts like a key that allows the glucose to enter

your body's cells to be used for energy or stored for later.

But in diabetics, this system doesn't function properly.

James has Type 1 diabetes,

which means that his pancreas can't produce enough insulin.

Until recently, he had to monitor his blood sugar level

and inject insulin several times a day.

Many people with Type 2 diabetes, need these injections too.

One mistake or missed reading can be devastating.

But an innovative medical trial is under way that may transform life

for many diabetics.

Researchers have developed an artificial pancreas that can respond

accurately to blood sugar levels

and even predict the body's insulin requirements.

-There?

-Yeah.

-One, two, three.

It consists of a blood glucose sensor and an insulin pump,

which is controlled remotely by a mobile phone.

James is one of the first newly diagnosed patients in the world

to use the new artificial pancreas system,

which is being trialled in cases of both Type 1 and Type 2 diabetes.

James, I'm really excited to see your artificial pancreas.

So, this is my blood glucose sensor and that shows up on my pump here.

And this is where the actual insulin is going in.

Is it painful putting those in?

It, like, stings a bit, but it's not painful.

It's very useful because, with injections,

it's like you have to monitor your blood sugars with finger prick tests

every two hours and before meals,

but with the pump, and this, it's keeping your blood sugar stable.

The components themselves aren't new.

The breakthrough has been to get them working together

to monitor glucose levels closely and respond with an accurate dose

of insulin, with the help of a specially designed phone app.

This is Addenbrooke's Hospital, where a team

from the University of Cambridge, led by Dr Roman Hovorka,

have been developing the artificial pancreas.

What would you say is the key difference between

the new modern artificial pancreas and everything that's come before?

It tries to mimic what the pancreas does behind the scene,

reacting on the glucose level, and in this instance,

every ten minutes changing the insulin delivery.

But perhaps the most ground-breaking innovation is an algorithm

that predicts when insulin will be needed.

By recording how much insulin James requires after meals,

the system gathers information and learns and adapts.

Does that look about enough, James?

-Can you manage that many?

-Yeah.

So that's 130g of potatoes.

The potential benefits of the artificial pancreas to manage both

Type 1 and Type 2 diabetes are huge.

Diabetes consumes 10% of the NHS budget,

and it's mainly through the complications.

Through improved glucose control, we can improve or reduce

these complications and also increase the life expectancy.

I find it astonishing that a few off-the-shelf components

in a mobile phone, can be brought together to make

such a sophisticated life-saving system.

This is intelligent technology that can learn from experience.

It's paving the way for a future in which artificial intelligence

will revolutionise medical practise.

The early results of the trial are in, and they look good.

And I think if they continue this way,

this treatment really does have the potential to be a game changer

for people suffering from diabetes.

That's it from us.

Next time, we'll be in Cambridge, where we'll be carrying out

the biggest experiment ever done in the UK,

to find out the effects of coconut oil on your cholesterol levels.