Episode 5

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0:00:04 > 0:00:08When it comes to our health, it seems everyone has an opinion.

0:00:08 > 0:00:11But what's the health advice you can really trust?

0:00:14 > 0:00:17We're here to weigh up the evidence

0:00:17 > 0:00:19and use our expertise to guide you

0:00:19 > 0:00:22through the contradictions and the confusions.

0:00:26 > 0:00:28We do research no-one else has done

0:00:28 > 0:00:31and put your health at the heart of what we do.

0:00:32 > 0:00:36We listen to the questions you want answered,

0:00:36 > 0:00:39and ensure you get the information you need.

0:00:41 > 0:00:43We're here when you want to know

0:00:43 > 0:00:46the latest findings and not the latest fads.

0:00:47 > 0:00:49I'm Michael Mosley, and in this

0:00:49 > 0:00:52series, I'm joined by a team of doctors.

0:00:52 > 0:00:54Together, we'll cut through the hype,

0:00:54 > 0:00:56the headlines and the health claims.

0:00:57 > 0:01:00This is Trust Me I'm A Doctor.

0:01:05 > 0:01:07Hello and welcome to Trust Me.

0:01:07 > 0:01:10This time we're in Exeter, where we're carrying out a fascinating

0:01:10 > 0:01:15experiment to see if beetroot can bolster your brain and your body.

0:01:15 > 0:01:17Also in the programme...

0:01:17 > 0:01:18Health apps.

0:01:18 > 0:01:22There are hundreds of thousands out there, but which can you trust?

0:01:22 > 0:01:27The implant that's helping to rewire the brains of stroke survivors.

0:01:27 > 0:01:31This truly could be a breakthrough treatment for patients after stroke.

0:01:31 > 0:01:35And can the flu vaccine make you ill?

0:01:35 > 0:01:37But first...

0:01:38 > 0:01:40As every mother knows, green

0:01:40 > 0:01:42vegetables are incredibly good for you.

0:01:42 > 0:01:44What is less well known is it's the

0:01:44 > 0:01:48nitrates in the veg that give you much of the benefit.

0:01:48 > 0:01:52Now, that might sound surprising, because nitrates,

0:01:52 > 0:01:55when added as a preservative to processed meats,

0:01:55 > 0:01:59have been linked to an increased risk of certain cancers,

0:01:59 > 0:02:01so they've had some bad press.

0:02:01 > 0:02:04On the other hand, there have been claims that naturally occurring

0:02:04 > 0:02:08nitrates in vegetables like beetroot, rocket and spinach,

0:02:08 > 0:02:13can improve both our physical health and our mental sharpness.

0:02:13 > 0:02:15So, is that true?

0:02:15 > 0:02:17Can eating nitrate-rich vegetables

0:02:17 > 0:02:21really make a measurable difference to your body and to your brain?

0:02:23 > 0:02:27To find out, we're carrying out an experimental first.

0:02:28 > 0:02:31We've recruited six volunteers of different ages to test

0:02:31 > 0:02:36both the physical and mental effects of nitrates from veg.

0:02:36 > 0:02:38Helping us run our study is

0:02:38 > 0:02:42Professor Andy Jones from the University of Exeter.

0:02:42 > 0:02:45So, what is new about this?

0:02:45 > 0:02:48A couple of things. We're going to measure blood pressure,

0:02:48 > 0:02:49exercise performance, but also

0:02:49 > 0:02:52cognitive function because that's something

0:02:52 > 0:02:55that's relatively new, and we throw that into the mix as well.

0:02:55 > 0:02:57But we're also interested in what

0:02:57 > 0:02:59happens with healthy middle-aged people.

0:02:59 > 0:03:03Most of our work so far has been with young athletic subjects,

0:03:03 > 0:03:04and we're interested to see to what

0:03:04 > 0:03:07extent that can translate into a different population.

0:03:07 > 0:03:09OK, so this is basically people

0:03:09 > 0:03:12more like me and less like elite athletes.

0:03:12 > 0:03:13Just like me, yeah.

0:03:15 > 0:03:19When we digest food or drink that's rich in nitrates,

0:03:19 > 0:03:22our body converts it to nitric oxide,

0:03:22 > 0:03:25which makes our blood vessels widen.

0:03:25 > 0:03:29This in turn could produce some very interesting changes.

0:03:29 > 0:03:33To find out, we'll measure our volunteers' blood pressure,

0:03:33 > 0:03:38test their physical performance, and their mental sharpness.

0:03:38 > 0:03:40We'll do all three of these tests

0:03:40 > 0:03:43before and after three different meals -

0:03:43 > 0:03:47a carefully weighed-out salad containing spinach and rocket,

0:03:47 > 0:03:50both of which have naturally high levels of nitrates.

0:03:51 > 0:03:54A portion of yummy beetroot juice,

0:03:54 > 0:03:57which contains exactly the same levels of nitrates.

0:03:59 > 0:04:01And a control,

0:04:01 > 0:04:03a salad made from foods that

0:04:03 > 0:04:05naturally contain almost no nitrates.

0:04:07 > 0:04:08It's a single meal, so we'll see what

0:04:08 > 0:04:11it does and if we get even a small effect,

0:04:11 > 0:04:12that can give us some insight.

0:04:12 > 0:04:14And presumably you'll also be

0:04:14 > 0:04:15able to tell whether there is a difference

0:04:15 > 0:04:17depending on whether you eat it

0:04:17 > 0:04:19as a salad or you knock it back as a shot.

0:04:19 > 0:04:21Same amount of nitrate in both cases.

0:04:21 > 0:04:24Physiologically, it should be the same, but we shall see.

0:04:24 > 0:04:28After three days, our volunteers have tried all three meals

0:04:28 > 0:04:31and completed the test before and after each.

0:04:31 > 0:04:33Andy has crunched the data.

0:04:33 > 0:04:35Time for the results.

0:04:36 > 0:04:38Salads delicious?

0:04:38 > 0:04:41- They were very large.- Very big. - Very large.

0:04:41 > 0:04:43First, the blood pressure results.

0:04:43 > 0:04:46When you consumed the high nitrate salad,

0:04:46 > 0:04:48your blood pressure on average

0:04:48 > 0:04:50was around three millimetres of mercury lower,

0:04:50 > 0:04:51and what we also found is that those

0:04:51 > 0:04:54of you that had the highest blood pressure at baseline

0:04:54 > 0:04:56were those that benefited the most.

0:04:56 > 0:04:59That was also true for the beetroot shot,

0:04:59 > 0:05:02showing it didn't matter what form you took the nitrates in.

0:05:02 > 0:05:07It's an impressive result with significant health implications.

0:05:07 > 0:05:09Actually, you can calculate that if

0:05:09 > 0:05:11that if that were reproduced across the entire population,

0:05:11 > 0:05:13the incidents of adverse cardiovascular events

0:05:13 > 0:05:16like heart attacks and strokes could be reduced by around 10%.

0:05:16 > 0:05:19Next, what about physical performance?

0:05:19 > 0:05:21We measured the oxygen demand

0:05:21 > 0:05:25of cycling and that was reduced by about 5%.

0:05:25 > 0:05:28It suggests that the effort required to exercise at that intensity

0:05:28 > 0:05:31is lower, so people might be more inclined to exercise.

0:05:31 > 0:05:33So you can kind of walk to the shops with less effort?

0:05:33 > 0:05:35The tasks of daily living - climbing a flight of stairs,

0:05:35 > 0:05:38walking to the local shops - should feel a little bit easier,

0:05:38 > 0:05:40people ought to be able to do that

0:05:40 > 0:05:42for longer or to do it without fatigue, really.

0:05:42 > 0:05:43And it's legal, presumably?

0:05:43 > 0:05:46- It is, absolutely.- It's legal for now.- Yeah.

0:05:46 > 0:05:50So, positive results on both our physical health measures.

0:05:50 > 0:05:52But what about our third test?

0:05:52 > 0:05:57Did nitrates improve our volunteers' mental performance?

0:05:57 > 0:06:00The final one I'm really interested in is the effect on the brain,

0:06:00 > 0:06:02on their cognitive ability. What happened there?

0:06:02 > 0:06:06Well, disappointingly there was no change at rest, so when we just did

0:06:06 > 0:06:08their cognitive function pre- and

0:06:08 > 0:06:10post the salad there was no difference.

0:06:10 > 0:06:11- But?- But...- There's a but there.

0:06:11 > 0:06:13Yeah, because they did the cognitive

0:06:13 > 0:06:15function test again after they'd cycled.

0:06:15 > 0:06:18In the control condition, their cognitive performance became worse,

0:06:18 > 0:06:20but when they took the high nitrate salad,

0:06:20 > 0:06:22their function was better preserved.

0:06:23 > 0:06:26So, looking at mental performance,

0:06:26 > 0:06:29our experiment took a surprising turn.

0:06:29 > 0:06:31When our volunteers were well-rested,

0:06:31 > 0:06:34taking in nitrates didn't make any difference.

0:06:34 > 0:06:36But, after exercising,

0:06:36 > 0:06:40the nitrates stopped their mental performance dropping off.

0:06:40 > 0:06:45So, they weren't smarter but they were less dumber, if you like.

0:06:45 > 0:06:48As you fatigue, there's just kind of more for your brain to process.

0:06:48 > 0:06:52That was certainly offset when they were consuming nitrate.

0:06:52 > 0:06:55I think that's fascinating.

0:06:55 > 0:06:59I often cycle to work, so it seems a beetroot juice before I head off

0:06:59 > 0:07:01could help me stay sharp when I get there.

0:07:02 > 0:07:05We are encouraged to eat five a day, but I think there may be a little

0:07:05 > 0:07:08twist to it which is that it's actually the green leafy vegetables

0:07:08 > 0:07:11containing nitrate that may be particularly important.

0:07:11 > 0:07:14I must admit, I do find it incredibly interesting.

0:07:14 > 0:07:18The idea that you can get these sort of changes in your body and things

0:07:18 > 0:07:20which I was completely unaware of.

0:07:20 > 0:07:23I definitely noticed on the third day I had the high nitrate diet

0:07:23 > 0:07:26and the exercise really genuinely felt easier.

0:07:26 > 0:07:30I think what I've learnt is that eating a diet higher in nitrates

0:07:30 > 0:07:34is going to help me age well, and who doesn't want to age well?

0:07:34 > 0:07:39Now, I was surprised that a single meal or a shot of beetroot juice

0:07:39 > 0:07:42could do all those things - reduce blood pressure,

0:07:42 > 0:07:44have an effect on muscle efficiency,

0:07:44 > 0:07:47and also prevent brain fade during exercise.

0:07:47 > 0:07:52For me, the very clear message is you've got to guzzle those greens.

0:08:00 > 0:08:05We all know that flu can make us feel seriously unwell.

0:08:05 > 0:08:09And though an annual flu vaccination is offered on the NHS to children,

0:08:09 > 0:08:13the over-65s and people at clinical risk,

0:08:13 > 0:08:16less than two thirds of those eligible actually have it.

0:08:16 > 0:08:18So, what's the problem?

0:08:18 > 0:08:21One for GP Zoe Williams.

0:08:24 > 0:08:27Over the winter months, like many GPS,

0:08:27 > 0:08:29I see dozens of patients with flu,

0:08:29 > 0:08:33yet many people who are eligible for the flu jab choose not to have it.

0:08:33 > 0:08:37So why are people worried about the vaccine, and should you be?

0:08:38 > 0:08:40The most common reason I hear from

0:08:40 > 0:08:45people declining the vaccine is that the jab actually gave them flu.

0:08:45 > 0:08:48Well, that's not possible because

0:08:48 > 0:08:51there's absolutely no live virus in it.

0:08:51 > 0:08:53It takes about 7-14 days for your

0:08:53 > 0:08:56body to develop the protection after the vaccine,

0:08:56 > 0:09:00so if you actually contract the flu during this time,

0:09:00 > 0:09:03or even in the week before, then you might not be fully protected.

0:09:03 > 0:09:06And that protection is important

0:09:06 > 0:09:11because flu kills up to half a million people worldwide every year,

0:09:11 > 0:09:15and during a pandemic, this can escalate to millions.

0:09:17 > 0:09:18The biggest challenge facing

0:09:18 > 0:09:20the scientists developing the flu vaccine is

0:09:20 > 0:09:23that the virus is always changing,

0:09:23 > 0:09:24which makes it one of the most

0:09:24 > 0:09:27difficult diseases to predict and control.

0:09:29 > 0:09:33Imagine this gift box is a flu virus.

0:09:33 > 0:09:36It infects a cell and then it multiplies...

0:09:38 > 0:09:42But when viruses are copied, sometimes mistakes are made,

0:09:42 > 0:09:45and the virus mutates. It's still flu,

0:09:45 > 0:09:47but it looks slightly different.

0:09:47 > 0:09:50Our immune system gets to work and

0:09:50 > 0:09:54learns to recognise the original flu virus and starts to destroy it.

0:09:54 > 0:09:58But our immune system can't recognise the mutated flu virus

0:09:58 > 0:10:02because it looks slightly different, so it doesn't get destroyed.

0:10:02 > 0:10:06The slightly new flu can then infect cells and multiply and infect

0:10:06 > 0:10:10more people and the cycle goes all over again.

0:10:10 > 0:10:12To keep up with these mutations

0:10:12 > 0:10:15requires a massive ongoing research effort.

0:10:15 > 0:10:17Scientists have to constantly

0:10:17 > 0:10:21monitor the latest flu strains so they can update the vaccine.

0:10:21 > 0:10:23But this involves predicting

0:10:23 > 0:10:26which strains will be most common each winter.

0:10:26 > 0:10:29Some years that's more successful than others,

0:10:29 > 0:10:31but it's always worth having

0:10:31 > 0:10:35the flu jab because some protection is better than none at all.

0:10:36 > 0:10:40And in future, we may not need to be vaccinated every year.

0:10:41 > 0:10:43Researchers are working to create

0:10:43 > 0:10:47a new broad spectrum or universal flu vaccine,

0:10:47 > 0:10:50which will protect against more viruses and last longer.

0:10:51 > 0:10:55The research takes place in a tightly controlled quarantine unit,

0:10:55 > 0:10:59as it involves volunteers actually being infected with the flu.

0:11:01 > 0:11:04The principle behind the new vaccine is to target particular

0:11:04 > 0:11:08protein molecules that lie deep inside the virus.

0:11:08 > 0:11:12So, these gift boxes all look different on the outside...

0:11:13 > 0:11:15..but if we look inside,

0:11:15 > 0:11:19you can see that the gift in each one is exactly the same.

0:11:19 > 0:11:22And this is similar with flu viruses.

0:11:22 > 0:11:25Although the proteins on the outside mutate,

0:11:25 > 0:11:28the proteins deep inside stay the same.

0:11:28 > 0:11:33So if you can get your immune system to look for a protein deep inside

0:11:33 > 0:11:38every strain, then it will be able to spot and destroy any type of flu.

0:11:38 > 0:11:41And even if a new strain comes along in the future,

0:11:41 > 0:11:43the vaccine will continue to work.

0:11:44 > 0:11:47Kim Denney, CEO of one of the companies

0:11:47 > 0:11:51developing the universal flu vaccine, has agreed to tell me more.

0:11:53 > 0:11:56So, we know that the immune system can recognise the proteins on the

0:11:56 > 0:12:01outside of the virus. How can it see the proteins on the inside?

0:12:01 > 0:12:04Part of that is how an actual virus infects a cell,

0:12:04 > 0:12:08so a virus doesn't have much in and of itself.

0:12:08 > 0:12:11It's very clever so it hijacks your own cells.

0:12:11 > 0:12:16It gets inside and turns your cells into its own factory, and in order

0:12:16 > 0:12:19to do that, it's got to fold and unfold. That's how it replicates.

0:12:19 > 0:12:22So when that virus opens up

0:12:22 > 0:12:25and exposes the internal proteins

0:12:25 > 0:12:28that we're targeting for our vaccine,

0:12:28 > 0:12:30it'll be able to see it and recognise it.

0:12:30 > 0:12:33At the moment as a GP, it's really challenging to try

0:12:33 > 0:12:35and get patients in year after year for their flu vaccine.

0:12:35 > 0:12:39With this new technology, how often will they need to come in?

0:12:39 > 0:12:41Well, we don't know quite yet.

0:12:41 > 0:12:44We're hopeful that it could be less frequent than every year,

0:12:44 > 0:12:47up to three years, potentially up to five years.

0:12:47 > 0:12:51Even if you had to go in and get a booster shot, though,

0:12:51 > 0:12:52it's going to still be much better

0:12:52 > 0:12:56than a seasonal vaccine because it's broad spectrum coverage.

0:12:56 > 0:13:01- Again, we won't have to, every year, guess what is circulating.- Yeah.

0:13:03 > 0:13:07We're still five to ten years away from a universal flu vaccine,

0:13:07 > 0:13:10but with research facilities like this,

0:13:10 > 0:13:13we're getting closer to better treatments for flu.

0:13:13 > 0:13:17And although the current vaccine isn't perfect, it does save lives.

0:13:17 > 0:13:21So if your GP recommends it, then please take the opportunity because

0:13:21 > 0:13:24it'll help protect you and those

0:13:24 > 0:13:27around you and it will not give you the flu.

0:13:35 > 0:13:38Coming up - the new implant that's

0:13:38 > 0:13:42helping rewire the brains of stroke survivors.

0:13:42 > 0:13:46And medical apps - which can you trust to help keep you healthy?

0:13:47 > 0:13:50But first, in this series of Trust Me,

0:13:50 > 0:13:53we are exploring some common mental health conditions.

0:13:53 > 0:13:55In this programme, psychiatrist

0:13:55 > 0:13:59Dr Alain Gregoire is looking at anxiety disorders.

0:14:02 > 0:14:03For most of us,

0:14:03 > 0:14:07anxiety is a perfectly normal reaction to many of the challenges

0:14:07 > 0:14:10that everyday life throws at us.

0:14:10 > 0:14:11But for some people, the anxious

0:14:11 > 0:14:14feelings and thoughts become so intense,

0:14:14 > 0:14:16so frequent and so disabling that it

0:14:16 > 0:14:20becomes a condition known as generalised anxiety disorder.

0:14:22 > 0:14:24It's called generalised because the

0:14:24 > 0:14:29anxiety experienced by sufferers is not confined to specific issues.

0:14:29 > 0:14:33Instead it spreads to almost every aspect of life.

0:14:35 > 0:14:39Almost 6% of the UK population has experienced GAD.

0:14:41 > 0:14:42Adele and Russell are among them.

0:14:44 > 0:14:47So, what's it like to live with this day to day?

0:14:47 > 0:14:50Oh, I could just be walking down the street,

0:14:50 > 0:14:54the switch in your brain goes like that, and then it's almost like

0:14:54 > 0:14:57someone's got their hand around your windpipe and squeezing it.

0:14:57 > 0:15:02These panic attacks were happening every day and they're very draining

0:15:02 > 0:15:03and the thoughts that you have

0:15:03 > 0:15:06during that time period are just warped.

0:15:06 > 0:15:07Really, really strange.

0:15:08 > 0:15:13For many people with GAD, feeling anxious is a daily occurrence.

0:15:14 > 0:15:17I'd worry about my husband driving to work,

0:15:17 > 0:15:18whether he'd get involved

0:15:18 > 0:15:21in a traffic accident, and until he'd phoned me,

0:15:21 > 0:15:23I would be in a highly anxious state,

0:15:23 > 0:15:26and you can completely convince yourself that that has actually

0:15:26 > 0:15:28taken place and then you feel almost

0:15:28 > 0:15:31disappointed when you get a phone call to say they haven't been,

0:15:31 > 0:15:33which is just a ridiculous reaction.

0:15:33 > 0:15:35The thought's ridiculous and the

0:15:35 > 0:15:37reaction to it is ridiculous, but you can't control it.

0:15:37 > 0:15:39If you think you or someone else is

0:15:39 > 0:15:43suffering from generalised anxiety disorder, what do you need to know?

0:15:44 > 0:15:49Some common signs are feeling on edge or fearful much of the time,

0:15:49 > 0:15:53excessive concerns and anxious thoughts,

0:15:53 > 0:15:57restlessness, and avoiding situations that make you anxious.

0:15:58 > 0:16:03There are also physical symptoms - a racing heart or skipped heart beats,

0:16:03 > 0:16:11rapid breathing, dry mouth, sweating, trembling, dizziness.

0:16:12 > 0:16:14Some people get panic attacks

0:16:14 > 0:16:17in which all of these features combine intensely.

0:16:19 > 0:16:23The exact psychological and physical symptoms will vary from person

0:16:23 > 0:16:25to person, and similarly research

0:16:25 > 0:16:28has identified a wide range of factors

0:16:28 > 0:16:30that can increase our vulnerability,

0:16:30 > 0:16:35including current stresses and past adverse life experiences,

0:16:35 > 0:16:39even stretching back to when we were babies in the womb.

0:16:39 > 0:16:43So what's the best way to start dealing with this?

0:16:43 > 0:16:46First, acknowledge that you have a problem,

0:16:46 > 0:16:49and then start talking about it.

0:16:49 > 0:16:50I suddenly realised that the

0:16:50 > 0:16:54level of anxious feelings that I was having and the thoughts

0:16:54 > 0:16:57that I was having weren't quite right,

0:16:57 > 0:17:00and I didn't really want to admit that,

0:17:00 > 0:17:04because nobody wants to admit that they've got a mental health problem,

0:17:04 > 0:17:06partly through the stigma of it, but

0:17:06 > 0:17:09also because of the fear of what is going to happen next.

0:17:09 > 0:17:14And I think accepting, accepting that you have a condition,

0:17:14 > 0:17:19that you have an illness, that there is something you struggle with,

0:17:19 > 0:17:23I think that is...that that in itself helps to improve.

0:17:23 > 0:17:26The day to day anxious feelings and thoughts we all get tend to go away

0:17:26 > 0:17:31quite quickly, but anxiety disorders can last for months or years,

0:17:31 > 0:17:33so it's really important

0:17:33 > 0:17:37to recognise them and get help as quickly as possible.

0:17:37 > 0:17:40What were the sorts of things that made a difference to you?

0:17:40 > 0:17:42Definitely find a support group if you can

0:17:42 > 0:17:44to talk openly about this over a coffee.

0:17:44 > 0:17:46And it doesn't matter whether

0:17:46 > 0:17:49the people have got different conditions,

0:17:49 > 0:17:51it's because you have this shared experience that matters.

0:17:51 > 0:17:54Treatment for GAD usually involves

0:17:54 > 0:17:59a talking therapy such as cognitive behavioural therapy, CBT,

0:17:59 > 0:18:03sometimes medication, or a combination of both.

0:18:05 > 0:18:09The CBT sessions that I had, I think, if anything,

0:18:09 > 0:18:12that was the best thing for me.

0:18:12 > 0:18:14We learned about mindfulness

0:18:14 > 0:18:19and sort of bringing yourself into the sort of present moment.

0:18:20 > 0:18:24There are also many changes you can make to help reduce your anxiety,

0:18:24 > 0:18:27such as exercising regularly,

0:18:27 > 0:18:29stopping smoking and cutting down on

0:18:29 > 0:18:33the amount of alcohol and caffeine you consume.

0:18:33 > 0:18:35Generalised anxiety disorder does

0:18:35 > 0:18:37not have to become a long-term disability

0:18:37 > 0:18:41if you recognise it and you get the right treatment.

0:18:41 > 0:18:45Understanding and support from other people and professional help

0:18:45 > 0:18:49will maximise your chances of a good recovery.

0:18:56 > 0:18:58Thousands of you have been sending

0:18:58 > 0:19:00in questions to the Trust Me website,

0:19:00 > 0:19:04and we have been finding answers to some of the more popular ones.

0:19:04 > 0:19:07Do the health apps on my phone really work?

0:19:08 > 0:19:10Zoe has been investigating.

0:19:12 > 0:19:16The market for health apps has exploded.

0:19:16 > 0:19:18There are now more than a quarter of

0:19:18 > 0:19:20a million to choose from for just about everything.

0:19:22 > 0:19:25From measuring your heart rate to dieting,

0:19:25 > 0:19:28from stress relief to getting a good night's sleep.

0:19:32 > 0:19:34For the consumer, harnessing the

0:19:34 > 0:19:38power of the internet to improve our health might seem a great idea.

0:19:38 > 0:19:44After all, many of these apps are free or cheap and make big claims.

0:19:44 > 0:19:49As a GP, I can understand how this technology has the potential to give

0:19:49 > 0:19:53people more control over their health and wellbeing and,

0:19:53 > 0:19:55in theory, it could lead to less visits to the doctor.

0:19:57 > 0:20:00But do these apps actually do what they claim?

0:20:00 > 0:20:03Surprisingly, the app market

0:20:03 > 0:20:06is largely unregulated with very little policing.

0:20:06 > 0:20:10In fact, anyone with basic programming skills can create an app

0:20:10 > 0:20:13without any quality or safety checks.

0:20:14 > 0:20:17Research has shown that many health

0:20:17 > 0:20:20apps are based on very little solid science.

0:20:22 > 0:20:26The big app marketplaces found online do some basic checks

0:20:26 > 0:20:27to make sure that the software will

0:20:27 > 0:20:30work on your phone and to check for malware,

0:20:30 > 0:20:32but they don't do any clinical

0:20:32 > 0:20:35trialling to make sure that the health advice is sound.

0:20:35 > 0:20:37And there's another snag, which I

0:20:37 > 0:20:41can demonstrate using a selection of smartphones.

0:20:41 > 0:20:42One of the most popular forms

0:20:42 > 0:20:46of apps are those that use your phone's hardware

0:20:46 > 0:20:48to take a physical body measure.

0:20:48 > 0:20:52For instance, this one, which claims to measure your heart rate.

0:20:53 > 0:20:58It uses the phone's camera and flash to illuminate the skin and capture

0:20:58 > 0:21:03minuscule colour changes that happen each time the heart beats.

0:21:03 > 0:21:04But look what happens when I use

0:21:04 > 0:21:07the same app to take my heart rate on this phone...

0:21:09 > 0:21:10..compared to this one...

0:21:12 > 0:21:15..and compared to this one.

0:21:16 > 0:21:19Same app, three different readings.

0:21:19 > 0:21:20The problem is the quality

0:21:20 > 0:21:24of the hardware varies widely from phone to phone.

0:21:24 > 0:21:27So the readings can often be inaccurate,

0:21:27 > 0:21:28which could be misleading

0:21:28 > 0:21:31and potentially more dangerous for your health.

0:21:31 > 0:21:34This inaccuracy combined with a lack

0:21:34 > 0:21:38of testing makes it really hard to know which apps you can trust.

0:21:38 > 0:21:40Well, the NHS is a good place to start.

0:21:40 > 0:21:43They have a library of medical apps, and although it's a small selection,

0:21:43 > 0:21:46at least you know they've been tried and tested.

0:21:46 > 0:21:48Apps here have all been put through

0:21:48 > 0:21:51their paces by clinical professionals

0:21:51 > 0:21:55and those labelled as "approved" will have proven health benefits.

0:21:55 > 0:21:58They don't depend on complex hardware,

0:21:58 > 0:22:00so both simple and effective,

0:22:00 > 0:22:03but many of us will still want to download apps from the usual places,

0:22:03 > 0:22:06so here are my top tips to help you weed out the duds.

0:22:08 > 0:22:11Check that the app is made by an organisation you trust,

0:22:11 > 0:22:15such as the British Heart Foundation or the NHS.

0:22:15 > 0:22:19These apps are more likely to be based on solid science.

0:22:19 > 0:22:20And look what the reviews say.

0:22:20 > 0:22:22Read the comments carefully

0:22:22 > 0:22:24and leave some of your own too, to help others.

0:22:25 > 0:22:29I truly believe in empowering people to manage their own health and

0:22:29 > 0:22:34prevent disease, and apps can be a really useful way of doing that.

0:22:34 > 0:22:38They can also be useful for logging information to share with your GP.

0:22:38 > 0:22:41But when it comes to diagnosis and managing disease,

0:22:41 > 0:22:43they'll never replace a GP.

0:22:51 > 0:22:52People who have had a stroke are

0:22:52 > 0:22:56often left with a loss of function in their hands and arms.

0:22:56 > 0:22:58Surgeon Gabriel Weston has been

0:22:58 > 0:23:02investigating a novel therapy that really could change their lives.

0:23:04 > 0:23:09Every year in the UK, 100,000 people have a stroke.

0:23:09 > 0:23:13Most survivors face dramatic changes to their lives.

0:23:13 > 0:23:17Almost two thirds leave hospital with a disability.

0:23:18 > 0:23:20The most common form of stroke

0:23:20 > 0:23:22is one that's caused by the blood supply to

0:23:22 > 0:23:25the brain being cut off by a blocked artery.

0:23:25 > 0:23:28Now, this can have bad effects throughout the body,

0:23:28 > 0:23:33but up to 75% of stroke survivors report some form of weakness

0:23:33 > 0:23:36or loss of mobility in the arms and hands,

0:23:36 > 0:23:39and this is the single biggest

0:23:39 > 0:23:42reason why these patients need long-term care.

0:23:44 > 0:23:48But a new form of therapy promises to transform the chances

0:23:48 > 0:23:52of restoring movement and strength for patients like Linda.

0:23:52 > 0:23:54She had a stroke four years ago.

0:23:55 > 0:23:58It was New Year. I'd been at my sisters.

0:23:58 > 0:24:00We'd had our dinner and I went to my bed.

0:24:00 > 0:24:02And then I woke up in the morning and I spoke to my husband,

0:24:02 > 0:24:06and he realised when I'd spoke to him that there was something wrong.

0:24:06 > 0:24:07He put the light on

0:24:07 > 0:24:10and then discovered my face had been drooping.

0:24:12 > 0:24:16Linda's stroke left her with severely impaired mobility.

0:24:16 > 0:24:20I couldn't go to the toilet myself. I couldn't move any of my left arm,

0:24:20 > 0:24:24my left leg. I was totally immobile. I just couldn't move at all.

0:24:24 > 0:24:26Patients normally go through a

0:24:26 > 0:24:31course of physiotherapy to help them regain hand and arm strength.

0:24:31 > 0:24:34But in many cases, this isn't fully effective,

0:24:34 > 0:24:38and patients are left with long-term problems.

0:24:38 > 0:24:41Right, we're going to start off with the cutlery, then, first.

0:24:41 > 0:24:43But Linda is now taking part in an

0:24:43 > 0:24:48innovative new trial at the Queen Elizabeth Hospital in Glasgow.

0:24:48 > 0:24:51The aim is to compensate for the damage to the brain

0:24:51 > 0:24:55by stimulating a key nerve in the body, the vagus nerve.

0:24:55 > 0:24:57Lovely wrist position there.

0:24:57 > 0:25:01The vagus nerve runs from the brain through the neck to the abdomen

0:25:01 > 0:25:04and has many functions throughout the body.

0:25:04 > 0:25:08The innovation at the heart of this new treatment is a surgical implant

0:25:08 > 0:25:13that uses the nerve to send electrical impulses to the brain.

0:25:13 > 0:25:19The trial is being run by professor of stroke medicine, Dr Jesse Dawson.

0:25:19 > 0:25:23So, this is the implantable pulse generator,

0:25:23 > 0:25:25so this is the electrical box, if you like,

0:25:25 > 0:25:27and it sits just under the collarbone,

0:25:27 > 0:25:30underneath the skin on the left-hand side.

0:25:30 > 0:25:33During the operation, the surgeon will connect this lead,

0:25:33 > 0:25:36which will be inserted into the device

0:25:36 > 0:25:37and will take the electrical

0:25:37 > 0:25:40signals up to the vagus nerve on the left-hand side.

0:25:40 > 0:25:42Check to make sure it's simulated.

0:25:42 > 0:25:45And the lead will also be fully implanted underneath the skin.

0:25:45 > 0:25:47Once the device is in,

0:25:47 > 0:25:51the participant would have six weeks of very intensive physical therapy.

0:25:51 > 0:25:55If you can pick this weight up and place it on its end here, right?

0:25:55 > 0:26:00Linda had her device implanted over two years ago.

0:26:00 > 0:26:04It's believed that stimulating the vagus nerve at the same time as

0:26:04 > 0:26:06repeating physical actions

0:26:06 > 0:26:11encourages the brain to bypass the areas damaged by stroke.

0:26:11 > 0:26:14So each time Linda performs a task during the therapy session,

0:26:14 > 0:26:16the therapist will press the push button,

0:26:16 > 0:26:19and that will then activate the computer

0:26:19 > 0:26:21and tell it to send a wireless signal to the device,

0:26:21 > 0:26:23which then stimulates the vagus nerve.

0:26:23 > 0:26:26That sends a signal to the main control centre in the brain,

0:26:26 > 0:26:28the brainstem, and by activating the brainstem,

0:26:28 > 0:26:31we then cause a release of several important chemicals onto the surface

0:26:31 > 0:26:33of the brain and we think that it's

0:26:33 > 0:26:36increasing the concentration of those chemicals at the same time

0:26:36 > 0:26:38that somebody's training that

0:26:38 > 0:26:41increases the ability of the brain to rewire itself and recover.

0:26:42 > 0:26:45Early results from the trial are promising.

0:26:45 > 0:26:47Before this treatment,

0:26:47 > 0:26:50Linda struggled with carrying out even basic tasks,

0:26:50 > 0:26:54but now she's able to manage most everyday activities.

0:26:55 > 0:26:57I can't really put it into words, like,

0:26:57 > 0:27:01how good it is to be improved as much as I am.

0:27:01 > 0:27:04It's brought normality and independence back to me,

0:27:04 > 0:27:06being a person,

0:27:06 > 0:27:09and I don't need to rely on anybody now and I'm just me.

0:27:11 > 0:27:14In the 17 or so years since I've become a doctor,

0:27:14 > 0:27:18I've seen tonnes of patients with strokes who get to a certain point

0:27:18 > 0:27:21in their recovery and then just don't get any better,

0:27:21 > 0:27:27so to see this patient get such a dramatic result is really amazing.

0:27:27 > 0:27:31A larger study is now planned to assess whether this treatment

0:27:31 > 0:27:34should be made available to stroke survivors across the world.

0:27:34 > 0:27:36We know that our traditional

0:27:36 > 0:27:39techniques just don't get enough people better,

0:27:39 > 0:27:42and there are tens of thousands of patients in the UK who could

0:27:42 > 0:27:45benefit from this therapy and many more worldwide.

0:27:45 > 0:27:47This truly could be a breakthrough

0:27:47 > 0:27:50treatment for patients with upper limb problems after stroke.

0:27:50 > 0:27:52Excellent.

0:27:52 > 0:27:53Well done. OK...

0:27:55 > 0:27:57What I've seen here today has

0:27:57 > 0:27:59reminded me that stroke is incredibly common,

0:27:59 > 0:28:03and can happen at any time in a patient's life.

0:28:03 > 0:28:06Now, this research is in its very early stages,

0:28:06 > 0:28:08but on the basis of what I've witnessed,

0:28:08 > 0:28:11I think this device holds out real

0:28:11 > 0:28:14hope to patients suffering from stroke

0:28:14 > 0:28:16and the people who look after them.

0:28:23 > 0:28:25That's it for this edition of Trust Me.

0:28:25 > 0:28:28Next time, we're in Leeds,

0:28:28 > 0:28:33finding out what type of exercise gives you the strongest bones.

0:28:33 > 0:28:37# I've just made an appointment for a special rendezvous

0:28:37 > 0:28:43# To see a man of miracles and all that he can do

0:28:43 > 0:28:47# I checked in at reception Put my hat to my lap

0:28:47 > 0:28:52# And when he walked in dressed in white I had a heart attack

0:28:52 > 0:28:55# Doctor I want you

0:28:55 > 0:28:57# Do what you want to do

0:28:57 > 0:28:59# I can't get over you

0:28:59 > 0:29:02# Doctor do anything that you want to do. #