Trust Me I'm A Doctor (2013) Episode Scripts

N/A - Series 2, Episode 1

Everywhere we go, we are bombarded with advice.
But it's constantly changing.
Should we eat this? And not drink that? What do you do when everything you thought was bad for you is now good for you? In the clamour of conflicting information, how do you know who to trust? I'm Michael Mosley.
In this series, I'm joined by a team of doctors.
And together, we're going to use our expertise to cut through confusing adverts, headlines and health claims.
This is Trust Me, I'm A Doctor.
As summer ends, we start this new series by asking, is sunshine good or bad for us? Could your leftovers be healthier than the original meal? World first for Trust Me, I'm a Doctor.
Could the paralysed move again? It is amazing! It's amazing! Does acupuncture really stop pain? And can plastic packaging give you cancer? But first Now, I've been a medical journalist for over 25 years.
And during that time, I've done a number of reports on the dangers of sunshine.
But perhaps the tide is turning.
We're in Bognor Regis to look at some of the more surprising benefits of sunshine.
And to ask, is it really as bad for us as we think? According to the Met Office, Bognor Regis is the sunshine capital of the UK.
Do you think sunshine is good for you or bad for you? Bad, I think.
It's good for you in small doses.
What do you think are the good things about sunshine? ~ You get a tan.
~ LAUGHTER One of the great things about sunshine is it boots your levels of vitamin D.
Vitamin D is known as the sunshine vitamin because when you stand there, the ultraviolet light acts on your skin to produce vitamin D in your skin.
Low vitamin D levels have been linked with everything from heart disease to cancer.
And we need good levels to maintain healthy bones and avoid osteoporosis.
Yet research suggests that around half the adults in the UK don't have adequate vitamin D.
So, if you want to boost your levels of vitamin D, what should you do? Get more sunshine, or something else? To find out, we're testing a group of people who, even here in sunny Bognor, frankly, don't get out much.
Good morning, University of Chichester.
How can I help? This is one of the admin offices at the Bognor Regis campus of the University of Chichester.
These workers spend their day in the office dealing with calls from staff, students and the public.
Do you think your vitamin D levels will be decent? Um probably lower than they should be.
I like to be in the sun, but I tend to use a moisturiser with SPF in it.
Your vitamin D levels, will they be OK? I really don't know.
~ Be interesting to find out, though.
~ Yeah.
Right, we're struggling to get blood out of you.
We're taking blood samples to measure our volunteers' vitamin D levels at the start of the experiment.
And the results are typical for the UK.
Even though our volunteers work in the sunniest town in the UK, fewer than half have adequate vitamin D.
The rest could all potentially benefit from boosting their levels.
And two of our volunteers are at risk of vitamin D deficiency, which can cause serious bone problems.
So, what are their options? Essentially, there are three different ways in which you can boost your vitamin D levels.
First, and by far the cheapest, in fact, absolutely free, sunshine.
Then there is fish.
Oily fish is one of the few foods we have that is rich in natural vitamin D.
And finally, there are supplements.
Now these are essentially the modern take on cod liver oil.
Which of these are the most effective and the most practical? Sunshine, fish, supplements? We're going to find out.
We're splitting our office workers into three groups to test three different pieces of advice.
The first group we're sending out for ten minutes of sunshine every day at lunchtime, as recommended by the National Osteoporosis Society's Sunlight Campaign.
Sitting by a window is no good.
Only direct sun can produce vitamin D.
I have got supplements.
The second group were given low dose daily vitamin D supplements, recommended for people who don't get much sun.
And the final group, we'll be asking to eat three portions a week of oily fish.
Right, I have fish.
Who are the fish eaters? Known to be a good source of vitamin D.
OK, have a look at this one.
You're going to have to eat 100 grams three times a week, OK.
100 grams three times a week.
That is 100 grams.
That is 100 grams.
~ Do you think you can handle that in one meal? ~ I expect so.
~ Three times a week.
~ Fine.
Thank you.
~ Looking forward to it? ~ I am, yes.
Any more fish eaters? The fish is carefully selected as only some fish contain high levels of vitamin D.
In this case, wild-caught smoked and tinned salmon, and mackerel.
All the volunteers will be wearing sun-exposure monitors during the experiment, so we can factor this in when we measure their vitamin D levels.
Professor Helen Macdonald from the University of Aberdeen will be analysing the results in three weeks' time.
Would you expect three weeks to be enough to make a difference? It is quite short, so it'll be interesting to see if there is an increase or not.
I wouldn't expect a huge difference, but I would hope to see some difference.
So, out of a daily dose of sunshine, supplements or oily fish, which will be the best way to boost your vitamin D levels? We'll be rejoining the volunteers later to find out.
I'm always going on about eating more healthily, but I'm a hypocrite.
I don't want to change my diet, I love my food.
And I enjoy a carb-loaded plate of pasta as much as anyone.
Starchy foods like potatoes and pasta have lots of calories, but can you make these foods better for you? Well, we heard a surprising claim that you can do just that by changing the way they're prepared.
To help me investigate, I've recruited the staff and their friends at this Italian restaurant.
Hi, everyone.
Can I ask, how many of you guys are Italian? Almost everyone is actually Italian.
And you're big pasta fans? ~ Of course! ~ Does anyone not like pasta? Not when it's cold at 8:00 in the morning.
LAUGHTER Now, carbs like pasta, bread and potatoes get a bad press, but I'm off to meet Dr Denise Robertson, who claims to have a way of making these foods healthier.
Without changing a single thing on the plate.
Denise, from the University of Surrey, and the restaurant's chef, Ross, have been busy preparing the experiment.
This is a very weird place to be doing a science experiment.
It is, it is.
It's not our norm, I have to say.
Our volunteers will undergo three days of testing.
On one day, they'll eat the pasta hot when it's freshly cooked.
On another, they'll eat it cold when it's been chilled overnight.
And on the third, they'll eat the chilled pasta reheated.
Denise believes that just by changing the temperature, she can make the pasta healthier and even reduce its calories.
So, the only difference between the meals is that.
? It's going to be the temperature.
And you think this is going to have a difference? I do, I do.
I'm confident it will, yeah.
I have honestly never heard of that.
Ross, what do you think of this? Is this news to you? To me, it's new news to me.
I mean, it looks, it looks, er If that's the case, it looks very good.
It's ground-breaking if that's the case, innit? Now, I'd better get serving.
All for you.
Cold.
What do you think of my waiting skills? It's nice serving waiting on the waiters.
~ How's the pasta? ~ I prefer hot pasta, but this isn't that bad.
But maybe because I'm really, really hungry.
~ I mean, now I could even eat the plate.
~ Right.
They have to take their own blood samples every 15 minutes over the next two hours as they digest the pasta.
Cappuccino.
Starchy foods like this are really quickly broken down into sugars, so they give us a very fast sugar hit.
In response, our bodies produce a rush of the hormone insulin to get rid of it.
Now, high sugars and the resulting high insulin are unhealthy and they may make you feel hungry soon after a meal.
And that's the problem with refined, sweet sugars.
But it's also true for things like pasta, potatoes, white rice and white bread.
But in our three-day experiment, Denise expected the temperature of the pasta to make a difference.
What results did you get? Well, you'll be very surprised what it's done.
I was quite surprised what it had done, actually.
First, Denise compared the freshly-cooked pasta with the chilled pasta.
When our volunteers ate the freshly-cooked pasta, their blood glucose showed the expected sharp rise and fall.
But when they ate the chilled pasta, it didn't rise as much, meaning that it's not causing such unhealthy surges in insulin and glucose.
OK, so this seems very important, that you can reduce the impact on hopefully insulin, definitely blood glucose, simply with the preparation of an identical food.
But why is the starch behaving like this? We know that when a starch such as potato or pasta is cooked in water and then it's allowed to cool, you're changing the structure of that starch.
And you're changing it in such a way, it becomes resistant to the normal enzymes that we have within our bodies.
And because the enzymes don't work on it, it releases less glucose, so you get a lower glucose response.
So it's good for you because you get a lower blood sugar.
You do.
And it's now called resistant starch.
And resistant starch, because you're not digesting it, will move down your intestine, it will end up in your large bowel and it becomes part of your dietary fibre.
~ Really? ~ So it contributes to dietary fibre intake, as well.
So, will it, then, in the large bowel, have all those other beneficial effects of fibre, effects on the heart, effects on gut health, ~ effects on your risk of cancer? ~ Yeah, that's right.
~ And we've known about that probably for 20 to 30 years.
~ Really? Although I don't think the general public have really been aware of it.
This first result is exactly what Denise was expecting.
But then we looked at the results from reheating the chilled pasta.
Something Denise hadn't tried before.
And astonishingly, it reduces the rise in glucose by another 50%, making it even healthier.
So it seems that reheating makes even more of the carbohydrate turn into resistant starch.
It's an extraordinary result and one never measured before.
Obviously, this is really fascinating and important, but we've only done it in ten people.
But it was ten people who have all done exactly the same thing.
~ All ten had the same results? ~ Yeah.
Now, anyone who studies human beings would say that that is significant, when all ten people behave the same way.
It is.
And this is a really, really big difference.
~ This is probably the biggest difference I've ever got.
~ Really? This is remarkable.
Thanks to our Italian volunteers, we've made a brand-new discovery on Trust Me, I'm A Doctor.
And something that could simply and easily improve all our health.
We can convert unhealthy carb-loaded meals to much more healthy fibre-loaded ones instead without changing a single ingredient, just the temperature.
In other words, our leftovers could be much healthier for us than the original meal.
You never quite know what's going to happen when you try and do science on television, but today, not only did we get one result that Denise expected, but we also discovered something new.
Scientists like her have known for decades, even if I haven't, that if you cool down cooked starches, you generate this beneficial resistant starch.
But what we didn't know is that when you reheat it, you get even more of it.
And that means lower insulin, lower blood sugar, fewer calories and, of course, more fibre.
And that's great news if you, like the Italians, enjoy your pasta hot.
For this series, we've created a special video booth that's been travelling with us around the country.
The people of Bognor Regis have been dropping in to record the questions they've always wanted to ask a doctor, but never had the time.
Can crossing my legs give me varicose veins? One for surgeon, Gabriel Weston.
A varicose vein is caused by the failure of a valve just under the skin.
Now, we've got lots of these in our legs to help return our blood from our toes to our heart, so that's where we tend to see them.
And if one of these valves fail, then blood can pool, causing the vein to bulge.
The things that most influence our risk of developing varicose veins are genetics, height and age, which we can't do anything about.
Other factors include obesity and pregnancy.
Crossing our legs doesn't seem to have anything to do with it.
However, varicose veins do happen more often in those who tend to be on their feet all day, like hairdressers, nurses or teachers.
So if you spend a lot of time standing up for a living, try to do basic leg or ankle exercises, or even walk around a bit just to keep the blood flowing.
Still to come, can plastic packaging give you cancer? And could fatty food actually be good for you? But first When I was a medical student, I flirted briefly with acupuncture.
The thing is, I could never persuade myself it was anything more than a placebo.
These days, you can get it on the NHS.
But does it work? And if you have, say, a bad back, should you give it a go? Well, A & E doctor, Saleyha Ahsan, has been investigating.
Like Michael, I've tended to think that the effects of acupuncture were all in the mind.
But many doctors are now offering it as a serious alternative to painkillers.
So I want to know, should we try acupuncture rather than simply popping pills? At this course in London, there's a huge variety of health professionals being trained in how to perform acupuncture as a medical treatment.
Tell me what you do.
I'm a GP in Southampton.
~ What do you do? ~ I'm a sports physician, a sports doctor.
~ I'm an anaesthetist.
~ I'm a GP registrar.
I'm an osteopath.
Obstetrician Dr David Carr of University College London already uses medical acupuncture for pain relief.
Hi.
Sorry to interrupt.
I'm Saleyha.
~ Hi.
I'm David.
~ David, hi.
What are you up to? We're doing a little bit of lower back acupuncture.
This is one of the things we focus on on this course, is back pain.
It's really very common.
The most common problem in the UK.
Healthcare professionals, doctors, are a sceptical bunch.
They're going to want to know how it works, why it works, what the data behind it is.
Since the '70s, there's been a lot of medical research into how this works.
And there are many different ways.
And not all of them will necessarily apply to every patient.
We certainly have local effects where we put the needles, we reduce tension, we have direct affects on pain.
We also know that it releases endorphins into the spinal fluid.
That can be quite similar to taking a dose of codeine in some patients.
It also affects the way pain signals are processed through the body.
That's a lot of big claims.
How is it possible that simply sticking needles in people can have effects like this? At the University of York's Neuroimaging Centre, one group of researchers has been trying to find out.
They've been using a scanner to study what happens in the brain during acupuncture.
And today, they're going to scan me.
Because of the scanner's strong magnetic field, I have to take off anything metal.
And our cameras can't come into the scanner room.
But Dr Hugh Macpherson has acupuncture needles that won't be affected by the magnetism.
Three, two, one, start.
He's going to perform acupuncture on me.
And while he does it, Dr Aziz Asghar will record my brain activity.
Stop.
Well done, that's all finished.
So, will acupuncture really produce an effect in my brain? ~ Hello.
~ Hi, there.
~ Now, then ~ Hi.
~ Hi.
~ How's it going? ~ We have results for you.
Oh, my God! Is that my face, as well? Oh! LAUGHTER I look I look like my dad! What are we looking at here? ~ You're seeing the deeper part of the brain.
~ Yeah.
~ And within that is something called the pain matrix.
~ Yeah.
And you would expect that if the needling was painful, you would expect to see a response there.
So we'd expect to see lots of increases in blood flow.
In fact, the exact opposite we're seeing here.
We're seeing decreases in blood flow here.
The blue areas show where the blood flow has reduced when Hugh stuck needles in me.
Less blood flow here may explain why we experience less pain during acupuncture.
And these results are typical of what Hugh found when he conducted this kind of test in 17 volunteers.
The fact that we see decreases in blood flow here suggests that acupuncture is not a painful stimulus, it's something else.
There's something about acupuncture that's causing the decreases in blood flow.
What that is, we don't know.
So if I had back pain .
.
just by looking at that picture .
.
I would assume that it would have been an effective treatment.
This is the first solid evidence I've seen that acupuncture can have a measurable effect on pain levels.
Although this study doesn't explain how it might reduce pain, at least it seems to provide objective evidence that it does.
The evidence for some of the more established painkillers is often no stronger.
And when acupuncture is carried out by a medical professional, the risks are very low.
So now I understand why more doctors are prescribing it for pain relief in some cases.
And I have to say that what I've seen has changed my mind.
So if your doctor suggests using acupuncture for back pain, I would consider it.
In our experiment in Bognor Regis, we're testing three recommended ways to boost your vitamin D levels.
One group of volunteers is eating oily fish, another is taking supplements.
Our third group is going out in the sun unprotected.
Something that goes against everything that I, as a skin surgeon, have always advised.
Very few patients will own up to being sun worshippers, but often, their skin tells a very different story.
My job involves surgically removing abnormal areas of skin that often turn out to be skin cancer.
And in many cases, it's overexposure to sun that's the problem.
I'd be the very first one to admit that, as doctors, we're so keen to send a really strong message that the sun should be avoided at all costs that perhaps we're reluctant to admit there's anything good about it at all.
But is this right? Are the potential benefits of the sunshine significant enough that we should be rethinking our advice? Like me, dermatologist Dr Richard Weller spends much of his time treating patients with skin damage caused by overexposure to the sun.
Here in Edinburgh, he's studying the effects of ultraviolet light on our skin.
And his results are surprising.
Richard, it looks slightly like we're in a tanning parlour.
Can you just tell me what's happening? Well, we're using UVA lamps here.
And we're measuring blood pressure and temperature.
If we took this subject outside, what would be the equivalent to what you're doing here on a sunny day? It's probably similar to 40 minutes in Cornwall midday, midsummer.
And what we're showing is that UVA lowers blood pressure.
This is a lasting effect.
Even after the UV lamp is switched off and the skin temperature returns to normal, the blood pressure remains lower.
We've only shown it for an hour and it's a fall of about two millimetres of mercury.
Which doesn't sound a lot, but if your blood pressure falls by two millimetres of mercury, your risk of having a stroke drops by 10% and of a heart attack by 7%.
And strokes and heart attack are the two biggest killers in Britain.
This drop in blood pressure could have such important consequences for our health, I want to know more about exactly what's happening.
Professor Martin Feelisch at the University of Southampton has been studying it in microscopic detail.
He's essentially carrying out a miniature version of the same sunbed experiment on a microscope slide with a tiny section of human skin.
This is a fluorescence microscope that allows us to look at a small section of human skin.
We have it focused on a section that shows the upper part of the skin and the lower parts, where the blood vessels are located.
The skin sample has been treated with a dye that lights up when a particular chemical called nitric oxide is present.
Nitric oxide is stored in the upper part of the skin and it plays a crucial role in controlling blood pressure.
As we continue shining UV light onto the skin, the upper part is getting more and more intense green, indicating there's a lot of nitric oxide being released.
And from there, because it's such a small gaseous molecule, it will diffuse into the lower layers to reach the blood vessels and cause dilation.
In fact, what you're showing me, this glowing section up here, is what would be happening to our skin if we were outside in the sunlight.
Yes, except we would not be glowing.
Do you need a hot, sunny day for this to happen? I believe this is happening already at more moderate light intensities.
Even a cloudy day.
But it will not happen indoors.
So, being outside in daylight is what causes this effect? Absolutely.
And we believe there is a whole host of other activities related to this nitric oxide.
We've come to realise in the last decade or so that skin is far more complicated than originally anticipated.
Martin and Richard's research suggests a potential mechanism for how sunlight lowers blood pressure.
But the real question for me is whether the benefit of lower blood pressure outweighs the risk of skin cancer.
Richard, I've been saying in my clinic, for years now, that, patients should protect themselves from the sun, and yet what you've told me today has thrown all of that into disarray.
What should I be advising people now? Well, some people are at particularly high risk of skin cancer from sunlight and melanoma's the skin cancer that matters.
If you've got red hair, if you burn and never tan, if you've got a family history of melanoma, if you've got lots and lots of moles, those people are at particularly high risk.
And I think for them, probably the message remains the same, but the majority of the population doesn't have those risk factors so if you have skin which readily pigments, if your blood pressure is slightly high, these are the people who would benefit more and I think, for them, they should be relaxing rather more than the guidelines would suggest.
It's a radical message, isn't it? Yes, but it's driven by data and evidence.
What I've learned from this research has completely changed my view.
Until now, I've been a doctor working in a skin cancer clinic unanimously telling patients that they should protect themselves from the sun and get out of the sun in order to avoid skin cancer.
And what I've found out here is that, while the connection between sunshine and skin cancer is still true, there may be benefits to our overall life expectancy in being out in the daylight.
So, whilst those with a high risk of skin cancer should still be very, very careful, for the rest of us, it could be that the outlook is somewhat sunnier.
Back in Bognor Regis, our Trust Me question booth has been buzzing as people drop in to record their burning health questions.
Can plastic water bottles cause cancer? Over to Chris.
There have been a lot of reports in the media recently about harmful chemicals in the plastic packaging used for our food and drink.
You may even have heard about the idea that leaving plastic water bottles in the sun and then drinking the water can give you cancer.
Well, that's just an internet hoax.
But there is some genuine scientific concern about a chemical called bisphenol A, or BPA.
BPA is found in a huge range of things from polycarbonate containers and the linings of cans of food to the heat-sensitive paper used in receipts and tickets.
Now, one of the ways that BPA is thought to cause harm is by acting like female hormones and there have been studies done at relatively high concentrations in mice that show it to be harmful particularly when the mice are pregnant or very, very young.
But there's a distinct difference, between mice and men, particularly in the way that chemicals like BPA are metabolised.
So, whilst it's been linked to everything from cardiovascular disease all the way through to childhood behavioural problems, there are no really strong studies, no good evidence that shows that at the concentrations we get it at in our daily food and drink, it's doing us any harm at all.
It's almost impossible to avoid BPA entirely.
Studies have shown traces of it in over 90% of people in developed countries.
But all baby bottles and many other food containers in the UK are now BPA-free.
You can tell which they are by reading the packaging.
Now, most plastic has a triangular recycling mark and in the middle of that mark, there's usually a number and if you see the number one, two, four or five, those plastics are BPA-free, they'll quite often say BPA free on them.
Here it even says it on the label.
Now, if there's a three or a seven in the triangle, these plastics may contain BPA and whilst they're safe at first, there's a chance that if you heat them up or use them or put detergent on them, that can increase the amount of BPA that's released.
So, if you're really concerned about BPA and just want to be super careful, you might want to avoid these plastics altogether.
MUSIC: Movin' On Up by Primal Scream Would you know what to do if someone was bleeding badly in front of you? As a doctor working in emergency medicine, I want to share some simple techniques that could help you save a life.
I've come to Scotland to meet a group who are especially keen to know how to stop a bleed.
Cyclists are involved in some 19,000 reported road accidents a year, so I'm about to show them, and you, how to do it.
Injuries that cause severe bleeding can ultimately kill you if not treated.
What I'm going to need is a willing volunteer.
I'll do it.
Mark, go over to Alistair and he's going to give you a wound.
THEY CHUCKLE Yes, he's going to give you a wound.
But it won't hurt.
Shouldn't hurt.
'Alistair's going to make a very realistic-looking 'wound on Mark's leg.
'We're making it as convincing as possible as it's important 'not to be put off by what a wound looks like, 'and to think about what you can do to help the person in trouble.
' Now, that is looking nasty.
Certainly can't be walking around on an injury like that.
That looks pretty deep.
It looks like you may well have hit some vessels, and if you have then I'm expecting it to squirt a bit.
Oh, there we go.
You have certainly hit a vessel.
'If you see an injury like this for real, 'the first thing you should do is call for help, 'but then there are some easy steps you should take 'to help stop the bleeding.
' The first step is apply some direct pressure, OK? So, direct pressure on the wound.
If you've got a bandage, use that.
If you haven't, use a T-shirt.
Again, use whatever you've got.
As you can see, it's all still seeping through, Mark, well done with the bag-squeezing.
'The key to stopping the bleeding is to apply the bandage quickly 'and firmly and not disturb the surface of the wound 'where a clot might be forming.
'Keep tying fabric around the wound until blood stops showing through.
'The important thing though, is to forget anything you've 'heard about tourniquets or tying these bandages as tight as you can.
' What essentially you don't want to do is apply it so, so tight that I can't get a finger in there.
I want to apply the amount of pressure that's going to work towards stemming the flow but without cutting off the blood supply to the rest of your foot.
'Once you've done all the bandaging you can, 'simply raise the wound up above the heart to help reduce blood flow.
'Not all wounds are clean and neat though.
'If you're faced with a wound like this, 'don't be tempted to pull the object out.
' That twig could actually be stemming the flow of blood.
By you pulling it out, you could be actually causing a mass bleed.
The principle of how we're going to treat that is ultimately the same.
You still need to apply pressure around the wound, so build it up and then cover it over.
'Protect the object by putting anything you can find 'either side of it, then keep pressing down firmly to help 'stop the bleeding as you tie a piece of fabric over the top.
' And just tie it tight, keep it secure, and there you go.
~ Mark, you feeling all right? ~ Yes.
~ Yeah, cool.
'Finally, there's one more very important thing to look out for.
' The thing that we worry about when it comes to serious bleed are people going into shock.
'Shock is a very dangerous condition caused by not enough blood 'reaching the vital organs.
' What I need you to look out for are some particular signs.
If they become dizzy, feel a bit faint, if their lips go blue.
If they become a bit pale, sweaty.
If their breathing is a little bit shallow and fast.
These are all worrying signs.
'Ensure the person is lying down with both legs raised to help 'blood flow to the brain and heart.
'Keep them warm and notify the emergency services immediately.
'By doing this, 'you'll have done everything you can to save their life.
' Hopefully, you'll never have to use these skills but if you do, stay calm and don't panic.
Stop the bleeding by applying pressure.
Call 999 as soon as possible.
Lie the casualty down and elevate the limb, and look for signs of shock.
You can watch this film again and read the main points on our website.
It's also worth getting your friends and family to have a look too, because if you know how, you could save a life.
Still to come, can the paralysed move again? And can the sun be good for us? The results of our experiment.
But first Now, we are bombarded constantly by conflicting health messages.
One day, it's eat more of this.
The next, it's eat less of that.
But how do we know what to believe? In the 1960s when I was growing up, medics declared war on saturated fat.
Out with the cheese and the butter, in with the margarine.
Unfortunately, the margarine they produced at the time was full of something called trans fats, and it made its way into everything from cakes to biscuits.
Now, we know that trans fats are fantastically bad for the heart and they're being phased out.
Now, this is an example of a public health campaign which had an unfortunate consequence.
But the original target, the saturated fats, how bad are they, really? Saturated fatty acids, as they're technically known, are found in animal fats including dairy and also in some vegetable oils like palm and coconut, while other oils such as olive and sunflower contain polyunsaturated fatty acids, traditionally thought to be better for us.
So, should we be switching from one to the other? Does saturated fat really increase the risk of heart disease as is widely believed? New research suggests the evidence isn't clear-cut.
Well, to find out more, I've invited a couple of leading experts whose research has led to contradictory headlines to meet me at the Royal Society of Medicine.
Professor Kay-Tee Khaw works in the Department of Public Health at Cambridge University.
She co-authored a controversial study which found no link between saturated fat and heart disease.
Your recent paper caused quite a stir because still people believe that saturated fat is clearly associated with heart disease and so for somebody with your reputation to come out and say actually the association is rather weak was a surprise.
Well, actually this paper was a summary of a lot of previous studies that had been done, looking at the relationship between fat in the diet and coronary heart disease.
For a long time, I think we've just thought of fat as a homogenous group and what is very, very clear is that there are all sorts of different fats and even within the saturated fatty acids, there may also be very different associations with heart disease.
So, it's really complicated? It's complicated in the sense that particular foods which may be high in saturated fats seem very consistently to reduce heart disease.
What do you think about dairy? There is some evidence now that the fat in milk, the saturated fat, fatty acids in milk may not be bad for heart disease and now several studies that have looked at these saturated fatty acids have found that they are inversely related to heart disease.
And some may be positively good for you? ~ Possibly, yeah.
~ You happy with butter? I do, I eat butter.
Some people think it's poison but you know I think that there is some evidence that dairy fats are not so bad for you.
OK.
What about things like meat? It's very clear that cattle that are fed on pasture have very, very different fatty acid patterns from cattle that are corn-fed.
So, I think how the animal has developed probably has a big impact in its nutrient profile and presumably on health outcomes, which may be why there's such conflicting evidence because it depends on where the source of your food comes from.
So, if I said to you saturated fats are just evil.
Avoid them.
What would you say? I'd say you can't say that, it's too simplistic.
I don't think people would argue that you want to eat a huge amount of saturated fats.
What seems to be very clear is there are some foods that appear to be high in saturated fats such as nuts, such as milk, that in the large studies do not appear to be adversely associated with heart disease.
If anything, maybe slightly protective, certainly for nuts.
So, I can happily eat a handful of nuts and knock back a glass of milk and not feel that it's furring up my arteries.
I think the evidence is very clear that it's the balance between saturated fatty acids and polyunsaturated fatty acids in terms of the outcome which is coronary heart disease.
Professor Khaw clearly thinks it's a mistake to demonise all saturated fat, and that some, such as those in nuts or dairy, may even be good for us.
But not everyone agrees.
Professor Christian Drevon is from the Department of Nutrition at Oslo University.
He's spent over 40 years studying the effects that different types of fat have on the body.
And he is sceptical about the latest research.
So, do you think there is an unequivocal link between saturated fats and heart disease? Yeah, I think that saturated fatty acids in the diet is one of the major factors for the risk of coronary heart disease.
There are very few cases in modern medicine where you have so good evidence for the whole chain of events.
So, what do you think is the mechanism that explains a link between saturated fat and heart disease? The saturated fatty acids have a marked influence on cholesterol levels.
We have more than enough information about the chain of events all the way until you accumulate cholesterol in the vessel wall or middle-sized arteries, especially damaging the heart.
So, I think the big picture is quite clear.
~ Now, you've been studying this area for something like 40 years.
~ Mm-hm.
How have your views changed in that time or have they changed? When it comes to saturated fatty acids, they haven't changed that much.
What we have learned is that there are differences between different types of saturated fatty acids.
What are the bad fatty acids and where do I find them? In dairy fat, in meat fat, and in certain plants like palm oil and coconut fat.
So why does someone like Kay-Tee say actually dairy products are probably neutral and possibly healthy? ~ You'd have to ask Kay-Tee.
~ I did.
I did and she said that it's because the epidemiological studies suggest that is the case.
And I say that I'd like to really see that evidence in a solid way.
I think epidemiology can go totally wrong, I think.
Do you think then that people should cut milk out of their diet, butter out of their diet, dairy products out of their diet? Butter, I think, shouldn't be used at all.
When it comes to dairy products, in general, I would say low-fat and dairy products are fine, and I would say also when it comes to meat, go for the low-fat variants in moderation.
It's very confusing.
Despite careful analysis of the latest evidence, Professor Drevon and Professor Khaw strongly disagree on the health effects of saturated fats.
With two leading experts having such difference of opinions, it's hard to know what to believe.
But I personally have reached a decision.
When I was at medical school, we were told that saturated fat was the devil and I largely cut out the diary.
These days, I do eat butter and drink milk.
But it's not an excuse to pour down double cream because whatever it's doing to your heart, fat is still very rich in calories.
Back in Bognor, people have been recording more health questions in our special video booth.
Does Vitamin C cure colds? That's one for Doctor Saleyha Ahsan.
It's a health message that's so ingrained, it almost feels like common sense.
Take a Vitamin C pill every day and you won't get a cold.
And if you do get one, take an extra large dose and that will knock it on the head.
But what's the evidence? We have chemist Linus Pauling to thank for the idea, which he pursued in the 1970s, and since he had not one Nobel Prize but two, people listened.
But his claims were premature.
The truth is that taking Vitamin C pills every day won't stop you from getting a cold but they might make your symptoms milder and reduce them by half a day.
But there's also no evidence that starting to take supplements after your symptoms appear, will see off a cold.
The endless search for a cure for the common cold has continued, and the most recent big hope has been zinc.
Research shows that taking zinc lozenges can have a moderate effect by reducing how long your symptoms last and how bad they get if you start taking the supplements within the first 24 hours of your symptoms appearing.
Zinc works by stopping the cold virus from replicating, but the downside is that zinc lozenges can leave a bad taste in your mouth and cause nausea.
Scientists say that the cure for the common cure is just around the corner.
But then they've been saying that for years.
Until that day arrives, I'm going to stick with my mum's remedy - good old chicken soup.
Works for me every time.
Now when you try out a new medical treatment, the results are often disappointing, occasionally better than you'd hoped.
But surgeon Gabriel Weston has been to Kentucky in the United States, looking at pioneering research which has produced results which were utterly unexpected.
It was a hot day in Texas in June 2009 when 21-year-old motocross rider Kent Stephenson headed out to practice.
'It was a perfect day, nice, sandy, loamy soil, 'just enough water on the dirt and everything, 'they had it tilled up real deep.
'And then I got this one section, like a long section of whoops 'and then a jump into the turn, 'and then after I faced that jump, the bike locked up.
'I was going through the air.
'When we landed, me and the bike did several cartwheels 'and summersaults and flips.
'I remember after everything finally stopped,' I was staring, like straight at the sun and it was, everything was kind of hitting me, I was sweating and It was, it was a bad deal.
'And that's when it kind of all hit me, like, man, I cannot feel my legs right now.
'Kent's spine was so damaged 'that he had no feeling at all in his lower body.
'The prognosis was as bleak as it could be.
'Doctors told him he would never regain 'any movement below the injury 'and would need care for the rest of his life.
' We surgeons love making an important contribution in our patients' lives, but there are some problems, like paralysis from complete spinal cord injury for example, that we've always had to accept are just too difficult for us to cure.
But maybe not anymore.
I've come here to the University of Louisville in Kentucky to meet a group of researchers who are completely redefining what's possible for this group of patients.
'The research team selected Kent to take part 'in a trial of a radical new technique.
' This involved putting a small electrical implant into his spine, below the damaged area.
The aim was to try to stimulate the nerves below the injury and make them active again.
The team hope that these nerves, independent of the brain, 'might help Kent support himself and balance 'if he could pull himself into a standing position.
' So, what's this bit here? So this right here is the remote that controls it and then there's the implant right in here, right inside my stomach.
And the electrodes that that's operating, where do they sit? ~ They're back here in my back.
~ OK.
~ So there's, like a cord that goes around back to my back.
~ Mm-hm.
So I, like take this and put it on it to turn it on.
BEEPING And when you switch that on, do you feel it at all? You feel like, like your whole body just feels, like charged and like, somewhat alive.
It's like, right now my legs feel really, really tingly and a, kind of charged feeling.
So, if you were to try to stand up, ~ can you just show me how that would go? ~ Yeah.
So, this 'Kent uses his upper body strength to pull himself upright, 'but once there with the stimulator on, 'the nerves in the base of his spine take over 'and allow him to stand upright without ANY help.
' ~ Wow.
That's incredible.
~ Pretty crazy, huh? ~ Did you ever imagine that you would be able to stand unassisted? ~ No.
So when you did it for the first time, when you felt that sense of you being on your own weight, what was it like? I remember looking down, looking in the mirror and seeing that, nothing was touching my legs, it was just like ~ Yes.
You couldn't believe it? ~ No, it was like, what is happening? ~ Yes.
And then you, kind of, like wiggled and stuff, trying to, you know ~ See if it was real.
~ .
.
is it balancing, then it's like, my gosh, ~ my legs are really holding me, you know.
~ Mm-hm.
'With just a tiny bit of electrical stimulation, 'the nerves at the base of Kent's spine have been reactivated.
'Even without connection to his brain, 'they give him back some balance and bladder function.
'This revolutionary success 'is due to the vision of Doctor Susan Harkema.
' We've known for almost a century that in all other species, the spinal cord is very sophisticated and actually controls almost all the aspects of locomotion.
But it was thought that when humans evolved and we got our fantastic brains, that the brain took over all that control, so my research really focused on whether or not the human spinal cord maintained those properties.
And it turned out that it did, and so what that means for a person with a spinal cord injury is that even though there's a complete, apparent disconnect from the brain, below that, everything is still intact and healthy.
I mean, for me, that's a, a really radical finding.
Regaining some function below the injury in his spine had already vastly improved Kent's life and health.
This was as much as even Doctor Harkema imagined could be achieved.
But then, they realised something MORE was happening in Kent's body.
Something completely unexpected.
I was laying on a mat just like this and hooked up to the, hooked up to a cord that was feeling, measuring how much I could pull and I'd done that test a bunch and nothing ever happened.
~ So, what were you expecting? ~ I didn't know.
~ Can you show me how it works now? ~ So that's where I take this and turn it on.
~ BEEP ~ And then I just like, ~ pull my leg, and then down.
~ Wow.
If I want my leg ~ That's amazing.
That's amazing.
~ .
.
put it back down.
~ That's like an able bodied person, isn't it? ~ I know.
They told me I'd never be able to do that again and it's like ~ Can you do that again? Oh, my goodness.
~ And it's down.
And how was that for you when it happened? It was overwhelming.
My mum was in the room at the time, so it was, it was, she burst into tears and I did too because it was just like.
~ Such a moment.
~ .
.
cos for so many times I was told, you never, ~ you'll never be able to do that again.
~ Yes.
~ You know, for this injury you sustained that it's, it just won't happen.
~ Yeah.
So, what does it feel like? ~ Can you feel it, that you're doing that? ~ Yeah.
I mean, it's, I don't know you, just think in your head, I'm going to move my leg.
Pull it up.
~ And put it down.
~ And yet without the stimulator on.
~ Yes.
~ Nothing.
~ Go like ~ BEEPING ~ That's off.
~ So if I said, could you do that again? ~ So now it's off.
~ Mm-hm.
~ Leg up.
And down.
And leg up.
~ Down.
It's off, it doesn't work.
~ It's totally wild.
~ I know, it's pretty crazy.
~ It's amazing.
It's pretty cool.
It is amazing.
KENT LAUGHS It's amazing.
No-one had thought Kent would EVER regain voluntary movement below his chest.
But now, with the stimulator on, he can do the seemingly impossible, move his muscles at will.
The stimulator is somehow allowing signals from his brain to get through to his legs and control his muscles.
Despite the damage further up his spinal cord.
And Kent is not a one-off case.
Doctor Harkema's team have had the same results with all four of the other people suffering paralysis whom they've given electronic chips.
Their work is causing a radical rethink of how patients with spinal injuries should be treated and what their future may hold.
A little while after my accident, I got this fortune cookie.
It stuck with me over the past four years.
It says, "Everything is impossible until somebody does it.
" There are full details about this remarkable research project and all the other items in this programme on our website UPBEAT MUSIC It's been three weeks since we began our experiment with office workers in Bognor Regis to test three recommended ways to boost your Vitamin D levels, vital for healthy bones.
Despite working in the sunniest town in the UK, at the start, fewer than half our volunteers had adequate Vitamin D.
And two were at risk of Vitamin D deficiency.
Well, we split them into three groups.
The sunshine group have been enjoying ten minutes of unprotected exposure to the sun every lunchtime.
The supplement group have been taking low dose daily supplements of Vitamin D.
And the oil fish group have been eating 300 grams of specially selected fish each week.
As expected, all three methods did succeed in boosting our volunteers' Vitamin D.
Interestingly, everybody went up, the fish group, supplement group and sunlight group all went up in their Vitamin D status, and there was no significant difference between the three groups.
Now, that surprises me, because I would've expected the sunlight group to do better.
If anything, the sunlight group, there's a trend of having less but that maybe because, they're only having sunlight, whereas the supplement and the fish group, as well as their intervention, they're getting a bit extra from the sun as well.
What was really interesting is that everyone improved, so those people who were at risk of deficiency, ~ they're absolutely fine now.
~ Just in three weeks.
~ Just in three weeks.
And the groups that were intermediate have all improved as well.
So the good news is, that in just three weeks all our measures made a different to our office workers.
The results were remarkably similar, whether through sunshine, supplements or oily fish.
Nearly all our volunteers recorded significant increases in Vitamin D, with the biggest changes in the two who were at risk of Vitamin D deficiency.
Knowing that it makes such a difference, I'll happily try to get ten minutes of sun, every day on my lunch break.
I will probably eat more fish, VIDEO/AUDIO SKIPS BACKWARDS I will probably eat more fish, my husband will go, that's good, cos he likes fish too.
Definitely going to carry on with the supplements.
Yeah.
Maybe, definitely not the fish, but I'll try and do the sun as well.
With all three approaches boosting Vitamin D levels by a similar amount, which is best? OK, well, let's start with sunlight.
Sunlight's free.
The disadvantage is if you have too much, you'll increase your risk of skin cancer, so you've got to protect yourself, that's the risk benefit.
For fish, again it's a good source of Vitamin D and other nutrients.
There is a concern about the contaminants, the pollutants in fish, and in 2004, the Government looked at this and decided that girls and women of child-bearing age shouldn't have more than two portions of oily fish a week.
So fish generally, oily fish, pretty good, but don't go crazy about it, and supplements? I think supplements are only for that group really at risk of deficiency.
Generally, for normal people, we can get anything we want from casual exposure to the sunlight and the food we eat.
Supplements are recommended for groups who are particularly at risk, and those with darker skin should also consider them, but watch the dose.
Too much can damage the kidneys.
Oily fish vary enormously in the amount of Vitamin D they contain and some cooking techniques can remove it.
While sunshine has been shown to lower blood pressure and reduce your risk of having a stroke, by about 10%.
You can find more information about all this on the Trust Me website.
During the winter months, eating oily fish a couple of times a week should keep your Vitamin D levels topped up.
During the summer months, between May and September, undoubtedly the easiest and cheapest thing you can do is to go out into the sunshine.
The advice is you simply roll up your sleeves and go out for around ten minutes, preferably between 11 and three o'clock.
That way you get the Vitamin D and you also get the benefits of improved blood pressure.
The Open University have produced a free information pack.
Health And Wellbeing: Exploring Everyday Challenges.
If you'd like a free copy, then ring Or go to .
.
and follow the links to the Open University.
CHEERING That's it from Bognor Regis.
Next time, we're in Cardiff finding out which foods really will lower your blood pressure.
Also, is it safe to eat food past its sell by date? And does shaving make your hair thicker? Argh! Trust me, we'll find out.