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

N/A - Alertness

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.
This time, we're in Southampton testing some surprising ways to boost our brains throughout the day.
We'll also be asking which painkillers work.
Oh, I don't like that.
Oh, my God! This is so bad! Do we really need to cut back on salt? It's published in a very good journal.
They're not making it up.
Well, the answer is, no, we don't believe it.
Are e-cigarettes safe? And do fatty foods spoil your skin? But first You know that feeling, it's the middle of the afternoon and you're feeling really sluggish.
Well, this week, we're based in Southampton to test some unusual ways to perk you up.
Before that, however, Dr Chris van Tulleken has been carrying out a rather unusual experiment.
I'm keen to find out if you're not a fan of exercise, is there a cheat's way to get fit? Moderate-intensity physical activity is a phrase you hear bandied around a lot at the moment.
And doctors recommend that adults should try to get at least 150 minutes of this per week.
'Moderate-intensity exercise is the sort of thing 'that gets the heart pumping and makes us sweat a little bit.
'Reach the weekly target and it's claimed it should help us 'avoid heart disease, cancer and obesity.
' 150 minutes, or 2.
5 hours sounds like a lot, especially if you're not that keen on going to the gym.
So I want to know, can we cheat our way to 150 minutes just by using our weekly chores? 'To find out, we've recruited eight volunteers 'of a range of shapes and sizes 'and we're going to make them do a whole stack of chores 'indoors and outdoors to measure which ones officially count 'as the mystical moderate intensity.
'Starting with housework.
' Ready? Go! 'Any chore that makes the grade of so-called moderate intensity 'means that it does count toward our 150-minute exercise target.
' OK, brilliant.
All right, everyone, move to the next activity.
'We've fitted our volunteers with activity monitors 'while they do four typical household chores.
'Ironing, vacuuming, dusting and mopping.
' You, er just missed a little bit there.
'The data from these monitors 'will allow exercise scientist Dr Andy Blannin 'to calculate whether any of them count as moderate intensity.
'He's going to be grading them on a scale of one to ten, 'depending on how much work they really are.
'What's called a MET score.
'Anything which gets a score of between three and six 'is good enough to count as exercise.
' ~ How's it going, Debbie? ~ I hate ironing.
Well, that's you and me both.
'After adjusting the figures to take into account age, 'weight and level of physical fitness, Andy has the results.
' So I started the day a bit sceptical, but it looks like from the graphs, you're going to prove me wrong.
So here's the summary data from the monitors that we've had on today.
And what it shows is that two of the four activities are indeed intense enough to be considered moderate-intensity activity.
So vacuuming and mopping just about make a MET score of three, which classifies them as moderate intensity.
'Excellent news for all you avid house cleaners out there.
'And since our volunteers spend an average of 37 minutes every week 'on just these two tasks, 'we're already a quarter of the way toward our 150-minute target 'without going near a gym.
'But there's still some way to go.
'Time to move outside to measure up some typical outdoor chores.
'Washing the car, cleaning windows, 'mowing the lawn and planting flowers.
' Looks like you're going to need one of these.
That's just ready for that.
How's this comparing to hoovering, mopping, ironing? About 200% nicer.
LAUGHTER Even to my inexpert eye, it seems like you've buried that one.
I think that one just needs some water.
How are you finding this as exercise? I think it's quite hard work, yeah.
'But do the activity monitors agree?' Looking at these graphs, it seems like the stuff that people have done outdoors is even more intense than the stuff they did indoors.
Yes.
All of these activities are sufficiently high, even something like planting, where you're not moving around a great deal because you're using lots of upper body, it's still sufficiently intense.
~ Bending down, flexing, using different muscles.
~ Yes.
So, these are all contributing toward the 150 minutes for the week? They're all making a sizeable dent in that 150-minute target.
'All the outdoor chores we measured 'apparently qualify as moderate-intensity exercise.
'Since our volunteers spend on average '72 minutes a week doing these activities, 'when combined with the indoor chores, 'our total has reached an impressive 109 minutes.
'And the last few minutes of exercise?' OK, nice and briskly, everyone.
'Well, just walking briskly or cycling score highly.
'As does simply picking up a shopping basket 'instead of using a trolley.
'So you don't need to don the Lycra to reach that 150-minute target.
'And there's one more tip from Andy's research to bear in mind.
' I've always wanted to do my exercise in a couple of big sessions a week.
Is there a benefit if you're just doing a smaller, less intense session once a day? It would probably be better if you were to do a little bit each day, sort of sprinkle the activity across the week.
We know some of the health benefits are quite transient in nature.
Some of them perhaps only 12 or 24 hours after the activity.
So with that in mind, it would be better for people to be doing a bit of activity every day, rather than condensing it all into one big day perhaps at the weekend, for example.
'That's a bit of a result, really.
'Many of the jobs we may hate, but that we have to do, anyway, 'can also be good for our health.
'And to get the maximum benefit, there's an excuse 'not to blitz the chores in one go, 'but to spread them throughout the week.
'And remember, even if you don't make that magic 150-minute target, 'every minute still helps.
' Now, I've been a health journalist for many years and most of my work has been fuelled by caffeine, but when it comes to being smart and alert, is caffeine really the answer? Surgeon Gabriel Weston has been investigating Britain's most popular pick-me-up.
I'll admit it.
When I'm flagging, the first thing I do is hit the caffeine.
'And I'm in good company, 'as over six billion people in the world do the same.
' So many claims are made for caffeine, from it keeping us awake to helping us boost our brain power.
But how much truth is there in any of this, or are we just hopelessly addicted to a drug that's doing us no favours at all? 'To find out, I've volunteered 'to undergo some testing at the University of Bristol, 'along with a group of students.
'Ten of them, remarkably, don't touch the stuff, 'whilst the other nine are caffeine drinkers, like me.
' I think I usually would have eight, maybe eight cups of tea or coffee a day.
I haven't had anything today and I'm beginning to feel the lack of it.
'While we're all caffeine free, 'both groups of us are having our mental agility, 'concentration and dexterity thoroughly tested 'to see how we compare.
'Now, here come some caffeinated drinks.
' Eurgh! That's disgusting! 'Then, time to sit the same tests again 'to see if there's been an effect.
'For some, hands are shaking.
' Oh! Oh, my God, oh, my God! My hands were I couldn't LAUGHTER I lit I was Yeah, I did not do very well with the needle.
'Professor Peter Rogers who designed the study 'has been analysing our performances.
' Overall, the caffeine consumers, before they'd had their drink, so they'd been without caffeine overnight, they were slower on the reaction time task, ~ they were sleepier, they were less mentally alert.
~ Yep.
'Seen here on the screen, the different is stark.
'The higher the bar on the graph, the worse the performance.
'Without caffeine, the regular users performed badly 'compared to the non-users.
'That's because we were suffering from caffeine withdrawal.
' That's why we go for it first thing in the morning, to get us going, to get us back up to our normal speed and our normal focus of attention.
'But when we caffeine users got our fix, did it give us a boost? 'Well, our test results show that it improved our scores.
'But all that did was bring us closer to normal, 'where the non-users had started.
'And for the people not used to caffeine, 'it made them feel slightly more alert, 'but in the needle-threading task, 'their hands were exceptionally shaky.
' The main effect in the non-consumers was they were made to feel more anxious.
That was the big effect.
They may also get an effect that causes them to be more wakeful, less sleepy.
Not necessarily more alert, and there's a subtle distinction there.
But not falling asleep is sometimes a good thing.
For example, if you're driving long distances or something.
But once they start drinking it on a regular basis They'll become part of the group that need it to stay as they are.
~ Exactly, exactly.
~ Yeah.
'So if you're not used to it, caffeine can help you stay awake, 'but it doesn't make you think any better 'and it makes you shaky and anxious.
'For me, though, as a regular drinker, 'the news was even more disappointing.
' The long and short of it is that my body's got used to coffee.
And what that means is if I have coffee, I'm just functioning at my normal level, but if I don't have it, I'm going to underperform.
And of course, there's the added bad side of the fact that if I have too much of the stuff, it makes me jittery and anxious, which is the last thing I want as a surgeon who has to hold a knife in their hands.
So, what are the alternatives if we want something to help us stay awake and alert? 'To find out, we'll be testing the best way to boost 'Britain's brains later in the programme.
' We've created a special Trust Me, I'm A Doctor video booth that's been travelling around the country with us.
We've brought it to Southampton, where members of the public have been dropping in with questions they've always wanted to ask a doctor, but never had the chance.
Will fatty food or chocolate ruin my complexion? One for Dr Saleyha Ahsan.
'I think everyone's heard at some point that eating fatty food 'or chocolate can give you bad skin, whatever age you are.
' In some parts of the world, acne is virtually unknown, even in teenagers.
And there's a hint.
It's got something to do with their diet.
But, is it fatty food, or chocolate that we should avoid if we want to keep our skin clear? 'We tend to think that the grease in our food 'could ooze our of our pores and cause bad skin, 'but that's actually not the case.
'And surprising though it sounds, 'there's no evidence of fatty diets causing spots.
' Actually, what can cause spots, apart from changes in teenage hormone levels, are high levels of blood insulin.
And there are two things that can cause your insulin levels to raise, and that's excessive amounts of sugar and protein found in some dairy products.
'Small trials getting teenagers to change their diets 'to less sugary ones for three months 'did lower their blood insulin and also improved their skin.
'It really needs repeating on a much larger scale, 'but it's certainly a promising start.
' So although the science isn't all there yet, fatty foods are off the hook.
But it's just possible that the sugar and milk in chocolate might be doing your complexion no good at all.
Still to come which painkiller to use when.
And is salt really that bad for you? But first Now, I have my own prejudices and preconceptions, and the great thing about making Trust Me films is they are often challenged by the facts.
At the moment, there is one subject that I am really passionate about and I'm dying to get to the bottom of.
Until seven years ago, it was quite normal to see people smoking away in restaurants and pubs.
Then it was banned.
Now, cigarettes in public places are making something of a comeback, albeit with a twist.
This is vaping.
Using an electronic cigarette to produce a nicotine-rich vapour, instead of burning tobacco.
But are they bad for you? In the last two years alone, the number of people using them has trebled to over two million.
They're legal inside most public buildings, and you can even see people vaping in offices.
But debates rage about their possible effects on our health.
It's a very emotive subject.
So I want to look at the evidence from a medical point of view.
The first thing to understand is that smoking and vaping are very different.
Smoking burns tobacco to release a large dose of addictive nicotine very quickly.
But nicotine's not the major problem.
Alongside it comes a cocktail of around 4,000 toxic chemicals, increasing the risk of cancer, heart disease and other serious illnesses.
Electronic cigarettes heat up a cartridge of liquid to form a vapour which can be inhaled instead of smoke.
This vapour contains a nicotine hit, along with flavourings and other chemicals.
In the UK, there are plans to regulate some e-cigarettes, depending on the nicotine content and the claims made for them.
This should ensure tighter controls on what they contain.
Now, the manufacturers of e-cigarettes obviously claim that they are much safer than normal cigarettes.
But are they? We thought it would be interesting to test normal cigarette smokers and those who use e-cigarettes and find out exactly what's going on inside their bodies.
We've taken samples of saliva, urine and breath from a range of vapers and a group of smokers.
And we've done the same tests to look at the risks of passive vaping.
First, nicotine levels.
We found the vapers get a similar dose of nicotine to smokers.
Now for the test on the real nasties.
Carbon monoxide, associated with heart disease and acrolein, associated with cancer and lung problems.
Here, the vapers had significantly lower levels, similar to those found in non-smokers.
As for the risk from passive vaping, our tests found no evidence that the vaper was affecting people nearby.
Despite the evidence from our small-scale test and other bigger studies, I still can't quite get rid of my gut feeling that because cigarettes are so harmful, there might be some hidden dangers lurking in e-cigarettes.
Professor Peter Hajek, Director of the Tobacco Dependence Research Unit at Queen Mary University of London has been looking into e-cigarettes in detail.
E-cigarettes have only been around for a short while.
Are there some long-term risks we're not aware of? I think we can't exclude it altogether.
I suppose some of the flavourings in e-cigarettes may turn up to be a danger.
There may be risks for some people with lung issues.
I think they are unlikely.
If there is a danger, it's likely to be a small fraction of a danger of smoking.
What about the addictive qualities of nicotine? They're getting nicotine, they're not getting the other toxins.
Are there dangers associated with that? There are.
Nicotine is an addictive substance.
And the proportion of people who use nicotine will become hooked.
A lot of people drink coffee, right? You've got a coffee cup in front of you, I've got one.
A lot of people are hooked on coffee.
And nicotine use would be roughly in the same category if there were no other toxic chemicals which accompany it.
Do you think that e-cigarettes are a big change? I think they could be a revolutionary change.
I think they have a potential to basically eradicate smoking-related disease and death on the population scale.
What I've seen and heard in making this film is beginning to make me rethink my opinion about e-cigarettes.
But their effects on our body are only part of the picture.
There are fears that allowing widespread use of e-cigarettes would make the consumption of nicotine an everyday sight again.
Already, there are stories of children as young as 11 trying them.
The British Medical Association is calling for a ban in public places.
Now, I do agree that you need to be very cautious about anything that makes it easier to consume an addictive drug like nicotine.
But considering cigarettes kill half the people who use them, if I was a cigarette smoker, I'd certainly give e-cigarettes a go.
Many of us experience a mid-afternoon slump.
And what do we do? We reach for the caffeine.
The trouble is, as Gabriel has discovered, caffeine is not a perfect answer.
It can leave you a bit twitchy and you rapidly become dependent on it if you want to keep functioning normally.
What I want is a caffeine-free solution to this problem.
A solution that doesn't have me feeling anxious and jittery and constantly running to the loo.
What about sugar? Our brain cells run on glucose.
And lots of us reach for a sweet snack when we hit a slump.
Maybe that's the answer.
Some people swear by sage.
The familiar kitchen herb has been found to contain a chemical that enhances the connection between brain cells.
And then there's chewing gum.
Surprising research suggests it could increase alertness.
To put these three options to the test, I've come to the Ordnance Survey headquarters in Southampton.
The folks who work here make a staggering 10,000 changes a day to the master map of Britain.
Every new house, road and manhole cover.
It's like a giant game of Spot The Difference in 3D.
Demanding intense concentration hour after hour.
So they're just the kind of people we need for our experiment.
We need to take eye breaks quite often because it's very easy for an hour or two to just fly by.
So I use that time to go to the tea station and have a cup of coffee.
So I have probably between five and six cups of coffee a day.
And frequent visits to the toilet, as well.
I currently drink far too much tea and coffee.
I'm looking for a substitute.
To see whether any of our potential alternatives would do the trick, Dr Andy Johnson at Bournemouth University has designed an experiment that's going to run all week.
We're going to test them twice each day.
Once in the morning at about 10:00 and once in the afternoon at about 2:00.
Our prediction is in the morning, they're going to be quite alert and their performance on the task will be quite good.
And we expect that to decline when they experience their sort of post-lunch afternoon slump.
So at 10:00am on day one, our 24 volunteers take their first morning test.
Involving a questionnaire about how alert they feel, followed by some really, really boring tasks on a laptop to see how on the ball they are.
We're also using a special piece of kit flown in from Holland to measure the blood flow in their brains as they do the tests.
In the afternoon, they're each going to take one of our caffeine alternatives.
They're either going to get a piece of chewing gum, a sage pill, or some fudge.
'There's also a fourth thing on the menu.
'A placebo pill with no active ingredient.
'It shouldn't have any effect on our volunteers' alertness.
' We're just going to use it as a baseline to compare the other treatments to.
Bit of irony, getting lost in the Ordnance Survey office, isn't it? No idea where I am.
Is that more fudge than you'd normally have of an afternoon? About three times more.
LAUGHTER If you can't manage all of it, don't sweat, but do as much as you can.
OK, I'll eat it for science.
An hour after their fudge, gum or pill, our volunteers do the same set of tests again.
And every day for the rest of the week, they will repeat the same procedure for us, but with a different potential brain booster.
Andy's collecting data from our volunteers each day.
So by the end of the week, we'll be able to tell whether any of our caffeine alternatives helped them stay on top of their game.
'As a doctor working in emergency medicine, 'I want to share some simple tips 'that any one of us could use to save a life.
'So I've come to join a group of ramblers in the northeast of Scotland 'to show them and you how to spot and treat 'a life-threatening condition, hypothermia.
' Many people think that hypothermia is a condition that only affects the adventurous outdoor types, but think again.
It can happen to all ages and in all places.
'All it takes is for a person's body temperature 'to fall by just two degrees, which can happen at any time of year.
'Falling into cold water can trigger it, even on a hot day, 'as can drinking a lot of alcohol, 'which causes blood vessels to widen and body heat to escape.
'It can happen indoors, as well as out.
'Young babies are especially vulnerable, as are the elderly.
' Hello, everyone.
Great that you're all here today.
We're going to talk about hypothermia and what you do if you come across someone who might be suffering from it.
'If you see someone who is pale, 'shivering and making irrational decisions, 'these could be signs that they have hypothermia.
'But with a few very simple steps, you could save their life.
'The first thing to do is to ensure they're dry and sheltered from wind.
' If you've been out on the hill and you've been walking, the chances are you might be sweaty, your clothes might be wet, so take off the wet clothing and get them as quickly as possible into something warm and dry.
If their clothes are not wet, just layer more on top.
'These techniques are the same whatever the age of the person 'you're treating and whether they're indoors or outside.
' You're sitting close together and huddling up, which is great, because the warmer person is helping to heat up the colder person.
'Once you've got the person warm and dry, call for help 'and then see what else you can do.
' Who's come across the silver foil blankets? 'The silver on these blankets 'reflects any heat back towards the body.
'You should put them over the top of clothing.
' If you put your hand in, it feels really warm, doesn't it? It is really warm.
It's amazing.
'There are a couple of things to avoid, though.
'Don't rub the casualty's skin 'and don't give them alcohol, like brandy.
'Both encourage blood to come to the surface of the skin, 'cooling it and diverting it away from vital organs.
'There are some drinks you can give to help warm them up.
' For my hypothermic patients, I have some tea, chocolate, sugary, warm drink.
OK? 'But be careful that any drinks are warm and not hot.
'Hot drinks and hot baths can cause blood vessels to open up too quickly 'and that can lead to a dangerous drop in blood pressure.
' I'm coming round with biscuits.
The biscuits are really important because it's all about sugar.
Sugar helps you to generate heat.
The hypothermic patient will probably not even feel like it, but just try to gently coax them.
It's all about gentle warming.
'And if you've got one, a bivvy bag or any protective windbreaker 'will help keep them warm and dry until help arrives.
' The good thing about these is they're quite huge, so you could actually both get in there, to be honest.
'If someone is showing the first signs of hypothermia, 'these simple tips can prevent the situation 'from becoming life threatening.
' The rules for treating someone with hypothermia at home are the same as out here in the wilds of Scotland.
The key things to remember are, slowly heat the person up using drinks, food and dry clothes.
Don't use alcohol, hot baths or rub the skin.
Seek medical advice as soon as possible.
If you follow these rules, you could save a life.
'You can see all this information on our website 'bbc.
co.
uk/trustme 'where there's also more about every subject covered in the programme.
' Still to come Surgery that's pushing the boundaries of life and death.
And the results of our experiment.
How best to boost your brain.
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.
" 'Getting public health messages right is infamously difficult, 'but one of the oldest-running campaigns 'is trying to get us to cut back on salt, sodium chloride.
' The press, however, is full of contradictory reports about salt and its risks.
Is there really such a vast difference of opinion between researchers, or is it a storm whipped up by the media? Who should we believe? Now, the average person in the UK consumes nine grams of salt a day.
The government recommendation is six grams.
That's about the equivalent of a teaspoon of salt, or the amount of salt you'd find in a bacon sandwich.
Not being able to have anything more salty than a single bacon sandwich a day is a pretty dramatic change, so what research is this advice based on and is it really strong enough for us all to act on? 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.
First I'm meeting Professor Graham MacGregor, professor of cardiovascular medicine at the Wolfson Institute of Preventative Medicine.
He's spent over 20 years investigating the effect salt has on blood pressure.
And he also leads an action group to campaign for the reduction of salt intake in the UK.
So what does excess salt consumption do to you? Well, too much salt puts up your blood pressure.
It also causes cancer of the stomach, but blood pressure's by far the biggest single cause of death in the world - 60% of strokes are due to high blood pressure and 50% of all heart disease is due to high blood pressure.
And do you think there is a clear correlation between salt consumption and blood pressure and therefore stroke? Oh, absolutely.
There's no doubt about that.
So there have been studies which show that if you increase the amount of fruit and veg you eat, fibre you eat, but you don't decrease the amount of salt you eat, you still get a drop in blood pressure.
Yes, that's true and they showed the maximum fall in blood pressure was actually when you did both.
So very clear evidence that reducing salt and increasing fruit and vegetable consumption had a double effect on blood pressure so we should be doing both.
What do you think about the argument that, once you get below six grams, what happens is your cholesterol goes up? That's just not true cos our own study there was no rise in cholesterol or anything, in fact, so no evidence whatsoever with modest longer-term reduction in salt, any evidence of harm.
My view is the evidence is so low in quality we should ignore it.
There's much evidence from other It's published in a very good journal.
They're not making it up.
Well, you know, you know very well that in any medical issue, there are always things like this that people disagree, and quite rightly.
You can take a study, and you get one group of people who grind through the statistics and come to a conclusion.
Another group come and they come a completely different conclusion.
Is that deliberate? No, definitely not.
I mean, there are different ways of looking at data and different ways of analysing it.
In general, with the salt studies, they're actually looking at different sets of data, and rather weak data in my view, and what you have to do is look overall, at the body of evidence - I think that's the important thing.
We're not looking at one bit of evidence.
That doesn't prove or disprove and it's looking at the totality and the totality, in my view, is quite overwhelming.
What do you think about the other things like, say, potassium that maybe we should be increasing potassium in our diet? Absolutely, very good evidence that increase in potassium lowers blood pressure and has the opposite effect to salt.
You have, I think, called salt a toxin before - is that right? Well, I mean, yes, it is.
It's toxic, it's toxic to mammals, in the quantity that we eat it in.
Chimpanzees, our nearest relative, if they're given the same amount of salt as we eat, their blood pressure goes right up, comes down when they stop it.
And that's pretty clear evidence, you know.
Do you think there's a possibility that in 20 years' time you will be recanting, and going "Actually, I was wrong about salt?" No, I don't think so.
I think the evidence of salt is stronger than for any other dietary factor.
To hear another view, I'm going to meet Professor Hugh Tunstall-Pedoe, professor of cardiovascular epidemiology at the University of Dundee.
He's spent over 40 years researching the causes of disease and his findings on blood pressure are at odds with the familiar public health message about salt.
It has been claimed by some that the link between salt and blood pressure is unambiguous and that reducing salt will lead to improvements in the nation's health.
What do you say to that? Well, I think the evidence on salt and blood pressure is much weaker than many people claim.
I think it's a crusade and if you're a believer, you want everything to prove it right and you want to throw out anyone who disagrees with you.
If salt consumption's going down, and blood pressure across the country is going down, does that not suggest that it is the fall in salt that leads to the fall in blood pressure? Yes, well, blood pressure's coming down and use of the internet is going up so use of the internet is reducing blood pressure.
~ I mean, there are thousands of correlations you can make ~ But The fact they're going, the fact they're going in the same direction is good for the story but it doesn't prove it and there are lots of other dietary changes occurring, changes in exercise.
So you're arguing that body weight and other factors are actually possibly more influential than salt when it comes to hypertension.
I don't think there's any argument about that.
We have done a lot of work on other risk factors and the first paper we produced showed that the sodium and potassium were very weak predictors of blood pressure, potassium being protective, sodium appearing to be associated with increased blood pressure but much weaker than alcohol consumption or body weight.
And we had difficulty in getting the paper published.
Do you add potassium at all to your diet? Potassium is not eaten as potassium, it is a component of fruit and vegetables.
~ You get it in bananas and things like that.
~ You get it in ~ Pretty well everything.
~ Pretty well everything.
Do you think the strategy of lowering salt, say, to six grams is a good one and would you agree that we should basically lower as low as it can go I think it's reasonable to have national reduction of salt in things that people have no control of.
You can't tell how much salt you're eating if it's mixed with other things.
People can always add their own salt if they want to.
Do you just think that the case against salt has been overstated, oversold? I think it's a matter of faith rather than proof, but doing nothing may be the worst option.
Doing something that may be beneficial and is not doing any harm may be the right thing to do, even if the evidence is not overwhelming.
So the guidelines are all terribly clear.
What you're suggesting is that the science is not at all clear.
The science is still controversial.
There is not a consensus.
Before today I would have said it's a done deal.
There's a clear link between salt and blood pressure.
Professor Tunstall-Pedoe, however, made a convincing case that the evidence is not as strong as one might think.
And he also pointed out that it is hard to get published when you're swimming against the tide.
Nonetheless I do think we should reduce the amount of salt we eat, although that is easier said than done, as an awful lot of it comes in processed food and in surprising things like bread and cereals.
Where my two experts do agree is we should increase the amount of potassium we eat - that means eating more broccoli, spinach, apricots and bananas.
Back on the streets of Southampton, and more of you have been popping in to our video booth with your health questions.
Is food with omega-3 better for me? This one is for Saleyha.
You can see omega-3 labels on all sorts of things.
Fish fingers, low fat spreads, mayonnaise.
And then there are omega-3 supplements, all touting big health benefits.
.
.
from lowering our risk of dementia to improving our memory and even being good for our eyesight.
But scratch beneath the surface and the scientific evidence for them is pretty thin.
There just haven't been big well-conducted trials with results to back them up.
But there has been one positive bit of news.
Research suggests that oily fish, rich in omega-3, can help keep your heart healthy.
Trials involving thousands of people show that eating one portion of oily fish a week reduced blood pressure and the build-up of fat in our arteries, but beware.
You might think that you could replace your weekly portions of fish with pill supplements, but it's not that simple.
Studies have shown that pills just don't deliver the same health benefits.
This could be because oily fish contains lots of nutrients, not just omega-3, and it's the combination of these nutrients that's important for our health.
At some point in our lives, many of us will be struck down by illness, or perhaps an accident, and require surgery.
Fortunately, surgical techniques are constantly evolving.
Surgeon Gabriel Weston has been to Papworth in Cambridge to watch a particularly extraordinary operation.
71-year-old Michael Eddy has been suffering from a life-threatening condition - a blood clot deep in his lungs that has left him struggling to breathe.
I can only walk a dozen paces.
It got that bad and then I had to stop for a few seconds to get my breath.
That wasn't like me.
Got me down at times, you know.
I've been somebody who's always been active and not one for sitting around and to be sort of housebound, the thought of that is not very clever.
Normally our blood only clots to stop us bleeding if we're injured, but clots can develop inside our blood vessels and get carried by the blood to the arteries of the lungs, where they become trapped.
When this happens, our body will usually dissolve them away but in rare cases like Michael's, this process fails and the clot becomes fibrous and grows, clogging up the arteries of the lungs.
It's dangerous and difficult to remove.
But here at Papworth, there's a radical solution.
As a surgeon, there's nothing I love more than watching cutting-edge procedures, but what I'm about to see here at Papworth Hospital, Cambridge, is like science fiction.
It's an extreme procedure that will take the patient to the very brink of life.
The staff have told me that the patient's already under anaesthetic and he's had his chest opened up so they're about to begin this really thrilling operation and I'm going to head off now to make sure I don't miss a minute.
Surgeon David Jenkins and his team have begun the delicate job of removing the white fibrous clot material.
But it's lodged deep in the arteries and is difficult to separate from the artery walls.
With blood constantly flowing, it's an impossible task, so now the team are about to do something truly extraordinary.
They're going to drain all the patient's blood out of his body into a vat beside him.
Prepare to stop the patient's circulation.
The patient's entire blood supply is now being drained from his body.
His heart has been stopped and is no longer beating.
You can see on the monitor that all of the lines have gone flat.
This is a really remarkable thing to see.
I've never seen a patient have their heart stopped and be drained of blood.
And there's something really very enthralling and amazing about that, to see that science and medicine has progressed to a point where these doctors are confident in essentially stopping a patient being alive in order to operate on them and then get them better again.
Now, with no blood flowing through the artery, the surgeons can remove the fibrous clot material piece by piece.
Got to be a little bit careful here because the artery wall is pretty thin anyway.
It is quite fragile on the inside.
But they're operating against the clock.
With no blood in the patient's body, there's no oxygen getting to his brain.
Under normal circumstances, brain damage occurs after just two minutes without oxygen.
The team need a longer window to operate and to achieve this, they've taken another remarkable step.
They've cooled the patient's body from the normal 37 degrees to just 20 degrees.
The grey dimpled-looking thing you can see in front of you is the cooling cap which is keeping the gentleman's brain really cold, while he doesn't have any blood in his body, to protect his brain.
The cold cap slows down the brain's function.
In this state, the brain can survive for about 20 minutes without any blood.
It's a balance of having enough time to do a good dissection and protecting the patient and their brain.
These two numbers up here, which represent the right and the left brain, are letting the anaesthetist know that the brain still has some oxygen.
When the oxygen level in the brain drops to a certain point, the team need to return the blood to the patient's body.
Back on full flow? Thank you.
The blood is now going back into this patient and Mr Jenkins just acknowledged that there's just a slight sense in which he's able to relax in the knowledge that the oxygen is getting round his patient's body again.
But they can't relax for long.
There's still a lot of clot material in the patient's lungs.
To remove it, the team will need to drain the blood from his body twice more.
So we're opening the left side now.
After six hours, the patient's blood is pumped back into his body for the last time and the team return his temperature to normal.
Mr Jenkins shows me the clot material he's removed from the patient's arteries.
I'll show you the specimen of what we've removed.
'When I see all this stuff that was clogging up his lungs, 'it seems amazing that he was able to breathe at all.
' That just looks horrible, doesn't it? The main trouble is they can't get any flow through the lungs past this, and so even though the right side of the heart, the pump is trying its best to pump blood through, it just can't get through.
Some of the things that I've seen in this room today, I've only ever seen before in a situation of surgical catastrophe, but what we've seen in here today is the exact opposite of that - taking a patient who was very unwell right to the brink of life and death, actually, and then bringing him back, hopefully, in a much, much better condition than he was in before.
The incredible surgery that I've witnessed here in Cambridge has a high success rate and in most cases is a complete cure, giving patients like Michael their life back.
Actually, I thought, my God, what have I got to look forward to in life? Of course, it was going to be rather grim.
But now having this operation done, well, I can't really put it into words.
I mean, it's brilliant.
Because of this now, there can be a future.
There's one thing that almost all of us take medicines for and that's pain.
But which painkiller should we use and when? As a doctor, I'm usually giving that advice.
Today, though, since I'm going to be on the receiving end of a painful needle myself, I think it's time to take a dose of my own medicine, so to speak.
But is that aspirin, paracetamol, ibuprofen or codeine? Would you know which to take and when? They work in different ways and so they're good for different kinds of pain.
Perhaps the best-known headache pill is aspirin.
It's a really good anti-inflammatory.
It reduces fever.
Probably works less well for headache than some of the other pills.
It has got some serious side-effects - it can cause gastro-intestinal or stomach bleeding and pain.
It could cause kidney damage and for under-16s there's a very, very rare syndrome called Reye's Syndrome that can be potentially fatal.
I mean, the needle looks big.
Yep.
~ It'll hurt, won't it? ~ That's right.
A newer anti-inflammatory that works the same way is ibuprofen.
Ibuprofen is a drug that's very similar to aspirin so you must never, ever mix ibuprofen and aspirin together.
On the plus side, ibuprofen is good for period pain, arthritis or swollen joints.
On the negative side, it can cause kidney damage and stomach irritation, particularly if you're over 65.
One of the things to notice is, if you put it on in a gel form, that still gets into your bloodstream and it can still cause the stomach problems and the kidney problems.
I don't think either of those is for me today.
But I've got two more options.
Codeine's another very old-fashioned drug.
It's an opiate, so your liver converts it to morphine.
Now some people actually can't do that reaction at all so they don't get any benefit.
A lot of people get side-effects from codeine.
It's constipating, it can make you drowsy and at high doses, it can stop you breathing.
Now, the reason you often give it with other painkillers is because codeine doesn't work at the site of your pain, it works in your brain and in fact it just stops you caring about the pain.
Most people having a tattoo just put up with the pain but, since I'm a doctor, I might just take my own advice.
The drug that I think most people with pain should start with is paracetamol.
It's very effective.
It doesn't have the side-effects that some of the other drugs have.
It doesn't make you drowsy, doesn't make you constipated, and it doesn't irritate the stomach.
The one thing to be really careful about is that taking even slightly too much can cause potentially fatal liver damage, You have to be massively cautious about that.
Read the dosage carefully, particularly for children, because the advice on how much we should take has recently changed.
The real benefit, though, is that because it works in a different way to all the other drugs, you can combine it with ibuprofen or codeine or both if you need to.
And there's one other drug that's often included in the capsules and that's caffeine and it makes the paracetamol work much, much better.
It's in the capsules or you can just have it with some coffee.
Right, let's have a look.
That's not what I asked for! In our search to find the best way to boost our brains, we're back at the Ordnance Survey in Southampton for the results of our experiment.
Having established that a daily caffeine habit isn't doing any of us any good, we've been looking at better ways to stay awake and alert throughout the day and now I'm going to go and find out some of the results.
Over the course of one week, Dr Andy Johnson of Bournemouth University has been testing the performance of our long-suffering volunteers.
We've been trying to work out the best way to avoid the afternoon slump, by testing them each day on one of four substances.
A sugary fudge snack.
Chewing gum.
A sage pill made from powdered sage leaves.
And a placebo pill, just to check that simply taking a pill doesn't give them a psychological boost.
Now we've gathered to hear Andy announce the results.
First, did any of our treats or pills make our volunteers feel more alert later in the day? The placebo pill certainly didn't.
The people who took it felt considerably less alert.
But what about the fudge? I've just been served quite a lot of fudge, I mean ~ Were you allowed just to kind of nosh away until you felt sick? ~ Yes, pretty much.
So this is our glucose fudge condition, as you can see, alertness drops as well.
It drops.
Which is quite interesting, isn't it, because I would have thought that if you have sugar at that point in the day where you're feeling a bit sleepy and drowsy, that that really perks you up.
~ I thought it would make me more active.
~ Yeah.
And I think it did for a little bit but then the crash afterwards, on the way home, I was supposed to go to a spinning class and I was just exhausted.
Can I ask you how many pieces of fudge you ate? I ate all of the fudge.
~ 15 pieces of fudge? ~ Yeah, I like sweets.
But it was a real slog to get it down.
So, what about the sage? We predicted that this would produce a benefit but in fact here we found a reduction in alertness in the afternoon, so not really terribly different to the placebo condition.
Next up, the chewing gum.
What we find is an increase in self-rated alertness, for the chewing gum.
So all of these other things that were tried didn't make you feel more perky or alert but the gum certainly did.
Just kind of felt more awake, having had it.
~ Really? ~ Yeah.
Yeah.
So, remarkably, chewing gum could be an alternative to caffeine if you want to feel more alert, but how on earth could it be working? One theory is that chewing increases blood flow to the frontal lobe of the brain, a theory that we put to the test with our brain monitors.
We looked at the increase in haemoglobin so the oxygen-carrying protein, and although we only had a very small sample of participants, we seem to see a sort of trend in the gum group that they had an increase in this oxygenated haemoglobin in both of the tasks relative to what they had at baseline.
So the gum gets a big thumbs-up from our volunteers.
But there's a big difference between feeling more alert and actually performing better.
When we set our team some brain-stretching tests, the gum, sadly, gave them no improvement in their performance whatsoever.
But this time the sage pill proved a surprising hit.
The final task is a sustained attention task.
It's an incredibly monotonous task and over ten minutes we expect performance to drop massively as they sort of lose the will to live.
So you can see with the placebo condition, accuracy drops in the tenth versus the first minute.
~ What about the sage? ~ And then sage, we get the opposite effect where performance improves in that ten minutes.
~ Wow! Look at that! To the same extent! ~ Yeah.
So it seems that sage might have the brain-boosting power we've been looking for to beat the afternoon dip.
It's being researched now for all sorts of benefits in the brain and body, even fighting dementia.
I think I'll give the chewing gum a go, especially in the afternoon, cos then I don't have to have another cup of coffee.
I just felt so much better doing the test and I just felt there was more concentration for a longer period of time.
I'm really keen to see if there's any sage lovers amongst you out there.
It just doesn't taste as nice as a chocolate bar.
Until someone starts selling sage extract in chocolates, that may be true, but I think our experiment throughout the programme has been extremely revealing.
It turns out, that in reaching for the coffee, you could just be feeding a habit.
You may well love the flavour of it but chances are you're probably also hooked on the effects of the caffeine.
Now what our experiment shows is that there are healthy alternatives.
A stick of sugar-free gum or even a hit of sage might make you feel more alert without any of the down sides associated with coffee.
Now that's what I call a win-win situation.
That's it from Southampton.
The Open University has produced a free information pack.
Health and Wellbeing - Exploring Everyday Challenges.
If you'd like your free copy, then ring - Or go to - and follow the links to the Open University.
~ That's it from us.
~ Arrrgghh! I hope we've helped cut through some of the confusing health headlines and clear up a few myths and mysteries.
~ You can even touch them if you like.
~ Thank you, but no thank you.
We've certainly been surprised at some of the things we've discovered.
Just by looking at that picture, I would assume it would have been an effective treatment.
From how to make our favourite meals healthier Ross, what do you think of this? It's groundbreaking if that's the case, innit? A world first on Trust Me, I'm a Doctor.
To the cutting edge surgery that's helping the paralysed move again.
That's amazing.
That's amazing.
That's like an able-bodied person.
I know.
They told me I'd never be able to do that again and it's just like Can you do that again? Oh, my goodness.
And you can find out more on all our stories on the Trust Me website.