We're constantly being told how to improve our lives.
Every day we are bombarded by health claims. How to get fit,
slim down, look young.
But all too often, that advice can be confusing.
Contradictory.
So how do you know what's best for you?
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 Chester,
running an experiment to test the remarkable claim
that simply standing up can transform your health.
Also, are vitamin pills just money down the loo?
And I'll be asking the experts.
Should I be taking statins? What do you say?
Could antibiotics be a novel way to cure back pain?
And does getting cold help you catch one?
A-choo!
We're asking about vitamins. Vitamins?!
First up, Dr Chris van Tulleken.
Guys, can we talk to you about vitamins? ..Just two minutes.
Asking whether vitamin supplements will give you a health boost.
You guys don't take vitamins? I did. What did you take?
I took folic acid and other bits and bobs because I've just had a baby.
So this is yours?
There's probably no health message more firmly placed in our minds
than that vitamins are good for you.
I take garlic perles. Garlic perles.
Yes, garlic perles. They're good. I've never heard of garlic perles.
Have you not? They're very good.
Who takes vitamin supplements? I do. Yeah, I've done them, but...
You've "done them"?! But now you've quit!
Why do you take the Vitamin B? For my nervous system.
That's interesting. Does it help? Do you feel less... I don't know!
Drives her mad, really!
So, if vitamins are good, surely more, in the form of supplements, would be even better?
As a nation, we spend three quarters of a billion pounds a year
on vitamin supplements.
No matter who you are, or what you're worried about, there's a pill for you.
We've got pills for teenagers, pills for women, men,
and pills for different parts of your body.
We've got for vision and eye health,
skin, hair and nails,
and pills for your heart.
Now, vitamins and some minerals are genuinely vital to our bodies.
But the key question is,
does taking them in supplement pills do us any good?
I'm going to do a little experiment on myself to find out.
We normally get our vitamins from our diet.
So my first step is to 'fess up to everything I've eaten, drunk, over the past week.
I started with breakfast. I eat good breakfasts.
I've got porridge oats and Weetabix. So I'll lay them out.
I'm pretty good for lunch. I usually have tomatoes
and I get a salad chicken baguette of some sort.
'So far, so good. But then I remembered more.'
Obviously I drank some booze.
I added it up. I only remembered one bottle of beer at first,
then there was a bottle of wine and two more bottles of beer.
Oh, yeah. Then there was also four tins of Guinness.
Two packets of Haribo.
A pack of nuts. Mid-morning chocolate bar.
Tea every morning. A packet of crisps.
And, of course, the obligatory two burgers and chips
I had in the wee hours of Saturday morning!
It's hardly what you'd call a virtuous diet,
but like with most people's diets, it's surprising how many vitamins are actually hidden in there.
Starting the day with the breakfast cereals,
fortified with B vitamins.
Right the way through to the late-night crisps and fries,
which, when fried quickly,
actually preserves the high levels of Vitamin C in potatoes.
So, I'm a normal person eating a pretty normal diet.
So, if I were to take a supplement, would it, in fact, do me any good?
Well, I'm going to take one and find out.
The pill I've taken is a typical multivitamin,
containing high doses of most of the vitamins.
Especially Vitamin C,
which is the most popular single vitamin supplement sold.
As a nation, we take about 600 million tablets of pure Vitamin C every year.
And a lot more in multivitamins.
To see if it's doing me any good,
I took a sample of my blood from before the pill
to measure the amount of vitamin C in my body from my diet.
Now, to see what happens with the supplement I've taken,
I'm collecting all my urine for 24 hours
as a lovely present for a team here at the University of East Anglia
led by Professor Bill Frazer.
Bill. 24 hours of pee!
That's a lot! Is it a lot? It felt like a lot!
Close on four litres, there, I would imagine!
'I never realised I peed so much every day!'
Apparently, I've produced so much urine, it wouldn't fit on the urine measuring scales!
Don't know how to feel about that. Slightly proud, maybe a little bit ashamed, as well!
'Bill's team get to work analysing my body fluids.
'They start with the vitamin levels in my blood before I took the pill.
'This will reveal how much Vitamin C I was getting just from my normal food and drink.'
So, Bill, have I got scurvy?
No, you've not got scurvy! That's a relief! I didn't think I had.
I'm pleased to say that you're not Vitamin C deficient.
'So, before I even took the pill, my normal diet was providing me
'with all the Vitamin C my body needed.
'But what happened when I tried to top it up with a supplement?
'How much of the vitamin in the pill would remain in my body
'and how much would pass straight through?'
From the tablet, we extracted about 425 milligrams.
Your urine contained over 530 milligrams
of Vitamin C.
So you've passed the tablet,
and a little bit more, which is probably what you've taken in your diet.
Basically, my body was as full of as much Vitamin C as it can hold.
And anything else I put in, I just pee out?
Peed it out. The majority of it's been peed out. Yeah?
It's tempting to think that if vitamins and minerals are good for you,
then taking more must be better.
But that's just not the case.
A recent study by the Food Standards Agency
showed that the average Brit was getting all their recommended daily allowance of every dietary vitamin
from their food.
And once you have enough, taking more vitamins won't give you a bonus boost.
Some can even be dangerous.
There are a few clear cases where vitamin or mineral supplements
can be beneficial,
such as for young children, strict vegetarians,
post-menopausal women or a few other groups where doctors have recommended it.
People with severe illnesses, people who might be pregnant,
people with absorptive or digestive problems.
The rest of us are victims of really clever, aggressive marketing.
And we should stop wasting our money.
We contacted the Health Food Manufacturers Association
and they said about our vitamin test,
"These results would be expected in someone with a good Vitamin C intake.
"This may not be the case for all UK citizens.
"For most, the best solution is to eat as healthy a diet as possible,
"combined with other health-related lifestyle changes.
"Daily vitamin supplements also provide important nutritional insurance
"for millions of users looking to safeguard their nutritional intake."
For more information, visit our website.
We're here in Chester to carry out what I hope is going to be
a really interesting experiment.
We want to get to the bottom of recent claims
that sitting down for prolonged periods of time
is bad for your health in all sorts of different ways.
Over the past year,
there have been lots of headlines screaming that "sitting is the new smoking".
Apparently, every hour of sitting in front of the TV
could reduce your life by 22 minutes.
But can that be right?
We wanted to find out.
Is sitting really that bad, and if so, why?
Our investigation starts with some of the more active residents of Chester.
We all know that we should get off the sofa, out of the car,
do more exercise, become more active.
But why?
What exactly are the benefits of becoming more active?
It keeps your heart healthy. Makes you fitter, makes you stronger.
If I do a bit of exercise, my brain is functioning.
All that is true.
But one of the really important things that exercise does
is change the way your body deals with sugar.
Any time you eat carbs, your body breaks them down into a sugar called glucose,
which is transported in your blood to all the cells in your body.
There is something of a paradox,
because glucose is an essential fuel for your body,
but it's also quite toxic.
If you have persistently high levels,
that increases your risk of heart disease, impotence, and going blind.
So your body produces a hormone called insulin
whose job is to get your blood glucose levels down to normal
as quickly as possible.
But how efficiently your body does that
is affected by how physically active you are.
Which I hope to demonstrate with the help of some more volunteers
with contrasting lifestyles.
Some firemen...
..and some cabbies.
Do you guys spend a lot of time sitting down?
Percentage-wise, 90% of my day.
You can't leave the car and be working.
You've got to be sitting in the car to be working. That's the job.
Do you deliberately set out to do exercise the rest of the time?
I'm not a great exerciser. Take the dog for a walk now and again.
No.
And you two guys a bit different, is that right?
Probably at least 50% of my day
is walking around and not sat at a desk, as such.
I'm walking around or doing drill on the yard. Running out the hose, that kind of thing.
I'm going to show you how physical lifestyle
can affect blood sugar levels
with the help of a blood glucose monitor and a lot of needles!
MAN SQUEALS
And a very sugary drink to simulate a carb-loaded meal.
Knock that back.
The question is,
who will get their blood glucose levels down fastest?
The active firemen, or the less active cabbies?
I'm just testing the sugar content myself. It's gone down now!
Time to get the real answer!
The blood glucose levels that went up the least were Eliot's.
The blood glucose levels which went up and went down fastest
was Richard.
For you two, I'm afraid, there was a decline, but it was more gradual.
Active people, like our firemen,
tend to bring their blood glucose levels down more efficiently after eating,
getting them quickly back to healthy levels.
If you're not getting enough exercise,
it is harder for your body to get the levels back under control.
That can lead to Type 2 diabetes,
and as the glucose starts to damage the linings of your blood vessels,
heart disease.
If people who sit all day have higher blood sugar levels,
will getting them to stand up
make a measurable difference to their health?
It sounds like a good idea.
So we thought someone should do a proper experiment to find out.
And that's exactly what Chris has been up to.
What we need is a group of people who spend their day sitting in an office,
to spend a few hours a day on their feet instead.
And for the lucky employees of this estate agent's,
it's exactly what we're going to make them do.
We're going to do a unique experiment
to see whether simply standing for just a few hours a day
could transform our health.
It'll be different, but looking forward to it, actually.
I don't know whether my back might ache or my feet might hurt. I'll have to wear sensible shoes.
The small of the back, I think it'll hurt. You reckon? Yeah.
What about you? Good thing? Bad thing?
I'm a bit worried, actually. Are you?
I'm worried I won't be able to stand up for all that time!
So, at the end of the day, it's out with the old desks and in with the new ones...
..as we create a new standing world.
We've asked ten of the estate agents to stand for at least three hours a day for a week.
Dr John Buckley and a team of researchers from the University of Chester
will measure exactly how their bodies react, and compare it to their normal sitting routine.
They've all got a movement sensor, an accelerometer, on their hip,
which will show how much movement they are doing.
We've got a heart monitor.
And we're going to be measuring their blood glucose.
These glucose monitors are much more sophisticated than the ones we used earlier.
They'll measure our volunteers' blood sugar levels constantly,
day or night.
They're all going to be eating exactly the same food
and we'll get a really accurate measure
of how quickly they get their blood glucose levels down,
both on normal sitting days
and the days when they're standing up in the office.
Could standing up a bit more really be the key to a healthier life?
Our results will be in later in the programme.
Out on the streets of Chester,
we've been inviting people to ask our doctors their health questions.
First, one for Dr Saleyha Ahsan.
One of my concerns is that whether or not deodorant causes cancer.
Is this true?
Actually, this is one of those concerns that doctors hear time and again,
that the chemicals we put under our arms
could increase the risk of cancer,
particularly breast cancer.
There are two theories to this.
The first is that, by stopping us from sweating,
toxins build up in the underarm
and somehow cause breast cancer.
But this isn't the case.
Our bodies have many ways of removing toxins.
Sweating is one. But most are simply carried away in the blood.
That theory is a simple myth.
The second theory is that products within the deodorant themselves
are harmful and can cause cancer.
But studies have shown this not to be true.
The reason women are advised not to use products containing aluminium
when going for breast screening isn't because it's bad.
It's because it might show up on the x-ray,
making it difficult to read.
Still to come: what's the truth behind the latest miracle cure for back pain?
And how to save someone who's choking.
But first...
We all have a touch of the hypochondriac about us.
Is that pain in my chest indigestion or perhaps early heart disease?
Well, fortunately, there are companies out there
willing to give you reassuringly expensive scans. But are they worth it?
Surgeon Gabriel Weston has been finding out.
We're increasingly being bombarded
by adverts for expensive health checks,
claiming to catch hidden problems
lurking inside us.
Some private health companies, although not all of them,
encourage us to carry out a whole range of tests,
even if we have no reason to suspect any health issues.
Now, you might think the more health checks a person can have, the better.
But is it really so clear cut?
Are there really benefits to seeing what's inside us without good reason?
I'm going to meet the experts and find out for myself.
The cream of the crop when it comes to looking at the body's internal workings
are MRI and CT scanners.
A number of private companies are offering these now
as part of their full body screening,
since they can look inside the body in the most miniscule anatomical detail
in just under a few minutes.
Dr Sue Barter is an NHS consultant radiologist
who's analysed more than 10,000 scans throughout her career.
Her job is to look for the potential cause of symptoms
in patients who are ill.
She shows me a typical CT scan of one of her patients
with tiny nodules of cancer in the lungs.
This is where CT really comes into its own.
It's an amazingly powerful way of looking at the body,
particularly for people who have a known problem
or for a problem-solving issue in somebody who's unwell.
The CT scanner takes thousands of x-ray images of the body
to form a series of cross-sectional slices
which allow Sue to see tiny structures inside us,
only one to two millimetres in size.
One of the things about CT is that because it's so powerful,
is that we find lots and lots of things which we don't know the significance about.
Right. Sometimes chicken pox in childhood, if it affects the lungs,
can leave little scars in the lungs which can look like that. Yes.
Now that would have absolutely no relevance to you,
and if you hadn't had a CT scan, you'd never have known about that.
But if we find those, we would be duty-bound to follow you up
for a considerable length of time
to ensure these were not going to grow and develop into anything more sinister.
'In fact, it's thought that the average individual has up to three abnormalities
'in their body that a CT would show up.
'Some will have many more.
'Just as things like freckles, moles and scars are an everyday part of our external appearance,
'so we all have similar little abnormalities inside us.
'But almost all of these are entirely innocent.
'Only two per cent of them in people with no symptoms
'turn out to be something significant.'
It sounds like going into a CT scanner
is a bit like opening a Pandora's Box.
I would describe it as precisely that.
We just don't know what we're going to find.
But more importantly,
we don't know whether the findings that we do find
will be of significance to that patient or not.
Abnormalities shown up on one of these very broad but detailed scans
need follow-up tests.
And those tests can be invasive, bring risks and worry.
But many companies also offer more targeted tests.
What about a specific test that can pick up a particular disease
or an increased risk of stroke?
Is that worth having?
An ultrasound of the arteries in the neck to assess the degree of narrowing
is commonly offered by companies as a way to know if you're at risk of a stroke.
Unlike body scanning,
it's only looking at this one particular problem.
But here, the question is what to do with the result,
as surgeon Ian Loftus has to judge every day.
Certainly if there is a significant narrowing, and the number we use is over 70% narrowing of the artery,
and we think that has caused a stroke or a mini-stroke,
then generally we would recommend intervention for that.
I think people might be surprised to hear that it's as big as 70%.
It does sound a lot, but surgery brings with it a risk to them at the time of the operation
around two to three per cent.
So that's one in 50 will maybe not survive the operation itself.
'This rather shocking figure
'is the reason why the ultrasound test is only recommended for those who've already had a stroke,
'for whom the risk from a blockage outweighs the risk from surgery.'
'Otherwise, knowing that your arteries have a bit of blockage in them
'will just lead you to worry
'and there will be no practical way to relieve you of that.
'Each test clearly has its risks and its benefits for each person.
'More is definitely not better.
'So how can we tell what might be useful for us?
'Professor Nicholas Wald is one of the most respected experts
'in preventative medicine.
'He's constantly researching the evidence on health screening.
'He thinks that there are three criteria
'that a test, whether it's for cancer, stroke, or any illness, should meet
'before it's offered to apparently healthy people.'
First of all, you're screening for a specific disorder that is serious
but can't adequately be dealt with, treated, if you allowed it to develop in the normal course.
In other words, early detection confers an advantage.
Secondly, that you have a test that can separate the population into a group
that will get that disease and that won't.
It really separates them quite well.
And then thirdly that you have a remedy
you can offer to those people who have the disorder that you've picked up from screening.
Because if there's no remedy, there's no point in doing the screening at all.
So, if there's a disease that's dangerous by the time it gives symptoms,
and can be treated if caught early,
then a test is worth having, as long as it's accurate.
But that really narrows the field.
The issue here is offering the test in the absence of symptoms
in people who are just kind of, in quotes, "healthy".
Couldn't I say, as a devil's advocate,
that if I go in and I have full body screening,
that at the end of that exercise,
I'll be able to come out knowing that there's nothing going on in my body that's about to kill me.
You can't be assured that you're in the clear
so it's impossible to give the kind of reassurance that I think people are expecting.
'No test gives you that 100% certainty we all crave.
'Professor Wald's advice is used by the NHS to design their free screening programmes.
'Now, many private companies offer perfectly legitimate individual tests
'but encouraging people to take tests when they have no symptoms
'and no evidence of high risk of a disease is a different matter.'
Despite what the private companies would have you believe,
there's no evidence for the health benefits of having a general body MOT.
Either in terms of safeguarding your health,
or giving you peace of mind.
In fact, I've come to the conclusion
that they do precisely the opposite.
On our website, you can see Professor Wald's expert opinion
on the evidence for or against
having a range of tests commonly offered by private companies.
Deciding whether or not to go for any kind of screening
can feel like a bit of a minefield.
At the end of the day, the choice is yours.
But do, if you feel in any doubt, go and discuss it with your GP.
Was it a fall?
Working in A&E, I get hundreds of patients coming through the door
needing help.
I'm on a mission to show people the length and breadth of the country
what to do before the paramedics arrive.
I'm going to show you how to save a life.
'More than 200 people choke to death in Britain every year.
'It can be a terrifying situation to witness.
'But knowing a couple of simple techniques
'will allow you to stay calm and save them.
'I've come to show a group of primary school teachers what to do.
'We all fear a young child choking.
'But actually, if they're old enough to walk,
'then treat them like an adult.
'Just remember three golden rules.'
Cough. Slap. Squeeze.
Get them to cough it up. If they can't cough it up,
try to slap it out.
If the obstruction doesn't come out after slapping, squeeze it out.
'Anyone can do this. Just stay calm and do your best.'
Get them to lean forward, like this.
Support them with one hand across their chest.
And you've really got to give it some welly.
It's not a slight little tap. Right back.
Way back.
Keep looking.
'Give up to five firm slaps
'right in the centre of the back.'
Have a look. If it's not working, back again.
All right. Still not working.
'Don't worry about hurting them.
'You need enough force to dislodge the obstruction.'
You should feel it in your hand.
It will hurt you a little bit if you're doing it right.
You'll have a bit of a sore hand.
'If the slaps don't work, you should then try an abdominal thrust.'
The first thing you do is you make your fist.
So pop your thumb into the palm of your hand
and wrap your fingers around your thumb like that.
And with the thumb side of your fist,
point it into the abdomen.
The landmark that you're looking for
is halfway between the belly button and their breast bone, the sternum.
So sort of in the squishy soft bit, above! OK?
Some of us have more squishy bits than others!
Push in and up.
That's it. Perfect.
'There's a simple pattern you should follow.
'Five back slaps, then five abdominal thrusts.
'And while you do that, get someone to call an ambulance.
'Whatever happens, once you've done an abdominal thrust,
'make sure that person gets medical treatment, in case there's any damage.
'For children under one,
'you just have to adapt your technique slightly.
'The best thing is to put them on your arm and slap their back.
'Be brave, though. You've got to be firm!'
It's not a tap. You do want to dislodge it.
And I expect in the panic of things, you will be giving it the right intensity.
Definitely you need it to be of some kind of intensity. Right, yes.
'If that doesn't work, don't panic.
'There's another simple thing you can try.'
We do two fingers and we do the chest thrust.
So it's more of a poke. You do that for five, OK?
If that doesn't work and they're still choking,
you turn them over and you carry on with the five back slaps.
'If you ever have to do this,
'once it's all over, get the child checked in hospital,
'in case there's any internal damage.'
Hopefully, you'll never have to use these skills,
but if you do, just remember, "cough, slap, squeeze."
If you want any more tips, just check out our website
and bring your friends and family up to speed, too.
Because if you know how, you could save a life.
'In this programme, we're always trying to get behind the headlines.
'For example, there's been a lot in the press about an amazing new use for antibiotics.'
Thank you.
Now, there are thousands of different versions of antibiotics.
Perhaps something for a urinary tract infection
or for your throat.
Or perhaps the problem is your chest.
What you probably wouldn't expect antibiotics to do
is to treat back pain.
And yet this one, which is simply a form of penicillin with a bit of a twist
appears to do just that.
The hype around this discovery was impressive
with claims of breakthroughs for half a million people in the UK on one side
and accusations of conflicts of interest on the other.
So what is the truth?
Well, firstly, it's not a cure for your average achey back.
This is for chronic back pain caused by a specific kind of damage
which starts in the squishy discs between the vertebrae
then spreads to the surrounding bones.
The sort of back pain that leads to a lifetime of painkillers or surgery.
It was researchers in Birmingham who discovered that the damage to the bones
was in some cases being caused by bacteria.
A Danish group then decided to see
whether antibiotics could help.
Trouble is that antibiotics are not very good at penetrating this area of the spine,
so they had to give them for 100 days.
Nonetheless, the results were spectacular.
Most of the patients reported a significant drop in their pain.
The figures have proved controversial
and the research needs replicating with further studies,
but it is certainly very promising for those half a million people who might benefit.
It's important to say that antibiotics are not going to work for every sort of back pain.
But if I had chronic back pain and I fitted the medical criteria,
then I would volunteer for the next trial like a shot.
But of course it's better to avoid damage to the spine in the first place.
Back in Chester,
physiotherapist Katie Copeland is showing Chris
and the volunteers from our standing experiment
how to look after their backs.
Katie, tell me, what are the problems with sitting?
Well, the spine is a curved structure. People sometimes think it's dead straight, but it's not.
It has curves and it's meant to have these curves.
So you sit down, and you sit well to begin with,
but then what happens to most people is you then start to slouch
which means the pelvis rotates backwards.
Unfortunately, that then means
you're putting pressure onto the front of the discs
and they are like a jam doughnut.
So you're putting the pressure on the front of the disc
which is squashing the jam and pushing the jam backwards.
And that's why we get backache.
So that's what can happen with our spine.
What are the other problems of sitting down?
You're less likely to have any activity going through your legs,
through your calf muscles.
People tuck their feet under the chair,
then they lean forwards, they put their elbows on the table.
This is exactly what I do.
You're describing how I sit at work.
Like that! And most people!
So, if you sit for long periods, slouched over like this,
you're squashing those discs at the base of your spine,
weakening your tummy muscles
and overstretching the muscles on your back.
If you tuck your feet under, like this,
you're risking stiff ankle joints.
If you rest your arms, like this,
you're pushing your shoulders up which can lead to tension in the neck and headaches.
Best advice is to pull the chair right forwards,
bum pushed right to the back,
feet flat on the floor under the desk,
hips slightly higher than your knees.
But most important of all, move.
Stand up, just as our experiment volunteers are doing.
So, Katie, how is Mike doing?
Well, he's doing very well now.
I was watching him earlier and he was obviously getting a bit tired
because he was starting to sag a bit!
When you're standing, you change the angle of the pelvis slightly
so you're more likely to use your core muscles.
He is now standing straight and everything is much better aligned now he's standing well.
And now you're standing next to him! Now I've got my beady eye on him!
And standing badly like you are is dreadful!
So standing is good for your back.
But will it revolutionise your health?
The results of our standing experiment are coming up later in the programme.
Still to come:
A new technique.
Could it allow thousands of women to have their own biological child
for the first time?
And is catching a cold from getting wet just an old wives' tale?
But first, I have to make a big decision.
We take pills for all sorts of reasons.
Sometimes it's just to treat a headache
or perhaps an infection.
More controversially, we take pills to reduce our risk of future disease.
One of the commonest of these are statins.
Statins lower cholesterol.
Cholesterol is a bad thing.
So should I be taking statins?
Well, it turns out this is a very controversial area.
Cholesterol is a fatty substance that is vital to our bodies.
It's made by the liver.
But we can produce too much of the bad cholesterol
that can block our blood vessels.
Statins reduce the amount of this cholesterol
and seem to reduce our risk of heart attacks and strokes.
Some experts think that far more of us should be taking them.
Others say they're already over-prescribed,
that the side effects of statins, which include muscle pains, nausea and insomnia
are too great for otherwise healthy people to routinely take them.
It's a choice many of us will have to make at some point in our lives.
Have you tried statins? Yes, I've been on them for about three years.
It has brought my cholesterol down. You know... Was it high?
It was pretty high, yeah. Eight point something.
Would you consider taking statins?
Personally, I don't need statins, but if a doctor prescribed them, yes, I would.
Definitely not! I think they do more harm than good.
Now, this is of particular interest to me.
A while ago, I started taking statins, but gave up after a few months.
I didn't know if they were doing any good.
So I've come to Oxford University
to hear the pros and cons from two experts with widely differing opinions.
Then hopefully I will have the information I need
to decide about statins, and so will you.
Sir Rory Collins is a professor of epidemiology here at Oxford.
He has been analysing the numerous studies that have been done on statins.
So, I am a 55-year-old male
with a family history of heart disease and diabetes.
Should I be taking statins?
I think that it's worthwhile considering taking statins.
We've got a huge amount of evidence from controlled trials
in all sorts of different types of people -
people who already have cardiovascular disease, and people who don't.
We have very good evidence that statins reduce the risk of having a heart attack or stroke.
How big is the effect?
It depends how much of the statin you take.
They reduce the "bad" cholesterol, so-called, LDL cholesterol
and if you take a good dose of one of the newer statins
you can lower your risk by about 40 per cent.
And they do so with very little in the way of side effects.
About one in 10,000 people per year
can get muscle problems
that are caused by statins.
What about things like diabetes?
I've heard there's an increased risk of developing diabetes.
So there's a suggestion that there's an increase in the diagnosis of diabetes.
But the main problem of diabetes is increasing your risk of heart attack and stroke.
And the trials show that statins produce very substantial reductions
in the risk of heart attacks and strokes
over and above this small change in the diagnosis of diabetes.
Is there a gender difference?
No. Because I saw some report the other day
saying that it doesn't seem to work as well in women, or there were some doubts.
No. The issue is that the studies tended to have much larger numbers of men
and therefore there was more evidence for men.
What we've done here in Oxford is collaborate with people who've done trials all over the world,
pulled the data together, so that we have large enough numbers of both men and women
and you see the same proportional reduction in risk.
Are you on statins? I am, yes.
But I had the experience of going along to my GP
and saying, "I'm old enough that the risk becomes big enough to consider it."
What did the answer come back? The answer from the GP was,
"Do you really want to take those drugs? There's a lot of side effects."
And I said, "Well, actually, no you don't!"
'But not everyone agrees.
'Dr David Bailey is an experienced GP.
'Every day he sees patients who are taking different types of statin.
'And so he gets a chance to see their effects first hand.'
Should I be taking statins? What do you say?
My short answer would be no, unless there were some significant things that would persuade me otherwise.
Rory Collins would argue that the only significant side effect
is muscle problems.
Rory Collins is a very, very clever professor.
I'm a jobbing General Practitioner
and I see all these patients that he never sees.
But I can tell him that about 10% of people do get significant side effects.
It's not life-threatening or sinister side effects,
but irritating life-altering side effects.
The aching, there are potential memory issues as well.
People get tired with them.
People get nauseous with them sometimes.
Is there a difference between men and women with statins?
There does seem to be a difference.
We know that overall, less women have heart attacks
and when they do, they tend to have them later.
It seems to be that the benefits to men are significantly greater than women.
Five or six times greater, in fact.
A lot of people suggest that women, a low risk group, probably don't benefit at all.
Can you imagine yourself one day going, "Aghh! I wish I'd taken that statin!"
as you fall to the ground?
I suspect I wouldn't be thinking rationally during my first heart attack!
If you decide to put up with the aching, because you know there's a slight reduction in your risk,
that's your choice.
If you've had a heart attack or stroke,
then taking a statin reduces your chances of another.
But what if you're healthy?
Seven million people in the UK are taking statins
with up to 700,000 experiencing side effects.
If you are one of these
and have no history of heart disease,
it's easy to see why you'd give them up.
There are other ways to reduce cholesterol.
Good diet and exercise.
OK, so, decision time.
And it's been really tough!
But in the end, I have decided...
..that I am going to put myself back on statins.
I think the benefits are quite clear.
I think the risks are minimal,
but if I do start to experience side effects,
then I'll either switch statins or give them up.
If I was a woman, would the decision be any different?
Yes, I think so.
But only in the sense of time.
I would probably go back onto statins, say if five years' time
when the risks had risen.
Now, this is my decision. It's a very personal decision.
You may come to very different conclusions.
And certainly you shouldn't think about doing anything
without first consulting your GP.
Now, back to Chester for another health question.
If I get wet, am I going to get a cold?
You might have read about that in a Jane Austen novel,
and how many of our mums have told us not to go outside with our hair wet?
But it's looking like there might be some truth to this idea.
Colds and flu are viruses,
so to catch them, you need to come into contact with them.
But there's a difference between catching the virus
and developing the symptoms of a cold.
Many of us have viruses up our noses
and most of the time, they don't get any further than that.
But it appears that when we're cold and wet,
we're actually giving the viruses a helping hand.
A team at the Common Cold Centre in Cardiff
showed that people who had their feet chilled with water for 20 minutes
were more likely to develop cold systems afterwards.
No-one really knows why this is.
But they think it's something to do with the fact
that our blood vessels in our noses constrict in the cold.
And this is thought to affect our body's natural defences.
So, the moral of the story is,
do what your mum says - stay warm and dry!
Throughout this series, surgeon Gabriel Weston
has been looking at some pretty radical approaches to problems.
For example, the desire to have children is almost universal
and yet one in six couples in the UK struggle to conceive.
A surprisingly common cause of infertility in women
is being born without a womb.
Sophie Lewis only discovered this fact about herself when she was a teenager.
When you're 16, you don't think about having children
so at the time, I was like, "That's OK. I don't have a womb.
"Think about it much further down the line."
Obviously, I'm 28 now,
so you see lots of people having children
and you think, you know,
it gets harder and harder every single day.
It's like a massive weight on my shoulders all the time.
Just thinking, "You know, when it gets to the stage of wanting to have children, what will I do?"
I've travelled to Sweden to witness a clinical trial taking place
that gives hope to Sophie
and 15,000 other women in the UK in her position
who are either born without a womb
or had to have it removed while young.
If it's a success, then Sophie hopes to undergo the same procedure.
But it's a surgery like no other I've ever seen.
Obviously, as a surgeon, there's nothing I like more
than getting to go into someone else's operating theatre to see what they do.
But what I've come here to Gothenburg today to see
isn't just any old operation.
I've come to see a man perform some surgery
that really is, I would say,
the most exciting and bizarre operation that I've ever heard of in my life.
He's going to take a womb from one woman, lift it out into plain air
and then transplant it into another woman's body
so that hopefully she can actually have a baby from it.
I can't believe how excited I am to see how he does it.
The surgery is so long and complex
that it starts well before dawn.
Specialist surgeons have flown in from all over the world to assist
or simply to watch.
If the operation is a success,
then it will open the door for transplants for women like Sophie everywhere.
It's a moment in surgical history.
So, let's start over here.
Both the womb recipient and donor have asked to remain anonymous.
Just rotate towards me, please.
There is no guarantee of success,
and the procedure has proved controversial.
SOPHIE: 'I've seen a lot of comments that people have written'
that for you to feel like a woman you don't have to have your own child.
"This is unnecessary.
"Why would you put the woman and a foetus, possibly, at risk?
"Why go through something like that when there are options such as surrogacy and adoption?"
But I think until you're in that position...
..you don't realise...
Sorry.
We need to have the artery exposed.
Surrogacy is illegal in many countries, including Sweden.
So today's surgery provides the only way for the young recipient
to have her own biological child.
And the woman who has given her this opportunity
has a special reason to donate her own womb.
I think it's really remarkable today
that actually the womb that's being lifted out of this woman
is going not just from one woman to another stranger,
but from a mother to a daughter.
I have to say, as a mother of a daughter,
and as a surgeon,
I find that completely mind-boggling.
'Two international surgical teams of 15 will work all day
'under the leadership of Professor Mats Brannstrom from the University of Gothenburg.
'Gynaecological specialists will work alongside transplant surgeons
'who will need to ensure that the womb has a good blood supply.
'In order to be able to carry a growing child,
'both the blood supply and the connective tissue around this unique organ
'will need to be strong.
'During pregnancy, the womb needs to expand 20 to 30 times in volume.
'In this case, the veins of the womb seem a little weak
'and will need repair and strengthening from the transplant surgeons.'
They want to preserve as many of those veins as they can.
Because obviously if you take the womb but don't take enough arteries and veins with it,
then it's going to die.
This surgery is incredibly important for Sophie and thousands of others.
A British team are planning to offer five women womb transplants in the UK
as part of another trial.
Sophie hopes to be one of those.
My mum was like, "Have my womb.
"If we can, I'll do it. I don't need it any more. You can have it."
Here is the function.
Very delicate.
I would do this for my daughter in the blink of an eye.
I really would.
'It's been ten hours of non-stop work for the surgical teams.
'Extracting the womb from deep in the pelvis, along with its precious blood vessels,
'is the most tricky part of the transplant.
'But as darkness starts to fall again,
'the excitement mounts.'
Here comes the womb. It's coming over.
It's now free from its donor.
'Now the transplant surgeons must work quickly
'in order to repair the delicate blood vessels.
'They don't want to keep the womb outside the body for long.'
We're actually cleaning the vessels now.
What's coming out of the vessels looks very clear, I think.
'The womb is now ready to be transplanted
'into the body of a woman who was once carried inside it!'
So there's a womb, all ready to be plumbed in to its new owner, the mother's daughter.
Amazing!
'The blood vessels that the surgeons have repaired on the mother's womb
'will now be attached inside the daughter in the theatre next door.
'This final part of the transplant is comparatively simple
'but it will be a full year before the recipient can attempt to get pregnant.'
Now we have to be gentle, to move the uterus down a little bit.
'If she does, though, and carries the baby successfully,
'this could become the most common transplant surgery in the world.
'There are nearly twice as many people needing a womb in Britain
'as need a kidney.
'So there's a lot riding on this young woman's journey.'
She's just got to base camp.
She hasn't even begun to climb the summit yet.
And certainly that really encapsulates for me
the fact that what is the end of today
is just the start line of a whole raft of other challenges
that are to be faced by this woman.
'With the eyes of the world on Gothenburg,
'and the hope that this surgery offers to so many,
'it's been a very special atmosphere
'in the operating theatre.'
This operation, unlike any other I've seen, really,
is not about disease, it's not about catastrophe.
This is about giving life,
about a woman giving her womb to her daughter,
and about the huge hope that what's been done in Gothenburg today
might, in the future, provide a solution
for the 15,000 or so women of reproductive age who are born without a womb
and who have absolutely no hope of having their own family.
'I would like three, but that might be a bit ambitious!'
Even if I had one, I'd be very, very happy and grateful,
and especially if I had it myself.
The patients we filmed in Sweden have made full recoveries.
But all round the world, teams are awaiting the moment of truth,
a successful pregnancy.
On our website are links to organisations providing support
for those affected by the issues covered in this film,
and the latest updates from Sweden.
In Chester, it's been a week since we turned the estate agents' world upside-down in the name of science.
Clare, how's it going? Very good. I'm far less stiff.
I used to find I'd get up all stiff, but I don't have that any more.
I think it's been fantastic. Has it? Yeah.
It's so much better standing up. I haven't sat down.
I've got to admit I miss my old desk! Do you? OK.
So you're happy going back to sitting all day? I'd be happy, yes.
'We've been measuring what simply standing up a bit more in their working day
'has done to our volunteers' bodies.
'Researchers have found that people who sit down all day
'could be really risking their health.
'Those who sat more than three hours a day lived on average
'about two years less than those who didn't.
'John Buckley and his team have been measuring the volunteers' blood sugar constantly
'to see whether that could be behind these figures.
'Could just a little bit of standing in a day
'change our office workers from being like our cabbies earlier in the programme
'to being like our firemen?'
On the day where they were seated,
the blood glucose remained raised for a longer period of time.
Whereas on the standing day, the blood glucose came down much more quickly.
That's interesting.
They're releasing this glucose into their bloodstream but cos you're using muscles standing up,
you quickly burn off that glucose. Yeah.
So you're actually disposing of that glucose, as it was designed.
'If you're sitting down all day, exactly the same thing will be happening in your body.
'And yet, once you stand up,
'the gentle exercise that gives you
'will help you get rid of dangerous excess glucose.
'And the fact that standing up counts as exercise,
'has other benefits, too.'
If we look at the heart rates,
we can see in the dark yellow line that is their heart rate
and calorie burn while they're seated.
So this standing one is obviously higher.
It's quite a lot higher. It's ten beats a minute higher.
Yes. And that makes a difference of about 0.7 of a calorie.
That doesn't sound like very much.
If I extend that over three or four hours of a working day,
over a week, over months, over a year,
it comes up at about 25 to 30,000 extra calories. Really?
In a year. That's a lot of hamburgers more per year that I can eat!
It's a lot of hamburgers. Maybe it's easier to explain it in pounds of fat.
It's about five to eight pounds of fat, which is about half a stone.
So if I didn't eat the hamburgers, I would then burn that fat. Yes.
Which is probably a better way of thinking about it!
But if you wanted to put that into activity levels,
that would be the equivalent of running about ten marathons in a year. Really? In a year?
OK. So just by standing up three or four hours in your day at work.
'So, it seems we do have evidence
'that might explain the dangers of sitting.
'The sort of imperceptible increase in muscle activity generated by standing all day
'is what all of us need.
'It's giving your body that tiny bit of extra exercise
'that allows it to deal with the carbs we're eating,
'helping us to burn calories
'but also to keep our all-important blood sugar levels under control.
'We can't all start standing up at work.
'But even just being aware of it,
'standing whilst on the phone, whilst on the bus or train,
'doing something like cooking or ironing whilst watching TV,
'we could all make a huge difference to our health.'
It's pretty clear that most of us spend far too much time on our backsides.
And anything we can do to reduce that amount of time
would be a good thing for our long-term health.
Even just a few hours standing up every day
can reduce your risk of some of the most common medical complications in the UK.
And, as we've seen here, it's not like you need to join a gym to get the benefits.
That's it from Chester.
Next time, we're coming from Lancaster,
where, amongst other things, we'll be testing the claim
that just planting a small tree outside your house
can significantly reduce your exposure to traffic pollution.
We'll also be asking, "Do probiotic products actually make us healthier?"
And is there a cure for hay fever?
A-choo!
Trust me, we'll find out!
Subtitles by Red Bee Media Ltd