0:00

This is the BBC. This

0:03

podcast is supported by advertising outside

0:06

the UK. Hello

0:09

and welcome to the Inside Health podcast. I'm

0:11

James Gallagher. can't believe it. It's

0:13

already our last edition of this

0:16

series. Going to be going for some celebratory

0:18

retail therapy later and we can see

0:20

what my shopping basket tells me

0:22

about my health But first, we

0:25

finished on a cliffhanger last time, writer

0:27

Naomi Alderman was preparing for her

0:29

new TV series for power when

0:32

things took a mysterious turn

0:34

in the dentist

0:34

chair, so I'd have been waiting ages

0:36

to say this. Previously, on

0:39

in side health. My

0:43

dentist said to me, right, I've got a crack

0:45

in one of my teeth. And he said,

0:47

if this is just gonna get worse because you're grinding

0:50

your

0:50

teeth. So how

0:51

did you know you've been grinding your teeth? Well, apparently,

0:53

there are sort of little bits that are worn

0:55

down. There's lots of signs on the

0:57

teeth. Did you

0:58

know? No. I have no idea. I've

1:01

been told that I snore, but

1:04

I have not been told that I It

1:06

sounds like I'm putting on a disco in there.

1:09

So having told me I grinders,

1:11

he said, oh, yes. This is very common. And has

1:13

become much more common since

1:15

the apocalypse, I

1:16

mean, the pandemic.

1:17

Okay. So how common did your dentist think it

1:19

was? So

1:19

what he said to me was that before the

1:21

pandemic, It was between one

1:24

in five and one in four people who came

1:26

in had

1:26

signs of grinders, and now it's

1:28

more than half. So that's a

1:30

lot. Have

1:31

you been recommended anything? Because I know a couple people

1:34

who grind their teeth, and they've been given a mouth

1:36

guard.

1:36

Yeah. So I was fitted for

1:39

a mouth guard, so had to put

1:41

my teeth into some kind of disgusting

1:43

putty to set around my teeth.

1:46

I mean, like, how do you sleep with a sing

1:48

in your mouth? If the mouth God

1:50

helps, then

1:51

fine. But I'm not sure how I'm gonna get

1:53

on with sleeping with it. Do you think you're

1:55

a a pandemic grinders, like some of the other

1:57

people your dentist thinks is is going

1:59

on? Or

2:02

is it like you've got TV series

2:04

coming out, got a new book to

2:05

write.

2:06

I'm I'm a naturally anxious person.

2:08

think I am a worrier, but at the same

2:10

time, I can certainly fear him

2:12

myself. But I'm not emotionally back

2:14

to normal. Oh,

2:15

namely, let me see if we can find some answers.

2:17

I would love that. I really want to know.

2:22

Hi. I'm Hannah Badis. I am a

2:24

consultant in Restorative Dentistry at

2:26

the Leeds Dental

2:27

Institute. Hannah,

2:28

welcome to Inside Health.

2:29

Thank you. Thank you for having me. So,

2:31

Hannah, do you grind ash clunch your teeth?

2:33

I definitely do. I have done that for

2:35

many years on and off And in the

2:37

past two weeks, I have broken two of my

2:40

teeth.

2:40

Oh my god.

2:41

That's you know, they've got little bandages

2:43

in. They're not hurting or anything. So it's fine.

2:44

Okay. That's what's known as broxism.

2:46

Is that right? Exactly. Brexism. That's

2:49

the thing. Yep. So, Brexism is

2:51

a behavior where there is repair

2:53

jaw movement or clenching or grinding

2:56

the

2:56

teeth. This can be when you're awake or

2:58

what we're gonna talk about today is while you're asleep

3:00

with sleeproxism. I may share a bed with

3:02

somebody who has sleep. Oh, really? Some. Yes.

3:04

So III have no personal interest in this

3:06

at

3:07

all. How common is it?

3:09

It's pretty common. Sleepbroxism is maybe

3:11

ten to fifteen percent of people.

3:13

So a casual seven million

3:15

people in the UK, not many. It's

3:18

a bit more common in children, a bit less common

3:20

in the elderly, but essentially it's caused

3:22

by activity in our brains while

3:24

we're asleep. We don't know exactly what

3:26

triggers off that kind of cascade, but

3:28

we know we have sleep cycles

3:30

that we go through with stages where we're

3:33

more or less deeply asleep. And baptism

3:35

happens during the lighter stages

3:37

of sleep when our brains are more active. What

3:40

we call arousal from sleep or where we're a bit

3:42

less deeply

3:43

asleep, is what gives us the windows

3:45

of opportunity for Marxism to occur.

3:47

That's interesting because I'd always wondered if it was something

3:49

to do with like stress or anxiety

3:51

or something like that in your day to day life

3:54

in the instant where you were like personifying that

3:56

by grinding your teeth.

3:58

Well, for sure, I mean, there is a really common

4:00

perception from dentists and from

4:03

people who grind their teeth that stress or mental

4:05

health issues can increase bruxism. There

4:07

is some evidence for this. It's a bit hard

4:09

to pin down, but For example, I read

4:11

a really interesting study recently that found

4:13

that forty percent of people with PTSD

4:16

have sleeproxism compared to only ten

4:18

to fifteen percent of

4:19

people. In the general population. So certainly,

4:21

there is an impact of those things. And apart

4:24

from having a partner going, can you stop

4:26

grinding your teeth in the middle of the night? Is

4:28

there any way that you would know if you had

4:30

sleeproxism?

4:31

Yeah. Well, the thing is a lot of people have

4:33

no idea that they have this. In the evidence, maybe

4:36

as many as eighty percent of people with sleeproxism

4:38

are unaware that they do this. Things

4:41

that people might notice is you might wake up with

4:43

a stiff or sore sore muscles, Your

4:45

teeth might feel a bit sore. You might notice

4:47

that your teeth are wearing away or little bit

4:49

breaking off them, especially if there's

4:51

any acid erosion alongside your grinding.

4:54

Sometimes people might feel their teeth feel a

4:56

little bit loose. Or as you have experienced,

4:58

quite a reliable indicator is that people

5:00

might hear you. Not everybody with sleep boxes

5:03

and grinds their teeth, it might be clenching, but certainly

5:05

grinding can make quite a bit of

5:07

noise. I I gotta get told off if I go into any

5:09

further detail. So I'm gonna move on if that's

5:11

okay, Hamid. Yeah. For sure. Okay.

5:13

So the reason why we got in touch is this this

5:15

kind of like anecdote, multiple sources,

5:17

including you heard from Naomi, the idea

5:19

that it's become more common during

5:21

the pandemic. And we got in touch with you and

5:24

you kind of went, I don't know. Like

5:26

in proper inside health fashion, you went, I'm gonna

5:28

try and find out for

5:29

us. So how do you get on?

5:31

There is some evidence it's

5:33

not all of a very high quality. A lot

5:35

of it depends on kind of questionnaires or online

5:38

responses to things or

5:40

looking at what people have been googling at various

5:42

points in the pandemic. So we have to interpret

5:45

it with a little bit of caution. There

5:47

was a study that was done online

5:49

questionnaires in Israel and Poland,

5:51

which I quite like because It asked

5:53

people if they felt that their Marxism

5:56

had worsened during the past months

5:58

and he was done early on in the pandemic. But

6:00

between fifteen and thirty percent of the respondents

6:03

felt their Brexism had got worse. So I

6:05

thought that was quite interesting. There are

6:07

other things about has the likelihood of crack

6:09

teeth increased, and there are

6:11

some publications that some people in

6:13

private dental practice. I found

6:16

some in America. Found that that has

6:18

increased, but it becomes then less

6:20

clear because when you look at cracked

6:22

teeth, you can't tell when that happened.

6:25

But you know, it's plausible, isn't it? Because

6:27

we know that mental health difficulties, PTSD,

6:31

can make us more likely to grind our

6:33

teeth. And if we know that post

6:34

COVID, Those things have increased, then it seems

6:36

plausible. I feel like we have to say because we always have to

6:38

say with COVID. There's no suggestion here that it's the

6:40

virus itself. No. We're doing something

6:43

something about the societal

6:44

Yeah. For sure. Definitely. It is

6:47

something which changes the

6:49

activity of your brain during sleep.

6:51

And I'm gonna risk getting in trouble

6:53

again here. So so we may have

6:55

purchased like a mouth guard type

6:58

thing to try to stop the teeth damaging as they

7:00

were grinding in the middle of the night and also try to help

7:02

me get a little bit more

7:03

sleep. Did they do anything?

7:05

Did you buy online or did you get it from a

7:07

dentist? 0II

7:08

think it was like a sports dumb shoe

7:11

type thing. Fine. In general, I would

7:13

always advise having one made

7:15

by a dentist. Because the ones that

7:17

you buy over the counter or

7:19

ones that you get online and you make yourself,

7:21

it's hard to know whether they're fitting okay.

7:24

Hard to know whether you're gonna cause any damage

7:26

to your gums. Also, it's important

7:29

that they cover all the teeth properly because if

7:31

some of the teeth aren't covered

7:32

properly, then there's a risk that those teeth might move

7:34

and you might get changes to your bite. Katie, I have

7:36

been adequately chastised for self medication. Do

7:40

a dent dentist prescribed one work?

7:42

Yeah. So it depends what you're

7:44

aiming for because when you have bruxism,

7:46

that doesn't mean you have to treat it. There's no

7:49

need to do that. It's a behavior. And do

7:51

you need to treat a behavior? I'm not so sure.

7:53

It's more if you are having problems as a

7:55

result of that. Like for me, I'm trying not

7:57

to break any more of my teeth. So I'm

7:59

putting something over the teeth to cushion the forces

8:02

of clenching and grinding. The

8:04

type of splint that dentists often

8:06

make as a kind of first line is a

8:08

a soft flexible splint. There's

8:10

not so much evidence that they

8:13

change anything about the bruxism behavior

8:15

itself, but at least they protect the teeth.

8:19

There's anecdotal evidence. Maybe ten

8:21

percent of people find that those

8:23

soft splints make their grinding

8:25

worse. They it's something about the texture

8:27

seems to promote grinding.

8:30

Also, like when my toddler is chewing on things.

8:32

Yeah. So maybe there's something there.

8:34

If that's the case, then you can have a different

8:36

sort made. There used to be a

8:38

kind of perception that Marxism was

8:40

caused by something about the teeth. That

8:43

led to treatment strategies of

8:45

adjusting the teeth to try and stop

8:47

people grinding their teeth. Now that has no basis

8:50

in evidence. And I would advise

8:52

people against having that kind

8:54

of treatment done.

8:55

Naomi mentioned both snoring

8:57

and grinders. Teeth. Are they

8:59

completely separate things or do they or are they

9:01

twinned?

9:03

In a way, they may be slightly related

9:05

in that both of those things some people might be more

9:07

likely to happen if we're lying on our backs.

9:09

But sleep apnea, which

9:12

is a condition where the airway is obstructed,

9:14

because we relax while we're sleeping. That

9:16

is possibly linked with bruxism, and

9:19

people with sleep apnea often do

9:21

snorkeling. If they're clenching and grinding is a

9:23

bit of a problem for you or

9:25

in your life, then is the

9:27

solution actually through improving like sleep

9:29

habits?

9:30

Potentially. Again, this is something that

9:32

we often talk to people about is

9:34

kind of sleep hygiene things, avoiding

9:37

caffeine or alcohol in the evenings

9:39

before bed because we know that those increase the

9:41

likelihood of bruxism. Or other

9:43

sleep related disorders, insomnia's, sleep

9:46

related epilepsy, the link between

9:48

those things seemed to be the increased

9:50

activity of the brain while asleep

9:53

or disturbance of the deeper

9:55

stages of sleep, so that there's more time

9:57

spent in lighter sleep stages. So we have

9:59

more time overnight when we can

10:01

spend grinding our

10:02

teeth. Hannah, thank you so much for coming on.

10:04

I love little stories like this because I do, you

10:06

know, it affects so many people up and down

10:08

the country and yet we never ever ever talk

10:10

about it. Well, I'm glad to spread the word.

10:13

Thanks to Hannah Beddes there and to Naomi

10:15

Alderman for putting us on the scent of pandemic

10:18

induced broxism. But now, I'm

10:20

joined by our resident GP, Dr. Michael McCarthy.

10:22

Hi, Michael. Intelligence. So you're

10:24

gonna help me way through the post bag.

10:26

Second one is a post bike. It really is an email

10:28

inbox these days. Isn't it inside health at BBC

10:30

dot co dot u k is the way to get in touch?

10:33

We've had lots of questions about the last program

10:35

we made together, Margaret the Warren, about

10:37

the obesity drug, the weight loss

10:39

drug, semaglutide,

10:40

Ozempic, Waygovie, however you want to call

10:43

it. So can you help me way through a couple of them?

10:45

I will do my best. So the first one

10:47

was from Wendy tool, and I think maybe we

10:49

failed to explain something completely clearly because

10:51

she thought really great program enjoyed it. So

10:53

thanks for that, Wendy. But was left wondering

10:56

whether it was actually the advice on meals

10:58

and exercise that was the key fact in

11:00

people losing weight rather than the

11:02

drug. So can you just explain how they account

11:04

for that stuff? Right. I I think the top

11:06

line answer is no. And so

11:09

the big trial it was done that we looked

11:11

at are almost two thousand adults

11:13

with body mass index of orthartic. Some

11:16

got the semaglutide some got placebo,

11:18

and they compared people, followed them up

11:21

over a year, a year and a half. And then they look

11:23

to see what would happen if people came off that

11:25

drug see what would make the difference. So

11:27

both groups of people, both the placebo group

11:30

and the semaglutide group, had interventions

11:32

every four weeks from a counselor who is giving

11:34

them advice about and healthy eating,

11:37

cutting their calories every day and exercise.

11:39

So both groups got that. But the big difference

11:42

was in the weight loss between the two groups.

11:44

So in terms of percentage body

11:46

weight loss, the semaglutide group

11:48

lost seventeen point three percent on

11:50

average compared with two percent

11:52

on the

11:52

placebo. So the difference is enormous. And

11:55

and that advice on meals and excite. It did

11:57

smidge their weight down during the trial having that

11:59

weekly appointment. It did they did make

12:01

a small dent into their weight. Absolutely. But

12:03

just nowhere near as much as the semaglutide

12:06

group. And of course, this drug is starting

12:08

to make kind of like other kinds of headlines. I thought

12:10

it was noticeable, but it came up when the government's

12:12

foods are Henry Dinwobi, resigned

12:15

and voided he pull no punches about

12:17

government policy around obesity see

12:19

when he quit. And he said he's

12:21

worried that this drug is just gonna end up becoming

12:24

the solution without tackling anything else and

12:26

being given to millions of people in

12:28

the

12:28

end. Here he was on the Today program

12:30

this week. When you roll out a drug that has

12:32

been trialed or quite a limited number of

12:34

people, to that many, you will get

12:36

side effects that will cause problems. It'll become

12:39

quite political. Secondly,

12:42

while I think it's a good thing in certain

12:44

extreme cases, to me, it

12:46

does not feel like a society that we want

12:48

to create where you're just shifting the

12:50

money from people selling junk food the money

12:52

people making drugs, and they're a quite reasonable

12:54

intervention you can make to create a healthier,

12:57

more pleasurable,

12:58

unmetigated, society. I

13:00

think this is the really interesting thing for me,

13:02

Margaret. I mean, like, the evidence about how well the

13:04

drug works is reasonably clear

13:06

cut. The big profound questions to ask are

13:09

how we want to use it and how do

13:11

we balance that up against the other

13:14

ways of tackling obesity.

13:16

I absolutely agree. And I think that this

13:18

drug will be really useful for some people.

13:20

But what are we doing in terms of the bigger picture?

13:22

Where are we going? Are we just going to let the population

13:25

become overweight, become obese, and then offer the

13:27

more treatment for

13:28

it. Is there not a better way? Margaret,

13:30

moving on from obesity to bank

13:32

pain. And one of my favorite episodes from this

13:35

series where we just spent half an

13:37

hour answering all you listened to Holmes

13:39

questions about Back Pain, it was a great

13:41

one. And one of the surprise findings that

13:43

kind of came out was that snookers

13:45

actually kind of alright for dealing

13:47

with back

13:48

pain. And Gordon

13:50

got in touch to say that he loves it too.

13:54

Hi, James. I've just listened to your back pain

13:56

edition. I was actually at my snooker

13:58

table, practicing my cue ball control at

14:00

the time of that edition. So I'm glad to hear

14:02

that snooker might be good for my back. And

14:05

as it happens, my preferred aerobic

14:07

the size is cycling, which often isn't

14:09

very good for one's back. And I do find

14:12

some time at the snooker table standing upright,

14:14

walking, gently turning, stretching, moving,

14:17

is good for back pain. Even if

14:19

my brake building isn't very good.

14:22

I'm pretty certain you would still thrash me because mine's

14:24

pouring, I think my highest brake is about eight. So

14:27

let's leave that

14:27

alone. Margaret, though, you're a

14:30

really keen cyclist. I am. And nothing's

14:32

good to say really from my bike, and

14:34

I do have bike problems, but you see my

14:36

bike is better 4 me than running. I need to get outside.

14:38

I need to get some exercise. And yes,

14:40

I have different things work for different people, but

14:43

I'm wedded to my

14:44

bike.

14:44

Big theme from that episode was exercise is

14:46

good. The best exercise is the one that you enjoy

14:48

doing.

14:48

Oh, totally. And honestly, if haven't been in your

14:51

bike for a while, seriously, spring is come and get

14:53

out there, it's glorious. Right, Margaret. Can

14:55

we do a runner and go shopping before somebody

14:57

sends me off to go to another Magut factory or

14:59

for a sperm analysis or to be exercised to

15:01

the limit

15:02

again?

15:02

I'm very happy to take shopping, James. No

15:04

problem. Excellent. Well, all of

15:06

those were real episodes that happened this

15:09

series on Inside Health. They're all on

15:11

BBC sounds. So while

15:13

Mark and I do a runner to the shops,

15:15

take it to listen to this. It's a response we got

15:17

from the sperm episode and an unexpected

15:20

discovery that end large veins in the test

15:22

these called varicoseal can

15:24

be a major cause of

15:25

infertility. So while Margaret and I hit the

15:27

shops, why didn't you have a listen? Hi. I

15:29

was so interested to hear your item

15:32

a couple of weeks ago on Vatica

15:34

Seal. I've never ever

15:37

heard this disgust anywhere,

15:39

really, even in programs concerning

15:41

infertility. And yet it's the very

15:43

condition that my husband had

15:46

and prevented me from getting

15:48

pregnant back in the nineteen eighties. We

15:51

were living in Hong Kong. We'd been married for

15:53

a year, and we're trying start a family

15:55

and nothing was happening. So

15:59

it was then diagnosed that my husband had

16:01

this varicoseal which was

16:03

preventing the proper movement of his

16:05

sperm. It was

16:07

suggested he have an op A

16:10

year and a half after the operation had been

16:12

done, I still hadn't fallen pregnant. We

16:15

saw another urologist. He examined

16:17

my husband and said, in the

16:19

way a plumber does when he's seen someone else's

16:22

bad work. Well, I don't know who

16:24

did this for you, but he didn't do a very good

16:26

job. So my long suffering husband

16:28

went in for a second operation in March

16:30

of nineteen eighty six. I

16:33

gave birth the following year. To

16:35

a beautiful healthy sun.

16:43

One basket, one jeans. One

16:45

month.

16:46

Let's go and see what we can find. Well,

16:48

as soon as we walk in modern, I see we're we're presented

16:50

with ever wants eternal dilemma. Do we

16:52

go for the

16:53

fruit? Or

16:54

the chocolates? Or the chocolate. Or the chocolate. I

16:56

have to see the presentation of bliss

16:58

morning apples and luminous oranges

17:01

are definitely a sight to me if they're updating you

17:03

in. What would happen, Margaret? Or how much

17:05

information would you have about me? If we

17:07

lived in a fantasy world where you could

17:09

see everything I

17:10

bought. So if you were constantly at my side

17:13

That's a shared load of data, isn't it? Yes.

17:15

That's a massive amount of stuff. So take

17:17

that you could know everything about your less

17:19

healthy items in your basket. You

17:22

might know about, you know, your fruit, your nacho

17:24

carbohydrates, where your proteins coming from. You might know

17:26

how much money you're spending on things, but

17:28

it is just data. It's just numbers. And

17:30

the big problem is then what do you do with all those

17:32

numbers? How do you interpret it? Market,

17:34

have you ever come a cropper with your shopping

17:37

basket habits? Well, well,

17:40

a few years ago, I can tell you where I was at

17:42

conference in Oxford and I

17:44

may have been having a few friends

17:46

around to chill out and

17:49

I might have been in a supermarket buying what might

17:51

have been a large quantity of alcohol

17:54

and snacks shall we see? And I got

17:56

to till. And I was asked whether,

17:58

like, a free test for diabetes at the pharmacy

18:00

pictures. So I've never quite worked out whether that was

18:02

anything to do with what Mabasco, whether it was just generic

18:05

or further we're giving everybody just

18:06

took one looking remark from when? I

18:08

was slightly offended. Now, obviously,

18:10

my We're not going to live in a world where somebody's actually

18:12

following you around all the time monitoring every

18:14

single thing that you buy. But if

18:17

you go into Supermarkets with your club card, ping,

18:19

there's everything you've ever bought in that supermarket.

18:21

And some scientists are trying to use

18:23

that data to learn more about

18:25

that health. So have a listen to this moment because

18:27

I was chatting to doctor Anja Skatova from

18:30

the University of Bristol earlier. Hi,

18:32

Anja. Welcome to Inside Health. Hi, James.

18:35

So We live in the world of data now.

18:37

Tell me, is it used for

18:39

anything other than marketing? I

18:41

mean, like, is it ever used to under stand

18:43

our health. It's not as much,

18:45

but we are doing quite a lot of work. For

18:47

example, we have a project on

18:49

pain. Chronic pain is notoriously

18:52

poorly diagnosed because people just don't

18:54

report it. So we're looking

18:57

at pain killer sales of the country

19:00

to see whether we can

19:02

improve our understanding how

19:04

much pain people feel in different parts

19:06

of the country. And that could

19:08

help provide recommendations to

19:11

public health interventions. For example,

19:13

setting up pain clinics. And I think

19:15

it provides us this insight

19:17

into people's health that we never

19:20

had before because usually

19:22

when we want to know about people's health, We

19:24

ask people like yourself how many

19:26

units a day you drank over

19:29

the past week and things like

19:30

that. And

19:30

then we all die. Yeah. Because people

19:33

don't want to say or people might not remember

19:35

or we might not reach out to all

19:38

people to have a good picture of

19:40

the population. But it provides

19:42

us this type of data that

19:45

can give us a better picture

19:47

of people's lifestyle

19:48

choices. Does it give us that much more information

19:51

than

19:51

we already have? Yeah. It would definitely

19:54

because with supermarket data, you can

19:56

go back in time, you know, potentially

19:58

five, seven years. And

20:00

see what people's diets were and how they

20:02

changed. One of the things that makes me

20:05

concerned when we're looking at this kind of data,

20:07

particularly once you start trying to give anything

20:09

out on a very personal individual level

20:11

is that we don't really have a

20:13

detail picture of what every individual person's

20:16

shopping is like. You tend to get what household shopping

20:18

is like. So I'm just thinking in my home. I

20:20

think the Nektar card is in my name,

20:22

but the Tesco Clubcard is in

20:24

my partner's name. I don't know what all

20:27

the other store cards are in. But, Cavic,

20:29

even in that scenario, it's all very

20:31

muddy

20:31

data, isn't it? It's true, but

20:34

what we're trying to do in research,

20:36

we're trying to understand those what we

20:38

call biases, bloodiness in the

20:40

data. So we can understand

20:42

in which cases we can use this data, in which

20:44

cases we can't. So you're right. It

20:46

is household consumption, but that's

20:49

your food

20:49

environment. That also

20:51

would affect your health.

20:54

Well, that was doctor Anias Kotova Margaret.

20:57

Still in the shop I think what this kind

20:59

of data does, it tells us what

21:01

actually is being bought in certain

21:04

places. Rather more people say is

21:06

being bought Exactly. The other thing that Amy

21:08

said that I was really interested was the idea about pain.

21:10

And I suppose if you look up and down the country, you can

21:12

see areas where people are using more pain

21:14

relief than

21:15

others, and that might give you insights that

21:17

you might not necessarily have because those people aren't

21:19

going to a doctor. Yeah. That that's boat tune.

21:21

You can see where peaks and troughs are of sales, but

21:23

it doesn't really explain to you why that is and why

21:25

the differences are

21:26

there. Have

21:26

there been any good examples where this kind of data

21:29

has been used successfully. Yeah.

21:31

I mean, before the pandemic, people were trying

21:33

to use this kind of shopping data to work

21:35

out where disease outbreaks were happening and then to

21:37

track them back. People were trying to work out when

21:39

you could look for peaks of respiratory illness.

21:42

For example, people buying cold and flu relief

21:44

tablets like kind of thing 4 clues

21:46

to go on and do more focused

21:47

research. They're trying to try and actually understand the

21:49

data rather than just presenting it to you. So Margaret,

21:51

just just walk me a sec. Because if we move past

21:54

all the chalky bars and crisps and everything, all

21:56

of the stuff that we really want. We can see here

21:58

as the fridges kick into gear. Like

22:00

all the medications that you can just buy over

22:02

the counter as part of your weekly shop,

22:05

things that you've got in digestion, things

22:07

for pain relief, And these actually became

22:09

really interesting and really important in the story

22:11

earlier this year that kind of kicked this

22:13

idea on a bit to not just coming

22:15

with someone's having to the health of an area,

22:17

but can you actually start understanding health of an

22:19

individual person? Because the claims

22:21

in the newspapers was, if I look look back

22:23

through your kind of like shopping habits. I might

22:26

be able to work out if you've got ovarian cancer.

22:28

Yeah.

22:28

Unfortunately, the media does perpetuate

22:30

that particular interpretation quite widely,

22:32

but what the studied it that we're talking about

22:35

is it observed women who had been diagnosed

22:37

with ovarian cancer and compared them

22:39

with women who hadn't been. And they basically found

22:41

women who have been diagnosed with ovarian cancer

22:43

in the months preceding their diagnosis had

22:46

an increased rate of buying over

22:48

the counter pain at indigestion relief

22:50

remedies. So kind of stuff we can see in front of us

22:52

here just now stuff that's very easy to buy

22:54

over the counter. Well, Margaret, we're gonna draw a crowd

22:57

if I keep playing out interviews in here, but I've got another one for

22:59

you to listen to. This is from doctor Yasmin

23:01

Hurst, who's now at the University of Lancaster,

23:03

but was doing this work when she was down in London.

23:06

And she's one of the researchers that was on that study.

23:09

Well, Yasmin, welcome to Inside Health. Hi,

23:12

James. So you were looking

23:14

at ovarian cancer. Why ovarian

23:16

cancer specifically? I mean, is a challenging

23:19

one to diagnose normally, isn't it?

23:21

We were interested in ovarian cancer

23:23

because 4 they get diagnosed,

23:26

often people's present with vague

23:28

symptoms that are often linked

23:31

with common illnesses such as bloating,

23:33

stomach pain, feeling full,

23:36

difficulty eating, indigest all

23:38

those kinds of things that are easily

23:40

dismissed because a lot of the time they will be something

23:43

minor.

23:43

And they often treat indigestion symptoms

23:46

So indigestion medication is a

23:48

common product, and we found

23:50

that about eight months before their

23:52

diagnosis there was a significant

23:54

increase for these purchases.

23:57

We're not trying to diagnose ovarian

23:59

cancer. We're trying to identify

24:02

signals and changes in behaviors

24:05

and how people manage their symptoms. And

24:07

that could tell us a bit more about how

24:10

people self care before going

24:12

and seeing their GP.

24:14

Can you just explain for me now that you

24:16

have seen this signal? You have spotted

24:19

a bit of a

24:19

difference. How do you think that

24:21

information can be used.

24:25

One of the first things we can do is

24:27

using that as a public health message. If

24:30

someone's using these products

24:32

longer. And if the symptoms

24:34

are persistent, then promoting

24:37

them to go and see their docs as

24:39

soon as possible. The second

24:41

thing is to see whether that signal can

24:43

be used as an alert to send

24:46

personalized messages to

24:49

say, have you been experiencing XYZ

24:51

symptoms? This is not a diagnostic

24:54

test, but it could tell us about

24:56

changes in careers, and I think that's what

24:58

we should be focusing

24:59

on. Well, that was Dr.

25:01

Yasmin Hurst. And Margaret, very much

25:03

agreeing with you really this is not a diagnostic

25:05

tool.

25:06

Absolutely. So it can possibly be oh,

25:08

it is as a signal on someone's shopping

25:10

list. You know, it may be, for example,

25:12

that women are using pain relief and

25:14

the pain relief gives them the side effect of indigestion

25:16

and they're using indigestion remedies instead. So it's

25:19

a signal and it's definitely of interest. But what we need to

25:21

do is explain that rather than assume that this is somehow

25:23

going to lead us to a silver bullet and diagnose

25:25

ovarian

25:26

cancer. What I was worried about when all

25:28

that reporting came out was that it what seemed

25:30

to be missing was the idea that well, if you started

25:32

looking across the general population, for people who

25:34

are ordering slightly more pain relief or

25:36

slightly more, you know, antacids.

25:40

You'd end up telling a huge number of people

25:42

they might have ovarian cancer. This is exactly

25:44

the problem, so we don't understand how

25:46

many people have had an increase in the

25:48

amount of pain relief 4 in digestion remedies that

25:50

are can. And then we don't understand what

25:52

proportion of that group have actually got a serious

25:54

underlying cause such as ovarian cancer.

25:57

And then we would have to work out if you can

25:59

fight a trigger. If you can find something there that's

26:01

telling you that something might be going on, what we need

26:03

to do is work it then away where we can diagnose

26:05

women usefully earlier. So so that we can

26:07

4 them something that actually benefits

26:09

them. Do you see anything in this that might

26:11

tell us about what we might be able to do in

26:13

the future in terms of analyzing shopping

26:15

habits and getting more information out

26:17

about our

26:18

health. Is there a glimmer of something

26:20

in? Yeah. No. Actually, I think this research

26:22

really does value. So one of the things that

26:24

I picked up was indigestion remedy has been increased.

26:26

Now, I would love to understand what is it about

26:28

that because that indigestion is in the list

26:30

that the National Institute for Health and Care Excellence

26:33

have, for example, in the list of symptoms of ovarian

26:35

cancer. So I'd like to understand, what would we

26:37

have been cheating then? Whether cheating bloating that

26:39

we do know is a myocardial cancer?

26:41

Or was it actually in digestion? Or,

26:44

you know, what's the meaning? But that is acid coming out behind

26:46

the breast, bone, acidists, and the mouth. Can

26:48

we understand what that the meaning of that actually

26:50

is. And would that give us any clues into other

26:52

symptoms that should be considered? And of course, there's

26:54

big shopping data that there might be other things that

26:56

they can tell us, but I think it's gonna tell us more

26:58

about populations. We already know about health

27:00

and quality. We already know that if you're prudent, it's

27:03

a massive risk factor for being diagnosed

27:05

with more diseases earlier and for dying younger.

27:07

You know, we already know that. So what you really

27:09

want to know is can you somehow get

27:11

better information?

27:12

Yeah. Better information that allows you to do something

27:14

useful with it. Well,

27:15

Michael, thanks for chewing over at all with me. Have

27:18

one super important question. Don't

27:20

throw it.

27:21

Do you take back fruit or biscuits? I

27:24

think I'll say off microphone you

27:26

know what I'll be choosing. Well,

27:29

that's it for another series of the Inside Health

27:31

Podcast with me James Gallagher. Thank

27:33

you for listening and to everyone behind the scenes.

27:35

Producers, Paula McGrath, Julia Ravi

27:37

and Harrison Lewis, as well as content editor,

27:40

Erica Wright, and Studio manager, Andy

27:42

Garrott. But before I go, I have to

27:44

say a special goodbye to two of

27:46

the nicest and most talented people

27:48

I've worked with. Producers Geraldine

27:51

Fitzgerald and Beth Eastwood have

27:53

both decided to leave the BBC. Their

27:56

compassion and eye for detail

27:58

have been woven into BBC

28:00

programs for decades. And

28:02

I'll be honest, you're a big part of why

28:04

coming into the office and spending time in this

28:06

program. It's like being with

28:08

family. It's been such an honor, so thank

28:10

you so much. And for everyone

28:13

else, Inside Health will be back with

28:15

a new series in the summer.