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greenlight.com/acast. BBC

1:17

Sounds, music, radio, podcasts.

1:22

Hello, I'm Greg Foote and welcome to the

1:24

show that investigates the wonder products promising

1:27

to make you happier, healthier or greener. Each

1:30

episode I run one of your suggested wonder

1:32

products through the evidence mill to find out

1:34

if it is indeed the best thing since

1:36

sliced bread or marketing BS. And

1:39

this week I'm joined by Kathy Kennedy

1:41

from Northamptonshire. Welcome Kathy. Thank

1:44

you very much Greg. Tell

1:46

us the wonder product that you would like us to investigate

1:48

today then and why you'd like to know if it is

1:50

SB or BS. Well, I've recently

1:52

been diagnosed with slightly higher cholesterol than

1:54

my GP would like. And I've chosen

1:56

to go down the lifestyle route. rather

2:00

than going straight onto a pharmaceutical option.

2:03

I'm doing a little bit more exercise. I'm trying

2:05

to cut down on the usual

2:07

things that come to mind when it's cholesterol-based.

2:10

But also in the supermarkets, there are the

2:12

little bottles of stuff that say, you

2:15

drink this, it will lower your cholesterol.

2:17

There are very expensive ones. There are much cheaper

2:19

ones, depending on whether it's a known brand or

2:22

whether it's the brand belonging to the supermarket. And

2:25

I'd like to know, is it worth it? Is

2:27

there any difference between the expensive

2:29

branded one and the supermarket chain

2:32

one? Do I need to then

2:34

just drink the little bottles? Or can

2:36

I just crack along with both angles?

2:39

Gotcha. Well, you know what? It's

2:41

hard to keep track of the number of emails

2:43

that we've had requesting. We look at cholesterol lowering

2:45

spreads and drinks. Our email, by the way, is

2:47

sliced.bread at bbc.co.uk. If you're listening

2:49

and you would like to suggest a Wonder product. We

2:52

also have a WhatsApp number you can send messages and

2:54

voice notes to, that's 07543306807. Loads

2:59

of requests for this topic on there,

3:01

including this one from listener Debbie. Hi,

3:04

Greg. I have high cholesterol and

3:06

I'd love sliced bread to help me with

3:08

what is actually an evidence backed way to

3:10

lower it. As well as

3:12

eating foods like oats, fruit and veg,

3:15

oil, fish, nuts, et cetera, that will

3:17

apparently help. We'll switch into

3:19

products that say they will lower your

3:21

cholesterol, help much further. For

3:24

example, should I switch my butter

3:26

for a Benecol or proactive spread?

3:29

They say they contain active

3:31

plant stannelles or plant sterols

3:34

that have been proven to lower cholesterol.

3:36

Have they? Thanks. No,

3:38

thank you, Debbie. Let me introduce today's

3:41

two experts then who are going to

3:43

help us investigate all this. Joining Kathy

3:45

and I in the studio are two

3:47

professors. First up, professor of clinical trials

3:50

and epidemiology and honorary consultant in public

3:52

health medicine at Oxford Population Health at

3:54

Oxford University, professor Jane Armitage. Hello, Jane.

3:57

Hi. And sitting alongside Jane is

3:59

Peter Penson. Professor of Pharmacy Practice at

4:01

Liverpool John Moores University. Welcome Peter. Thank

4:03

you, Greg. Jane, let's

4:05

start. Maybe explain first what cholesterol

4:08

is for us, please. Well, cholesterol

4:10

is a molecule, so it's something

4:12

that circulates in the blood. It's

4:15

an important molecule because it helps make

4:17

the surrounds of cells, what we call

4:19

cell membranes, but it's also

4:22

important in the early stage of

4:24

making various things like hormones, for

4:26

example, vitamin D, sex hormones, estrogens,

4:29

progestins, those sort of things. So

4:31

it's very important that we have

4:33

some cholesterol and we

4:35

largely make it in our liver, although

4:38

we also get a little bit from

4:40

our diet. And the reason

4:42

that everybody's interested in it is

4:45

because it is a major

4:47

cause of heart disease and strokes. So

4:49

we need some of it. We need

4:51

some of it. But too much sounds

4:53

like a bad thing. Tell

4:55

me about good and bad cholesterol as

4:57

it's been labelled. OK, so when you

4:59

have a measure of cholesterol done by

5:01

your doctor, they will typically measure

5:04

all the cholesterol circulating in the blood. I

5:06

mean, they'll give you a number and

5:09

it will be made up

5:11

of about four fifths. So

5:13

maybe around 80 percent will

5:15

typically be bad cholesterol. LDL

5:18

is the bad cholesterol and the

5:20

other will be good cholesterol. And

5:22

HDL is the good cholesterol. And

5:25

it is possible through lots of

5:27

different ways of reducing the amount

5:29

of bad cholesterol. And

5:31

we do that in order to reduce

5:33

the risk of people having heart attacks

5:36

and strokes. Peter, in the product descriptions

5:38

of these spreads and these drinks on

5:40

supermarket websites, they do say that high

5:42

cholesterol is a risk factor in the

5:45

development of coronary heart disease. They're talking

5:47

about LDL there, I assume. What is

5:49

our biggest source of LDL? In

5:52

terms of things that we do

5:55

that increase LDL cholesterol, particularly eating

5:57

saturated fat, that modifies the way

5:59

in which... the liver deals with

6:01

LDL particles and tends to elevate

6:03

those in our blood. Saturated

6:05

fats are typically fats that are solid

6:08

at room temperature. So when you've roasted

6:10

your meat, whether it be lamb or

6:12

beef, and the fat goes solid, that

6:15

is saturated fat. And so that's partly

6:17

why the recommendations are to minimise the

6:19

amount of that. Similarly, cheeses and butter

6:22

are very high in saturated fat. I

6:24

mean, you can look on the label and

6:27

you can see how much saturated fat

6:29

is. But if it's something that's very

6:31

fatty and congeals, then that gives you a

6:33

bit of a clue as well. And

6:36

what's the usual GP advice for

6:38

how to lower your cholesterol? Really,

6:40

I would always recommend that sort

6:42

of heart-healthy diet, which is composed

6:44

of low saturated fats and higher

6:46

levels of polyunsaturated fats, particularly things

6:48

that we might find in oily

6:50

fishes. And fibre

6:52

and low salt is a really good

6:55

heart-healthy diet. Sometimes these things can be

6:57

hard to take from those general principles

6:59

into ways that people can use at

7:01

home. I'd strongly recommend websites like the

7:03

website of Heart UK, the cholesterol charity,

7:06

that gives really practical steps into recipes

7:08

that people can make at home and

7:10

that follow those principles that the GP

7:12

or another healthcare professional might give you.

7:15

Often statins come up in this conversation as well.

7:17

And Jane, I know you have a particular interest

7:20

in statins. Could you explain first what they do?

7:23

Okay, so statins work in the

7:25

liver to reduce the amount

7:27

of cholesterol that we make along what's

7:29

called a metabolic pathway. And they're very

7:31

effective at doing that. And

7:34

they can lower cholesterol very

7:36

substantially, depending on the dose

7:38

and the statin. And they

7:40

do so very safely. We

7:42

have a lot of very

7:45

high quality, what we

7:47

call randomized studies, which have shown that if

7:49

you take a statin for, I mean, most

7:51

of the studies last at least three years

7:53

and often five or six years. And if

7:56

you take that, you can reduce your risk

7:58

of having a heart-healthy diet. attack or a

8:00

stroke very substantially. Can we put a percentage

8:02

figure on that? We can.

8:04

A typical statin, moderate dose

8:06

average statin can easily lower

8:08

the cholesterol by 35 to

8:10

40% drop in

8:13

your LDL cholesterol. Cathy, you

8:15

said just then that you're keen

8:17

to make changes to your diet

8:19

and your lifestyle before turning to

8:21

a pharmaceutical option like a statin.

8:23

Why is that? I

8:25

don't take any tablets. I'd rather that

8:27

went on for as long as possible.

8:30

And if it's something that I can do, it's about

8:33

taking responsibility for my health rather

8:35

than relying on somebody else doing

8:37

it for me. Okay. And Jane,

8:40

many listeners who email in are keen

8:42

to avoid going on to statins. Where

8:44

do you think that reluctance comes from?

8:47

And would you suggest trying diet and

8:49

lifestyle changes? Like Cathy says, doing what

8:51

you can yourself first before turning to

8:53

drugs? I think the lifestyle changes

8:56

are really important. And when

8:58

we prescribe statins, we would always advise

9:00

them on top of a healthy diet

9:03

because you'll actually get added benefit. So

9:05

the sort of healthy diet is the

9:07

foundation if you like, and certainly people

9:09

should be on that. But for some

9:12

people, that's not enough to get your

9:14

cholesterol to a level that the doctors might

9:16

consider to be acceptable. I mean,

9:20

statins did have quite a lot of

9:22

bad publicity a decade or

9:24

so ago. And the

9:26

concern has typically been about

9:28

muscle pain. But much

9:30

more recently, we've got very detailed

9:32

information now, which tells us how

9:34

rare the muscle pain actually is.

9:37

The problem that statins have had

9:39

is that we all get muscle

9:41

pain. And it's when people have

9:43

started statins in the past, and

9:45

then got muscle pain for whatever

9:47

reason, they have sometimes attributed it

9:49

to the statin when it's not.

9:52

So our recent review of this

9:54

suggests that if there were 15 people

9:56

who went to their GP complaining of

9:58

muscle pain having started a statin, only

10:00

one of them might be actually the

10:02

result of the statin and the other

10:05

the others not. So it's actually a

10:07

very rare problem. The other issue is

10:09

that very rarely between

10:12

one in a thousand and one in ten

10:14

thousand get a very serious muscle problem which

10:17

can cause weakness and that rare

10:19

side effect has to be

10:21

warned about but actually when we've looked

10:23

in detail at in all these trials

10:26

where they've compared a statin and a

10:28

dummy and neither the person taking it

10:30

or the doctors know which

10:33

they're on then you see very very little

10:35

problems with the statin. I mean the trouble

10:37

is that most of us do get muscle

10:39

pains and aches and pains and headaches and

10:42

all those other things and if they happen

10:44

to coincide with starting tablets we often are

10:46

going to attribute them to it but

10:49

our evidence would suggest that statins

10:51

are actually very safe and in

10:53

terms of lowering your LDL cholesterol

10:55

actually very effective. Peter do

10:58

you share these thoughts? Very much

11:00

and I think in addition perhaps is

11:02

perhaps a little philosophical difficulty that people

11:04

perhaps struggle with in that if

11:07

you think about how an antibiotic works you

11:09

feel unwell because you've got an infection you

11:11

take an antibiotic to which that bacteria is

11:13

sensitive to and you feel better much quicker.

11:16

With preventative medicine is much harder we

11:19

can predict who's likely to have a heart

11:21

attack or a stroke but we can never

11:23

do that with any great certainty. So when

11:25

people take a statin they might perceive some

11:27

adverse effects but they don't necessarily see the

11:29

benefit the benefit is in preventing something that

11:31

may have happened in the future had they

11:33

not taken that so people can see not

11:36

only side effects but the inconvenience of having

11:38

to go to the pharmacy and collect the

11:40

prescription pay for prescription if they're not eligible

11:42

for free prescriptions so they see the downsides

11:44

but don't see the benefits quite so quite

11:46

so easily as they will with some other

11:48

kinds of Let's focus

11:50

though on personal changes to diet and

11:52

lifestyle that's what you're interested in Cathy.

11:54

We're going to turn to these products

11:56

in particular very soon but what foods

11:58

did you enjoy? do you recommend you

12:00

eat more of to lower your cholesterol?

12:04

There wasn't a definite do this, do that,

12:06

do the other. I didn't get any advice

12:08

around positive things that I could do. It

12:10

was more a negative thing that I could

12:12

cut stuff out rather than eat more of

12:14

that. Well, I found a systematic review from

12:16

2020 that looked at

12:19

various foods and the level of

12:21

evidence around whether they could reduce

12:23

LDL cholesterol and therefore the risk

12:25

of cardiovascular disease. They found great

12:27

evidence for tomatoes, flax seeds,

12:29

and almonds. They found

12:32

moderate evidence for avocados, hazelnuts,

12:34

walnuts, pulses, turmeric, and green

12:36

tea. Peter,

12:38

as listener Debbie asked, can any

12:40

of those foods actively

12:43

lower your cholesterol, or are

12:45

you simply potentially swapping them

12:47

for something that could increase

12:49

your cholesterol? I think

12:51

both of those things can be true to

12:53

an extent. So foods that

12:55

contain molecules called plant sterols and plant

12:57

stanels can actively reduce cholesterol. The trouble

13:00

is with trying to get those sterols

13:02

and stanels from the diet is that

13:04

you have to eat an incredibly large

13:07

quantity of those foods to have the

13:09

sort of effects that would have a

13:11

meaningful impact on patients' LDL cholesterol. And

13:14

that's really the idea behind some of these fortified

13:16

foods that we take something, I guess

13:19

we've got from nature and we know reduces

13:21

LDL, but we put it into the foods

13:23

in a much higher concentration because the effect

13:26

follows the dose. So a bigger dose, you

13:28

get up to a point, a bigger effect,

13:30

and that's the thinking behind these functional foods.

13:36

One size fits all seems like

13:38

a good idea for clothes until

13:40

you try them on. Same goes

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an eye on kids spending and saving. have

16:00

a single bond. Now sometimes and often in

16:02

medicine and biology a simple difference like that

16:04

could have a really big effect on how

16:07

a molecule interacted with the body. In this

16:09

case it doesn't and I think really in

16:11

terms of cholesterol lowering, sterols and stanols could

16:13

really be considered to be equivalent to one

16:16

another. That's good to know. Jane,

16:18

Benacol say on their website that quote,

16:20

more than 80 independent clinical

16:22

studies have shown that plant stanol,

16:24

ester, because that's what they contain,

16:26

can reduce cholesterol. What do

16:29

you think of the evidence base around stanols and

16:31

sterols on cholesterol levels? I think

16:33

it's okay. I think they've done a lot

16:35

of studies. The studies, I mean

16:37

you can do them on relatively small numbers

16:39

of people if you're measuring the cholesterol as

16:41

it were before and after and

16:44

they do seem to fairly

16:46

consistently show that with enough

16:48

and I think on the packages it

16:50

often refers to two or three teaspoons

16:52

full of the spread or whatever it

16:55

is a day, then you can lower

16:57

your cholesterol by around 10% or

16:59

so. So a much smaller effect than

17:02

you would get with a statin for

17:04

example but nevertheless if it's part of

17:06

a healthy diet can still be a

17:09

valuable reduction. We've taken a look at

17:11

the studies that Benacol reference and a

17:13

few of the notable ones appear to

17:16

be partly funded by the RACEO group

17:18

who are the parent company of Benacol.

17:20

That's a concern, right? Well

17:23

the reality is that you're not going

17:25

to get independent people doing these sort

17:27

of studies and typically, particularly if they've

17:29

got what they would refer to as

17:31

a label from a regulatory agency, they

17:34

will have had to look at that

17:36

data to check that the studies have

17:38

been done adequately. I mean there is

17:40

a lot of concern about industry

17:43

funding the studies but the reality is

17:45

that that is where a lot of

17:47

our data actually comes from and I

17:50

don't see that as a major issue

17:52

although sometimes one has to be alert

17:54

to the possibility of I mean

17:57

certainly not falsifying anything but

17:59

perhaps taking the best

18:01

case scenario from the data. Now

18:04

there's one line that multiple products

18:06

across multiple brands say pretty much

18:08

verbatim in their product descriptions. They

18:11

all say something along the lines of

18:13

quote a daily intake of 1.5 to

18:15

2.4 grams of plant sterols can help

18:17

reduce cholesterol levels by 7 to 10 percent

18:20

in 2 to 3 weeks and or a

18:22

daily intake of 2.5 to 3 grams of

18:24

plant sterols has

18:26

been shown to lower cholesterol by 10

18:28

to 12 and a half percent in

18:30

2 to 3 weeks. I think those

18:32

orders of magnitude are broadly in line.

18:35

They seem plausible to me. And

18:37

you're seeing that dose response effect in other words

18:39

the lower you know one and a half to

18:41

two and a half grams seven

18:43

to ten percent and then the bigger

18:45

amount a bit more. It is worth

18:47

mentioning that the European Commission regulation also

18:50

says that quote the consumption of more

18:52

than three grams of plant sterols and

18:54

plant stanols should be avoided. I actually

18:56

only saw that warning on one of

18:58

the products Tesco's cholesterol reducing strawberry yogurt

19:00

drinks where they do say no more

19:03

than three grams of plant sterols should

19:05

be consumed each day. And is the

19:07

best way to consume these plant sterols

19:09

and stanols by a product that is

19:11

enhanced with them? Kathy you asked whether

19:13

switching from butter to a to an

19:16

alternative say an olive oil or a

19:18

sunflower based spread could be just as

19:20

beneficial for cholesterol as one

19:22

of these plant sterile or stanol based spreads.

19:25

Can these actively remove cholesterol

19:28

then Peter? Yes they

19:30

can they can prevent the absorption of

19:32

cholesterol in the gut and

19:34

so therefore they're going to have an additive

19:36

effect compared to swapping your butter for a

19:38

standard olive oil spread. So yeah there's a

19:41

bigger effect there swapping butter for an olive

19:43

oil spread is a great thing to do

19:45

but certainly we'd expect a bigger reduction in

19:47

LDL cholesterol when the product was fortified with

19:50

sterols or stanols. So I'm

19:52

interested to hear what time of day would

19:54

be a good time to take my little

19:56

bottle of stuff. I would

19:58

think based on the ratio small studies. I

20:01

think the evidence probably wouldn't be there to

20:03

make a recommendation of that sort. With statins,

20:05

some of the short-acting ones, they are more

20:07

effective when taken at night because of the

20:09

rhythms of the body in producing cholesterol. But

20:11

I think not enough evidence to say. I'd

20:14

say whenever is most convenient for you, really.

20:17

Right. Yeah. Whenever I remember to do it.

20:20

Yeah. And the statement,

20:22

the claim, is specific on lowering

20:24

cholesterol levels. Do we have

20:27

any evidence that shows that that

20:29

leads to a reduction in heart

20:31

attacks and strokes? Yes. We have

20:33

overwhelming evidence that it does. I

20:35

mean, from trials, not just of

20:37

statins, but from other agents that

20:39

also lower cholesterol. Good. And

20:41

so a lot of the healthy diet

20:43

messages need to be also directed at

20:46

younger people because the lower you can

20:48

keep your cholesterol throughout your adult life,

20:51

the lower your risk will be in

20:53

your old age. It's about level and

20:55

exposure time. And based on what Jane's

20:58

saying, Peter, would that suggest that younger

21:00

people could have a benefit from these

21:02

products as well, potentially? So there's a

21:04

catchphrase that we like to use in relation

21:06

to LDL that lower is better for longer.

21:09

And we tend to start measuring

21:11

LDL often when it's too late. Essentially, you

21:13

can think of it as a toxin. And

21:16

as Jane says, the longer you're exposed to

21:18

it, the more that the damage is done.

21:20

And we know, sadly, from autopsy studies and

21:22

things that the earliest stages of damage to

21:24

the blood vessels will often happen in people

21:26

in their late teens and twenties. So there

21:28

really is an enormous benefit

21:31

to be had from reducing exposure to

21:33

LDL cholesterol through our whole lives. And

21:36

that brings us on nicely to the price

21:38

that you mentioned. You know, the branded versions

21:40

are more expensive than the supermarket owned versions.

21:43

And you wanted to know if they

21:45

have the same efficacy. Yes, they are

21:47

averagely twice the price. Yes, I've been

21:49

running the numbers, of course. The supermarket

21:51

owned cholesterol reducing drink from Tesco's and

21:53

Morrison's Nourish drink. They're almost half the

21:55

price of Ben Nicole's original yogurt drink

21:57

per bottle. 42 pence per bottle versus

21:59

around I

22:02

wondered if that price reflected a difference in

22:04

the amount of the sterols or the stanols

22:06

inside them. Well, Benacol say they

22:08

have 2 grams of plant stanols per

22:10

bottle, Tesco say they have 2 grams

22:12

of plant sterols per bottle, Morrison say

22:15

they have 3.4% plant sterols

22:17

which is the equivalent of 2% free

22:19

plant sterols which again would be 2

22:21

grams. And Peter you said earlier that

22:23

you don't consider any difference in effect

22:25

between the stanols and the sterols. No,

22:28

that's right. I think it's important

22:30

to recognise though that this market

22:32

is far less regulated than would

22:34

be for conventional medicines and so

22:36

whilst we wouldn't particularly expect sterols

22:38

and stanols to behave any differently,

22:40

you wouldn't have I think quite

22:42

the certainty that two similar products

22:44

would have the same effect as

22:46

you would if you took two

22:48

different brands of the same statin.

22:50

I think most of the

22:53

trials that I've seen show at

22:55

that dose range similar reductions

22:57

in LDL cholesterol so no particular reason to

22:59

believe that the different brands would differ very

23:01

much but perhaps we wouldn't have quite the

23:04

same certainty on that as we would with

23:06

conventional medicines. Another thing you

23:08

ask Cathy is could you drink these drinks and then

23:10

not have to change your diet? Yes. I mean that

23:12

would be... But marvellous wouldn't it? What

23:15

do you think Jane? It sounds like it's all additive.

23:17

It is all additive. The more you do the better.

23:19

The more you do the better. So put the building

23:22

blocks together. Let's move on

23:24

to the spreads. I actually didn't see any supermarket

23:26

owned versions of these have you Cathy? No

23:28

I haven't noted those at all. Of

23:30

the two leading brands Proactive Buttery comes

23:33

out almost one and a half times

23:35

the price of Benacol Buttery. Again the

23:37

only difference I can see is that

23:39

Benacol has plant stanols versus Proactive plant

23:41

sterols. Interestingly you mentioned this earlier Jane,

23:43

Benacol suggests you need three servings of

23:46

their spread a day i.e. three bits

23:48

of bread or toast with their spread

23:50

on it to have the desired effect.

23:53

Any concerns there Jane with consuming

23:55

that much potentially? No.

23:58

You have to have that as part of your

24:00

regular diet. Three slices a day.

24:02

Let's hope it's whole meal then. Indeed.

24:06

And of course it depends on how thickly

24:08

you're spreading it. It does. And listener Hillary

24:10

made a very good point. This is

24:12

something that comes up a lot when

24:14

we investigate a food product on the

24:16

show. Hillary notes that these cholesterol lowering

24:18

products all have the hallmarks of being

24:20

ultra processed foods, UPF, and therefore the

24:23

question comes, do the benefits that they

24:25

offer outweigh the dangers of UPF that

24:27

we're all becoming more aware of? Peter,

24:29

what are your thoughts? I think it's really important

24:31

and really great that people are thinking much more

24:33

about what they eat and how it's produced. But

24:36

I don't think it's necessarily the case to

24:38

say that because something's processed that it's necessarily

24:40

bad. Some ultra processed food is clearly

24:42

bad, particularly when it's very calorific and

24:44

got a lot of saturated fat in

24:47

there. But to my mind, taking

24:49

a spread and adding something that we know to

24:51

be beneficial to it is a very rational thing

24:53

to do. So I don't have any concerns from

24:56

that point of view. And Jane,

24:58

are there any concerns with people having

25:00

these drinks or eating these spreads if

25:02

they don't have high cholesterol? The reason

25:04

I ask this is because on Tesco's

25:06

website, under their cholesterol reducing strawberry yogurt

25:09

drink, they say, quote, if

25:11

taking cholesterol lowering medication, this product

25:13

should only be consumed under medical

25:15

supervision and quote, this product is

25:17

not intended for people who do

25:19

not need to control their blood

25:21

cholesterol level. However, the

25:23

British Association of Dietitians have said that

25:26

although there is no benefit for

25:28

people with normal levels of cholesterol, plant

25:31

sterols stanels are generally safe for

25:33

most healthy people. If

25:35

you've got a very high level of cholesterol, then

25:37

a 10% drop will be quite a big

25:39

drop. Whereas if you have

25:42

a low cholesterol naturally because you're

25:44

on a very good diet and

25:46

avoiding saturated fat,

25:50

then a 10% drop might be quite

25:52

trivial, quite a small amount.

25:54

I mean, certainly in the days when

25:57

I was treating people with very

25:59

high cholesterol, who were on drugs, we would

26:01

advise them to have these sort of spreads

26:03

in addition. So I don't think there's any

26:06

reason not to. Cathy you

26:08

said that you're doing everything you

26:10

can now, diet and indeed exercise,

26:12

not the lifestyle changes. Jane what

26:14

do those effects have on your cholesterol

26:17

level? How does exercise reduce your LDL

26:19

levels? Not very much, if

26:21

at all. When we're sort of talking

26:23

about heart disease and strokes there

26:26

are three things that really matter. One is cholesterol

26:28

that we've been talking about. One

26:30

is blood pressure and the other

26:32

is smoking. Now I would anticipate that

26:34

you're not a smoker but blood pressure

26:37

is really important and more exercise will

26:39

be beneficial for your blood pressure as

26:41

will reducing the amount of salt in

26:44

your diet and I think

26:46

that we don't talk enough about

26:48

that because there's a lot of

26:50

evidence that salt reduction and

26:52

salt substitution with these low salt

26:55

type products is also a good

26:57

idea. Lots of

26:59

information there let's try to pull it

27:01

all together for the big final question.

27:03

Do you think cholesterol lowering products, the

27:06

spreads, the drinks are indeed the best

27:08

things since sliced bread? Are they SB

27:10

or are they marketing BS?

27:12

Peter I think they're the best thing to

27:14

put on your sliced bread. Well

27:17

said. I don't think I can

27:19

top that. But

27:21

one needs to understand that it's a modest

27:23

effect not a major effect on your cholesterol.

27:26

Absolutely agree. So you think they do what they say on

27:28

the bottle or the box? Yes

27:31

but if you have been recommended

27:33

to take statins they will give

27:35

you four or five times the

27:37

lowering impact. 35 to 45

27:40

percent you said earlier. Yeah and they

27:42

are safe and well tolerated for the

27:44

vast majority of people. So Kathy where

27:46

does that leave you? Are you going to

27:48

add a little bottle of something per

27:50

day or I'm talking about these not

27:52

you know bottle of wine

27:54

or some of this spread to your

27:56

diet? Well it's been really

27:58

really interesting to hear. both of you, thank

28:00

you very much. I think

28:03

I'm gonna stick with making changes

28:05

to my diet and look at

28:07

things that are more likely

28:09

to do good things, cutting and

28:11

avoiding the stuff that does bad things.

28:14

I certainly have upped my exercise so

28:17

I'm pleased with that and I'm

28:19

probably gonna go and buy the

28:21

cheaper versions of these from

28:24

my local supermarket but what I have learned today

28:26

is I need to stick with it. I need

28:28

to be consistent. I can't buy a

28:31

packet one week and not the next and it's

28:33

very interesting to know that actually if I'm consistently

28:35

taking something at nine o'clock in the morning that's

28:37

fine so that's really good to know. Well

28:40

with that let's wrap up today's slice bread. A

28:42

big thank you to Kathy, to Jane and to

28:45

Peter for joining me. Thank you all. Thank you

28:47

very much. And if you are listening to this

28:49

and you're thinking Greg I have a Wonder product

28:51

I'd really like you to investigate just send it

28:53

over please do either on email to slicer.bread at

28:55

bbc.co.uk or as a message or voice note on

28:57

WhatsApp to 07 543 306 807. Next time I'll

29:00

be joined by not just one listener but hundreds

29:06

of listeners as I head to

29:08

Hay Festival in Wales for a

29:10

special live recording of slice bread

29:12

investigating new designs of earplugs from

29:14

brands like Loop. Do they help

29:16

you focus, sleep or filter out

29:19

unwanted noises better than classic foam

29:21

or silicon earplugs? We will all

29:23

be finding out. See ya. Sliced

29:31

Bread is written and presented by me

29:33

Greg Foote and this episode was produced

29:35

by Simon Hoban. Our science AP is

29:37

Emma Solkeld and today's studio manager is

29:39

Jack Morris. Sliced Bread is a BBC

29:41

Audio North production for BBC Radio 4.

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