0:00

Good

0:01

day, Dr. Carl here. The University of Sydney

0:03

was shot as a science talking to Professor

0:06

Claire College from the University of Newcastle

0:09

where you are a Laureate? Yeah. It's called

0:11

a Laureate professor. That's a word

0:13

that means special. Special. And you're

0:15

talking about something that's is actually

0:17

awfully common in Australia, arthritis.

0:20

And the role of diet,

0:22

food nutrition in helping us

0:24

with this incredibly common disease you've

0:27

got papers, peer reviewed stuff, fifteen

0:29

meters thick, where should we start? Professor

0:32

Claire? I think we should just focus on what

0:34

you

0:34

mentioned, Karl, that arthritis is

0:36

really common. So in Australia, four

0:39

million people actually have some

0:41

type of arthritis. And I think we've

0:43

all heard of rheumatoid arthritis osteoarthritis.

0:47

But in fact, there's over one

0:49

hundred

0:49

different types of conditions,

0:51

ankylosing, spondylitis, lupus,

0:55

a whole range of conditions and unless you've

0:57

got that, other people probably

0:59

don't even know it's a type of arthritis.

1:02

But what all of these varying

1:04

forms have is that they all cause

1:06

pain, discomfort, and

1:08

effective quality of life. So

1:10

they're a big deal. Arthritis

1:13

is like a fever in the sense that it's

1:15

a common end symptom. So you

1:17

can have fever from pneumonia in your lungs,

1:19

or fever from a bone infection, or

1:22

from a liver infection. But you

1:24

still end up with the same fever, and it's still in the same way

1:26

with these hundred different diseases, you still end up with

1:28

the underlying symptoms of arthritis,

1:30

which are joint pain and stiffness and often

1:33

reduced function and

1:34

Yeah. Absolutely. So what happens

1:36

is There's an immune

1:39

component. So something goes

1:41

wrong. Your immune system's activated.

1:45

and that recruits all of these

1:47

cytokines, chemokines,

1:50

acute phase proteins. They're just

1:52

fancy words that represent

1:54

what's happening in the inflammatory process. But

1:56

unfortunately, they end up in tight

1:58

places like your joints.

1:59

So

2:00

that leads to inflammation of the

2:03

lining of the capsule around, like,

2:05

your knee joint or your elbow joint or

2:07

your finger joints. And then that eventually

2:10

erodes the tissue in there

2:12

the cartilage. Mhmm. And

2:14

if that keeps on going and

2:16

there's no treatment, then that can eventually

2:19

even affect the bone. So

2:21

in osteoarthritis, for example,

2:23

there can be no choice but to replace

2:25

the bone. So you have a knee replacement or

2:27

you have a hip replacement. talk

2:29

to someone you know who's got arthritis

2:32

about their level of pain.

2:34

It's so severe that in fact in

2:36

Australia right now, there's more than fifty thousand

2:38

people who can't work full time

2:40

because of their arthritis. And they're

2:43

in that age group where they should still

2:45

be working and, you know, enjoying their life

2:47

and putting money away and super and

2:49

their age between, like, around that forty

2:51

and sixty. Mhmm. And what the

2:54

studies have shown is that their income is

2:56

only one quarter of

2:57

their contemporaries who can

2:59

still work full time. So

3:01

it it does affect your quality of

3:03

life, but it actually affects your life

3:05

savings as well.

3:06

So can you just give us some of the different

3:08

names of some of these different types of arthritis.

3:11

So the audience has got an idea

3:13

that you have all these different underlying

3:15

conditions, any other the same

3:17

common end symptom of

3:19

joint pain and stiffness and maybe

3:21

redness and swelling and decreased

3:23

range of motions, etcetera? Yes. So some of

3:25

the common ones are that rheumatoid arthritis

3:28

and osteoarthritis -- Mhmm. -- that

3:30

we've already mentioned, but ankylosing spondylitis

3:32

-- Uh-huh. -- I guess we get the little pits on

3:34

your fingers figuring

3:37

out. Yeah. Okay. Yeah. Psoriatic arthritis.

3:39

Yeah. So you're the little sort of

3:41

dry skin on your elbows and knees yet? Yep.

3:44

Gout, did you realize that was a type of

3:46

arthritis?

3:46

So the uric acid crystals

3:48

appearing in your joints. Yeah. Yep. Yep. They dump

3:50

in the joints and they trigger that process.

3:53

scleroderma. How does we get the hard

3:55

skin? And I've met one person withcleroderma

3:58

whose skin was so tight that

4:00

she could only feed

4:02

herself through a straw. She couldn't open

4:04

her mouth further than that. Wouldn't that just be

4:06

unbearable? Strogan syndrome?

4:09

Yep. Dry eye. Yeah. I know someone with

4:11

that. hemochromatosis, which is relatively

4:13

common. Too much iron. So the iron overload

4:15

yet. And

4:16

then there's another one

4:17

called reactive arthritis. and

4:19

that usually follows an acute infection

4:21

that can either be bacterial -- Mhmm. --

4:23

or it can be viral. And

4:25

there's another ninety that you didn't go through.

4:27

So the point is that there's a whole lot of them.

4:29

Many of them are auto immune to

4:31

some degree or immune. And

4:34

osteoarthritis is kind of like a

4:36

wear and tear one as well. That's

4:38

right. and osteoarthritis, it relates

4:40

to some of the things that you can't

4:42

control.

4:42

So that's the whole weird thing about arthritis.

4:45

There are factors like your genetics,

4:48

whether you're male or female, how

4:50

old you are. Mhmm. But other things like

4:52

repetitive injuries,

4:52

body weight, the job

4:55

you do, and

4:55

some of those infections, and as well as

4:57

smoking. Some

4:58

of those smoking again has a

5:00

bad effect here. Yeah. because of the inflammation,

5:03

you know, like, all of those

5:05

components that you breathe in -- Yeah. -- lead to

5:07

inflammation and can make you more susceptible

5:09

to lung infections as

5:10

well. So you know, you might not be able

5:13

to change your occupation,

5:13

so that's one that I think we should factor

5:15

in both of those. But all of these things

5:18

can set you up basically for

5:20

developing one of those one hundred types

5:22

of arthritis. And you said

5:25

four million people in Australia, which is sixteen

5:27

percent of the population, which is now.

5:29

Yeah. And when you think about around the

5:31

world, it's estimated that it's three hundred

5:33

and fifty million people.

5:36

Mhmm. You'd think we'd have better treatments.

5:38

but I think it's not surprising why

5:41

people want

5:42

to try, oh, what if I change my data?

5:44

What if I buy supplements? If you

5:46

go into one of those giant camera shops

5:48

-- Oh, the world of shops here. -- yeah. There's

5:50

just supplement after

5:52

supplement after supplement.

5:55

They're not cheap, but

5:56

people really are seeking some

5:59

relief if their regular

6:01

medications for their arthritis are not

6:03

giving them relief. I think that kind of reflects

6:06

that, you know, we we would need

6:08

better treatments, don't we? If I

6:10

was not getting joy from

6:12

regular medications. I'll try anything to get rid

6:14

of pain. Pain does not make you a better person.

6:16

And it just means I have to spend a short load

6:18

of money on supplements and I've

6:20

tried even if it didn't work. Oh, wow.

6:23

So people are often trying to

6:25

get relief from that pain. This stiffness

6:27

or swelling or, you know, even the warmth

6:29

in their joints. When

6:30

it comes to those supplements, I

6:33

was super excited when

6:35

I saw how brave

6:37

the European alliance for

6:39

the associations of rheumatology, which

6:41

just means that all the European expert

6:43

groups in arthritis they decided

6:46

that they would just jump in and

6:48

do the most comprehensive review

6:51

of all studies that have ever

6:53

tested any particular diet or

6:55

any particular supplement across

6:57

any type of arthritis? Now I should

6:59

point out the importance of this to what is so

7:01

you get your individual paper, which is

7:03

like a brick in the wall. And here,

7:05

they're looking at sort of a metaphorical

7:08

entire wall or building at

7:10

the entire structure, and they're looking at

7:12

papers across a whole bunch of fields.

7:15

Absolutely. And and they they

7:17

try to and there are they can be good

7:19

or bad papers. And and

7:21

and there are, in fact, what

7:23

are called, paper mills that have popped up

7:25

in the last decade, which

7:28

have very low quality, and they'll publish

7:30

anything new right if you pay a money.

7:32

And so you can write a paper proving that the earth

7:34

is flat because Glaukosamine is

7:36

put in our water supply by kilowales,

7:39

and they'll publish it. They'll publish anything you

7:41

want. a little bit scary. So that's

7:43

why The good so this is why you had the good one.

7:45

Yeah. It's called the European alliance

7:47

of associations for rheumatology.

7:50

so many countries. Mhmm. And you can

7:52

Google them and see all the wonderful work

7:54

that they're doing, but they decided this

7:56

is gonna be such a big job will

7:58

pool our resources and do this really well.

8:00

Mhmm. So they found there were twenty four

8:02

of those systematic reviews, those

8:05

giant brick walls of Summaries

8:07

of studies -- of knowledge. Yeah. -- they didn't

8:09

stop there because there's research

8:11

going on all

8:11

the time. They found another

8:13

separate one hundred and fifty

8:16

studies have been conducted since

8:18

the previous big reviews. Mhmm.

8:20

They found they covered eighty

8:22

different types of special supplements

8:25

or special diets across

8:27

a whole range of types of

8:29

it. There's a couple of months of stuff you can buy in little bottles

8:31

and diets are I will eat only

8:33

food that is grown on the full

8:35

moon intended by naked to fit in months

8:37

or whatever. Some some of them

8:39

like that and some of them more familiar

8:42

diets like the Mediterranean -- Oh. --

8:44

died. Or can you please even? I love kids you

8:46

please. Yeah. Well, there is there's always good news when it

8:48

comes to kidney beans. So

8:50

what's interesting

8:51

is that after all of

8:53

that effort, you get

8:55

to the conclusion and you go,

8:58

no. But I

8:58

kinda suspected it. So what

9:01

it found was that There's

9:03

actually limited studies

9:04

despite all of that on

9:06

each individual product tested

9:09

-- Wow. -- and the most

9:11

studies

9:12

Even the ones that showed an effect

9:14

were

9:14

low quality

9:16

and mostly could only

9:18

support a moderate effect.

9:20

So most of the studies were

9:22

low quality? So low quality means

9:24

is let's say we

9:26

do a randomized controlled trial and

9:28

I'm testing my special arthritis supplement

9:31

on you.

9:31

Mhmm. And I say,

9:33

doctor Karl, you got in the special

9:36

supplement group. You are so

9:38

lucky I can't wait to

9:39

see if your arthritis improves

9:41

and if you tell me you're experiencing

9:43

less

9:43

pain. Well, if I tell you that, then

9:45

that's a type

9:46

of bias. Yeah. We've lost a double blinded

9:48

because now I know what I'm

9:50

taking. Yeah. And really, I shouldn't know whether it's

9:52

just inert powder or

9:55

clear special chemicals. That's right. So

9:57

that's just a very exaggerated

9:59

type of

9:59

bias. Right. But the other reason why some

10:02

of them are biased is The

10:04

only indicator whether this worked or

10:06

not, if you only say, do you feel better,

10:09

then people can want to please

10:11

the researchers as well. instead

10:13

of asking, how do you feel?

10:15

They say, do you feel better? Or do you

10:17

feel like death? In each you say you're

10:19

just trying to please them in each case. you

10:21

think that's what they want? Or you could

10:23

actually measure the level of

10:25

destruction or change in a

10:27

joint, that would be objective. there's

10:29

that. And the other thing is a

10:31

lot of these studies were small.

10:33

So what if I advertise

10:36

that hey, recruiting for a study

10:38

and, you know, it might be pretty hard work,

10:40

but if you want to get be in the

10:42

study,

10:42

you might only then recruit

10:44

people who are, you know, their

10:46

volunteers. They're really super keen.

10:48

They'll do everything you say. But

10:50

that introduces another mindset. They don't

10:52

represent everybody else who's living

10:54

with arthritis. And it could

10:56

well be that you're getting only, for example,

10:58

university students, hospital staff,

11:00

workers at the stowage, wherever you happen

11:02

to put post up as opposed to a broad

11:04

scattering of society. Yeah. So that leads

11:06

to low quality evidence

11:09

because the studies could be

11:10

designed and conducted better. But

11:13

there was actually still some good

11:15

news. For two particular groups,

11:17

rheumatoid arthritis and osteoarthritis,

11:19

there was good news

11:22

but the supplements had moderate

11:24

effects. It's important to

11:26

explain what a moderate effect is because this

11:28

is where the confusion comes in

11:30

society. A moderate effect means

11:32

that we're

11:33

making a judgment call now based on

11:35

the results of these trials. Mhmm. But if you

11:38

do more trials in the future, That

11:40

evidence may change when

11:42

we get more studies, bigger studies

11:45

that have gone for longer.

11:46

why it's important is for

11:49

osteoarthritis, there

11:50

was moderate quality evidence for a

11:52

small positive effect on improving

11:55

pain, and improving your function.

11:57

Pain function? Well, they're they're good things to go for

11:59

you. Sure.

11:59

Yeah. like that. But for chondrutin

12:02

and glucosamine and vitamin

12:04

d, Now why this might

12:06

confuse people is because

12:08

the previous review had

12:10

flipped the evidence back to say, can

12:12

write and there's no benefit.

12:14

glucoseamine, there's no benefits from taking

12:17

them out. because I do know people who

12:19

love glucosamine to pieces. So

12:21

originally, the evidence was saying not really

12:23

now it's saying It's flipped three

12:25

times. It was when the

12:27

first reviews are

12:28

done, go, wow. Here's some supplements people

12:30

can take. And then it went back

12:32

to More

12:33

studies being done. Now the evidence

12:35

is saying, you know, no effect.

12:37

Yeah. And now with this most recent

12:39

review, it's saying, There's a

12:41

moderate effect recognizing the

12:43

studies are are low quality for

12:46

chondriding glucosamine but also

12:48

vitamin d.

12:49

the i So how

12:50

do you live with that? Now

12:52

if you've got pain

12:54

and poor function, I think the way

12:56

forward is do a

12:59

trial on yourself because

13:00

these supplements are not cheap.

13:03

If you're gonna spend anywhere between thirty,

13:06

forty, fifty dollars on supplements,

13:08

then

13:08

do a trial on yourself. Purchase

13:11

them or use up what you've got

13:13

and then is your pain better? Is

13:15

your

13:15

function better? Because it may

13:18

be that you're one of those people who

13:20

do respond to it or it may be that it's

13:22

having no effect And if it's

13:24

having no effect, then save

13:26

the money, and we'll talk in a minute

13:28

about spending that money on sale. Yeah. But you're

13:30

you're saying thirty dollars. Is that thirty dollars

13:32

a week depends how many supplements

13:34

are in the bottle. Mhmm. So when you go

13:36

and you see all this one's ten dollars

13:38

cheaper, it may be that there are

13:40

fewer capsules in the bottom, for

13:42

example. Oh, let's say thirty instead of a

13:44

hundred cap shells. And prices vary

13:46

from shop to shop. So you've really good to go and do Isn't

13:48

research? Checkers will work. If I buy medical

13:51

grade stuff, I can be pretty sure

13:53

that what I'm getting is within, say, a half

13:55

or a tenth of a percent. But

13:57

if I buy, I know this for sure,

13:59

melatonin.

13:59

from a wellness shop,

14:02

if I buy a ten milligram tablet, it can

14:04

vary between eight point five up to

14:06

fifty. You

14:06

know? So the grade of what you're buying

14:08

through the wellness shops not guaranteed like

14:11

misreadings. Some of these supplements

14:13

are not covered by the same medicines

14:16

laws, drug laws,

14:18

because they're actually not a chemically active

14:21

drug in the way that Panadol

14:22

is, for example, or a course of

14:24

antibiotics. Mhmm. But the other

14:27

thing that's I think is a little bit interesting

14:29

about vitamin D. There's

14:31

potentially an

14:33

effect where it relates

14:35

also to physical activity. You

14:37

can get vitamin D from the supplements, and that's

14:39

what they tested. But you can

14:41

improve vitamin D by being more

14:43

active and going out in the sun

14:46

because you can make vitamin D in

14:48

your skin.

14:49

And for the mushroom lovers out

14:51

there, you

14:51

can boost your vitamin D intake

14:54

from mushrooms if you give them a little

14:56

sun bake before you eat them.

14:58

What? Isn't that amazing?

15:00

III yeah. I thought I was anyone

15:02

allowed to get a sun bake if I give a little

15:04

sun baked to my mushroom Turn them underneath

15:06

so the little brown under layers are exposed, they

15:08

can

15:08

actually synthesize vitamin d

15:11

there in the same way we manufacture

15:13

in our skin. So you can boost

15:15

your intake of vitamin d

15:18

by eating suntanned mushrooms.

15:20

By the way, just a little aside here, you have changed

15:22

my life in the past, and now I

15:24

try to get mushrooms at least once

15:26

a week. and tomatoes at least every second day

15:28

because the effect doesn't last as long but

15:30

mushrooms, the effect can last longer.

15:32

So thanks to I have changed my

15:34

diet. You you have done God's work. Thank you

15:36

very much for your time. I'm glad that you've become

15:38

a mushroom lover because that's a whole other

15:40

topic. But -- Yeah. -- people who eat more mushrooms

15:42

a lower risk of cancer. Oh, okay. Remember

15:44

that? But now back to arthritis again, which

15:46

is a Yeah. So that's osteoarthritis, the

15:49

wear and tear one. So for now,

15:51

the inflammatory arthritis

15:53

-- Oh. -- so there was rheumatoid arthritis. So

15:55

you just pick up. So osteoarthritis, chondroietin,

15:58

the case vitamin vitamin D in the latest

15:59

study shows that it has a small

16:02

beneficial effect. That's right. Flipped flop a few

16:04

times in the past. So that was Osteo.

16:06

Now So So rheumatoid

16:09

arthritis, again, it's moderate

16:11

quality evidence, which means this

16:13

may change over time for a

16:15

small positive effect for

16:17

pain for fish oils.

16:19

For sure. Sometimes called omega

16:21

three.

16:23

So why that is

16:25

is because fish oil contains

16:27

two bioactive chemicals and

16:29

specific fatty acids with

16:31

thirty nines. shorten to EPA

16:33

and DHA, but it's icosa

16:36

pentanoic acid -- Mhmm. -- DOCA, Hexa,

16:38

Coa. Oh, anyway. What are

16:40

those? Yeah. And the

16:42

EPA gets converted to the DHA,

16:44

but what they do is they

16:46

can drive the anti

16:48

inflammatory cytokine

16:50

production that your body can produce

16:52

itself to deal

16:53

with inflammation, and then that

16:55

helps control the pain. So that'd be

16:57

from Fish and Tim Sardines?

16:59

Yeah. One of my family chucked me out in the

17:01

snow once when I was eating Tim Sardines in the camp

17:03

because she smelt out the house. doing myself good.

17:05

you got some fresh air. There's a visit

17:08

in snow. Yeah. People who don't like

17:10

fish, walnuts, chia seeds,

17:12

flax seeds. Walnuts? Yep.

17:14

Canola and soybean oil

17:16

and the red kidney beans.

17:18

Really? Yeah. And they just

17:20

keep on giving him giving and also with fiber. They're twenty five

17:22

grams to a hundred grams. Yeah. Fantastic. We're

17:24

on every on every level. This smokes

17:26

haven't gonna give me some Yes. It

17:29

will. Just make that your

17:31

special occasion food that Why is that?

17:34

Because this is another

17:36

discretionary food like chocolate. Are you gonna pick up without having

17:38

chocolate? Well, there there's a lot of

17:40

nutrients in got omega three, but

17:42

foods that that are smoked do

17:44

increase your risk for bowel cancer. So

17:46

so make that only an occasional food, but you

17:48

can have edible seaweed. that makes something

17:50

interesting and you can have sushi so that's great.

17:52

Yeah. But there's one caveat on

17:54

this. So okay. So

17:56

I've got rheumatoid arthritis.

17:58

There's evidence for

17:59

a moderate effect from

18:01

low quality studies on pain -- Yeah. --

18:03

but you're in pain. So it's worth taking

18:06

a trial. But the dose is the trick here.

18:08

Of the dose. Yeah. For rheumatoid arthritis,

18:10

you need between at least two and three

18:12

grams per

18:13

day. Of

18:14

the EPA plus DHA -- Yeah. --

18:17

provide to you by fresh food, hopefully, rather

18:19

than a tablet. To

18:20

get that dose, you're not gonna be able to

18:22

eat all the salmon. so you are going to have to have

18:24

a trial of omega-three capsules in

18:27

order to get that two to three

18:29

grams of EPA

18:30

plus DHA.

18:32

but I've read that they also can be variable and sometimes

18:34

they don't even come from fish or That's

18:36

exactly right. All you can do, doctor Karl

18:38

--

18:38

Mhmm. -- is do a trial on

18:41

yourself. to see if it's worth it. That's the

18:43

only different way. You're in mind that the easiest person

18:45

to fool is yourself. But once you know that,

18:47

then go ahead and give it a go. Okay? And

18:49

For fish oil, it has to be a three

18:51

month trial. Three months? Yes. So

18:54

the reason for that is

18:56

because where does these fish oils go when

18:58

they're in your body? body puts them in

19:00

the membrane of every single red

19:02

blood cell, so it's got a

19:04

reservoir for manufacturing these anti

19:06

inflammatory cytokines. and

19:08

a red blood cell has a half

19:10

life of about three months. Yeah. So

19:12

you won't really get that peak effect.

19:14

Is this working for my pain until you've been taking

19:16

them for three months? So where does

19:18

it go again? You read blood cells, all

19:21

cells in fact. They have a

19:23

coating -- Mhmm. -- to stop their

19:25

contents leaking out. Mhmm.

19:27

And in

19:27

that coating are fatty acids.

19:30

And the fatty acids

19:32

EPA and DHA when

19:34

you eat them, your body goes, yeah, I'll have

19:36

that. I'll put that in the membrane of the

19:38

red blood cells. Your body

19:40

doesn't really mind what

19:42

particular fatty acids, there's a range that it

19:44

could put in there. So if you eat fish oil,

19:46

it goes, yeah, I'll put you in there, and

19:48

then they're ready to be metabolized.

19:51

into anti inflammatory cytokines.

19:53

And what about in non red blood cells? because

19:55

the red blood cells make up about eighty four percent of

19:57

all the cells in your body, which just

19:59

an astonishingly large

19:59

number. They will end up with fatty

20:02

acids in the fatty acid membrane

20:04

of all cells. Right. But

20:06

so you forget taking it for three days

20:08

and wanting in effective. You're saying three

20:10

months. That's right. Three months. So you

20:12

can really judge. What are your

20:14

pain levels now? You've never

20:16

been on omega threes before you

20:18

really want to have a trial. You're facing increasing

20:21

other drugs that maybe you do or

20:23

don't want to take, so you've decided

20:25

to give it a go. So do

20:27

a three month serious trial. Make sure you tell

20:29

your doctor because they do

20:31

increase your bleeding time, so

20:34

you may be more likely to bruise

20:36

if you were having a procedure, you'd

20:39

likely be told to stop, you know, if you're

20:41

gonna have an operation -- Yep. -- because they

20:43

don't want you to keep on bleeding when they're doing

20:45

an operation on you. to make sure your

20:47

doctors fully aware and then you

20:49

do your three month trial. Did your

20:50

pain go down or not? And if it didn't, then

20:52

you go, okay, did or did not

20:54

work for me. Okay. So dear listener, Laura

20:57

listener, it seems that they have to take the advice

20:59

of the mythbusters, which is the

21:01

difference between science and

21:03

screwing around is that you write it down.

21:05

So do a written record over that

21:07

three month period. So you know when you started and,

21:09

you know, when you finish okay.

21:11

And then Carl, the bad

21:13

news was, for every other

21:15

arthritis

21:15

category, every other

21:17

supplement under the sun,

21:20

there was no effect.

21:23

Wow.

21:23

Or there was

21:25

even moderate evidence

21:28

for no effect. Okay. So when you get this

21:31

right, bit of an effect for

21:34

osteoarthritis with regard to chondroietin,

21:36

glucosamine and vitamin D

21:38

with a later study, and it has flip flops in the

21:40

past -- Yeah. -- with the room to an

21:42

arthritis, autoimmune one,

21:44

three months trial of a fairly

21:46

hefty dose of fish oils. Everything

21:48

else, forget it. Absolutely. And,

21:50

you know, all the names under the sun,

21:52

all the special light, you

21:55

supplements with pomegranate. I've seen

21:57

those pomegranate. Apparently, it'll cure

21:59

sunstrokes, syphilis, very close range, and make your

22:01

handwriting better. Oh, well. you're I

22:03

for prongle and all these.

22:04

Anyway, so what does it mean? Well,

22:06

if it oh, that's too sad. What

22:08

about if you have a healthy lifestyle?

22:11

and this

22:12

is where the interesting advice is provided

22:14

at the end.

22:15

People who have

22:16

these immune functions --

22:19

Yep.

22:19

-- arthritis, they're at a much higher risk

22:21

of developing heart disease. And depending

22:23

on the type of arthritis and the particular

22:26

heart disease, type

22:27

we're talking about anywhere between

22:30

fifty percent more risk

22:32

to one hundred percent more risk. If you

22:34

have an autoimmune disease

22:36

such as you've got a

22:38

higher risk -- Yeah. -- of some sort of

22:40

hard condition over the next fifteen, twenty years? Yeah.

22:42

That's right. Because a lot of people

22:44

don't realize that heart disease

22:46

risk is accelerated in the

22:48

presence of inflammation because those

22:50

inflammatory components, they actually just don't stay

22:52

in your knee or or in your finger joints or in

22:54

your hip joint. they travel out through the

22:56

body, they infect your arteries, for

22:58

example, and that can

23:00

accelerate atherosclerosis, which

23:02

means the fatty plaques that

23:04

build up

23:04

in your arteries. Wow. So

23:07

there's evidence that having a healthy

23:09

lifestyle

23:09

and eating healthy foods

23:12

improves overall health

23:14

well-being, and risk for all the other

23:16

chronic diseases that are

23:17

out there, especially

23:19

heart disease. So

23:21

the good news is that

23:22

eating healthily has benefits for

23:24

your overall health and well-being.

23:27

so

23:28

that arthritis doesn't win

23:30

all the wars if you like. You

23:32

can win that war against heart

23:34

disease by eating healthy. And you've got

23:36

a webpage that helps people On

23:39

a budget, it's called no money,

23:41

no time. No money, no

23:43

time. Gotcha. There's the healthy

23:44

eating quiz. Mhmm. On there, you can do the healthy

23:46

eating quiz, and it gives you some personalized feedback.

23:49

You can save it, create a profile,

23:51

come back and check how you're doing over

23:53

time. Mhmm. and then all

23:55

recipes and

23:55

all hacks and myths on a lot of these topics

23:57

we've talked about.

23:58

But the other interesting advice

23:59

they made was to

24:02

avoid alcohol.

24:04

avoid alcohol. That was the general

24:06

rule. people to zero,

24:08

one glass a day. They had

24:10

a caveat, and it said

24:12

that While small amounts of

24:14

alcohol are not likely to interfere

24:17

with arthritis at all --

24:18

Mhmm. -- talk to your doctor because

24:21

we don't know what other health issues you've

24:23

got -- Right. -- you know, whether you've got liver

24:26

disease or whether you're on other

24:28

medications like methotrexate, for

24:30

example,

24:30

And they said that particularly for room

24:32

or tweed arthritis, there is a

24:34

risk that alcohol could increase a

24:35

flare up, and it can increase flare ups

24:38

for

24:38

things like gout.

24:39

So talk to your

24:40

doctor in general, small amounts, okay,

24:43

but you need that personalized for

24:45

yourself. Alcon's weird because on one hand, it

24:47

can strip the oil stains off your garage floor

24:49

and store a body

24:51

part of an animal like an axolotl for a

24:53

quarter of a thousand years. but

24:55

also make you less shy, but

24:58

also improve risk of breast cancer

25:00

in women with one glass

25:02

a day and there was two classes a

25:04

day increase that risk a lot more. So it's

25:06

got swings and round a bit. That's right.

25:08

Alcohol is associated with in crest

25:10

in risk for, not just breast

25:12

cancer from women, but all the head and neck

25:14

cancers, so you're a esophages, your

25:16

tongue, your mouth. then

25:17

the next piece of advice

25:18

is aim for a healthy weight. Healthy

25:21

weight. Yeah. That's really challenging

25:23

for everyone. The best way to do

25:26

that is by looking at what you're eating and try to

25:28

eat more healthily. So again, come

25:30

to no money, no time. And when

25:32

you fill in a healthy eating quiz, if you

25:34

select that your goal is

25:36

weight management, then

25:38

the info we send you as part of

25:40

that and the recipes relate relate to

25:42

healthy weight. but we've also got a free

25:44

course called the science of weight loss

25:46

dispelling diatements. Oh. And if you

25:48

google that, that's underway, and you you can

25:50

enroll in that as well. healthy

25:52

weight counts a lot because if you imagine yourself

25:54

coming up or down a set of stairs,

25:57

carrying airport, legal, luggage

25:59

in each hand at seven kilograms, plus seven

26:02

kilograms. Significantly harder

26:04

to walk up the stairs just carrying one bag

26:06

and yet many people carry seven kilos

26:08

of extra weight anyway spread out over the

26:10

whole body. So there are grounds for sort of getting

26:12

back to a healthy weight. It's

26:15

so challenging for people if your physical

26:18

activity is disrupted because of your

26:20

arthritis pain and your movement,

26:22

then again, go back and talk to

26:24

your doctor because the good news is

26:26

there's new generations of

26:28

medications that are very

26:30

helpful in weight management,

26:31

particularly if you also have diabetes.

26:34

Even though there are supply issues at the

26:37

moment, they will improve.

26:39

Go

26:39

and ask

26:40

for help and get an evaluation as to

26:42

whether medication could help you. But the

26:44

good news is every bit more

26:47

healthily you eat is

26:49

improving

26:49

your

26:49

health and your

26:51

well-being. like you feel better in

26:53

yourself even if your weight does

26:55

not change. But for

26:56

people who are living with

26:59

obesity,

26:59

definitely talk to you GP

27:01

because It's exciting that the first time

27:03

in about twenty years, there's really

27:05

effective medications coming back onto the market.

27:07

Wow. And of course, they should chase up your article

27:10

in the conversation called

27:12

cancer supplements or diet reduce symptoms as

27:14

arthritis. Here's what the evidence says by

27:16

Professor Claire Collins on August twenty 92022

27:19

and how can people follow you in your fine work

27:21

as we sort of ride up this? Well,

27:23

if you're on Twitter, you can follow me on

27:26

Twitter at Prossy Collins.

27:29

Prossy Collins. Gotcha. You can follow me

27:31

on Twitter. You can follow no money,

27:33

no time. It's at NMNT

27:36

eat well. Yep. But you

27:37

can come to Facebook, follow our

27:39

no money, no time group, and

27:41

ask if you can be allowed into

27:44

our private discussion group where we

27:46

share ideas on how to eat

27:48

healthily while saving money and saving

27:50

time. It's really

27:52

exciting call to see how many people are

27:54

benefiting now from no money, no time. We've

27:56

had something like

27:57

three hundred and fifty thousand people --

27:59

Third of a million. Yeah. Come to the website. We've had

28:01

six

28:01

hundred thousand people do the healthy eating

28:04

quiz, and we're now up to about

28:06

seventeen hundred who participate

28:08

in this online discussion group to

28:10

help

28:10

people eat better, feel better, save money,

28:13

and time. Physically, thank you so

28:15

much. You really do know so

28:17

much about this stuff, about food and dietetics

28:19

and the balance of the body. The science

28:21

is exciting. It can be complex,

28:24

but we really take great pride in being

28:26

able to translated into

28:28

what to eat for dinner. What better way to

28:30

finish up? Thank you very much for, Professor

28:32

Claire. My pleasure.

28:33

Forty years after my very first story on

28:36

climate change, I'm still on the

28:38

case, but now I've

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decided to ride a book on

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it. This doctor Carl's little

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book of climate change science, and it

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will explain how we got into

28:48

this mess and how we can get

28:50

out of it. You'll find out

28:52

who did the early research in