Inside Health Folgen

Scotland is considering whether to add folic acid to staple foods like flour to protect babies against conditions like spina bifida. Frustrated at the lack of action by the UK government on the issue - despite government advisers recommending for 16 years that flour should be fortified with folic acid - the Scottish government is preparing to go it alone. Spina bifida is one of a group of severe congenital abnormalities known as neural tube defects that affect around 5000 developing babies in Europe every year. It's long been known that taking folic acid supplements, before and after pregnancy, can reduce the likelihood of these defects, as Helen Dolk, Professor of Epidemiology at the University of Ulster explains to Dr Mark Porter. Professional footballers are vulnerable to hip and groin injuries and much more likely to get arthritis as they get older. Southampton Football Club has introduced a new hip stretch and flexibility programme for all their players and the result is a dramatic reduction in injuries. Mark visits the club and meets Olufela Olomola, who, before his transfer to The Saints, spent a season on the bench with hip and groin injury at Arsenal. Just a season later he's recovered and now captains The Saints under 18 team. Mo Gimpel, Director of Medical and Science Performance Support at Southampton FC says the decision to focus on hip flexibility came several years ago, after serious hip and groin injury was keeping key players off the pitch, and the club was losing matches. The new pre-activation sessions have transformed the club's injury rates and research teams are partnering the club to find out how hip impingement develops in the first place. Professor Sion Glyn-Jones from the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences is leading a group tracking 110 young players from The Saints' Footballing Academy, a league two club, a cricket club and pupils from local schools. Detailed mechanical and imaging studies of these young players' hips will help to show exactly when hip injury, or femoroacetabular impingement, first appears, what causes it and most importantly, how to prevent it in the first place. Private medical helplines providing 24/7 advice are the latest development in private medicine. New companies are popping up, attracting millions in private finance. They offer people access by e-mail, phone or online visual link to a GP consultation, for a fee. Dr Karen Morton, founder of DrMortons.co.uk tells Mark why she believes pressure on primary care will result in an inevitable rise in demand for such services. People who want reassurance and advice, she says, can use such helplines and avoid clogging up GP waiting rooms with relatively minor complaints. But Dr Margaret McCartney disagrees and says phone-only consultations risk fragmenting medical records and undermining the relationship between a GP and their patient.

Dr Mark Porter unpicks the science behind the so called 'weekend effect'. Politicians have quoted research claiming that people are 20% more likely to die of a stroke at the weekend, while another much cited study finds 11,000 more deaths in people admitted at the weekend. But how valid are these figures and the research that generated them? Dr Margaret McCartney reviews the stroke data that has been criticised by experts as being out of date. While Mark Porter talks to Editor of the BMJ, Fiona Godlee, who published the 11,000 figure but is concerned about the political use of the findings. And discusses the study with lead author Nick Freemantle, plus Consultant Surgeon Sam Nashef who is sceptical about the results.

Inside Health listener and keep fit enthusiast, David Heathcote, wanted advice on how far he should safely push himself when he's training in the gym.In this special programme about the health benefits of keeping active, Dr Mark Porter helps David to find the answer to his question about the exercise "sweet spot". If you struggle to screw the top off a jar, or use your arms to push yourself out of your chair, that's a sure fire sign, according to Dr Philip Conaghan, consultant rheumatologist and Professor of Musculoskeletal Medicine at the University of Leeds, that your muscles are weak. And the good news is that building muscle strength will protect your joints, not damage them. Dr Conaghan tells Mark that there's a worrying lack of understanding about the impact of muscle weakness on arthritic joints.Over the last decade there's been a growing interest in the relationship between activity and the risk of developing cancer. Studies have demonstrated that exercise appears to have a protective effect against at least four different cancers (breast cancer, colon cancer, endometrial cancer and some upper gastrointestinal cancers) and that being fit helps recovery from cancer too. Dr Denny Levett, a consultant in peri-operative medicine and critical care at University Hospital, Southampton who has a special interest in the relationship between exercise and health, says the reason for the apparent protective effect of fitness is still being researched but the evidence that the effect exists is now widely accepted. Professor of Clinical Cardiology, Sanjay Sharma from St George's University of London outlines the benefits to our hearts of keeping active and Park Run fan and regular Inside Health contributor, Dr Margaret McCartney, admits how running has become something of an obsession and promises that the evidence shows that when it comes to getting fitter, it's never too late to start.