big brands have committed to fair working conditions and sustainable production. but who is monitoring the some contractors. and investigative documentary goes to italy and china and looks behind the glamorous facades of fashion houses. luxury behind the mirror starts no membership on t.w. . this week on in good shape we'll be looking at the micro biome how your gut influences your brain. and multiple sclerosis a diagnosis that can change your life. and here comes your

host dr constantly. hello and welcome to in good shape this is a highly automated bus it works with our driver and it brings people everywhere because mobility is important to us but not everyone is as mobile as i am and if mobility is not there we've got a problem. hello and welcome marc on i'm meeting. and she suffers from multiple sclerosis so why don't you have and we'll check and have of will i like to go with the world. but they are poor this is what i'm going to talk about with professor harms he's the head of the neurology apartment here at the bed and charity and is very well known. and we will continue our

talk in just a moment but 1st i will show you a young man who loves nothing more than to jump off high cliffs so it's pretty normal life but he suffers from multiple sclerosis and he's got a you tube channel and he talks about this to his fans. but also to try to be out in nature to jump off a cliff into the sea from a height of 20 or 25 meters that's a feeling of independence and freedom various kinds of fun finds. patrick island just loves that feeling and he loves sports he's super fit the 2 years ago his body gave him a nasty surprise. i had attending feeling in my left arm and leg like ants running up and down. at the beginning flare ups were sometimes so intense i couldn't control my movements properly so i had to stop

cliff diving. at least the diagnosis. as multiple sclerosis patrick was 28 at the time the thought that he might end up in a wheelchair was terrifying. covered on totally knock me off my feet because if you've never been diagnosed with an illness like that it's hard to understand how lousy you feel when they tell you it's patrick has been spared frequent flare ups but when they occur they interfere with everyday life and especially sports his knowledge just monitors his condition what he does feel all the time however is the tingling in his left arm and leg. it's the result of inflammation in the brain. multiple sclerosis is a disease of the brain and spinal cord which causes inflammation in certain areas there has to be and that causes flare ups. these flare ups are the symptoms that the patients experience. they vary depending on the area of the

brain where the inflammation occurs. neurological tests show that patrick allen just still in pretty good shape his reflexes and coordination are barely compromised. by hand and this is the good news is that mr argent is not suffering from any serious enduring problems that manifest in everyday life then it's often the case that in the early stages of m.s. issues that arise with flare up subsided again. still patrick does sometimes have difficult moments. i was on the board and about to jump but i just couldn't quite my body was telling me no not today that was a blow to my self-image i fuck terrible that triggered a downward spiral of i dunno will you go on. medication prevents or at least delays

flare ups but never knowing how the disease will proceed is a considerable emotional and psychological burden. if you get into a depressive phase it's hard to get out of it again without the right help and the right people around you but also. patrick has sought help and seen a therapist he's created a you tube channel called eye of patrick about enjoying life to the max what ever adversity you face he also addresses issues related to his disease. i want to talk about disability what does it mean you don't have to be in a wheelchair to be disabled it's enough to have rheumatism diabetes all like me and mess. with my you tube channel i want to encourage others with m.s. and tell the world that even with the disease you can still have fun. for patrick fun means high diving including cliff diving but he's going to carry on diving as

long as his condition permits. serious flare ups could mean difficulty moving or even paralysis. if he were to develop persistent coordination problems i think it would be difficult for him to continue with sports such as high diving. though in general sport is good for m.-s. patients it keeps them fit i would support his carrying on although he should always ask himself whether he's really up to it. it can help with m.s. patients train coordination balance and core strength. but the quality of life is also important not withdrawing into ones show. because the figures will climb if it's off a little things that help you cope i think the right friends doing sport your sport i come here almost every day here i am a life it goes on like

a mask isn't going to get you down but i'm not going to hide myself away. once i learn to accept things but i forgot very much better now so accept you if you smear might be more fuel for if you feel better. so how are you today i'm fine today i like my day it's perfect so if you think back for the 1st signs you had from the small to the still roses what was it like what were the 1st signs oh i didn't know what happened it's a long time ago it's in 1985 the 4th time and i started to weep blind and here i'm betting. they don't know what it is. this is a puzzling poort as i didn't know and so forth and i have to. buy. points on the spine and yes running that to examine the spinal fluid and see

her and you say well send that said i don't want that i'm sorry about it i wanted to i wanted to wait until my body felt fully what happened so you believed in your body and the body would give you all the answers you need as i had lots of stress and a chop in the live and it started in 2005 again and then 20 years yes my 3 years and i have lost my husband and in paris and oh man took there over 3 feet and the traffic played came to light came from. red to green and i couldn't go and this was a proper member came back to berlin and let somebody have some days later and here it was clear so finally you got your spring routine and then you got the diagnosis he had his doing everything motley's everything changed him didn't change that i changed my job i was there by a year later again and i said ok it's fine but i will change my life either change

it so isn't it very hard to get a diagnosis which you need to change your life i think it's a very very bad everybody used to his normal life and then there's a complete change from one moment with the other. for me it was great but i think that a lot of people and there are lots of property i think it's better so what were your greatest fears sitting in the wheelchair for instance in the 1st time yes but later on i had the feeling field trip it's not the problem. the problem are i think it's not a field trip so so now you're living with multiple sclerosis there are certain kinds of attacks the disease worsen sort of what i mean like the attacks are very hard i can't move lakes i can't move beyond i can't. car larry my country it i can count moves that i and and the earth heart but normally it goes away and

then i started to to live fish so sharply what. i wanted to do then a mass thing writing i made one mash and says how can you keep your good spirit oh i think my mother 1st said i'm a fan winning character. if you give her a push and save on make it so it's in the feeling that everything will be over and i think she was right i don't know much and i i have this idea of the 1000 from monty python always look on the bright side of life it's very good so let's 1st take a look at what research is saying about multiple sclerosis so i will have a good talk to her face all the sobs. times is a neurologist who researches multiple sclerosis

a prelim shall he hospital he's also a medical advisory board member for the german m.s.i.e. he and his team are trying to find out what causes multiple sclerosis by discovering more about the triggers they hope to develop better treatment options. this multiple sclerosis doesn't mean you will end up. looking at a house full of things to date and why you see him is called the disease of the fouls and thesis that's because symptoms of multiple so this is very different very regime use militaristic so we have for instance. in laws we have numbness and tingling you have perrie's this. is also later on we have dysfunction of urine blood and later. often fatigue is a big problem for some patients so if you take

a look well divide you will find that there are approximately 2500000 cases of m.s. world wide and the number of patients increasing so why so we cannot compare the situation 40 years ago and today because a change so many things for instance. because advanced imaging was not available 40 years ago today is the standard. diagnosis not stick to will. we can make. all years and. for many years we have new. year for diagnosis. and so also many opportunities of treatment also increase our values for the disease so we have much more diagnosis but that does not mean that we have really more ill patients is there any explanation that occurs mainly in young people especially in

women. multiple throws a very complex disease immune mediated. disturbance lead to destroy of tissue of the brain and spinal cord and that means. in other autoimmune diseases that you have over a reaction of the immune system and of course in young people's there's a more potential of an active immune system and the disease different here or in europe or on a global scale will divide in different countries yes it's a very interesting question and trusting fixed. data already showed us that there is a difference pending from the region patients are living that means depending from the left that you would. it's a greater distance from the. the. incidence of the disease so do we really

know what causes multiple sclerosis. beasts mentioned global differences different hypothesis has been established that means for instance a series of. exposure to sunlight and vitamin d. plays a role in the disease development we have the hygiene hypothesis. which means that the development of the immune system in the child needs some challenges which we don't have this amount in developed countries but if there are so many different causes and the perhaps don't know them all how can we treat m.s. . we don't treat the causes of we try to. stops. just. over activity and so we have to do.

about 16 different drugs approved during the last 25 years and they are very different from the sea from the side effects from the application of you have injectable so you have drugs infusions and so we can try for every individual patients the best. treatment. our aim is to reach the so-called. that means no evidence of disease activity so if we speak about the immune system really have to take a look at our gut flora all the big tyria in our intestines because they play an important role for immune system even in a mess patients. that may be the key to health in particular the head. the brain new research shows that the brain axis plays a significant role in this is like parkinson's alzheimer's and multiple sclerosis.

can order for your brain to function normally an intact gastrointestinal system with healthy intestinal flora is crucial the intestines feed the brain. new discoveries are coming so fast that i'm certain will no longer be able to ignore the gut when it comes to therapies for diseases. recent studies show that the bacteria in our intestines are of more importance than previously believed billions of microorganisms live in our gut around 2 kilograms worth and they affect our brain 2. studies on mice have shown that eliminating intestinal flora can damage brain activity. we've found that when mice have a flawed gastrointestinal system with no gut bacteria the immune system in the brain is dramatically affected in the east. researchers at the university of

medical center took a close look at immune cells the protect the brain against disease they discovered that these cells only function if intestinal bacteria can produce certain substances that they need. the mother wasn't easy usually visa called micro cells are very active in the brain they have small appendages which monitor the nerve cells of the central nervous system if bacterial metabolites short chain fatty acids disappear then visa immune cells are hampered they wither away like plants in a garden that are not watered. the brain's immune system atrophies when it doesn't get certain materials from the gut. intestinal bacteria are responsible for turning the food we eat into valuable substances among them short chain fatty acids like probiotic acid. scientists wanted to know if these fatty acid. couldn't turn cure a disease brain they tested this by adding probiotic acid to the drinking water of

a sick mind the result the immune system recovered. this time for it was a completely surprising finding we didn't expect it at all. would it also be the same case in humans would it be possible to heal the brain by the gut doctors that trying to use of hospital in bookham think so. they've seen that the brain as well as the intestines are affected in patients with multiple sclerosis. is in an affair in the home the competence and we've observed a change in the composition of the intestinal micro biome that means all of the bacterial strains that exist within the intestines and what we're seeing is in effect an impoverished not a decline in diversities of bacterial species in the gut dom among the hundreds of bacterial species found in our guts about $160.00 appeared to be common to the

healthy human intestine people with m.s. some of those are missing for reasons that aren't entirely clear and that leads to a deficit of short chain fatty acids such as proteomic acid. then you go back to because there are fewer bacteria present less probiotic acid is developed in the intestine and that's reflected in the patient's blood. that also proved true for an orator who has m.s. she had unusually low levels of probiotic acid in her blood. the doctor decided to add appropriate supplement to her other medication and it appears to help york. coughed i have more strength it's easier for me to complete my daily activities i also feel more focused and nice but in this mode. patients say that after a short period of time they already noticed an improvement they feel more fit they

have more strength experience less fatigue. and they're less susceptible to infections vinita in fact unfairly but the main change could be measured in their blood the doctors found that immune cells increased by 30 percent and the number of certain white blood cells implicated in inflammation drops by up to 50 percent ariano szpilman must also given probiotic acid and not only did the symptoms of m.s. improve another condition did as well. to tap and i was waiting for my hay fever symptoms to appear but they didn't and then i realized that it could have to do with the probiotic acid that i took. the hypothesis is that part of the immune system is located in the intestinal walls immune cells as well as bacteria and their metabolic products are all found there and the fatty acids that the bacteria produce could be what strengthening the immune system.

neurologist god is convinced that that's the case he's a multiple sclerosis specialist he says he hasn't found any negative side effects from protein on a gas and quantities we don't know of any risks and the european food safety authority has cleared an amount that is actually $200.00 times higher than the concentration and dose that we consider useful. when patients ask me i say try it out and see if it works for you i have to emphasize again and again that we don't have data from clinical trials and kind of clinician. therapies are still being researched but one thing is for sure healthy balanced diet benefits your intestinal flora will make your gut feel good and maybe help your brain as well. what's your take on property i guess who well. very often from our patients if they should take probably on a guess it but is it probably only as it is

a short shane 30 as it's produced by special bacteria in the gut and he knows it is probably going to get it is influencing special immune cells from his animal studies we know that it has a lot of tory effect and so we hope it's also effective in patients in the treatment of as patients as additional treatment but there's a lack of studies still that there are no major side effects so you could just try it. if patients want to say ok take it because it has no side effects and what about vitamin d. i mean there are several studies suggesting that this might be helpful in the mist patients. we know that from other studies too and also in our patients look for it to be delivered as a blot and most of the patients really have a very low vitamin d.

level so we. give them a supplement of vitamin d. and the most neurologists are doing that but you don't know except if it really influence the course of the disease so what else can patient to say nutrition wise response and exercise 'd is 1st of all as a physician recommend that they should be observant as it should take prescribed medication but they can do a lot of talk about that so we recommend that they show to perform insurance sports that means walking jogging swimming or cycling saw they can and should not smoke because smoke this lead to a progression of multiple sclerosis so if a patient today would get the diagnosis multiple sclerosis what are his chances to stay out of a wheelchair in the past is evidence that. shorter

life span a little bit but you have known you are data. concerning the modern treatment and. hope for the modern treatment. enabled the patient to lead a normal life or a good life. even bizarre out. thank you so much for this talk today and i know this is a very very interesting show and you don't want to leave your t.v. screen but you have to if you want to write us an e-mail. in good shape issue weekly health show on d w covering many aspects of health care we look at what's new in medical treatment nutrition fitness and beauty. we discuss these topics in depth with specialists and offer you opportunities to pose your own questions. on an upcoming show we'll be talking about antibiotics they're being prescribed

more often than ever but resistance is also on the rise what are the consequences and are there alternatives send your questions to in good shape at d w dot com just like the word antibiotics in the subject line we look forward to hearing from you. so how do you see your future i think the future of computer open and i like it and i like the net for everything what's coming out there and he wishes now lots of. i want hope for everybody i want that people are respecting everybody and i think it's a very important courage and let's check a few very important issues let's hope that they get true. so see you again next week and until then let's all try to stay in good shape.

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a destroyed city. the philippines in the sunshine starts october 24th on the w. . the. place . this is state of unit was live from berlin protesters in hong kong defy a bad idea making their voices heard thousands of demonstrators take to the streets for an unauthorized rally undeterred by recent violence attacks the pro-democracy activists. and also coming up thousands have turned out in love and up for a 4th day they're protesting austerity measures aimed at tackling the country's

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