Instant Genius - Heating and Health, with Dr Radha Modgil

Episode Date: November 4, 2022

With energy bills skyrocketing of late, many of us are thinking twice before putting the heating on, or maybe not even putting it on at all. But what effect could living in a cold home have on our health? We speak to Dr Radha Modgil, an NHS GP and BBC Science Focus columnist to find out more. In this episode of Instant Genius, Dr Radha explains what the cold does to the human body, who is most at risk and if the solution really is to heat the human, not the home. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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name audio.com to learn more. Hello, welcome to Instant Genius, a bite-sized master class in podcast form. I'm Jason Goodyear, commissioning editor at BBC Science Focus magazine. With energy bills skyrocketing of late, many of us are thinking twice before putting the heating on, or maybe not even putting on at all. But what effect could living in a cold home have on our health, particularly for those with underlying health conditions? In this episode, I speak to NHSGP, resident medical expert on BBC Radio One's life hacks, and BBC science-focused columnist Dr Radhaudgill about who is most at risk, and if the solution is simply to heat the human, not the home. So as everyone's no doubt painfully aware at the moment. Energy bills have skyrocketed and lots of us are thinking twice before putting

the heating on if we're even putting it on at all. So I thought it'd be interesting to talk about the effects this could be having on our health. So I think a good place to start is by saying, you know, what temperature range is the human body best suited for? You know, when's it most comfortable? Yeah, so the optimum temperature of the human body is about 37 degrees Celsius, but that can vary during the day and according to different things. So, for example, if we're exposed to elements in the environment, if our metabolic rate changes, if we're unwell, for example, with infection and we have a fever, also due to our hormones. So for example, during a menstrual cycle, it can also change. So it does vary. But the clever thing about the human body is that we regulate

our temperature through a process called homeostasis. And that's the sort of self-regulating process. So for example, if we get too cold or too hot, the systems in our body, like the nervous system, the circulatory system, for example, actually sends messages to a part of our brain called the hypothalamus. And the hypothalamus is basically the master regulator of our temperature. So it sets of lots of different changes in our body to then regulate that temperature to come back into that normal range. So what sort of processes does that trigger when the temperature's colder? Yeah. So for example, if we get too cold, then the systems that are put in place are contraction of the muscles on our skin to the hair erector muscles, which basically stand up

and that traps a layer of air at the skin level, which basically acts as an extra jumper, if you like, a bit like an insulator. Also things like it decreases how much we sweat, for example. So also something called vasoconstriction where the blood vessels know the surface of our skin basically get narrower and that allows less blood to the surface of the skin and therefore we lose less heat. But also things like shivering. So nerve impulses are sent to the skeletal muscles, the muscles which basically move and kind of generate heat. So basically that causes lots of contractions within those muscles and helps us shiver, which basically raises our body temperature and also an increase in metabolic rates. So our liver is very clever and produces extra heat

in order to raise the temperature of our body. So lots of different mechanisms that are very self-regulated and very, very intelligent. And we don't need to do anything about that at all. So taking this to an extreme case then, which I hope nobody listening has to experience or has ever experienced. What are the signs of hypothermia? Yeah, so hypothermia is basically a drop in body temperature. It's very dangerous and it's below 35 degrees Celsius. So again, remember normal body temperature is about 37. It's a medical emergency and it needs to be acted on immediately.

So some of those symptoms might be pale, cold, dry skin, blue lips and skin. So there's less blood, delivery going to those places. Slow breathing. Confusion is a very common one. Slurred speech and shivering as well. So if someone is very drowsy, confused and has any of those symptoms, they may be suffering from hypothermia. So we're saying about 37 degrees is the body's internal temperature.

So how do ambient temperature, you know, how does the temperature of the room affect that? So ambient temperature of the room affects that, again, by interacting with that homeostatic mechanism with our hypothalamus. So for example, if our skin is exposed to a cold environment, then that will set off those triggers to the hypothalamus. If it's too cold to say you're too cold, try to put in place these involuntary mechanisms, all the ones that I mentioned before, basically to raise the temperature of the body. If that is not enough or our body can't cope with that, then obviously we can't raise our cold temperature enough. And we then end up

getting to a state of hypothermia or being very cold. There are obviously voluntary responses to being cold as well as those involuntary ones that I've mentioned. For example, as we know, putting on a jumper, getting a warm drink, for example. But obviously if those involuntary or voluntary mechanisms are not enough, then our body can't raise that cold temperature to the level where actually we are able to function and our metabolism is able to function to an adequate level. And that's when we become hypothermic potentially. Does being cold affect our ability to fight off infection? So there is some research to say that it does, yes,

but not necessarily in the way that we might think. So often, I don't know, you know, you might have heard your mom or dad say to you, don't get cold because, you know, you'll get a cold itself. That doesn't necessarily hold true. So we know that, for example, the common cold virus, rhinoviruses, for example, can increase during the winter. But we think that's not necessarily because that actually they're transmitted more, but they may replicate more in terms of the rhinoviruses.

So the temperature inside the nasal cavity is about 33 degrees Celsius, which makes it an ideal breeding ground for the rhinovirus. And that's why we think that actually cold weather may increase the replication of those type of viruses. When it comes to flu and flu viruses, we think that actually in that case it's more the transmission potentially which cold weather can actually increase the chances of. So some people are particularly vulnerable to lower temperature. First off, people of different age groups. Yeah, absolutely.

And again, I think it's important just to talk about the effects of cold weather, not just on virus transmission and replication, but also on our immune systems as well, because we know that in winter, for example, we can have reduced vitamin D levels, which can potentially increase our risk of infection. And also, it has been shown in some studies that lower temperatures can actually affect the immune response as well.

But you're right, there are some groups of people who are particularly at risk in cold weather and when, for example, we can't turn our heating up and they might be the elderly. So for someone who is older, living in a cold home basically increases their chance of serious illness or death. So that higher risk of stroke, breathing problems, flu and also heart attack. And that just doesn't happen in extreme cold weather, but also can happen actually in moderate conditions as well. But especially when the temperature outside drops below about six degrees Celsius. So that's one group. Also, people who have heart conditions or underlying heart conditions. Cold temperatures basically cause an increase in our blood

pressure and causes our heart to basically pump faster. So your heart has to work harder overall. And cold weather can also make our blood potentially more at risk of thickening and potentially causing clots, which can obviously increase the risk of strokes and heart attacks as well. So how are people with respiratory issues such as asthma or COPD affected? Yeah, so we know in terms of the mechanism of asthma that actually cold weather can really cold, dry weather can actually have a really bad impact on their asthma in terms of frequency of asthma attacks, for example. So when cold air hits our airways, our lungs basically reacts by tightening up even more. And because cold air has less moisture in it, then our breathing can

get harder. So our airways dry out and basically our lungs can go into spasm and our airways can spasm too. And that's what basically is the reason for why people find it more difficult in winter if they have asthma and we potentially see an increase in frequency of asthma attacks. Also, I think it's important to say that if we don't have a warm home, then potentially we're at more risk of mould growing in our homes. And we know that obviously mould potentially has that link with asthma because asthma is associated with allergies. And so moles can really spores which potentially can trigger asthma attacks as well. So sort of taking a different approach to this then, I think a lot of people might overlook. How does something like this

affect people with cognitive conditions like dementia or Alzheimer's disease? Are these vulnerable to these colder temperatures? Yes, absolutely in many ways. The major way I think is because obviously someone living with dementia potentially doesn't know when they're too hot or too cold so that those voluntary responses of turning up the heating, putting on a jumper, for example, making a warm drink, potentially those people who live with dementia may not be able to recognise that and may then not be able to put those voluntary actions into place. So it's even more important during this winter to check in on people who may have dementia, who are older, who may have particular health conditions that put them more at risk.

And how does living in a cold environment affect people with mental health conditions, such as depression? So there's quite substantial evidence actually about mental health getting worse in terms of cold environments. So we know that obviously transitioning to living in a cold home increases the risk of mental distress, not just because of the cold itself, but also most of the time, unfortunately, that's because people can't afford to heat their homes. And that's obviously a big issue at the moment. So they then have the added pressures of worries about financial stress, financial challenges and debt, for example. We also know that the risk of severe mental distress doubles for those with no prior mental ill health and actually triples for those previously on the borderline of severe mental distress. So we know that there is a massive impact in terms of how we feel mentally, emotionally,

when we're living in a cold environment and also our ability to actually function to be active to get out and do those things that we want to do and to come back to a warm, safe home. So obviously with the pandemic over the last few years, we've all become a little bit more careful about the spread of viruses. But can colder temperatures affect how easily viruses spread? So they can affect, as I said before, the rhinovirus, a common cold in terms of replication rates, potentially, but also things like flu, because we're spending more time inside with less ventilation, there's more chance of transmission and more chance that actually

we're going to be sitting in an enclosed environment and potentially if viruses are there, then actually we're going to increase the rate of transmission and potentially picking those viruses up ourselves. Yeah, so with that in mind, would you recommend that our listeners all go out and get a flu jab? So there's very clear guidance for the NHS about who should get a flu jab. They include older people, so people aged over 65, for example, 65 and over, and to people under 65 who have certain medical conditions. So, for example, people with asthma, diabetes, heart disease, for example, and also, are people living in a residential nursing home. So there's very clear guidance about who you should get the food up on the NHS website.

But it's very important, I think, for all of us to think about our own risk, how we can stay healthy, what we can do, what kind of simple steps we can take day to day to keep ourselves well in terms of sleep, what we're eating, exercise, all these kind of basic things which we know about, but actually are even more important in the wintertime. So one common phrase that a lot of people are using around this time is heat the human, not the home. Is it as simple as that? What would be your, let's say, top three tips to keep warm this winter? I think we need to heat both because obviously our bodies react to where we are. And I think it's a really

critical and very scary worrying time for people, everyone, but particularly people with health conditions. So I'd say think about a few things. So wrap up warm, just like our bodies reacts and kind of create that extra layer of insulated air to keep us warm. You know, We can dress in layers. So wear different layers, different hats, gloves, scars, for example, when you're indoors, wear warm socks and slippers to keep your feet cozy. So anything, basically, they can keep that heat in. And then think about keeping the cold out. So what can you do around your home to keep the drafts out, to keep the heat in, to make sure that any energy you're putting into heating is actually as efficient as possible. And alongside that obviously goes checking your heating system to make sure that's working as efficiently as possible. Warm food and drinks, very important, and that can help us feel warmer and keep our body temperatures warmer. And also staying as active as possible. Now, that's not easy for everybody, but moving around, generates a rise in our body temperature and keeps us obviously fit and healthy as well. But I think the big thing when it comes to this winter is to check what support is available

for you in terms of your energy bills, to ask for support. Because I think, you know, when we feel like there's support out there, there's some practical tips, or at least there's some emotional support from neighbours, for example, from friends and people know that we're struggling or know that we're in difficulty, then I think actually there are some steps forward that all of us can take. And I think this winter more than any, I think, you know, our communities and all of those amazing support organisations who are out there for different people with different health conditions can really play a part in helping us keep healthy and safe.

Thank you for listening to this episode of Instant Genius. that was NHSGP and BBC Science Focus columnist, Rada Moggill. The current issue of BBC Science Focus magazine is out now. Grab a copy wherever you buy your favourite magazines or visit ScienceFocus.com. This podcast is sponsored by Name, Audio and Focal. The texture and emotional depth of music can be lost through digital sources or poor signal. Name audio believes you can have digital precision with analogue warmth. Alongside French acoustic specialist focal,

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