- This week on The Check Up ` Jayani bares her soles. - How wearing shoes affect our feet. - The 411 on phobias. - For some people this could evoke a massive fear response. - How do type 1 and 2 diabetes differ? - In type 1 diabetes, the body doesn't produce insulin at all. - But first ` is fasting more than a fad? - (MAN RECITES PRAYER) - Each year, Muslim households celebrate the Islamic holy month of Ramadan. During this time, Faroq and his family abstain from food and water as part of a fast that lasts from sunrise to sunset. - Fasting is actually... It's not just about the food. So it's actually to do with the spirituality as well. And you have a feeling of how it is for the less fortunate. So in our religion there's actually five pillars of Islam, and one of them is fasting. So it's compulsory on anyone who's reached the age of maturity who is in a healthy state to fast during the month of Ramadan. - At sunset, it's time to break the fast. - So, it's been 12 hours since we last ate. So, we started our fast at 5.30am in the morning. And now it's about 6pm, and we're enjoying dinner. - While Faroq and his family choose to fast in observation of their Islamic faith, the potential health benefits of fasting in the wider population have been getting a lot of airtime lately. It's not only being touted as a weight-loss solution but also may help in the fight against cancer, diabetes, Parkinson's disease and Alzheimer's. Sounds too good to be true. So how do we incorporate fasting into our lifestyle? There are dozens of fasting regimes out there, but those thought most likely to positively impact our health generally fall into three categories ` those that involve eating on alternative days, those where calories are severely restricted on certain days, and those where energy intake is only consumed within specific time windows. If you're fasting to shed a few pounds, there's some good news. Many studies show almost any intermittent fasting strategy can result in some weight loss. It's also been shown to influence insulin levels, gut health and metabolism. Some animal trials have even found fasting has anti-inflammatory effects, improves cognition and delays ageing. But not yet in humans. Sorry. The reason scientists believe it's worth looking into is because time-restricted fasting may support our body's natural rhythms. - When we're fasting, I notice a big difference in my health. For the first three, four days, when you start fasting, you find, like, a big drop in, like, the energy levels. But then after that, like, after a week, all of a sudden you actually have a big jump in energy levels. So this is a whole month of me not drinking coffee. So for someone that drinks about one or two coffee cups a day, that's saying something. - Any time we give our body's cells a break from having to process and deal with food, there's an opportunity for them to do other things, like repair and regenerate. Whether you're looking to tighten your belt or shift some winter weight, intermittent fasting can help. But at the end of the day, the success of any eating plan is really whether or not you can stick to it. - Thank you. - Thank you. (FUNKY MUSIC, BEATBOXING) - We might all come into the world barefoot, but archaeologists have uncovered shoes dating back to around 3653 BCE. Shoes are intended to protect our feet from all manner of things ` (FUNKY MUSIC CONTINUES) old gum, dog poo, broken glass and judgemental stares. But not every shoe is a good shoe. Personally, I'd love to be barefoot all the time. But the reality is my feet are tucked away for most of the day. - OK, Jayani, just wanna have a walk over the mat for me, thanks. - As Head of Podiatry at AUT, Matthew Carroll not only understands feet but how wearing shoes affect them. He's putting me and my well-worn kicks through our paces. So, some of these issues that I've got in my feet, would I still have had these issues if I had, maybe, been barefoot my whole life? - It's a really good question. Bare feet... If you'd stayed barefoot and not worn shoes, your feet would have callus all over them and nice cracks. They'd probably be nice and tough, but I don't know if you'd be too keen on how they would look. - With babies or infants that are just starting to walk for the first time, is it best to let them have time barefoot without any shoes on? - I think a good mixture of both. There are shoes that are specifically designed with some good features for those new to walking. Some time in barefoot is great, I think. Those who are just transitioning into walking, who are still crawling around a lot, it's OK to have a little bit of protection on the feet, but inside the house, I think barefoot is the way to go. - In the first year of life, babies' feet are soft and supple with ample fat pads on their soles and are very flexible. Our bones are actually soft cartilage when we're born, and these continue to develop right up until we're teenagers. Of course, as adults our choice of footwear is up to us, and fashion often seems to override practicality. - Let's have a look at these ones. So that heel height's fine. We've just got to be really careful that the front of the shoe is not too constraining on the foot. The higher the heel goes, the more the foot gets pushed down, and the more pressure we get underneath that big-toe joint. So, you know, the most important things here are making sure the shoe is relatively close to the shape of the foot. Very difficult to achieve in a high-heeled shoe, but I guess the main thing there is a little bit of heel is OK. - I've seen some really high stilettos at times. Not that I own any here, but... (CHUCKLES) - Yeah, they make your calf muscles look good, but not too good on the front of the foot, unfortunately. Let's have a look at these sneakers. I think a couple of key things here. We still want the shoe to bend in round your big-toe joint. We've got some good cushioning under there. The shoe's got a nice curve there. So that helps us really roll efficiently off the front of our foot. And this, importantly, quite different to a child's shoe. For an adult, we've got a lot of joint movement through the middle of the foot. So having that shoe nice and stiff through there's really normal. - And the flame helps you look like you're running faster. (LAUGHS) - They look fast, don't they? I'd choose them based on the flame too. - (CHUCKLES) - The ultimate Kiwi classic ` the jandal. Ah, great for the beach, great for round the home, great for washing the car. But that's about it as far as feet go. - What's the verdict on my shoes? - Ah, they're into retirement. Great for walking around in at home, round the shopping centre, but we need some specific running shoes to help with your feet. - My shoes have been kicked to the kerb. So now I have an excuse to go barefoot, but this time in a more appropriate place. Sneakers with heels. Hoes with wheels. The trends just keep on coming. The most important thing is to make sure you have the right shoe for the right activity. And, ultimately, your feet will let you know when you've got it right. - Fear is a natural response when we perceive danger to ourselves or others. If those feelings don't subside once that threat is gone, you could be suffering from a phobia. (SCREAMING) - At some time in our lives, we've all been afraid. - I am afraid of needles. - I'm petrified of heights. - I'm afraid of dogs. - Probably my biggest fear would be rats. - I don't like spiders cos they can move really fast. - Or, like, roller coasters. Mm-mm. - The ocean, and especially orcas, I'd have to say. They just terrify me. - I have a fear of ants. - I'm pretty scared of giving blood. - I cannot go ice skating, cos I have this dumb phobia that my hands, like, my fingers are going to get cut off. Don't ask me why; I just do. And it's just really stupid. - Fear is a natural response when we perceive danger to ourselves or others. I'm actually super interested in this spider. I think this is awesome getting to look at him up close like this. But for some people, this could definitely evoke a massive fear response. - (SCREAMS) - It makes me feel gross. Like, genuinely like... (RETCHES) - Kind of a skin crawling. - I could definitely feel my heart racing. Now I'm thinking about it, I'm like, 'Aargh.' - It, like, makes my hands go weak. Like, you can't, um... I can't scrunch them together. - Panicked, I guess. And my voice shakes as well. - Oh, like, I just feel, like, tingly and yuck. - I do feel a little bit light-headed. - It just makes me feel, like, sick. - I see a spider, and I'm like, 'I don't like it.' I'll just run away. - Thanks, Ryan. - No worries. - Once the scary situation is resolved, we should effectively return to normal business. But if those feelings don't subside once that threat is gone, you could be suffering from a phobia. - Psychiatrist Dr Hiran Thabrew knows the science. How does a fear differ from a phobia? - Well, a phobia's a really intense type of fear about something that in reality poses little or no actual danger. But it can make people feel very distressed and also stop them doing things they either need to do, like going to school or work, or things they want to do, like fun stuff. - How would you know that you had a phobia? - Well, there's two main types of symptoms. There's changes in their mind. So having thoughts like, 'I'm in danger,' 'I need to get out of here,' 'I'm gonna die.' And also changes in their body, like feeling their heart racing really fast, finding it difficult to breathe, noticing butterflies in their tummy or feeling really hot and sweaty. Most people usually know that the thoughts they're experiencing are irrational, but it's quite hard to control them. In fact, just thinking about the thing they're afraid of might bring on some of the symptoms of anxiety, and being confronted by the thing they're afraid of can make them feel really overwhelmed or like they're having a panic attack. Most people also take great pains to avoid the thing they're afraid of. People might avoid, say, doing presentations in the classroom or work, which can mean that it's hard for them to progress. They might avoid travelling. They might avoid going to social gatherings. And this can affect their families as well, who also can't go to those gatherings. - So is a phobia considered a disorder? - Yeah, a phobia is a type of anxiety disorder, and, in fact, it's really common. About one in 10 people around the world will have some kind of phobia. - That's a heck of a lot more than you'd expect, eh. - It is indeed. - There are hundreds of phobias out there, but they fall into three main types ` specific phobias, social anxiety disorder or social phobia, and agoraphobia. - (BARKS) - Specific phobias are very common. These involve animals, objects, people, environments and certain situations. Some are more surprising than others. There's fear of the number 13, fear of clocks, cooking, crossing the street, belly buttons, feathers and even clusters of holes. For others, just being amongst people can induce terror. - When people have social phobia, they have fears of being in places with strangers that they don't know, or even with people that they do know. This can be quite debilitating. They can experience thoughts like feeling that people are judging them or thinking they're not good enough. And they can also experience some of those feelings in their body that we've mentioned before. - There's also that fear of being in any sort of open public space, yeah? - Yeah. Some people have a fear of being in wide open spaces to the extent that they won't even leave their house. And that's something that we call agoraphobia. - Yeah. What causes somebody to develop a phobia? - Most phobias develop in childhood either because we experience something scary or because we live with other people who have certain fears about things and we pick up on those fears. In that situation, our brain stores a memory of the thing that happened, and if something similar happens in future, a part of our brain called the amygdala sets off an alarm that says we're in danger and tells us that we need to get our bodies ready to either fight the danger or, more likely, run away. - So it's the whole fight or flight response? - Exactly. - How likely is it, if you have a phobia, that it will go away on its own? - Not very likely. You're probably gonna have it for a long time. But there are things you can do to make it go away. The most common type of treatment for specific phobias is something called exposure therapy. If you've got arachnophobia, which is a fear of spiders, for instance, you might start by looking at pictures of spiders. You might go on to watching videos of spiders. You might then try and be in a room with a small spider, and then work your way up towards, kind of, having a small spider sit on your hand. This might sound really impossible to some people, but they can actually get there. At each step, what you need to do is stay for long enough for your anxiety to rise, and then fall again. Otherwise, you keep being as afraid every time you come back to that same point. If exposure therapy is not enough, then there's other more detailed kinds of therapy, like cognitive behaviour therapy and also medication that can be helpful. - What would you like people who have a phobia to know? - I'd like them to know that they're not going crazy, that it's common, and that they don't have to live feeling as out of control with those experiences as they are. There are definitely things that they can do, with or without the help of other people, to change how they live. - Mm. The saying goes we have nothing to fear but fear itself. But if you think your fear might be tipping into phobia territory, it's OK to get help. - Over 250,000 people in New Zealand have diabetes, but only about 10% have type 1. - Yawning is contagious. But what triggers such a spontaneous reaction? (ALARM BEEPS) - Peyton, are you up? Let's go. Get ready. Come down, have some breakfast. We were so shocked with the diagnosis of type 1 diabetes. We just hadn't even considered it. Looking back now, I know that she had every single sign, but there was an explanation for everything. She was vomiting, but then gastro had just gone through school. She was really thirsty, but it had been unusually warm and she'd been quite active. She'd lost a lot of weight, but she'd also had a growth spurt. - Over 250,000 people in New Zealand have diabetes, but it's estimated that only about 10% have type 1. The first thing to note is that type 1 diabetes and the much more common type 2 are very different beasts. They are not interchangeable, and one can never turn into the other. Type 1 can occur at any age, but it used to be referred to as juvenile diabetes, because it most often presents in childhood in children 7 to 12 years of age. Peyton was 9 when she was diagnosed. - The first time I was told I had diabetes I was very confused. I didn't know what it was. - Diabetes occurs when the body can't control its blood sugar levels. When we eat sugars and carbs, our body turns them into glucose, or blood sugar. This is our main energy source. The cells in our bodies, however, can't access this fuel unless we have enough of the hormone insulin. Imagine my car is the glucose and it needs to get into the garage, or, in this case, our bodies' cells. (GARAGE DOOR GRINDS) Insulin is like a key, or a remote, that opens the door to the cells and lets the glucose in. Diabetes occurs when the body doesn't create enough insulin to keep blood glucose levels in a normal range. In type 2 diabetes, insulin is produced, but the body is resistant to it. In type 1 diabetes, the body doesn't produce insulin at all. - Peyton was really unwell after school one day, and over a couple of days, she didn't get any better. Lots of vomiting, really thirsty, couldn't hold anything down. And she started breathing strangely, really heavy, like, she was puffing out like a... (PUFFS HEAVILY) One night she woke up with horrendous pain in her diaphragm, and she was telling me to call an ambulance. - Peyton was suffering from diabetic ketoacidosis, a life-threatening complication of type 1 diabetes, which causes abdominal pain, nausea, vomiting and shortness of breath. But there are other common signs of type 1 diabetes ` thirst, fatigue, peeing a lot, hunger and weight loss. - Walked into the waiting room at Christchurch Hospital, and they took one look at her and her breathing, and Peyton had a bed and a diagnosis in five minutes. - Family history, genetics or even certain viruses may mean a higher likelihood of getting type 1 diabetes. But the exact cause is unknown and unpreventable. The aim for Peyton, and others with type 1 diabetes, is to keep blood glucose levels as close to normal as possible by adding insulin to their bodies. - My challenge is when I'm, like, having fun. Sometimes I'm having so much fun that I ignore it, and then it leads to much bigger problems. It's actually really difficult when you are living it, yeah. - Type 1 diabetes requires constant attention 24/7, and is a lifelong condition. If left untreated long term, it can lead to kidney and heart disease, vision loss and many other complications. Fortunately for Peyton, managing her condition is made easier by 21st-century technology ` a continuous glucose reader and an automatic insulin pump. - What's your number? - 5.9. - 5.9. That's good. So have you put some insulin in for that smoothie? - Mm-hm. - How much do you think is in there? Banana, berries and milk ` carbs. - 10. - Yeah, I think that's about right. To stay on top of Peyton's diabetes, we have to make sure that we are counting the carbohydrates. Everybody thinks it's sugar-related, but everything is carbohydrate related. So, for every carbohydrate you eat, which includes sugar cos it is a carb, you must put in the insulin to balance that out. - How my pump works is I put grams in for the food that I am eating, and it tells me how many... units I have for my insulin. The patch on my arm is a glucose reader. It's measuring my blood sugar. It connects to my phone, and then sometimes it alerts me. - The pump was life-changing for us, definitely life-changing. And for her too. Despite having a device attached to you for 24 hours a day, it gave her a sense of freedom. - There's only, like, one or two things that I can't do. Like sleepovers and maybe being a bit more careful about what I eat. People sometimes aren't the kindest about it, but you still just got to go like, 'Eh.' (LAUGHS) (FUNKY MUSIC, BEATBOXING) (HARMONIOUS SCATTING) - Spontaneous yawning typically occurs when we're tired or bored. The action's even been spotted in unborn babies. (SCATTING CONTINUES) It's been suggested yawning could be our body's attempt to wake itself up by drawing in more oxygen, flexing muscles and joints, and increasing our heart rate. But this is still up for debate. What we do know, without a doubt, is that yawning is contagious. How can just seeing, hearing... (MAN ON TV YAWNS) ...or even reading a word trigger such a spontaneous reaction? Resist, I dare you. This jaw-dropping chain reaction is a phenomenon also found in monkeys, chimps and even man's best friend. Many studies suggest its contagious nature has to do with empathy. Monkeys yawn more while grooming each other or when watching those most familiar to them. Hi, Mum. - Hi, honey. How's it going? I'm getting by. What are you doing this weekend? Human studies also reveal we're more likely to catch a yawn from close friends or family than we are a stranger. (YAWNS) - Stop yawning. - You started it. That wasn't me. - (CHUCKLES) - This correlation between emotional closeness and the degree of yawning contagion suggests yawning could be a way of putting ourselves in another's shoes ` an attempt to feel what they are feeling or empathise. All right, Mum, I'll talk to you soon. - OK, I love you. Bye. - Love you. Bye. Extensive evidence shows that people that suffer from disorders which affect social interaction, such as autism or schizophrenia, are less likely to experience contagious yawning. Age also plays a part. Infants and pre-school children appear largely immune to contagious yawning. This is in marked contrast to older children and adults whose brains have learnt to recognise the mental state of others. There's no cure for the contagious yawn. In fact, the more we try to resist, the more the urge is increased.