- This week on The Checkup ` Shawn checks his bladder baby. - The big, black blob there, that's all your urine that you've made. - The risk of relying on social media for self-worth. - What happens when we don't get this validation? - Eat or bin? - Spoon it out; throw that bit away and eat the rest. - But first ` how can the strong protect the weak? (CURIOUS MUSIC) Smallpox was once one of the most feared diseases in the world, killing three out of 10 people that caught it, but thanks to a global vaccination programme, in 1980, the World Health Organisation was able to declare that smallpox had been wiped out. Vaccines have the power to prevent illnesses that have no cure and, when used to their full potential, can even eradicate some of the world's deadliest diseases. There's been no getting away from the topic of vaccines since the COVID pandemic took hold. But before coronavirus made headlines, New Zealand was dealing with a serious measles outbreak in 2019. Like COVID-19 and smallpox, measles is highly contagious, can be life-threatening and has no cure. It is also easily preventable with a vaccine ` a vaccine with a 99% success rate after two doses. Why, then, are so many people suffering? It's estimated that 400,000 Kiwis could be at risk because they are not fully vaccinated. 2019 saw one of the most significant outbreaks in recent years, with 2191 confirmed cases. Paediatrician Dr Simone Watkins was at the front line. - I worked during the outbreak in South Auckland, and it was just devastating seeing these babies be in hospital for weeks at a time. And there wasn't much that we could really do but support these families and babies while they kind of rode it out and their own body built up that immunity. - Before vaccines, catching the virus and building an immune response was the only option. But when it comes to measles, the health risks are high. Up to 30% of people with measles develop complications. - There's still things that we don't know about in terms of further development or issues with their brain and memory and function that we won't see until those people grow up. - Unfortunately, many of Simone's patients were our community's most vulnerable ` young babies not old enough to be immunised or complete their immunisation programme. - What would have protected them is if people had vaccinated around them, for example, extended family, friends, the community. - This is what is known as herd or community immunity. Herd immunity describes the strong protecting the vulnerable, and a reliable way to gain that strength in a human context is to be vaccinated. The children from Wesley Primary School have kindly offered to help demonstrate how being vaccinated not only protects you and your family but also stops the disease spreading in the community and on to future generations. (UPBEAT DRUMBEAT) (CHATTER) In the middle of the circle, in the yellow caps, are those unprotected and most vulnerable to a virus. These include newborn babies, the elderly and people with compromised immunity. On the outside, in the red caps, we have our virus. If we have a strong defence line, say 95% of the population is vaccinated ` that's them in the blue caps ` the virus has a very difficult time getting through. (CHILDREN LAUGH, SCREAM) But as the percentage of people protected drops, the likelihood of getting through rises. (CHILDREN LAUGH, CHATTER) Viruses are categorised by their rate of transmission, or how many people on average each infected person will go on to infect. It's known as the R0, or basic reproduction number. Measles is particularly dangerous because it has an R0 between 12 to 18. That means each infected person has the potential to spread it to 18 susceptible citizens, and so on. (CHILDREN SHOUT, LAUGH) By comparison, the virus that causes chickenpox and shingles has an R0 between 3.7 to 5. When it comes to a new virus ` like COVID-19 ` and no vaccine, physically distancing yourself from the chain of transmission protects the people around you. With vaccines, like the one for measles, those who are vaccinated break the chain. Measles may not be the virus at the forefront of our minds right now, but when immunisation rates drop off, we risk exposing the most vulnerable to its effects. If you have questions about your own immunity or that of your family members, seek advice from your GP. (CURIOUS MUSIC) - JAYANI: It was Aristotle who said, 'Man is by nature a social animal,' and our many methods of communication over the years prove him right. Our social environment and connections with others all contribute to our well-being. But how we connect has changed profoundly since Aristotle's day, and there is growing concern about how that impacts our mental health. Social media is defined as any digital tool or application that allows users to both consume and create content. This is an estimated month's use in 2018. These media platforms, which are so much a part of our daily lives now, have increased our social interaction by reuniting us with old friends, reminding us of Auntie's birthday and even suggesting events we might like to attend. But alongside these positive aspects are concerns of a potential link between the growing use of social media and increasing mental distress, especially amongst young people. As prime users of these platforms, the students at South Seas Film School agreed to share their views. - Social media creates this expectation to be like the people you see on your phone. Then they don't think they will ever fulfil that expectation, and that creates this sadness that you aren't gonna be like those people. - This feeling of inadequacy can come from comparing ourselves to others' social media. Who got the most likes? What do the comments say? Thumbs up. Thumbs down. Sad-face emoji. (GROANS) Back in the day, we got our validation from a smile or a nod. Now it comes in the form of notifications. (CELL PHONE CHIMES REPEATEDLY) But what happens when we don't get this validation or we don't get as much as our friends are getting? Studies have shown that in youth, high levels of social comparison are associated with depression and a high risk of eating disorders and body-image concerns. Not only can social media be wrongly used as a measure of self-worth and identity, but has it also changed the way we view relationships? - You're looking at all these people and you get this false sense of` that you've been hanging out with all your friends when, really, you haven't, and you're just alone in your bed. - The amount of viewers, subscribers, followers or friends we supposedly have on social media may range from double digits to six digits. The numbers may be gratifying, but is it quantity over quality? - People have become a bit more disingenuous. I feel like now that there are, like, set sentences that you have to say to someone to feel accepted, like, 'That's so blessed. I love that about you,' you know, 'That's great,' or only positive information. And then when you do hear the negative information, it comes out in such a way that you feel alienated or alone. So it's quite hard to judge people now through a screen, how they really feel. - It may also be reducing our ability to enjoy the benefit of real face-to-face connections. - I think young people now have a lot more social anxiety. So when it comes to having face-to-face connections and conversations with people, I think people resort to small talk and, 'What are you studying? What are you doing at the moment?' And then when those questions, kind of, run out, it becomes a bit` I know I feel a little bit anxious, and you're kind of like, 'How do I end the conversation?' - There's no denying that social media has enriched our lives. We're connected in ways that our grandparents never dreamed possible. But maybe ` just maybe ` it's time for a reality check. Our challenge going forward lies in using it in ways that are beneficial, not detrimental. - What about holding it in? - You wanna listen to your bladder but not always obey your bladder. - I hope I don't get performance anxiety. (CHUCKLES) (LIQUID TRICKLES) - Looks like a really good flow. (FEEL-GOOD ELECTRONIC MUSIC) - SHAWN: The fun quickly drains out of a night out when you feel like you're spending more time in the bathroom than you are on the dance floor. Why is it that some people need to urinate frequently when others seem to have bladders of steel? To find out, I'm consulting urologist Dr Anna Lawrence. Anna, I've got this little homemade experiment here. We're gonna use this balloon to try to represent a bladder, and we're gonna pump this here... - Great. - ...to fill it with our makeshift urine. - I'll hold this. - If you hold that bit there, and let's... - Join our bladder to our ureter. - Let's get going. Let's get flowing. (CHUCKLES) - (LAUGHS) When it comes to urination, it's a question of what goes in must come out. Small amounts of urine are being emptied from our kidneys via the ureters into the bladder every 10 to 15 seconds. How much do you think is in there? - That, to me, looks like about 500mm, which would be in keeping with our bladders naturally. - Oh. So just like this balloon is stretching, our bladder's stretching out just like that. - So a bladder has three layers. And so as it fills, it all stretches out beautifully, and it's got this elastic properties to it that are fantastic. And that's why it allows us to go from nothing up to sort of 600ml capacity without any change of the pressure inside there. So, it's a very clever organ, I think, in its ability to hold that amount of urine without starting to make you feel desperately uncomfortable and panicking. - The burning question I have is ` do some people have smaller bladders than others? - The normal bladder should hold somewhere between 300ml to 600ml, and so that's a variation. And so just like you and I are different shapes and sizes, our bladders will be different shapes and sizes as well. - And what are some of the things that influence how much urine we produce? - Some people go frequently because of their fluid intake ` the type of fluid they have. So if you have lots of coffee or lots of caffeinated products or fizzy drinks, it really irritates the bladder. And that will make you go, say, more frequently than your friend who's drinking plain water. - So what exactly is it about, like, alcohol or coffee that make you feel like you need to go more and more? - So they do two things. First of all, they're both diuretic. So when you drink them, you start making a lot more urine a lot faster than you would if you had water. So your kidney goes into overdrive. But not only that ` when they actually hit your bladder, they've got irritants in them, and those irritants make your bladder feed back more information to your spinal cord, up to your brain, saying, 'I'm full. I'm full. I'm full.' - So I remember back in my uni days, we used to have the myth that if you broke the seal, you needed to pee more. Is that true? - It's a combination of things. That's about the time that your body's started to actually absorb all the alcohol that's making it irritable. And often when we drink quickly, you're drowning it in lots of urine quite quickly, and so therefore it wants to go to the toilet more often. - And what about holding it in? Is it particularly bad to hold it in all the time? - A lot of people will go to the toilet immediately ` soon as their bladder tells them, and what that does is it just starts to train the bladder to get a little bit smaller and a little bit smaller and a little bit smaller. Holding till you feel like you're a bit desperate is fine. You wouldn't want to start ignoring that feedback all the time, because then you're going to stretch your bladder, and actually, your bladder doesn't become very effective at emptying if you've overdistended it. So you wanna listen to your bladder, but not always obey your bladder, if that makes sense. - Well, I'm listening to my bladder right now, and it's telling me it's chocka. 'So far today I've had my usual morning coffee, 'a smoothie and two glasses of water.' An ultrasound will show me exactly what that turns into. - So the big, black blob there, that's your bladder. So that's all your urine that you've made. - This flowmeter will measure the rate at which I wee. I hope I don't get performance anxiety. (CHUCKLES) (LIQUID TRICKLES) And Anna can review the results instantly with this graph. - So the reason we look at these things is we want to make sure that people are emptying their bladders almost to completion. And in addition to that, we wanna know how they're emptying, with what flow they produce, cos that represents, often ` is the bladder pumping enough? Or is the pipe opening up enough? - So how'd I do, Doc? - So it looks really good. So you've emptied really well. And this is your flow here. So I can see here a little bit of hesitancy, probably cos I didn't tell you exactly where to go. But then once you worked it out, away it goes. But it was perfect. Yep. - Ah, good. That's what you like to hear. The piping is working. - The piping looks good. - Well, I do feel much better after that. - Good. And it looks like a really good flow. - Excellent. Well, I'm glad I can go with the flow. (CHUCKLES) - Taking into account what's already in your food is vital before popping a pill. - What do you do if your bread is blooming blue spots? Is mould a health risk? Or can we cut it off and carry on? This could be you. I've lost 28 kilos with the help of Jenny Craig. The food was tasty, the variety available to you is great. VOICEOVER: Start today and save $30 on your first weekly menu on our Rapid Results weight loss plan. Call Jenny Craig now. * - JAYANI: For decades, movies have romanticised the life of the pirate, but very few films feature the scourge of the sea. Scurvy, due to a lack of vitamin C, was rife among sailors and caused bleeding gums, swollen joints, anaemia and death. We've come a long way and learnt some hard lessons about just how essential vitamins and minerals are to our health. But have we gone overboard? At last count, almost half of all Kiwis were taking a supplement or a natural health product. In New Zealand supermarkets alone, over $140 million was spent last year. Supplements claim to help everything from... Then again, I can get all the same benefits by going on a walk. In New Zealand, it's scientifically proven that as a population, our diets can lack certain vital nutrients. To combat this, nutrients are already added to some of our everyday foods ` calcium to soy and rice milk... folic acid to bread... iodine to salt, iron to some breakfast cereals and fluoride to water. As for the thousands of other supplements out there, according to the Ministry of Health, if you're regularly eating from the four key food groups, then chances are you're already getting a good balance of vitamins and minerals and in the right amounts. Come on, boy. (PATS) But there are exceptions. Taking folic acid helps prevent birth defects, so it's recommended for pregnant women or women planning to have a baby. The elderly and those with diets low in animal products need to watch out for low B12 levels. Iron deficiency is common in teenage females and women during their childbearing years. People who don't spend enough time outdoors, don't expose their skin to sunlight or have darker skin are more at risk of vitamin D deficiency. But if you're not deficient in these particular vitamins and minerals, is there any harm in taking supplements you don't need? It may depend on what you're taking. For example, there are two types of vitamin supplements ` fat-soluble and water-soluble. Taking water soluble vitamins like vitamin C and B vitamins at the right dose is pretty harmless. They aren't stored in our bodies, so anything we don't need goes straight through. It might make for pricey pee, but at least the only thing left hurting is the budget. Fat soluble vitamins like A and D, on the other hand, are stored in our fat tissues and liver ` some for a few days, some for up to six months. Overdosing can cause adverse effects and some serious damage. Getting supplement dosage right and taking into account what's already in your food is vital before popping a pill. We're bombarded by ads and influencers suggesting that supplements are a way for better health. But experts agree ` for the majority of us, a healthy, balanced diet is our best insurance policy. (FUNKY BEATBOX MUSIC) - SHAWN: It's been a long time since lunch, and a delicious cheese toastie seems just the answer to conquer those growing hunger pains. (SIGHS) But what do you do if your cheese is covered in white fluff and your bread is blooming blue spots? Is mould a potential health risk? Or can we just calmly cut it off and carry on? Moulds are microscopic fungi that live on plant or animal matter. They grow from tiny spores that can be transported by air, water or insects. When these spores fall on to a piece of food, they grow into mould and give it the colours we see. To eat or not to eat. I'm displaying some not-so-tasty options today to find out where people draw the line. First up, the hard cheese. What do you reckon? Do you go ahead? - I just chop it off. - Yeah? - Nah, I wouldn't, really. - Cheese is kind of mould anyway, isn't it? - That's great. - You go ahead? - Yep. - Mould and all? - Yep, mould and all. - I would trim it up and see what it looked like in the middle, and if it was OK, then I would use it. - Yeah, I definitely would eat that. - Yeah? All right. You've got your cheese, and you go and reach for the chutney, and what about that? You've got a little bit of mould on top of it. - Probably not so much on that. - Spoon it out; throw that bit away and eat the rest. - Nah, nah. - Nah, not really. I wouldn't go for that one. - You've gone to this bread here. What do you reckon? Would you eat that one? - No, no, cos to me, like, with bread, you can always kind of taste that. - Yeah. - Yeah, I'd do it if it was the last one. - I would definitely have a really good look, cos quite often the mould goes right through. - Yeah. - Yeah, I would chuck it. - And how about our less-than-fresh produce? We got this little apple ` small spot there. - I'd probably cut round that. - Think it's going bad. - No, I wouldn't eat it. - No, toss it. - That end's looking a little bit worse for wear. - I would chop out the bad bits, and I would use what I could if I could. - I'll cut it open and see how it feels. - Yeah, I'd probably just shave that off and probably still run it. - Yeah. - That could still be all right. - I'll say no to the carrots. I'll pass on the carrots. Yeah. - I'd eat it. - A wide range of opinions there, but to get a professional verdict, I'm taking a few samples to food-safety expert Dr Brent Seale. So if I have a piece of bread like this one with a small bit of mould on the top of it,... - Yup. - ...would the rest of the bread through the pack be OK? - One piece of bread with a spot on it ` you could probably chuck that one piece away, and as long as you see no other spots, it might be OK for the next day. But then if you see multiple spots throughout the whole loaf of bread, you need to chuck it, definitely. The thing about mould is that when you're looking at it, the spots that you see aren't the only thing. The moulds actually produce hyphae that actually are the roots that are growing throughout the food, and so you're not actually seeing it. - What are some of the health risks with eating mouldy food? - It really comes down to if you're immunocompromised or not. Do you have any severe allergies? That can create problems that can trigger reactions and things like that. But some of the other things for healthy people is some of these moulds actually produce mycotoxins. If you eat enough of it, you can actually get pretty sick. Moulds typically like foods that are quite dry, so like breads and nuts and things like that. It also depends on how dense or how porous they are. So bread, typically, the roots will grow through it quite easily, whereas things like cheeses ` especially a dense, hard cheese ` they might have a harder time actually growing through. - So if we look at these cheeses... - This one in particular I probably wouldn't touch, but if it maybe had one spot on it, you could probably cut it off and be OK. A soft cheese, like a Camembert or Brie ` if it's actually got mould growing in the actual cheese bit, definitely don't go near it. - What about fruits and vegetables? Which of those are more at risk? - They're pretty much all at risk. One of the big things is making sure that your fruits are kept in kind of cooler, drier climates ` not kept in moist environments ` and also that the skin isn't punctured. As soon as the skin is punctured, you give the mould a chance to actually grow and start to take over the entire fruit. - Mould may not only contain mycotoxins but can also be an indicator of other dangers. - For foods that actually have higher water content, there might be other things in there, like bacteria that are growing, that could be potentially dangerous. It could range anywhere from you getting diarrhoea, vomiting, and there are some severe cases of listeria which can cause death in people that are immunocompromised or at risk. - So once we've finished cooking for the night, what's the best way for us to make sure we're safe with our food? - Soon as they're done cooking the meal, wrap it up; keep it covered; stick it directly into the fridge. Don't let it sit on the bench for too long, cos you're giving the opportunity