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Larry King Live
Doctors Give Advice on How to Get and Stay HealthyAired March 29, 2000 - 9:00 p.m. ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
LARRY KING, HOST: Tonight, top-notch doctors give advice that could save your life. Joining me in Washington, Dr. Bernadine Healy, president and CEO of the American Red Cross, in Boston, Dr. Timothy Johnson, medical editor for ABC News; in San Francisco, best-selling author Dr. Dean Ornish; and in Los Angeles, vitamin guru Dr. Art Ulene, plus later, Maureen Reagan tells us about her father's battle with Alzheimer's; tips from Lauren Hutton on keeping fit for life; and Broadway star Robert Goulet on surviving prostate cancer. They're all next on LARRY KING LIVE.
We begin the first segment with each of our doctors who will be with us for the full hour. We thank them all. We'll start with some questions for each.
Dr. Healy, what's the Red Cross doing in Fort Worth?
DR. BERNANDINE HEALY, AMERICAN RED CROSS: Doing in Forth Worth?
KING: With the tornadoes and everything. Were they involved...
HEALY: Oh, the tornadoes. We send our chapters in. We are there on the spot. We also have sent in some people from around the country to deal with it. We're there almost immediately with the tornadoes, and of course we're there as part of the people's -- helping people get through this. We focus not only on the rebuilding of buildings, but on providing havens, providing food, providing coupons so they can get clothes and rebuild their lives, and also helping them negotiate through the complicated government insurance claims that are there, which is a nightmare. That's stress.
KING: We're going to do a whole program on emergency claims and what you with do with stress. You're a cardiologist. We'll get to stress.
HEALY: Dr. Johnson, it was on another network, but it's become famous. How important do you think it was for Katie Couric to come forward on colonscopy?
DR. TIM JOHNSON, MEDICAL EDITOR, ABC NEWS: On colonscopy specifically, I think it was really very important. The thing I find most confusing to people about colon cancer is which of the tests they should have for screening. Remember, this is a cancer that if we screen properly and correctly, we can detect in order to prevent it from ever advancing to the point where we can't cure it. We can't say that about most cancers.
But people wonder, should they have blood tests for their stools? Should they have flexibly the sigmoidscopy, which is done in a doctors's office. Should they have the colonscopy, which is typically done in a clinic setting, and I for one agree with her emphasis, I think colonscopy is the way to go, because it's the only test that looks at the entire colon.
KING: Prevention is the best course of medicine.
Dr. Ornish, you've been famous for a long time. You wrote "Eat More, Weigh Less." You've got your own Web site. And I guess when we think of health and doctors, you come right to mind.
Are we a healthier country.
DR. DEAN ORNISH, AUTHOR, "EAT MORE, WEIGH LESS": I think we're seeing both ends of the spectrum. On one end, I think there's more evidence than ever that the simple choices we make in our diet and lifestyle play a more powerful determinative of our health than I or any other doctor can do. But on the other end, there's a resurgence of interests in the high protein diets, and smoking cigars things like that. So I think we're seeing both things at the same time.
KING: You're not a fan of high-protein diets, I would gather?
ORNISH: No, I am not of high-protein diets. You probably know I did a debate last month with Dr. Atkins and some others, and it makes me want to tear out what's left of my hair when you see how much interest there is. But if you actually look at the data, there are no data showing that high protein diets are good for you. They can help you lose weight in the short run, but you're mortgaging your health in the process.
If you eat a healthful diet -- we can talk more about what that is -- you can lose more weight, you can keep it off without being hungry, without being deprived, and instead of mortgaging your health in the process, we have more data than ever showing that it can actually reverse many of the most common diseases, like heart disease, and maybe even prostate cancer.
KING: Dr. Ulene, are vitamins and minerals now accepted by the medical fraternity, are they taught in medical school? Do most doctors now say it's good to take them?
DR. ART ULENE, "DR. ART ULENE'S COMPLETE GUIDE TO VITAMINS, MINERALS AND HERBS": I think that most doctors do. The unfortunate problem is that only about 20 percent of physicians even discuss vitamin supplements with their patients. And of those who do discuss it, about 15 percent tell their patients, across the board, that they're not necessary. We know this is not true. The government's own studies show most Americans are not getting even the minimum amounts of vitamin they need from the foods they eat, and there are other studies that show in many cases, these minimal amounts are the not the optimal amounts. Somehow, we've got to get the message across -- Dr. Ornish is preaching it -- nutrition does count for so much more than most people realize.
KING: Dr. Ulene, by the way, has a new book called "Dr. Art Ulene's Complete Guide to Vitamins, Minerals and Herbs." There you see its cover. He's the chairman of Feeling Fine, an organization devoting to making Americans feel better through vitamins.
How important is it, Dr. Healy, when a David Letterman -- you're a cardiologist -- has heart surgery? I am one of those who've had it. And then famous figures come forward and discuss it. Does that help?
HEALY: I think it's very powerful, because they show that they have faced this, that they, too, are vulnerable, and in fact, that they can get through it and go right back to work as you were three weeks later, and as Mr. Letterman was.
And I think it also shows that even when you take good care of yourself, you're fit and trim and you eat a prudent diet, and you exercise, that you know, genes play a role, too, and you, too, are going to be vulnerable to diseases. You can't control them all. You know, Larry, I often say, sooner or later, we're all going to be patients.
KING: That's right. Heart disease still our number one killer?
HEALY: Number one killer, both men and women, in the United States.
KING: Will it ever be forecastable? Will we ever be able to say, "You, Phil, are going to have a heart attack within a week?"
HEALY: I think absolutely. I think that we'll be able to see the erosion of those plaques noninvasively, you know, with censors, and be able to say, you know, we're worried and it could be forecastable within a week, within a month. We're not quite there yet.
KING: Dr. Johnson, we going to live to be a hundred soon?
JOHNSON: Soon? I don't think soon. I think probably our biological lifespan is somewhere in the 120-130 range, meaning that's theoretically possible. Obviously, our current life expectancies fall short of that, in the 70s. But I do think over the next 10, 20, 30 years, it will not be uncommon for people to live into their 90s and reach 100.
KING: And as smoking disappears and the like and more attention to health and prevention, that should go up and up, right?
JOHNSON: Well, smoking would be the number one thing if I could do to help improve the health overnight in this country would be to eliminate smoking. We were talking about colon cancer, rightly so, because there's so much to say in terms of our prevention, but I think many in our audience would be shocked to hear that the total number of deaths from lung cancer exceed the number of deaths from breast cancer, prostate cancer and colon cancer combined. So we know what is the cause of the vast majority of lung cancer. We can therefore prevent it if we simply didn't have people start to smoke.
KING: And how much would hearts be better if everybody stopped smoking?
HEALY: Across the board, healthier hearts.
KING: Cigars, cigarettes, goodbye.
HEALY: Cigars are just as bad?
HEALY: Right. We're looking at lung disease. We're looking at heart disease. We're looking at cancer risks. We're looking at skin wrinkles, Larry. Do people know that?
KING: We'll be right back with more. We're going to be joined by Maureen Reagan in the next segment. We're going to talk about a disease we weren't talking about 20 years ago: Alzheimer's.
Don't go away.
(BEGIN VIDEO CLIP, MARCH 6)
KATIE COURIC: As many of you know, my husband, Jay Monahan, was diagnosed with colon cancer in 1997. He had no family history of the disease. After an unbelievably courageous battle, he died nine months later, just two weeks after his 42nd birthday. During this terrible nine-month struggle, motivated by fear and desperation, I got a quick and painful education about this devastating disease.
Some of the statistics I think bear repeating. I learned that colon cancer is the second leading cancer killer in this country: 130,000 people diagnosed every year; 56,000 of them die. It kills more people than any other cancer with the exception of lung cancer. And if we were lucky enough to convince people to stop smoking, colon cancer would have the unfortunate distinction of being at the top of the list.
(END VIDEO CLIP)
KING: We'll break it down into various aspects of medicine, and certainly one that's gotten a great deal of attention is Alzheimer's. It's estimated the number of Americans with Alzheimer's is going to triple in the next 50 years.
Joining us, our panel. Joining us from Sacramento is our good friend Maureen Reagan, a board member of the Alzheimer's Association. Naturally, her father has the disease.
No one gets better with this disease, right, Maureen?
MAUREEN REAGAN, DAUGHTER OF FORMER PRESIDENT RONALD REAGAN: Not yet, Larry, but we're working on it. We're working on ways to prevent this. In your first segment you talked about life expectancy. If we're going to live to be a hundred, we're going to have to solve Alzheimer's.
KING: Is that why we know so much more about it now, people living longer?
REAGAN: Yes, absolutely. People -- it is an age-related disease. At 75 of age, it's about 25 percent. At 85 years of age, it's about 50 percent. And if you get to 90 years of age, you're about 80 percent. So...
KING: So when people were dying at 65, we never heard of it.
REAGAN: Yes, something else got you before the Alzheimer's did, that's right.
KING: What's the worst thing about it, Maureen?
REAGAN: Well, the worst thing about it is that you start out with a death sentence. It's a terminal illness. The brain tells the body everything to do, and eventually it will tell it to stop breathing. But then you come back 180 degrees, and you live for years with a patient who just deteriorates: losing memory, and then finally, function. And through that time you know that there is nothing you can do to make it better.
KING: Dr. Dean Ornish, in the field of prevention, do you think or do you know whether it is preventable, or can we slow down its onset?
ORNISH: There's a lot of evidence that lifestyle choices may begin to affect it. Some studies suggest even things like fish oil capsules may play a role.
But I want to also follow up on something that Dr. Healy said, which is that smoking causes wrinkles, because, as you know, Larry, so many people say things like, you know, am I going to live longer or is it just going to seem longer if I change my diet and lifestyle? And we want to try to show people that it's not about prevention or risk factor reduction, which most people think are really boring. It's about feeling better, having more energy. And when you smoke, when you eat a lot of fatty foods, when you put yourself under stress, your arteries constrict in your brain so you don't think as clearly, in your heart, so you may get chest pain, and even in your sexual organs, which tend to cause impotence.
KING: Yes. Let me get back the Alzheimer's, though, and then I'll come back to you.
KING: Dr. Ulene, do we have any evidence about vitamins and Alzheimer's?
ULENE: Actually, there's one very interesting study in which high doses of vitamin E appeared to prolong the functioning ability to some extent, a very modest effect, but it was an interesting effect. Larry, I believe the answer to diseases like Alzheimer's, heart disease, so many of these diseases is going to lie in an increased commitment to research. If the folks watching tonight could take any message home, it's to support increased research into all of these diseases.
Heart disease kills more people every year than all of the wars in the history of the United States combined. We are making progress, and it is time for us to invest more heavily in this. I believe we can turn over a world free of cancer, free of heart disease and free of Alzheimer's to our grandchildren if we simply commit more to research now.
KING: Maureen, would you agree with that?
REAGAN: Well, I certainly would. I testified before a Senate Appropriations subcommittee just last week, Larry, and the thing that we asked for among other things was an additional $100 million for Alzheimer's research. The money that is available in the National Institutes of Health right now for Alzheimer's research will only fund about 22 percent of the viable grant requests that are received.
It's like a triangle. One leg of it is what the government does. One leg is what the pharmaceutical companies do, and one leg is what we in the Alzheimer's Association do.
But the National Institutes of Health, as a government agency, has an incredible opportunity to use public funds, and the vitamin E studies that are under way right now are because of those grants.
In addition, we're testing Ibuprofen, ginkgo biloba, estrogen, because these are readily available things that we can tell people within five years, if you take such and such at such and such an age, you will help protect yourself in later years.
KING: What does your father take?
REAGAN: My father, he doesn't take medications now...
KING: No medication.
REAGAN: ... but he exercised regularly, as you well know. He always was very finicky about his diet. He took antioxidants. He did all the things that you're supposed to do, and yet, he still has Alzheimer's.
KING: You were at NIH. Is she right?
HEALY: I ran it. I -- there is no question...
KING: You ran NIH.
HEALY: I ran NIH, and it was one of the most magnificent experiences, because you really see, Larry, that the future of every one of us is really NIH. I mean, every one of us has been blessed by NIH's work and every one of us in the future will benefit from it. With regard to Alzheimer's, though, this is a very complicated puzzle. And you know, there are some interesting facts. First of all, did you know that women had more Alzheimer's than men, even when you correct for the fact that they do live longer. Estrogen may or may not play a role but there's provocative information that post- menopausal estrogen may be important, and in a very positive way, that using your brain may help ward off certainly the early phases of loss of...
KING: There are some drugs now that make it come slower, right?
HEALY: That are suggested.
HEALY: But I think -- but the notion, you know, we talk about exercise and with regard to our skeletal health, our muscles, well, in fact, using your brain, as people get older they should be reading, they should be in book clubs, they should be doing crossword puzzles...
KING: But who would use a brain more than a president?
HEALY: Well, of course, that is -- that may well be an exception, but we're talking about things that can prevent and delay the onset of this.
KING: We'll get Dr. Johnson's thoughts and spend a little more -- some more moments with Maureen as well. This is Larry King. Don't go away.
KING: Before we take a call for Maureen, Dr. Timothy Johnson, Dr. Healy was just telling me the one thing we don't have with Alzheimer's is a test to tell us you have it.
JOHNSON: That's right. The only definitive test, unfortunately, is a brain biopsy, and obviously, that's not a usable test for screening.
I firmly believe that with any disease, the only way we're going to have truly effective prevention and/or treatment is to have a precise understanding of the underlying biological mechanisms of that disease.
JOHNSON: We're not there yet with Alzheimer's, but we're getting close. We read hints all the time of new biological discoveries. And I just have a feeling in my bones that within the next decade we will arrive at a point that where we have a precise enough understanding that we really can have some truly effective prevention and treatment...
KING: Next decade? JOHNSON: Next decade, I'm betting on it.
KING: Seymour, Indiana, on the phone, hello?
CALLER: Yes, question for Maureen Reagan.
CALLER: Is Alzheimer's disease a hereditary disease?
REAGAN: Well, there...
KING: Do you fear it?
REAGAN: I don't fear it, no. We've got to stop being afraid of this disease and confront it. I'm at war with Alzheimer's, and I plan to win.
There are some genetic markers that have to do with Alzheimer's, but again, you have to live long enough. So something else may get you first.
KING: You're confident, Dr. Healy -- I know you were shaking your head when Dr. Johnson was talking. You think it's going to happen, too?
HEALY: I think that's right. I think the biology is mature enough. We know about processing enzymes, their related to this amyloid protein, which basically kills nerve cells. And I think if we can find a way to diagnose early, maybe with something like functional MRI, where we can see very early Alzheimer's, and then we can block some of these processing enzymes, we could actually arrest it in its early phase. And if you can arrest it in its early phase for five, 10, you know, you really have the disease essentially cured.
UNIDENTIFIED FEMALE: You've bought a last time.
KING: It's a shame though, isn't it, that you need a famous person to get it before you really focus on it?
HEALY: And how wonderful that President Reagan and Mrs. Reagan have allowed their secret, which could have been a secret, to be given to the public.
KING: That's right, Maureen. They could have kept this quiet.
REAGAN: Well, they could have, but that wouldn't be their way of doing things, would it, Larry?
KING: No. So you remain very confident that -- we're not going to cure your father. We know that, right? That's not going to happen.
REAGAN: No, but we -- we are all determined, we in our family and those of us who work together in the Alzheimer's Association, are determined that we are the last generation of families that will have to live without hope. We believe that with the treatments now, if we can find it early enough, that can buy people some time, and with what we know is coming online, we really believe that the next generation of families that face this disease will at least have hope. They will have something that they can do to make it better.
KING: I salute you. Thanks, Maureen?
REAGAN: Thank you, Larry.
KING: Maureen Reagan. Our panel remains, and we're going to talk about slimness and body fat with Lauren Hutton, and of course doctors Ornish and Ulene will have a lot to say about that as well.
And later, we'll talk about cancer and prostate cancers. Bob Goulet joins us.
Tomorrow night, DA Alex Hunter of Boulder, Colorado will be with us. Don't go away.
KING: We're back. Our panel remains. Joining us now from New York is Lauren Hutton, author of "The Slim Fast Body-Mind-Life Makeover." If we could all look like her -- there you see its cover -- life would be better for all of us.
The concept is you can change, Lauren, is that it?
LAUREN HUTTON, AUTHOR, "THE SLIM FAST BODY-MIND-LIFE MAKEOVER": Yes, it's what the doctors were saying, that health really is about lifestyle. I put on one pound a year from the time I was 30, which most people do, one or two pounds a year. So by the time I was 55, I'd put on 25 pounds, which was over one-fifth of my body weight. And being a model that had never ever dieted -- I couldn't ever get enough to eat -- I just sort of kept doing what I had been doing.
And I finally -- some scuba diving pals of mine turned me on to this stuff in a can, this Slim Fast, and I tried it, and I lost 11 pounds in about a month and a half, two months. So then I...
KING: Without any damage to your health?
HUTTON: Not at all. I went and talked to the doctor who invented it, Dr. Blackburn of MIT and some other -- you know, my own doctors. And no, it's got 24 vitamins and minerals. It's better than almost all the fast food that people eat. I mean, it is better than all that.
And you just have one at breakfast, one at lunch and...
HUTTON: The thing that's bad for us is fat. And even 10 pounds after 40 will start taking years off your life. Even 10 pounds over your weight.
KING: Dr. Ulene -- I mean, Dr. Ornish first, then Dr. Ulene. Dr. Dean Ornish, do you agree with that, that Slim Fast helps?
ORNISH: Well, it's not the approach that I would recommend for most people, because, you know, but I will say most people are confused. You know, they hear about high protein or low protein diets, or traditional or alternative medicine. And they say, these damned doctors can't make up their minds, to hell with them, just bring out the bacon and eggs and don't worry about it.
I testified yesterday before the Senate Appropriations Committee about these issues, and I said, look, there is a way to help people sort out all of these conflicting claims and it's called science. The whole point of science is to help people say what works and what doesn't by saying, "What's the evidence?"
Now to me, the best way to lose weight is to change the type of foods you eat. If you eat primarily fruits, vegetables and grains and beans and foods that are really low in fat naturally, whole foods, you can eat whenever you're hungry, you can eat until you're full, you can lose weight and you can keep it off, because fat has nine calories per gram. Protein and carbohydrates have only four. So if you go from eating a lot of fat to a little fat, you don't have to reduce the amount of food you eat.
KING: Are you saying therefore Slim Fast doesn't work?
ORNISH: I think Slim Fast works, everything works in the short run. The problem is keeping it off. Half the people who've lost weight gain it back within a year, and 97 percent gain it back within five years. We found in our studies the average person lost 25 pounds in the first year and they kept off half that weight, because instead of changing the type -- the amount of food, eating less food, they changed the type of food. Instead of being hungry, you do that.
KING: Lauren -- Lauren, are you keeping yours off?
HUTTON: Yes, and the way you do it is you know what weight you want to be and you weigh yourself every day, and when you find yourself slipping up a couple of pounds, you just, you know, have a can for breakfast and a can for lunch, and that it's it, and a good healthy meal at dinner.
And you know, you watch -- you change your lifestyle. Also for some reason I'm not as hungry as I was. So it's pretty -- it's easy now. It's been about five months, six months.
ORNISH: Dr. Ulene, she says there are -- there are a lot of vitamins in it. Do you support the Slim Fast concept?
ULENE: Larry, I can't imagine anything worse than a can for breakfast, a can for lunch and a good healthy dinner.
(LAUGHTER) But let me put it this way: Does it work? Yes, you can lose weight. Does the popular high-protein diet work to lose weight? Yes. Is it the right way to go, the right way meaning the healthiest way and the way that's most likely to last you for life? Absolutely not.
ULENE: This is the problem with diets. The problem with diets is anyone who goes on one by definition must go off. And as soon as you stop doing those strange things, like a can for breakfast and a can for lunch, you're going to put the weight back on.
I subscribe completely to Dr. Ornish's approach, which is eat well. With Dr. Ornish's approach, you can eat in the morning. You can eat a rich breakfast. You can eat a rich lunch.
KING: What if you can live your life with a can every morning?
ULENE: You know something: There's going to be something for everyone. But this is not about living longer or just weighing the right weight. This is about living in good health until the day you die. When I went...
KING: All right. Hold -- I'm sorry. I'm sorry. Go ahead, finish. I'm sorry, Art.
ULENE: Well, when I went to medical school, if a guy died at 55 of a heart attack, they said he died of natural causes. We know there's nothing natural about that, and there's nothing natural about a can in the morning and a can at lunch.
KING: Dr. Healy, you're a cardiologist. Cardiologists have to be interested in diet. What do you make of the Slim Fast use?
HEALY: Well, first, I think our knowledge in cardiovascular medicines has paved the way fro our recognition of the link between diet and disease, heart disease, and then we found out a few other things, like cancers, I think, going back to the Framingham study.
But I think the key thing is it's not just only diet or only exercise or only vitamins. We're talking about something which is more holistic, if you will. And we have to look at what is a healthy lifestyle: what are the things that we have to do to discipline ourselves to say it is important enough for me in the long rough run to have a healthy body and a healthy mind, a healthy soul, that these are the things that I'm going to incorporate into what I do every day.
Now, occasionally, if you do, you know, a liquid diet or this diet or that diet to lose a couple of pounds, short term you're not going to probably hurt yourself. But in the long term, you're not likely to sustain it.
KING: So you're telling Lauren come back in two years and see if you're still doing it.
HEALY: Yes. I mean, you might get tired of all of that liquid. KING: When we get a break, we'll come back. We'll get more of Lauren's thoughts, and certainly the thoughts of Dr. Tim Johnson. This is LARRY KING LIVE. Don't go away.
KING: We're back with one of our more popular medical shows. We like to do these every once in a while.
And with us is Dr. Bernadine Healy, formerly of that place out in Bethesda, Maryland, and now president and CEO of the American Red Cross -- she ran a lot of what this country's medicine was all about for a long time -- dr. Timothy Johnson of ABC NEWS, its medical editor, in San Francisco -- Dr. Johnson is in Boston; in San Francisco is Dr. Dean Ornish, the author of "Eat More, Weigh Less" and has a new Web site called Ornish.com; and dr. Art Ulene, author of "Dr. Art Ulene's Complete Guide to Vitamins Minerals and Herbs;" and in New York is Lauren Hutton, author of the Slim Fast Body Mind Life Makeover."
We want the thoughts of Dr. Johnson about the liquid diet concept -- Tim.
JOHNSON: Well, when it comes to weight control, there are two sides of the equation: What we take in and what we burn up. And I hate to be a killjoy, but I think for most people weight control is hard work, that is it's hard work in paying attention to what you eat, and it certainly has to be a certain amount of hard work in exercise. I don't know of anybody who maintains long term weight control without regular exercise.
LAUREN HUTTON: Yes.
JOHNSON: I don't think there are any magic formulas, magic pills, magic answers to this; I think it's a lot of hard work.
HUTTON: That's right.
KING: And you have to apply -- it's not just -- Lauren, it's not Slim Fast, right?
HUTTON: No. It's exercise and relaxation and -- but the exercise, you know, if you do an hour every day 20 minutes at a time, 20 minutes in New York City, you know, I'm walking here, walking there and back and then very quickly you've walked 20 minutes. Even in an office building, if you're walking around or you take the stairs instead of, you know, an elevator, you can get 20 minutes a day somehow. And also, it's a life change. I mean, I certainly don't intend to be drinking cans for breakfast for the rest of my life, and I have met people who have lost 50 and a hundred pounds, and they don't do it anymore. They've changed their whole style. And you get so much more energy when you're not overweight, and most of us are.
KING: let me get a call.
Fort Lewis, Washington, hello. CALLER: Larry, my question is for Dr. Ornish.
CALLER: With all the fat-free products on the market today, is it best for someone on a diet to eat these products, or is it best to eat regular foods in moderation?
ORNISH: It's a good question, and it's one of the reasons why people are so confused, because the reason that an Atkins-type diet, a high-protein type diet works, is because so many Americans eat a lot of sugar, and a lot of the fat-free products you talk about are high in sugar. When you eat a lot of sugar, you eat a lot of calories that don't fill you up and make your blood sugar zoom up so your pancreas makes insulin to bring your blood sugar down. But the insulin accelerates the conversion of calories in the fat, so the high-protein diet people say, all carbohydrates are bad, eat meat, and pork rinds and bacon and sausage, because that won't do that. And in some way, there actually is benefit because you're not provoking an instant response, but as I mentioned earlier, you're mortgaging your health.
KING: So are you saying, buy the fat free, or don't buy the fat free?
ORNISH: Don't buy the fat-free if they're high in sugar. Eat the naturally fat-free products, the fruits and vegetables, and grains and beans, then you get the complex carbohydrates that don't provoke an insulin response so you don't gain weight.
KING: By that explanation, would the best of all meals be Cheeios?
ORNISH: No, because Cheerios actually,,.
KING: Cheerios with the skim milk and Sweet 'N Low?
ORNISH: Cheerios are OK, but they have a lot of sugar in them.
KING: Not that much.
ORNISH: A whole wheat cereal doesn't have sugar.
Not that much. You're right.
I think if you can eat the Cheerios with fat-free milk or soy milk, some sliced bananas, some fresh fruits, some whole wheat toast or oatmeal, that's a great breakfast.
HUTTON: But it's a lot more than 220 calories, which is what I get when I slug back a can. Oh come on, of course it does.
KING: And it's faster you're way, too, Lauren. HUTTON: Ye, it takes five seconds, and you save an hour. I love it.
KING: Can you go to the Regency Hotel and order a power breakfast, and say "Bring me a Slim Fast, or do you have to bring your own?"
HUTTON: I am trying to get it in every minibar around the country because I travel all the time.
ORNISH: Instead of eating a can of something that has all of those calories, you can eat a lot more food that is less dense in calorie, get more full, and enjoy the food a lot more fully. That's what I recommend.
HUTTON: Hold on -- what kind of food? And also schedules?
HUTTON: What kind of food? Schedules?
ULENE: There's another important point to make about food, and that is that food contains much more than just sugar and protein. When you're eating whole foods like tomatoes, you're getting lycopene, which may play a preventive role against cancer, you're getting antioxidants. If you mix in a rich variety of foods like soy, you're getting the isoflavones on the soy proteins that can protect your cardiovascular system and improve bone health. You're not going to find those ingredients in a can. There may be 24 vitamins and minerals, but you're leaving a lot behind.
KING: Hold it, Lauren, one second -- Dr. Healy.
HEALY: First, I am delighted to hear this kind of discussion, Larry, about components of food. Nutrition has been the most outrageously neglected science.
KING: Least taught in medical school.
HEALY: Least taught in medical school, and actually neglected by NIH. It's been an area that's not -- it's "woman's work." It's not seen as the real hard science. That's starting to change, and finally we are talking about isoflavones and soy and whether that's useful to reduce prostate cancer or breast cancer or treat women with symptoms of menopause. Finally, we're addressing the nutritional components. But the important thing is, let's not go wacky about it either. Let's not say that this, you know, one compound is going to cure everybody or make everybody live forever. Let's put it in balance.
KING: Lauren, you wanted to add something. I've got to get a break.
HUTTON: Yes, I was just saying, yes, that meals, great healthy meals -- half of the book is recipes and all kinds of different meals. KING: It's not all Slim Fast?
HUTTON: No, not at all.
KING: We'll come back and talk cancer -- thanks, Lauren Hutton, very much for being with us. Robert Goulet will join us. Our panel remains. We'll talk about cancer. He had prostate cancer and successful surgery for it.
Don't go away.
KING: Joining us now from Las Vegas is Robert Goulet. The famed entertainer is a survivor of prostrate cancer. He's discussed it a number of times on this program, and he is one of those pushing public awareness of prostate health, urging people to get the PSA test.
Is that how they found yours, Bob?
ROBERT GOULET: Exactly. I was taking a test because I was doing a musical going on the road and I had to take an insurance policy test, and the doctor at that time, Dr. Kipper in Los Angeles, said why don't you take this PSA test? And I said, what is that? He said, something new. It had only been out about four or five years at that point. I said, what's it for? He said, for prostate cancer. I said, well I don't have it. He said just take the test. I took it and the count was between three and four. Three and four is good. I think anything above that, you have to watch out for. And so about 13 months later, I took another test and I was whipped so I was between seven and eight. And then five months after that, I was within 12 and 13. So they said let's get some more tests, then I had a bone marrow test, MRI, sonar test, and finally a culture test that said you have cancer.
KING: And they did the surgery removing your prostate, right?
GOULET: Exactly, about six months after that. I couldn't take it before because my producer said: I can't give you any time off now, we're booked. And so I had three weeks off in December. The doctors wanted me to take five or six weeks off, but he gave me three. And so therefore, that was worthwhile.
KING: All right, I...
GOULET: And it was a radical prostatectomy.
KING: That means everything out?
KING: OK. Dr. Timothy Johnson, what is prostate cancer?
DR. TIMOTHY JOHNSON, MEDICAL EDITOR, ABC NEWS: Prostate cancer means cancer that grows in that little walnut-shaped gland right underneath the bladder through which passes the tube that carries urine from the bladder. So when that gland...
KING: Only found in men?
JOHNSON: Only found in men. They're the only ones who have prostate glands.
KING: Not found in animals, right?
KING: Not in animals?
JOHNSON: Not in all anyway. I'm not an expert on the prostates of animals, I'm the first to confess. But what I want to stress here is that the PSA test is extremely valuable as a screening test. It alerts you to the fact that the prostate gland is enlarging and producing more of this chemical, but it's not an ultimate diagnosis test. In order to prove what's going on in the prostate, you eventually have to have a biopsy, and that's the only way you can say that an elevated PSA really means prostate cancer. It may simply mean benign enlargement.
So the PSA alerts you to the fact that something may be going on. Then you have to have further testing.
KING: But recommend everybody taking it.
JOHNSON: I recommend all men starting at age 50 having a yearly PSA along with a digital exam, meaning a rectal exam with the doctor's finger, because those two tests are complementary.
KING: You have to do both.
JOHNSON: You have to do both.
KING: Dean Ornish, you worked a lot on this with doctor -- with Michael Milken, who has prostate -- inoperable prostate cancer, but had downed -- he's got his PSA down to zero.
ORNISH: That's right. Well, Mike, is doing the kinds of things that we've been talking about, and he's also, along with Larry Ellison and others, helping to support a study in collaboration with Bill Fehr (ph) at Sloan-Kettering and Peter Carroll at UCSF to see whether we can slow or stop or maybe even reverse the progression of prostate cancer by changing diet and lifestyle. And we're about halfway through it. Our preliminary data are really encouraging. We're finding it does seem to be making a difference in some people.
But I want to make the point that even if the person has surgery, like Robert Goulet has, you also need to talk about changing lifestyle, because half the time even with surgery it comes back within five years.
KING: How can it come back?
ORNISH: Well, actually 30 percent within five years and 50 percent within 10 years, because even though it looks like they got the whole thing there are microscopic metastases. And the kinds of things that Dr. Ulene was talking about, that when you go from a meat- based diet to a plant-based diet, you're getting a double benefit. You're not getting those things that cause heart disease and prostate and colon cancer, but you're getting literally thousands of other substances that are actually protective.
KING: All right. Let me ask Robert Goulet: Have you changed your lifestyle since or have you gone back to eating what you were eating, doing what you were doing?
GOULET: I have always eaten, I think, properly. I don't eat fatty foods and I don't junk foods. We eat meat maybe once every two weeks. I remember meeting Michael backstage somewhere, and he said, no cheeses. I said, aren't soft cheeses OK? He said no cheeses at all.
KING: So you watch your diet. Do you agree, Dr. Ulene, that diet plays a part in prostate cancer?
ULENE: There's no question about it. There's evidence some of the proteins in soy may be protective now against prostate cancer. There's evidence that high consumption of foods containing large amounts of vitamin e may be protective as well.
On this eating score and lifestyle score, too often we make it sound like punishment. And I'd like to point out two things. One is we're talking about eating richly, eating fabulous foods, marvelous salads. You're a California guy part of the time. You know what I'm talking about.
And the second...
KING: A lot of the time, you bet.
ULENE: OK. The second half of my message is that nothing is ever forbidden completely. Once a year on my birthday, everybody knows here in town, I show up at Ruth's Chris Steak House and I bring a lot of guests. And the rule is I get to eat to all -- I get to eat all the leftovers.
KING: You eat the baked potato with the sour cream and butter.
ULENE: Larry, I eat it all. I sit up all night wondering why did I do that and how many more days until my next birthday.
KING: Can I ask you doctor -- is it OK to ask you about prostate cancer? This is very macho.
KING: What do you know about prostate cancer? You're a lady!
HEALY: Oh, a lot. A lot. KING: What do you know?
HEALY: Well, I'll tell you, it's very interesting that prostate cancer has certain similarities to breast cancer. And I think in many ways what the mammogram has done for early detection of breast cancer is what the PSA has done for early protection of prostate cancer.
KING: And you're supportive of what Goulet did, right? You're one that says go in and get it out?
HEALY: Go in and get it out. I mean, we...
KING: There's a lot of controversy.
HEALY: I know there's a lot of controversy, but if you could get -- if it's within that capsule, and there's no evidence of spread, no evidence of it moving into any of the -- just penetrating that capsule, you have close to a chance of a cure. And my feeling is go for the cure.
And remember, even radiation treatment, that -- you're not absolutely assured that you're not going to have problems with...
KING: Because men go through this...
HEALY: ... incontinence and or impotence.
KING: Watchful waiting, radiation, some medication.
HEALY: And watchful waiting.
KING: Because men don't want to have this surgery.
HEALY: Well, and watchful waiting is problematic to me. There's an assumption that maybe when you're at a certain age those extra years of life...
KING: You'll die with it, not of it.
HEALY: Yes, but if you're shooting to live for a hundred, Larry, I mean, there's a...
KING: Go get it.
HEALY: Go get it.
KING: We'll continue with Robert Goulet and our panel, and get his thoughts and the panel's thoughts on that, and then a windup with just the doctors, right after this.
KING: Before we take a call on this, does everyone on the panel agree with Dr. Healy? Do you, Dr. Johnson, that in most cases go for the surgery?
JOHNSON: I think certainly at younger ages, in the 50s and 60s, that's the way to go. I personally think that by the time a man is diagnosed in 70s and 80s I would prefer radiation in most cases.
And I do think that once you reach a certain age -- and nobody can say what that is for any given individual -- but I, for example, would never recommend a radical prostatectomy in a 90-year-old man.
KING: And Bob, you're certainly glad you did it. Are you fearful of it returning?
GOULET: I'm not fearful, because if it comes back, I'm sure that we have all sorts of doctors in the world today with all sorts of new prescriptions and pills, and areas and places to go where you can get rid of all this. The thing that I got -- I get a kick out of, when I had my operation, I was looking at all of these medical journals from all over the world, and they all said the same thing about the prostate operation, the radical prostatectomy. If you live, they said, for five years after that operation, on average you have another year and a half left to live.
So June the 7th I should be dead.
KING: Did it at all affect -- the manhood concept, you know, that old image of manhood -- Dean, do you want to say something?
ORNISH: Yes, I do, because I think that if we're going to take a science-based approach, you have to say it's really not so clear that just because you have it you should cut it out. I mean, intuitively, that might make sense, but there are no randomized trials showing that any of these interventions -- surgery, radiation, hormonal treatments, brachial (ph) therapy -- none of them have been proven to prolong life or prevent the spread of cancer. But they all leave many men impotent or incontinent or both. So rather than...
KING: Well, wouldn't surgery prevent spread if you get it all?
ORNISH: I'm sorry?
KING: If you get a great doctor and you get it all, you've prevented spread.
ORNISH: No. As I said before, a third of the time it comes back in five years even if you think you got it all, because it spread microscopically.
KING: But you got five years.
ORNISH: But you don't know whether it would -- most prostate tumors are pretty slow-growing anyway. Most men are more likely to die with it rather than from it.
Now, I'm not saying... KING: You don't want to be the one that -- you don't want to be the one that says from it?
ORNISH: Well, you don't know. That's the problem.
KING: That's the decision a man faces, right?
ORNISH: It's a hard decision, and it's not necessarily watchful waiting, meaning you're just sitting around watching, waiting for it to grow. If you change your lifestyle, that may also have an impact. That's part of what we want to find out.
KING: Let me get a call in from Albuquerque. Hello.
CALLER: Dr. Ulene, I wanted to find out if there are any over- the-counter natural vitamins to keep the prostate its natural size.
KING: We've seen little products that say "ProstHealth."
ULENE: Well, it's interesting. You're going to see tons of products that claim they can do that. It is interesting that some products, based on the herb saw palmetto, have been shown to improve urinary flow but not necessarily to reduce the size of the prostate. Vitamin e has been shown, people who consume very high quantities of vitamin e have -- appear to have a lower risk of prostate cancer, and indeed soy proteins may be predictive.
Having said that, let me just tell you that I would not go for any specific, individual product as the salvation to a prostate problem, but rather to the comprehensive program that everybody has been talking about.
KING: And, Bob, we asked Maureen. She's very optimistic in the area of Alzheimer's. Do you think we're going to rid ourselves of prostate cancer? You work in it all the time trying to make people aware. Do you think we're going to see it go away? Mr. Goulet?
GOULET: I'm sorry, sir?
KING: Do you think we're going to see prostate cancer end?
GOULET: Gee, I hope so, Larry, my goodness gracious.
I had one other quick story I wanted to tell you. Some young girl sent me a letter saying that her father was a marine, and he had the operation, and he was lying in bed, and he was incompetent and incompetent, and he said, I'm finished, my life is over, I am not a man anymore. He saw me on "Good Morning America" talking about this and how I was back on stage in three weeks in tights and that his daughter heard some noises, went into his bedroom. He was putting on his pants, and his sweater and his shoes, and she said, what are you doing? He says, I am getting in here. I going back to work. If that little twerp can do it, so can I.
Thanks, Robert. Thanks so much for joining us. We'll be back with our remaining moments with our panel, that began it all, and has been us through this, for some more questions on the state of health, right after this.
Tomorrow night on LARRY KING LIVE, you've heard from the Ramseys. Now Boulder district attorney Alex Hunter gives us his side of the story. He'll be our guest for the hour, and he'll take your calls. And then on Friday, a distinguished panel of journalists, including Walter Cronkite, Hugh Downs and Catherine Graham. It's all ahead this week, 9:00 Eastern on CNN.
KING: One more quick call.
In Cote St. Luc, Quebec, hello.
CALLER: Good evening, Larry. My question is to the whole panel. With everything involved in a long and healthy life, what do they feel is the most important thing a person should be paying attention to?
KING: Great question. Let's start with Dr. Johnson. A long and healthy life -- what's the most important thing?
JOHNSON: No smoking.
KING: And if you don't smoke, what's second?
JOHNSON: Then I would say the kind of things we were talking about tonight could be very important. But want to say this: As important as healthy lifestyles and eating habits are -- and I certainly think they are important -- none of them are a hundred percent guaranteed, which is why I stress even if you're living healthy and think you're healthy, you need to do the screening kind of tests we've been talking about tonight -- PSA for prostrate, colonscopy for colon cancer -- because they can find things even when you think you're doing everything right.
KING: And the one thing you can't do anything about is genes.
JOHNSON: That's right.
KING: Dr. Dean Ornish, what's the number one health tip you could give someone?
ORNISH: To realize the most powerful difference in your health are the choice you make every day, not what I or any other doctor can do to you. And I am going to be working with web MDs to set up a Web site to make this kind of information more widely available. In the next few months, you'll be able to get a tailored program that's just right for you by doing that.
KING: We're involved with that on CNN, right?
ORNISH: Exactly. I think they're really the world leaders in this area.
KING: So the main thing is, it's a daily thing. ORNISH: Yes, we think it has to be a new laser, a new drug, something really high-tech or expensive to be powerful, but people don't realize that the simple choices they make everyday are really the most powerful determinates of their health and their happiness.
KING: What's your answer, Dr. Ulene, to that important question? What's the number one thing you'd say?
ULENE: I agree with all the panelists, but I feel I have to add one thing, and that is, pick your parents carefully; genes do count.
KING: But the number one essence would be what, the number one health tip you would give someone beyond not smoking, which is obvious -- that's obvious.
ULENE: I'd put it all together in one sentence: No smoking, good diet and regular physical activity.
KING: Dr. Healy?
HEALY: Larry, I'd have to say mental attitude, because a mental attitude that values yourself has a certain sense of discipline that makes you say that I'm going to do the things that make my life joyful. Part of that is taking care of my physical well being, but also my mental and my spiritual well being. So if you have the right mental attitude, you'll accomplish all of these things we've been talking about today.
KING: Supreme court says it's up to Congress, so this is for all of you, starting with you Dr. Healy: Should the FDA be in charge of tobacco?
HEALY: I think we have to let the legislature decide that.
KING: Would you recommend yes or no if they asked you?
HEALY: Well, I think we have to have a law to define it, because the FDA is in a very precarious position, and it's too important an agency to be constantly a punching bag on this issue.
KING: Dr. Johnson, should they control submit.
JOHNSON: Congress has the axle that they can. We've got to stop the next generation from smoking somehow.
KING: Dr. Ornish?
ORNISH: I agree. Nicotine is a drug, even the tobacco companies finally admitted that, so the FDA should regulate it.
KING: Dr. Ulene.
ULENE: Nicotine is the most dangerous drug in the world and it should be controlled, absolutely. KING: It is the most dangerous drug in the world, would you agree with this?
HEALY: Heroin's pretty bad.
KING: But it ain't third or fourth either.
HEALY: Right. The problem is that it's so prevalent and it's seen as a socially -- or it used to be socially acceptable kind of behavior. So I think that that's why it's dangerous, because it's everywhere.
KING: Is it true if you wiped out tobacco you'd have to close hospital beds?
HEALY: No, of course not. But it is certainly true we would see less cancer, all the problems we were talking about, yes.
KING: Thank you very much, Dr. Bernadine Healy, the president and CEO of the American Red Cross, Dr. Tim Johnson of ABC News, Dr. Dean Ornish. His new Web site is Ornish.com, and Dr. Art Ulene. His new book is "Art Ulene's Complete Guide to Vitamins, Minerals and Herbs."
Stay tuned to CNN and more top -- and a big story coming out of Miami. They're following it closely. Stay tuned for that.
Tomorrow night, Alex Hunter.
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