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Sanjay Gupta MD

What's In Smoke Could Be Deadly; How To Quit Smoking; After Bariatric Surgery Alcohol Affects Differently; Just How Toxic Are We?; Marketing And Childhood Obesity

Aired November 11, 2006 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

SUSAN ROESGEN, CNN ANCHOR: Now in the news, two bombs exploded at a Baghdad market just five minutes apart today. At least six people were killed and nearly three dozen injured. And there were several bombings around Iraq today.
For the first time, entire National Guard combat brigades could be headed back for second tours of duty in Iraq. The Associated Press reports that plans are being developed by the Pentagon to do that. And if that happens, that redeployment would break the 24 month deployment limit.

Meanwhile, the U.S. military is offering $50,000 for information that leads to the reward - to the return, rather of this U.S. Army translator. He was abducted in October while he was visiting his wife in Baghdad.

President Bush will lead the nation in honoring America's veterans today. He's going to lay a wreath at Arlington National Cemetery in about three hours. And we will have live coverage.

Yesterday, the president hosted the dedication of the new Marine Corps Museum in the Washington area.

Your next check have the headlines is coming up at the top of the hour. But first, "HOUSE CALL WITH DR. SANJAY GUPTA" starts right now.

(BEGIN VIDEOTAPE)

UNIDENTIFIED FEMALE (voice-over): It's in the air, could be in what you eat and what you wear. How toxic is the world you live in?

UNIDENTIFIED MALE: It may be that these are perfectly harmless, these chemicals at these levels. Or it might be dangerous.

UNIDENTIFIED MALE: Plus, could weight loss surgery lead to addiction? We investigate some troubling links.

Why is lung cancer a top killer?

UNIDENTIFIED MALE: I would say smoking, smoking, and smoking.

UNIDENTIFIED FEMALE: What you need to know before you light up.

(END VIDEOTAPE)

DR. SANJAY GUPTA, CNN SR. MEDICAL CORRESPONDENT: Good morning and welcome to HOUSE CALL. I'm Dr. Sanjay Gupta.

And this morning, we're looking at some of the most toxic elements in our world. We start with tobacco. About 20 percent of Americans smoke. And what's in that smoke can be deadly.

It's made up of more than 4,000 chemicals, 69 of which are cancer causing. We know lung cancer's the deadliest cancer in both men and women. And the primary cause is smoking. Thelma Gutierrez now with a look at who's most at risk.

(BEGIN VIDEOTAPE)

THELMA GUTIERREZ, CNN CORRESPONDENT (voice-over): It's a solemn routine. Each week, Vickie McDuff sits in this hospital room for chemotherapy she hopes will save her life.

VICKIE MCDUFF, CANCER PATIENT: I guess when I saw the x-ray, it said it all. I knew.

GUTIERREZ: Vickie says it all started with a deep wheezing in her chest. She thought it was pneumonia. Oncologist Dr. Leo Orr of the Donald P. Loeker Cancer Cure Center diagnosed Vickie with stage four lung cancer

MCDUFF: I didn't bargain for this. This is not what I bargained for. I want this time of my life.

GUTIERREZ: But at the age of 54, after surviving breast cancer, Dr. Orr found 11 malignant tumors in Vickie's lungs. The cancer is inoperable.

According to the American Lung Association, African-American men and women have the highest lung cancer incidence rate compared to all other races and ethnicities. And lung cancer is among the top three killers of African-Americans. Why?

DR. ZAB MOSENIFAR, CEDARS SINAI MEDICAL CENTER: I would say smoking, smoking and smoking.

GUTIERREZ: Dr. Zab Mosenifar says studies have actually shown that African-Americans may have different smoking habits, like taking deeper drags, and smoking mentholated cigarettes.

MOSENIFAR: And it's been known that mentholated cigarettes are associated with the higher rate of lung cancer.

GUTIERREZ: Another major factor is exposure to secondhand smoke. As a child, both of Vickie's parents smoked. In her 20s, she smoked up to two packs a day, but she says she hasn't picked up a cigarette for 30 years

MOSENIFAR: Someone who smoked, had parents who smoked, it's almost like doubled the risk of exposure. It's not surprising that she contracted lung cancer. It's one of the sad stories of our society.

GUTIERREZ: Thelma Gutierrez, CNN, Los Angeles.

(END VIDEOTAPE)

GUPTA: Thanks, Thelma. And an update on now Ms. McDuff. She has finished her chemo and her doctors say she is cancer free for the time being. So good luck to you.

And as the doctor in Thelma's piece explained, by smoking and being around parents who smoked, Vickie's risks doubled. So this morning, we're talking about cutting those risks at the beginning, actually cutting the habit.

So here with us doing just that is Dr. Taylor Hays. He's associate director of the Mayo Clinic Nicotine Dependence Center.

First of all, welcome, doctor.

DR. J. TAYLOR HAYS, MAYO CLINIC: Thank you.

GUPTA: You know, it's so interesting. Now this is something that people talk about all the time -- trying to quit smoking. There's a new type of cessation drug which has come on the market called Chantix. Now first of all, what do you think of the drug and who does it really help?

HAYS: The drug is very effective for any smoker who's motivated to quit. It's easy to take. It's just a pill taken twice a day. And it has been shown to be effective in the studies where it's been tried.

GUPTA: So is it -- are we actually substituting nicotine here? How does it work exactly?

HAYS: No, Chantix is not a nicotine agent like nicotine replacement therapy. It's a drug that actually interacts with the receptor in the brain that nicotine attaches to when people smoke. And by attaching to this receptor, it can mimic a few of the effects of nicotine. And it can also block the effects of nicotine that's obtained by smoking. So people don't get the satisfaction. They also get relief of withdrawal and they're able to quit.

GUPTA: Is there anybody who shouldn't take this medication?

HAYS: There are really very few people who can't take the medication. The only people who can't are people with kidney disease, who are on kidney dialysis. And for those people, it probably is something that they should avoid.

GUPTA: So this sounds very promising, I mean, a drug out there for anybody who wants to quit. What is the first step people need to take if they want to quit smoking?

HAYS: Well, the first thing I'd say is medications are never a silver bullet. And the things that people need to do to prepare themselves for quitting are first getting motivated to quit, thinking of the reasons why it's important for them to quit, getting a plan together.

And that plan should include some effective medications like Chantix and nicotine replacement or others, and an effective behavioral program. By that, I mean being able to change the way they think, change some of the behaviors that surround smoking, and then put that plan into action.

GUPTA: You know, it's interesting because so many people who are watching right now, maybe smokers may have tried to quit. Fewer than half of the people who are trying to quit long term actually manage to stop smoking.

First of all, what makes it so difficult? And how excited are you about Chantix actually solving some of those problems?

HAYS: Well, it's difficult because smoking is an addiction. It has all the hallmarks of other addictions. It's -- when people smoke, the nicotine in tobacco becomes addicting. And it is required then to be able to feel normal for them.

Chantix is exciting because it's a new therapy. It's a novel approach to treating nicotine dependence by interacting with this receptor, and is not a nicotine medication like nicotine replacement.

So for people who have tried other drugs and have failed, this is a new approach that hopefully will motivate them to try again.

GUPTA: There are a lot of products out there to help smokers stop. You know, there's patches, there's gums, there's sprays. We're obviously talking about Chantix. But out of those, are there any that you think work particularly well?

HAYS: I actually think they all work well when they're used properly and when they're used in people who are motivated to quit. And there's nothing in any of the data that we've seen in any clinical trials that suggest one of them is far superior to others. And a lot depends on patient preference. If - for instance, someone who's tried something and failed before, trying something different might motivate them to try to quit.

GUPTA: You know, when you talk about these sorts of addictions, nicotine as an addiction in particular, it seems so strong. How do you -- as someone who's an expert in this area, how do you rate it as compared to other addictions?

HAYS: Well, it has, as I said, all the hallmarks of any other addiction. And one of the surgeon general's reports from a number of years ago said it had the same power as cocaine addiction. And probably the main reason is because cigarettes are smoked. And delivering nicotine through smoking is one of the most addictive ways to deliver a drug.

GUPTA: Well, it's interesting. And I appreciate the good work that you're doing because a lot of people are watching right now. Maybe smokers and maybe wanting to quit. So great advice. We really appreciate it. Dr. J. Taylor Hays, thanks for being with us this morning.

Coming up, from smoking to food and alcohol, we're talking about toxic addictions after the break.

UNIDENTIFIED FEMALE: Swapping addiction -- why weight loss surgery may be just a beginning for some battling addiction. And later, marketing food to kids.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: The Internet is potentially way more powerful than television advertising.

(END VIDEO CLIP)

UNIDENTIFIED FEMALE: What you need to know before your kids go surfing.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL. Bariatric surgery, you may know it as gastric bypass or gastric banding. It's surgery on the stomach or the intestines to physically force obese people to eat less.

Now as these operations become increasingly popular, researchers are seeing something strange and troubling starting to happen.

(BEGIN VIDEOTAPE)

PAUL LENTZ: Eleven, twelve.

GUPTA (voice-over): Paul Lentz is intimidating, a lean, 6 foot hospital security guard who leaves no doubt he can subdue a bad guy. This is him before bariatric surgery. Lentz was eating five, six big meals a day. And at nearly 500 pounds, hid his pain.

LENTZ: Kids would look and laugh. Made me feel really bad that I, you know, have to be that heavy.

GUPTA: Lentz realized he didn't have to be that heavy and underwent gastric bypass surgery in 2001. Within six months, he was half his old size, but says he was drinking like he used to eat.

LENTZ: Just to get that feeling, that you know, I feel -- I feel OK.

GUPTA: Paul Lentz wasn't OK, and he wasn't alone, judging by letter after letter to a Web site for weight loss surgery patients. Why? It's a fact. After bariatric surgery, alcohol affects you differently. It passes into the intestine more rapidly than normal. And blood alcohol levels can become high quickly.

DR. PHILIP SCHAUER, AMERICAN SOCIETY FOR BARIATRIC SURGERY: If they're used to drinking a beer, one beer will feel like two beers.

GUPTA: But is that all? Or is there something else? Are people swapping addictions?

DR. NORA VOLKOW, DIR., NATL. INSTITUTE FOR DRUG ABUSE: If a person used to compulsively eat and you remove the fork, they are going to try to generate a new compulsive behavior.

GUPTA: Dr. Volkow says clues to alcohol abuse and overeating lie in the brain. Neural imaging shows a starting contrast between dopamine receptors lit up in a normal brain. And the addicted brain is dully by comparison.

Since dopamines are brain's pleasure chemical, researchers say this may explain why some people crave food or drugs to achieve normal levels of pleasure.

VOLKOW: All of these compulsive behavior is a result of changes or defenses on the way that the brain of this individual functions.

GUPTA: Still, bariatric surgeons insist there's no evidence weight loss surgery actually causes other at addictive behaviors.

UNIDENTIFIED MALE: I would say certainly less than five percent of our patients have a new addiction.

LENTZ: I don't have to worry about my drinking.

GUPTA: As for Paul Lentz, after AA, he's been sober 23 months and is no longer turning to food or booze in his life, but spirituality. For him and others, experts say, you can't blame the brain. But recognizing the role of biology may help better manage addictions.

(END VIDEOTAPE)

GUPTA: And this idea of switching addictions isn't exactly new. We called the Betty Ford Center. And they tell us 25 percent of the alcoholics they treat who relapse switch to a new drug such as opiates.

Now doctors say counseling is the key both before and after weight loss surgery to identify pre-existing conditions.

Stay tuned. More HOUSE CALL after the break.

UNIDENTIFIED FEMALE: How toxic is the world we live in? This man had thousands of dollars worth of tests to find out.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: This is my level on the green bar, and you can see that's way up.

(END VIDEO CLIP)

UNIDENTIFIED FEMALE: The results after the break. But first, this week's medical headline in "The Pulse."

(BEGIN VIDEOTAPE)

JUDY FORTIN, CNN CORRESPONDENT (voice-over): Chemical pollution may have harmed the brains of millions of children around the world, according to a new report in The Lancet. Researchers pinpointed more than 200 toxic chemicals in the environment that they say can lead to autism, attention deficit disorder and mental retardation.

A low carb, high protein and fat diet does not increase risk of coronary heart disease in women, according to a study in The New England Journal of Medicine. The findings also suggest eating fats made from vegetable products like sunflower oil, soy, nugs, as well as certain veggies may moderately reduce the risk of heart disease.

Judy Fortin, CNN.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL. We've been talking about how toxic addictions can be. Now we turn to how many toxins every day people like you and me may already have in our own bodies, whether in the food we eat, the air we breathe, or even the clothes we wear, just how toxic are we?

CNN's Ted Rowlands now with the story of one man's quest to find out, and his disturbing results.

(BEGIN VIDEOTAPE)

TED ROWLANDS, CNN CORRESPONDENT (voice-over): In the modern world, potentially toxic chemicals are everywhere in the obvious, like pesticides, and in the seemingly harmless, like home carpeting. And many of those chemicals have made it inside many of us.

DAVID DUNCAN, SCIENCE JOURNALIST: The problem is like a lot of chemicals that seem wonderful on the one hand, these do get out in the environment.

ROWLANDS: San Francisco science writer David Duncan decided to find out exactly what chemicals are inside his body. National Geographic shelled out $15,000 to have David's blood tested for 320 different chemicals.

DUNCAN: They yanked out, sucked out about 14 bottles of blood.

ROWLANDS: The results reported in the October issue of "National Geographic" showed David's body has detectable levels of 165 different chemicals, including 97 PCBs, which are so toxic they were outlawed in 1977.

There were 16 different pesticides found in David, 10 dioxins, which are linked to cancer, seven different phthalates that have been found in things like shampoo and baby toys, seven different PFAs, a suspected carcinogen used in non-stick pans, three metals, including mercury found in fish, and lead found in oil paint. And finally, there were 25 different PBDEs, chemicals that are very common used as a fire retardant for fabrics and carpet.

DUNCAN: This is my level on the green bar. And you can see that's way up.

ROWLANDS: The amount of fire retardant chemical in David was more than 10 times the average amount found in a recent study of Americans and 200 times the amount found in a group tested from Sweden. The effects are unclear. Lab animals have suffered deformities. David says he doesn't know why his levels are so high.

DUNCAN: It might -- may be that these are perfectly harmless, these chemicals at these levels. Or it might be dangerous.

ROWLANDS: Another shock for David had to do with his mercury levels. At first he tested at five micrograms per liter, well below the level of 10 that's considered high. But then he ate two consecutive meals of fish.

DUNCAN: I had the sword fish for dinner and the halibut for breakfast.

ROWLANDS: Twenty-four hours later, his level of mercury shot up to 12. Medical experts say mercury levels usually fluctuate. Other chemicals, like the ones found in non-stick frying pans can stay in your system for life.

DUNCAN: These are, together, in my inside of me, and in all of us. And they're interacting in ways that is very poorly understood.

ROWLANDS: Health advocates think that chemical exposure could explain rising rates in certain cancers and possibly even be linked to other conditions like autism.

JANET NUDELMAN, BREAST CANCER FUND: We're literally looking at an increasing body of scientific evidence that links chemical exposures to increasing rates of disease.

GOV. ARNOLD SCHWARZENEGGER (R), CALIFORNIA: It is important to know more about how those chemicals build up in our bodies.

ROWLANDS: Governor Arnold Schwarzenegger recently signed legislation making California the first state in the country to have a program that will test volunteers and compare what's inside different people. The challenge then will be to figure out which, if any, of the chemicals are harmful.

UNIDENTIFIED MALE: By spraying a non-toxic weed killer on the jungle growth...

ROWLANDS: Agent Orange, now banned, was considered harmless to humans when it was dumped on the jungles in Vietnam, as was asbestos, which had to be pulled out of millions of buildings after it was linked to cancer. Without more information about the effects of these chemicals, none of us know what, if any, part of our modern world may actually be making us sick.

Ted Rowlands, CNN, San Francisco.

(END VIDEOTAPE)

GUPTA: Wow, Ted, thanks. An amazing story.

Next on HOUSE CALL, you worry about the influence of television on your kids, but what about computer advertising? We have that story coming up.

UNIDENTIFIED FEMALE: From chasing Chester to finding some lucky charms -- find out how experts say these games could be affecting your pocket book and your child's health.

(COMMERCIAL BREAK)

GUPTA: We're back with HOUSE CALL. A new study shows American children and teens are getting bigger bellies. Researchers say belly fat in kids has more than doubled since the 1990s, increasing by more than 65 percent. Remarkable.

This is, of course, just the latest evidence that the United States has a mounting childhood obesity problem. And now a new report looks at whether the way food is marketed to kids might be part of the problem.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Go undercover with Chester Cheetah. Sling syrup for points. Or take a ride on the Pop-Tart slalom. These are the newest Internet games young kids are playing. Hours of free entertainment.

But these are more than just games. The Kaiser Family Foundation calls them adver games because of the ads and characters pushing food products as kids play.

VICKY RIDEOUT, KAISER FAMILY FOUNDATION: As we look at the problem of childhood obesity, and as we look at the possible role of food marketing and perhaps helping to address the problem of childhood obesity, we need to be sure we're looking at online food marketing to kids.

GUPTA: A report by the foundation says eight out of the 10 brands that advertise to children on TV, some healthier than others, are now trying to reach kids on the Internet.

It found 77 unique Web sites which received 12 million visits from children under the age of 12 in just three months. Three- quarters of them featured adver games.

Some critics point to food marketing as one of several reasons American kids are becoming more overweight. The latest government figures show the number of overweight and obese children has risen to 17 percent. That's a steady increase over the last 30 years.

RIDEOUT: The Internet is potentially way more powerful than television advertising ever dreamed of being. But it's also way more challenging in terms of any kind of oversight.

GUPTA: Where television ads are regulated in length, Internet ads for now are only regulated voluntarily. But advertisers point out that the Internet can be used to market healthy food as well as junk food

DANIEL JAFFE, ASSN. OF NATIONAL ADVERTISERS: I believe that if you really did look at these sites, you would find quite a number of foods that are healthy.

GUPTA: Now studies on food ads for kids have stopped short of saying they cause obesity. But experts say there is evidence to show that advertisements do influence what products children buy or urge their parents to buy, and what they eat.

(END VIDEOTAPE)

GUPTA: And you can tune in every week for our continuing coverage on the obesity problem in this country. We're looking at what's working and what's not. And we're keeping our leaders honest. We are committed to this issue.

More HOUSE CALL after this break.

(COMMERCIAL BREAK)

GUPTA: If you missed any of this week show, just go to our Web site, CNN.com/HouseCall. Click on the transcript link. There, you're going to find a library of HOUSE CALL free transcripts. Also, links to my weekly podcast.

From there, click on over to CNN Health page at CNN.com/health for the latest medical headlines and access to our medical library as well.

Unfortunately, we're out of time for today. Make sure to tune to an exciting show we have for next week. We're going to be exploring happiness, how you can find it, and how important it is to our health. E-mail us your questions on happiness to HouseCall@CNN.com. Tune in next weekend to HOUSE CALL at 8:30 Eastern.

Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.

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