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Sanjay Gupta MD

New Research on a Popular Fertility Treatment: How Well Does It Really Work?; Losing Weight By Eating More Food; Creating Designer Babies: Is It a Parent's Right?

Aired January 17, 2009 - 07:30   ET

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

DR. SANJAY GUPTA, CNN HOST: Good morning. Welcome to HOUSE CALL, the show that helps you live longer and stronger.
We've been investigating new research on a popular fertility treatment. How well does it really work? We've got some answers for you.

Plus, losing weight by eating more food. You heard right. I'll have details on that. And some say it's the same as creating designer babies. Couples choosing the gender of their baby and even more than that. Ethical problem for a parent's right. We're discussing it all. That's coming up.

But first, it's a treatment that new evidence shows may largely overcome infertility in women under the age of 40. In vitro fertilization or IVF, you have heard of that. But now, a new study in the "New England Journal of Medicine" looked at more 6,000 women undergoing IVF treatment, they found that younger women had great success of conceiving children through IVF. In fact -- listen to the numbers -- women under the age of 35, the range of success is between 65 percent and 85 percent. It sounds promising. But it's expensive as well.

So, here's a question: would you go overseas to maybe get pregnant?

CNN's Alina Cho looked into it.

(BEGIN VIDEOTAPE)

ELLEN LAVESQUE, MOTHER: So this is from the top of Prague Castle in Prague.

ALINA CHO, CNN CORRESPONDENT (voice-over): It's a vacation that literally changed Ellen and Bob Lavesque's lives forever.

LAVESQUE: We didn't even have passports.

CHO: Their first time abroad, the Lavesques traveled halfway around the globe to the Czech Republic. But sightseeing wasn't their ultimate goal. This was their dream trip for a different reason; they came home with a special souvenir.

LAVESQUE: And then we found out that I was pregnant with twins. CHO: They went to the Czech Republic specifically for in vitro fertilization. Helen and Bob had been trying to get pregnant for years. She was in her early 40s. Doctors told her IVF was the best option, but the cost was huge. And Ellen says her insurance wouldn't cover it.

LAVESQUE: I literally left the office in tears when I heard what the number was. And, of course, you know, just doing in vitro once doesn't necessarily take.

CHO (on camera): And what was that number?

LAVESQUE: That was about 28,000 per attempt.

CHO (voice-over): Enter IVFVacation.com, one of several Web sites for women seeking in vitro fertilization overseas. Here for a fee, almost everything, except airfare, is booked for you and included in the cost -- lodging, medication, IVF, and spa treatment. One-stop shopping.

LAVESQUE: I remember being amazed.

CHO: Ellen had to go twice because the first try didn't take. Each trip cost about $12,000. Still, less than one attempt in the U.S. The Lavesques were lucky. But there are some risks.

DR. ALAN COPPERMAN, INFERTILITY SPECIALIST: We have local and state rules that help govern us, that helped make sure that if that patient's eggs, her husband's sperm, their embryos that are put in place, we're not as sure in many other parts of the world.

UNIDENTIFIED FEMALE: And in the clinic.

CHO: Marcella and Craig Fite, founders of IVFVacation.com disagree. They insist the Czech clinic is safe, reassuring clients that they did it themselves. Marcella is from the Czech Republic and went to her home country for IVF. The Fites now have twins.

CRAIG FITE, FOUNDER, IVFVACATION.COM: There's nothing like getting a phone call from a woman who has been trying for five years to get pregnant and she says, "I'm pregnant, I'm pregnant." You can feel the tears through the phone.

CHO: Ellen Lavesque gave birth to her twins a year and a half ago.

LAVESQUE: Catch the bubble.

CHO: The family she's always wanted, with a little overseas help.

LAVESQUE: This is our dream. A little tiring on occasion, but joyful.

(END VIDEOTAPE)

GUPTA: And that was Alina Cho. Thanks so much. A great story.

You know, as you know if you've been watching the show, January on HOUSE CALLS is all about resolutions, your resolutions. This week, we're focusing on eating better and how you can break those bad food choices. A lot of diets focus on eating less, but how about eating more? Possibly losing weight and becoming healthier in the process. I know it sounds like a gimmick, but it isn't.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Okinawans tend to eat more food than Americans, but are often thinner and live longer. In fact, Okinawa has more centenarians per capita than anywhere else on the planet. You see, despite eating a greater volume of food, they're consuming fewer calories. That's because much of their diet consists of fruits, vegetables, tofu and soups. And all these foods contain a lot of water.

They also follow a tradition called hara hachi bu, pushing away from the table when they're only 80 percent full.

BARBARA ROLLS, PENN STATE PROFESSOR: So, you're starting the day on the run and you get a typical breakfast. And, for 400 calories, you're going to get 3/4 of a cinnamon bun.

GUPTA: Half a world away, Penn State professor, Barbara Rolls, studies the way Americans eat. She says Americans are eating too much fast food. It's food she calls "calorie dense."

ROLLS: And they're sold very cheaply and very conveniently, and they're very easy to over eat.

GUPTA: A burger and a fries, for example, is mostly fat, protein and carbohydrates. Fat is 255 calories per ounce. Carbohydrates and proteins are each 113 calories per ounce. Fruits and vegetable, on the other hand, are mostly water and fiber. Fiber averages 57 calories per ounce. Water -- zero calories.

Rolls thinks we should eat less calorie dense foods, in other words, more fruits and vegetables as well as soup. She calls this "volume metric eating."

ROLLS: Volumetrics helps you to feel full on fewer calories. And we know that eating foods that are low in calorie density helps to fill you up.

GUPTA: So, what about Americans following hara hachi bu?

ROLLS: How do people know if they're 80 percent full if they don't know even when they're 200 percent full?

GUPTA: Instead, Rolls says we should make sure we get full on less.

(END VIDEOTAPE) GUPTA: All right. So we're not going to stop there. We're going to have a lot more on how you can achieve your New Year's resolutions to eat better. A lot of you have that.

Coming up a little bit later, we're going to have tips from a leading diet expert.

But first, this week's medical headlines. Some more recent new details about STDs and sexual health.

(COMMERCIAL BREAK)

GUPTA: Taking a look at this week's medical headlines now.

Trouble at Apple: CEO Steve Jobs is taking a medical leave of absence until the end of June. And Jobs recently announced he's suffering from a hormone imbalance that's caused him to lose weight, a lot of weight, if you look at those pictures. In a letter to his staff, he now says the situation is more complex but he is not elaborating.

Also, some alarming news figures from the CDC about whose most at risk for developing sexually-transmitted diseases. The CDC notes a record number of new Chlamydia cases, more than a million nationally, and the disease occurs three times more often in women than in men. Also, African-Americans who make up 12 percent of the population have 70 percent of gonorrhea cases. And also, another recent study by the CDC shows that one in four teenage girls has HPV, Chlamydia, herpes or Trichomoniasis. Think about that -- one in four girls.

Also this week, in the first study to tract the impact of small sleep disturbances on the body's reaction to cold viruses, researchers at Pittsburgh's Carnegie Mellon University found that people who sleep less than seven hours a night are three times more likely to catch a cold than people who are more well-rested.

More HOUSE CALL after the break.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL.

You know, there may be no better time to talk about eating better. New numbers out this week confirm that Americans are getting bigger than ever. A lot of us have heard this. People who are obese now out-number people who are merely overweight. Both groups, of course, are putting their own lives at risk.

Plus, it is January. The time so many of us refocus on our health priorities. And here to help us break through those bad-eating habits is Doctor Melina Jampolis. She's a physician nutrition specialist in San Francisco. She's also a regular contributor, I should add, to CNNHealth.com.

Welcome.

DR. MELINA JAMPOLIS, PHYSICIAN NUTRITION SPECIALIST: Thank you so much. Glad to be here.

GUPTA: Yes, Happy New Year to you. Yes, thanks.

JAMPOLIS: Happy New Year to you as well.

GUPTA: You know -- thanks. This is such an important topic to us, as you know. I want to get to a survey. A little bit of disheartening news about people who make resolutions, about 1/3 of them are going to break them when the next couple of weeks by the end of January. And 75 percent will break them by the end of March.

Tough -- tough to keep those resolutions. This is what you do. What do you tell people?

JAMPOLIS: Well, it really is. And I think, one of the main reasons that happens is that people don't start with the right foundation to lose weight. They just jump right into it.

And so, I really, when I'm working with patients, I really make sure that they start building the infrastructure, and that's both mental and physical. From a mental standpoint, they have to have realistic expectations ...

GUPTA: Yes.

JAMPOLIS: ... for both the amount of weight and also the rate. You know, you didn't gain the weight in a week or two weeks. You're not going to lose it in a week or two weeks.

And then really, I think one of the biggest mistake where's they fall off track within the first few weeks is that they have this "all- or-nothing" mentality. They either have to be perfect and only eat steamed broccoli and boiled chicken and get to the gym five days a week or they're going back to their old habits. And so, they're setting themselves up for failure from the beginning.

GUPTA: Right. So, you have to have some middle ground that's achievable. What are the lines that you've told our producers?

JAMPOLIS: Yes.

GUPTA: I think it was interesting, and maybe a good segue is, don't just let meals happen. What did you mean by that?

JAMPOLIS: Yes. Well, this is one of the most important mistakes that I see. This is where people get into problems, is they don't plan ahead. They know that they want to lose weight. They have these kind of generic ideas to eat healthier and to try to cut back, but they don't have plans in place.

And not that I want people to spend a lot of time, you know, cooking and preparing meals, but you have to think about what your day is going to look like. If you have a business meeting, do they generally serve pastries? If so, maybe you bring a nutrition bar with you or yogurt and a piece of fruit. If you're running around all afternoon with the kids, taking them to their soccer games and pizza parties, maybe you have some things in the car that you can have healthy snacking options.

If you're going on vacation -- any of these things, you have to have a plan and you have to build the infrastructure for success. And another really important part of that is in the eating environment and its portion control, because one of the things we have -- we live in kind of an obesogenic environment. So, everything is really promoting weight gain.

So, building in portion control. I talk about this all the time, too. So, I actually keep a measuring cup in my cereal box. Every Sunday night, I take a quarter cup of nuts and put it in seven zip- lock bags so I have portion control.

GUPTA: That's great.

JAMPOLIS: Eating off smaller plates. There's lots of things you can do. But these are the kind of changes that you can stick with long term. So, it's not just, "I'm going to eat better and lose weight this year." You actually have a plan and you have infrastructure.

GUPTA: Right. Good tips for an obesogenic society. That's just good term. I haven't heard that. We got a lot of e-mails. You answered some of these emails ...

JAMPOLIS: Yes.

GUPTA: ...all the time on CNNHealth.com.

JAMPOLIS: Yes.

GUPTA: Let's get to a specific one.

JAMPOLIS: OK.

GUPTA: Myra from Illinois asked this, "How long after you change your diet can you expect your cholesterol numbers to decrease?" I'm actually curious about that as well, someone who ...

JAMPOLIS: Yes.

GUPTA: ...occasionally teeters on the high cholesterol numbers. How fast you could see results?

JAMPOLIS: Well, first of all, let me talk a little bit about diet for cholesterol reduction, because some of the recent studies are really exciting. There's a diet called the "portfolio diet." And it's really combines a lot of really heart-healthy things, like low saturated fat, high in soluble fibers, cereal fibers. It has some of the plant sterols that we know to help lower cholesterol, soy protein in almonds.

And researchers show that actually, when they compared this optimal heart healthy diet in the lab to the starting dose of Lipitor, which is a statin, one of popular cholesterol-lowering drugs, that in one month, they had a 30 percent reduction in bad cholesterol. So, really, when you're making these changes in diet, if you're really making an effort and you're combining that with exercise and weight loss, you can see changes within a month.

GUPTA: That's great.

JAMPOLIS: Yes. And it's really exciting -- I mean, a 30 percent reduction. And when they took those findings to the real world, they actually showed that 20 percent of the patients still maintained it, and the average cholesterol reduction when they were living in the real world, eating the real food, plus the heart healthy food, they still maintained a 14 percent reduction in bad cholesterol.

So -- but I say, on the whole, you can start seeing changes in four weeks. I usually retest patients' cholesterol after about three months of a heart healthy, exercise, weight loss-lowering diet.

GUPTA: That's really good, I think, inspiring as well for people who may be too quick sometimes to jump to the medication. Diet can help.

JAMPOLIS: Right.

GUPTA: Let's quickly get to another one if we have time for this.

JAMPOLIS: Sure.

GUPTA: A question from Susan in Georgia who asked this very specific question, doctor. "How can a post menopausal woman lose weight?" She says, "I spend 30 minutes a day at the gym. I don't eat fast food. I'm still overweight." I mean, this is real life, doctor.

JAMPOLIS: Right. Absolutely.

GUPTA: What do you tell someone like her?

JAMPOLIS: Well, first of all, I applaud her for spending 30 minutes in the gym a day ...

GUPTA: Right.

JAMPOLIS: ... and cutting out fast food. But she is definitely -- I talked about this on CNNHealth.com -- she's definitely healthier no matter what. But understand that weight loss is, obviously, an objective for a lot of people. And my advice to her would be for perimenopausal, peri- and post-menopausal women, as estrogen levels drop, your ability to metabolize carbohydrates is also affected.

And so, oftentimes, with women in that weight, in that age category, I tell them to cut back on their total carbohydrates and particularly the refined carbohydrates, the white flour, the white sugar, the sugary beverages, and that may be an effective way to go to help her kind of breakthrough that hurdle.

GUPTA: You're helping a lot of people. You know, there's a lot of people who are serious about this. JAMPOLIS: I hope. That's my goal.

GUPTA: And I appreciate it. You're also a member of our team now at CNNHealth.com. We look forward to having many more of these discussions. I wish we could talk a little longer. But thank you so much for your time today.

JAMPOLIS: Happy to be here. Happy New Year. Be healthy.

GUPTA: And to you. All right, take care.

Now get this -- you may no longer need to leave your home to see the doctor. Find out where some Internet-savvy patients are going online for help.

Plus, learning the gender of a child used to be the most anticipated moment of pregnancy. But new technology is changing that by giving parents some rather controversial options. We've got the details -- just ahead.

(COMMERCIAL BREAK)

GUPTA: You know, you logon to pay bills, to shop, and even chat. But have you ever used the Web to see a doctor? Well, virtual clinics are a booming trend. But how do they compare with seeing a doctor in person?

To help keep up the savvy, Elizabeth Cohen joins us for the top online trends you need to know about -- Elizabeth?

ELIZABETH COHEN, CNN SR. MEDICAL CORRESPONDENT: Sanjay, it's so interesting how in so many ways the Internet has changed everything. We now bank online, we look for houses online, but when it comes to seeing your doctor, that's pretty much the same. You call up to make an appointment, you go to the office, you sit in the waiting room, and you see the doctor. But experts tell me that may start to change in 2009.

Let's meet Michael Casaro (ph). He is a casting director in New York City. And one day, a couple of months ago, he had lots of auditions, he was really having a hard time getting his work done and he didn't feel well. He could feel he strep throat coming on.

So, he didn't want to go to the doctor's office. Instead, he logged into his account at this clinic which offers online services, and an hour later, his doctor popped up on the screen. He had a chat with him, he explained his symptoms. The doctor said, "Well, you've had strep so many times before, it sounds like the same thing," and he called in a prescription for an antibiotic. And Michael Casaro (ph) was very pleased with the attention that he got.

Now, let me -- let's take a look at some of these services, these online services that people are starting to offer very slowly. Video chatting, which we just talked about. In some places, you can instant-message your doctor if you have a question. In other places, you can text your doctor if you've got a quick question. Now, of course, not all physicians are doing this, and these kinds of online communication are never going to replace interacting with the doctor face-to-face, but some people say that they will augment the kind of traditional face-to-face interactions that we all have now with our physicians -- Sanjay?

GUPTA: All right, Elizabeth, thanks. And be sure to view the rest of Elizabeth's top E-health trends by visiting our Web site, CNN.com/empoweredpatient.

Now, you're thinking about going vegetarian? Stay tuned for tips you need to know about when making the big change.

Plus, many Asian couples prefer boys. It's known to be a cultural choice. What if had you the option to choose a boy or a girl? Would you?

(COMMERCIAL BREAK)

GUPTA: And we're back with HOUSE CALL.

Not knowing the sex of a baby until its born is exciting for many couples. But some Asian immigrants are opting for fertility advancement that allows them to choose the sex of the child ahead of time. For a growing number, the choice is more often than not, a boy.

Gender selection is nowadays a reality. But the real question for many: Is it ethical?

Ines Ferre has the story.

(BEGIN VIDEOTAPE)

INES FERRE, CNN EN ESPANOL CORRESPONDENT: The most anticipated moment of pregnancy used to be finding out the sex of a child. But today, having a boy or a girl is a matter of choice, especially among some Asian immigrant couples who often prefer a boy. Fertility specialist, Doctor John Zhang says about 1/3 of his patients are Asian, 70 percent of them want a baby boy.

DR. JOHN ZHANG, FERTILITY SPECIALIST: Because in many countries, the option of gender selection may not be so easy or popular. So when they came here, the first thing they learn, oh, we can do something like that? And they all come. So, that's why you see the typical Asian community, most are the new immigrants.

FERRE: It's a trend that's been studied at Columbia University using Census 2000 figures, which found that second or third children of Asian, Indian, Chinese and Koreans in the U.S. tended to be male if the first child was a girl.

LENA EDLUND, COLUMBIA UNIVERSITY: Two things driving this. One is the preference for some, and the other one is a willingness to do something about it.

FERRE: An increasingly popular technology to do this is called PGD, pre-implantation genetic diagnosis, part of an in vitro procedure where a cell is taken out of the embryo to look the sex before being implanted in the mother.

(on camera): PGD is a technology that was initially used to detect hereditary diseases, but it quickly became popular in determining gender.

(voice-over): The entire procedure raises ethical questions.

ZHANG: Technology always comes first, and our moral standards are trying to follow. The rules and regulations would come after technology.

FERRE: The United States is one of the few countries where the use of pre-implantation genetic diagnosis in sex determination is unregulated.

Ines Ferre, CNN, New York.

(END VIDEOTAPE)

GUPTA: You know, despite the ethical concerns of PGD or pre- implantation genetic diagnosis, as Ines was talking about there, this technology does continue to grow. The American Society of Reproductive Medicine has discouraged PGD solely for sex selection, and many European countries and Canada have banned sex selection in some cases that were unrelated to health purposes.

Now, here's a question: does anyone ever tell that coffee could stunt your growth? What do you think? True or false?

(COMMERCIAL BREAK)

GUPTA: Well, it's time for my favorite segment of the show "Ask the Doctor." Let's get right to it.

Luca in Massachusetts writes this, "Does coffee really stunt your growth?"

Well, that's actually a myth, that sort of decades ago when caffeine was thought to be the cause for osteoporosis, which results in the loss of bone mass. Now, research shows that coffee has no affect either making you taller or shorter, no affect in height whatsoever. Still, you should limit your consumption.

There are some other adverse side effects -- we've talked about this on HOUSE CALL -- upset stomach, nervousness, shakiness, rapid heartbeat, insomnia, irritability as well. It's best to drink coffee in moderation. You get that message a lot. About two to three cups a day is how we define that.

Another question now from Archie in Indiana, writes this, "I have been seriously giving consideration to becoming a vegetarian. What are the pros and cons associated with making a drastic transition in diet plans?" Archie, the biggest concern, if you were to transition to a vegetarian diet would be not getting the same amount of nutrients as before. For instance, protein that people usually get from eating meat help us maintain healthy skin and organs. Tofu, soy products, nuts, whole grains might be some good alternatives for you.

Also in meat, you have vitamin B-12 and Iron. Both are crucial components of red blood cells. They help prevent anemia. To keep these levels up, a vegetarian can eat leafy, green vegetables, beans and soy-enriched cereals.

Now, both meat-based and vegetarian diets are healthy options. Of course, you have to choose the right foods and you got to watch your portions.

Unfortunately, that's all the time we have for today. Make sure to tune in next week as we continue to jump-start your health with some great tips to ease stress, something we all have. Ease of stress in 2009.

Send us your questions. HouseCall@CNN.com. Remember, of course, this is a place for the answers to all of your medical questions. Thanks for watching. I'm Dr. Sanjay Gupta.

More news on CNN starts right now.