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Sanjay Gupta MD

Report Raises Questions About Diet Soda; Cannabis Cure?; Inside Elder Care

Aired July 27, 2013 - 16:30   ET

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

DR. SANJAY GUPTA, CNN HOST: Welcome to SGMD.

Today, a young who says marijuana is saving his life. You're going to see exactly what he means by that and also why real evidence to support medical marijuana is so hard to pin down in this country.

Also, Morgan Spurlock is going to stop by to talk about the emotional experience of putting his own grandmother into a nursing home.

But, first, it has no calories. It has no sugar, it's healthy, right? Well, not so fast, at least according to a new report.

(BEGIN VIDEO CLIP)

GUPTA (voice-over): Artificial sweeteners have been under fire for years, from some experts suggesting they're bad for your health.

Well, now, Purdue University researchers are fueling that debate. They're saying sweeteners in diet beverages may increase your risk of obesity, heart disease, diabetes, and even stroke. Their editorial is published in the journal "Trends in Endocrinology and Metabolism." It's the review of a dozen of long-term scientific studies.

(END VIDEO CLIP)

GUPTA: So, I want to bring in physician, nutrition specialist and our friend, Dr. Melina Jampolis.

Thanks so much for joining us. I know you keep an eye on these stories as I do. And as you know, artificial sweeteners in diet drinks are FDA approved. They are regulated for safety. We did talk to Coke, Melina, as well. They said that most studies do not show a link to weight gain or any harm.

We talked to the American Beverage Association. They gave us this statement. They said that this was an opinion piece, not a scientific study. Low calorie sweeteners are some of the most studied and reviewed ingredients in the food supply today. They are safe and they are an effective tool in weight loss and weight management, according to decades of scientific research and regulatory agencies around the globe.

You've heard these statements before. You've seen this new review, this new opinion piece. Well, what's your take on it? DR. MELINA JAMPOLIS, PHYSICIAN NUTRITION SPECIALIST: Well, I mean, I think there were two large studies that came out in the past year, showing an increased risk of both stroke and type 2 diabetes with higher levels of diet soda consumption.

Now, again, we can't really determine cause and effect, but I think the bottom line is that just because these are low calorie or don't have sugar doesn't mean that they're completely safe or risk-free.

Again, we don't have any nail in the coffin data, but I think the two studies that came out this year really bear more flashing out.

GUPTA: Yes, and what you're describing I think as something that people refer to as reverse causality.

JAMPOLIS: Exactly.

GUPTA: Do people who are already at risk of these things start drinking more of these diet drinks, for example, or do the diet drinks cause them actually to gain weight. Now, one thing I find interesting and we've talked about this a little bit in the past. But some people will say, look, they crave sugar more after consuming the artificial type. Does that really happen, do you think?

JAMPOLIS: Yes, that's a really interesting question. And the science of hunger and cravings is very complex. We don't even fully understand it when it comes to regular sugar and with artificial sweeteners we have even less of an understanding. But what we know is that there are hundreds of times sweeter than regular sugar.

So, over time when you consume them, you really could become desensitized to the normal sweetness of things like fruit and need higher and higher levels to feel satisfied.

GUPTA: What about foods? We talk a lot about drinks but what about these artificial sweeteners in foods?

JAMPOLIS: My personal opinion is that it is not as clinically relevant, because in this case, you're actually combining the taste of sweetness with calories. So there would be a more appropriate response to that food group and actually if some of my patients really love drinking diet sodas, I say at the very least, drink it with a meal.

So, I think we need to look into this. We need to see the interaction, but I think associating calories with sweetness is a more physiologic approach to nutrition and digestion.

GUPTA: So, bottom line, Melina, and I think I may know the answer from you specifically, if you were drinking a diet or a regular soda, you had the choice between the two -- for you or your patient, let's say -- what would you recommend?

JAMPOLIS: Well, from a health perspective, neither is a really good option. But if we're talking about weight, I would still go with the diet soda -- unless you find yourself doing all the right things and very resistant to weight loss or at high risk of stroke or diabetes, I really would discourage you from having any of those. But diet at the end of the day, and you can even try a soda sweetened with Stevia which may turn out to be a better option. But, again, we don't know, more research needs to be done.

GUPTA: And water is always a good option, I know you say as well.

JAMPOLIS: Right. And, of course, water would be my first choice, water, green tea, coffee which actually has favorable effects on disease outcomes.

GUPTA: We'll have you back to talk about that sometimes. Thanks a lot, Doc. See you soon.

JAMPOLIS: Thanks. Take care.

GUPTA: Doctors and patients they complain all the time about red tape, and about insurance companies. So, what happens if a doctor says, the heck with it? Well, this summer a family doctor in South Portland, Maine, decided to give that a try.

CNN's Christine Romans went to see how it's going.

(BEGIN VIDEOTAPE)

CHRISTINE ROMANS, CNN BUSINESS CORRESPONDENT (voice-over): Dr. Michael Ciampi was fed up.

DR. MICHAEL CIAMPI, FAMILY PHYSICIAN: Just have a seat.

ROMANS: The family doctor from Portland, Maine, used to do lots of paperwork -- so much it was taking time from his patients. So earlier this year, he stopped taking Medicare and other insurance altogether.

CIAMPI: We ask patients to pay at the time of service just like you would be expected to pay at time of service at your garage, at the barber shop, or at the grocery store.

ROMANS: Under his new system, Dr. Ciampi's prices are clearly marked on his Web site: $75 for an office visit, $150 for a complete physical. That's roughly in line with how much he had been receiving from Medicare and private insurance plans. With less paperwork, his operating costs are much lower as well.

CIAMPI: We've had real cost savings already in that that we have been able to cut the staff down. We have one full-time employee to support me, and she answers phones and draws blood and so forth. And so, that's been a huge savings.

ROMANS: He says he now has more time to focus on his patients and even make house calls.

CIAMPI: So, how are you doing, Rudy?

ROMANS: But for many patients, they can't pay out-of- pocket. Dr. Ciampi says he's lost a quarter of his roughly 2,000 patients. But he expects others to take their place.

CIAMPI: Hey, God bless.

ROMANS: He admits his model works best for those who either lack insurance or who have high deductibles.

An hour north of Portland, another family practitioner, Dr. Michael Clark, understands Ciampi's frustration.

DR. MICHAEL CLARK, FAMILY PRACTITIONER: The idea of a streamlined, simplified billing and collection practice is very attractive. A lot of us hunger for a simpler structure to our practices where it can just be about the care we give to patients.

ROMANS: But in this rural community, Dr. Clark felt he simply couldn't turn away as many senior patients who are reliant on Medicare. And some experts say other groups would also be vulnerable.

UWE REINHARDT, PROFESSOR, PRINCETON UNIVERSITY: There are not that many patients who are able to put up with this. Some very rich patients, of course, they could do this. But a lot of low-income people couldn't afford the fees.

ROMANS: But with endless bureaucracy and costs that often seem out of control, some doctors are trying different tactics to stay in business.

(END VIDEOTAPE)

GUPTA: And Christine joins us now.

You know, it's interesting when we look at the statistics about 90 percent of doctors roughly still take insurance but the trend that you're describing here is growing. I'm curious just from a moral perspective -- is there a moral sort of, they feel an obligation?

ROMANS: You know, rural doctors struggle with it more because they want to make sure there's other choices for their patients, right? But it cuts both ways. Some of these doctors, they'll lose 20 percent to 25 percent of their patient base, they'll lose customers who would have been paying through insurance or Medicare. So, they're going to have a smaller patient base to choose from but those people will be paying cash or credit.

But many of them say, look, in the case of this doctor, house calls. He can make house calls now. That's almost in a way improving care for his patients and that's really important to him.

GUPTA: You were just saying $75 for a house call.

ROMANS: I'd pay it.

GUPTA: Is it a lower price for him or how did he figure it out?

ROMANS: It's right in line with what insurance or Medicare would have reimbursed him. But he doesn't have any of the overhead. So, he doesn't have an employee, an extra employee who's just chasing after all of this paperwork, cuts the red tape and that's what makes the difference for his very small practice.

GUPTA: That's how he makes it up. I'd like to check in with this doctor in a year.

ROMANS: We will.

GUPTA: See what happens with him.

ROMANS: We will.

GUPTA: Thanks for joining us. We appreciate it.

ROMANS: You're welcome.

GUPTA: Up next, we've got something edgy for you, this man has a severe disorder of the lungs and diaphragm, but wait until you hear what happens when he smokes marijuana.

(COMMERCIAL BREAK)

GUPTA: Eighteen states now allow the use of marijuana to treat at least some medical conditions, that includes Colorado and Washington state, where voters also decided that any marijuana use by adults should be legal.

The federal government still says this is against the law, by the way. And that leaves doctors and their patients in this weird kind of limbo. But for one young man I met in Colorado, the weed has had a dramatic effect for him.

(BEGIN VIDEOTAPE)

CHAZ MOORE, 19-YEAR-OLD: I always have two strains --

GUPTA (voice-over): Meet 19-year-old Chaz Moore. He uses many different strains of marijuana to treat his rare disorder of the diaphragm.

MOORE: My abs, like, lock up.

GUPTA: That's why he's talking this way, almost speaking in hiccups like he can't catch his breath. It's called myoclonus diaphragmatic flutter.

(on camera): This fluttering here, it's annoying but it becomes painful pretty quickly I imagine.

MOORE: Yes. After, like, 15, 20 minutes is what I can, like, start to really feel it.

GUPTA (voice-over): He's about to show me how the marijuana works for him. He's been convulsing now for seven minutes.

(on camera): How quickly do you expect this to work? MOORE: Within, like, the first five minutes.

And I'm done, like --

GUPTA: That's it?

MOORE: That's it is.

GUPTA (voice-over): It was actually less than a minute.

MOORE: Depending on attack and the day, like, it will work within the first couple hits.

GUPTA: Hear how his voice is completely different. That attack lasted eight minutes.

(END VIDEOTAPE)

GUPTA: Now, this is obviously not conventional therapy, but for Chaz, smoking this has had a dramatic effect for him.

Now, the question you are probably asking, what do the studies say about this? And that's the problem. There really aren't any studies. This is anecdotal evidence because it's illegal to study in this country and Chaz's condition is rare.

Doctors in those 18 medical marijuana states, by the way, they do prescribe it for a variety of conditions. Now, in terms of real evidence, the most solid support for cannabis is as a way to suppress nausea, as a pain medication and for some types of nerve damage. There are studies looking at effectiveness in a wide range of conditions including people with M.S., epilepsy, inflammatory bowel disease, PTSD and schizophrenia to name a few.

You can learn a lot more about this. It's fascinating stuff. Watch my documentary. It's called "Weed." I traveled all over the world looking for answers to some of these questions.

You're going to see what I uncovered. That's Sunday, August 11th, 8:00 p.m. Eastern, right here on CNN.

You know, a lot of us like to maintain our personal space these days, maybe more than ever, but at one New Mexico restaurant, the customers, they don't seem to mind a little PDA, Tim Harris, he's the owner of Tim's Place Restaurant. He said the hugs are worth the trip, and the best part, they're free.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Breakfast, lunch and hugs.

TIM HARRIS, RESTAURANT OWNER: The hugs are free, no charge at all.

GUPTA: That's what's on the menu at Tim's Place Restaurant in Albuquerque. This is Tim Harris. He's the owner and he has Down syndrome. T. HARRIS: I do have Down syndrome. I have a disability, but I have the ability to make tons of friends, it feels awesome.

GUPTA: The atmosphere for customers is equally awesome.

Walk in the door, get a hug. Only if you want one, of course. Serve that up with a side of green chili cheese grits. You have a recipe for the world's friendliest restaurant.

UNIDENTIFIED FEMALE: We come here for a therapeutic hug every weekend because after a long week of work, we both need it.

GUPTA: But Tim's dad Keith wasn't always so sure about the idea.

KEITH HARRIS, FATHER OF TIM HARRIS: At first, I can say, that not even I really took him all that seriously, but we began to realized it might be a great, great way for Tim to have an independent life.

GUPTA: Keith helped his son start the business, and then got out of his way.

UNIDENTIFIED MALE: (INAUDIBLE). It's my signature.

GUPTA: The best part for dad is sitting back and watching the show as a customer.

K. HARRIS: Our world, our society, I think, in many ways has become so sterile that a restaurant experience is a transaction and here it's an experience, a human experience. And that's the magic.

GUPTA: As for Tim --

T. HARRIS: I am a ladies man, but I do have a girlfriend, though.

GUPTA: His favorite part is the hugs.

T. HARRIS: I'm almost at 40,000 hugs. I am excited.

(END VIDEOTAPE)

GUPTA: I think we could probably call that the world's friendliest restaurant, looks like it to me. Good stuff, Tim. Thanks for the hugs.

Up next, planning care for an aging population. Make your parents? Morgan Spurlock is here with a sneak peek at Sunday night's brand new "INSIDE MAN."

(COMMERCIAL BREAK)

GUPTA: End-of-life planning, you know, it's something that no one wants to talk about, let alone think about. These are tough conversations to have.

But on this weekend's brand-new "INSIDE MAN", elder care gets personal for our very own Morgan Spurlock. (BEGIN VIDEOTAPE)

MORGAN SPURLOCK, INSIDE MAN (voice-over): Trudy (ph) still has an active life even if it is maintained by our family. Every week someone helps her with her grocery shopping.

(on camera): OK.

(voice-over): And drives her to her weekly appointment at the beauty parlor.

(on camera): Peggy, how long has Trudy been coming here?

UNIDENTIFIED FEMALE: She first started coming when I first opened the shop 41 years ago.

SPURLOCK: Wow.

(voice-over): But this week, Trudy has a monumental event, her 74th high school reunion and I get to be her date.

(on camera): One, two, three, big smile, Truds.

UNIDENTIFIED FEMALE: That's good.

(END VIDEOTAPE)

GUPTA: So, in this episode, you go back to West Virginia.

SPURLOCK: Yes.

GUPTA: And you move in with your 91 grandmother.

SPURLOCK: It's like "bosom buddies." I called her up on the phone, I said, hey, Tudy (ph), how's you like to have a roommate for a week, week and a half. And she's like, come on down, bring whoever you want.

GUPTA: Did he mind the cameras and the fuss?

SPURLOCK: No, she was great. The whole idea was to show what elderly people have to go through, the health problems they may face, you know, how they have to manage, you know, their medicine or their doctors' appointments, whatever it may be and she's 91 and still going, you know, and I want to move in with you and see what it's really like.

GUPTA: You wanted to tackle this. Topic of elder care and it's a topic that comes up a lot in health care overall. It's part of the Affordable Care Act and thinking of health care in the future --

SPURLOCK: Yes.

GUPTA: -- but you did it in a personal way. So close to home.

What made you do that? SPURLOCK: I mean, for me I have such a close relationship with my family and I love my grandparents and it was one of those things where I wanted to -- I want to kind of tell it just from my point of view about how we don't think about these things or we don't prepare for them, you know, my grandmother, you know, was kind of scraping by on the Social Security she would get every month and, you know, when you're that age, all you need is one thing to go wrong and it can be problematic, you know? And thank goodness she had my father and my aunt there to take care of her, but a lot of people don't have that.

GUPTA: Right.

SPURLOCK: And what you learn over the course of the show is that getting old and dying can be expensive if we don't plan for it.

GUPTA: And people talk about it. I mean, the vast majority of the health care dollars that we spend on our own lives are spent in the last five years of life.

SPURLOCK: That's right.

GUPTA: There's a lot of decisions. Did you have discussions with your grandmother about the types of things that she would want, not want?

SPURLOCK: Yes. If she'd had these discussions with my dad and my aunt who are basically -- they are basically her signatories, they basically had the right to decide what would happen to her once she became unconscious.

And she -- they had very open conversations, that she didn't want to be plugged into a machine. She didn't want to be kept alive, she wanted to, you know, she wanted just to this go out, you know, the way God intended and it was -- I mean, and those conversations what you realize is a lot of people don't talk about those --

GUPTA: Right.

SPURLOCK: -- those types of things because we all want to believe we're going to live forever and the reality is we're not.

GUPTA: I can't -- I'm a doc and I have a hard time having those. I know I should. With my parents and grandparents, but they are incredibly hard conversations.

SPURLOCK: You don't want to think about it.

GUPTA: You're forced to confront, you know, your mortality and it's just an unpleasant thing. How will people feel when they watch this documentary, do you think?

SPURLOCK: I think you -- it's such a lovely story. It's a beautiful story and I think you'll feel moved. I think you'll be touched and I think you'll be eternally grateful for the beautiful people you still have in your lives, your mothers, your fathers, your grandfathers and grandmothers and it will make you reach out and talk to them and hopefully take care of them.

GUPTA: Give them a call.

SPURLOCK: Get on the phone immediately.

GUPTA: Thanks again. Really appreciate it.

SPURLOCK: Great seeing you.

GUPTA: You, too, thank you.

Again, these are difficult conversations to have but so important to have as well, make this serves as a wake-up call to start those conversations with your loved ones.

"Inside Elder Care" debuts this Sunday night 10:00 p.m. Eastern, right here on CNN.

And we'll be back right with today's "Chasing Life" right after this.

(COMMERCIAL BREAK)

GUPTA: We're just about a month and a half away now from race day. That's when the "Fit Nation" six-packs will jump into the Pacific Ocean and begin the Malibu triathlon. They are training hard to swim, to bike and to run and last time we checked in with the ladies. So, now, I want to check in with the fellas.

(BEGIN VIDEOTAPE)

UNIDENTIFIED MALE: Good morning, "Fit Nation."

WILL CLEVELAND, FIT NATION TRIATHLETE: Basically everything's been going well.

DOUGLAS MOGLE, FIT NATION TRIATHLETE: Douglas Mogle here, checking in from Atlanta, Georgia.

UNIDENTIFIED FEMALE: One, two, three.

STACY MANTOOTH, FIT NATION TRIATHLETE: When I started this whole journey, I couldn't really run 40 seconds, and now I'm a runner.

UNIDENTIFIED MALE: Go!

UNIDENTIFEID FEMALE: It's not about being the leader or not, that we're stronger together than we are apart.

CLEVELAND: Working out on a regular basis, watching my weight, trying to eat right.

UNIDENTIFIED FEMALE: It's about the rhythm of your stroke.

MOGLE: You know, I'm at the point now that I know I'm going to finish the race. But finishing is no longer good enough for me.

MANTOOTH: I won't say this has been easy. It's been one of the hardest things I've ever done. Has it been worth it? Absolutely.

UNIDENTIFIED FEMALE: Whoo!

(END VIDEOTAPE)

GUPTA: "Chasing Life" today as heat waves continue to sweep the country, society so hot out there. I want to remind you of a couple of things. First and foremost, use your sun sunscreen, it protects the skin but keeps you cool. If you do get burned, though, don't wait, medicate.

You know, a sunburn is essentially just an inflammation of the skin. So, taking an over-the-counter anti-inflammatory can help with swelling and redness and helps right away.

Next up, moisturize, aloe vera is a good idea but look for lotions that have vitamins C and E, it will help promote the healing of the skin. For more relief, you can try soaking in a cool bath, I've done it recently. Some experts suggest adding a tablespoon of baking soda or white vinegar.

And remember this, symptoms from a sunburn, they tend to develop up to six hours after the exposure. So, even if you see a little bit of pink during the day, take cover. Don't stay out. You'll just make it worse.

That's going to wrap things up for SGMD. But do stay connected with me at CNN.com/Sanjay and let's keep the conversation going on Twitter @DrSanjayGupta.

Time now to get you a check of the top stories in "CNN NEWSROOM" with Don Lemon.