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SANJAY GUPTA MD
Giffords Update; Alzheimer's Tragedy; Doctor: Limit Sugar, It's a Toxin
Aired April 30, 2011 - 07:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DR. SANJAY GUPTA, HOST: Thanks for joining us. I'm Dr. Sanjay Gupta.
We got a lot to talk about this morning.
First off, Congresswoman Gabrielle Giffords, Gabby -- she left the rehab hospital this week so she could watch her husband lift off into space. We're going to have an update on how she's doing. I'm also going to take you inside an O.R., an operating room, to demonstrate how we neurosurgeons do the operation that just may have saved her life.
Also this weekend, my friend Larry King, he has a special about Alzheimer's disease. It's devastating for any family it touches. You're going to see what I told Larry.
Also, I had a fascinating conversation with a doctor who said that sugar isn't just bad for you, it's toxic. I couldn't let it go with that. You'll see what I mean.
Let's get started.
GUPTA: First up, though, the shuttle launch.
GUPTA (voice-over): The next to last shuttle mission ever was supposed to take off Friday afternoon. But just a few hours before the scheduled launch, NASA put things on hold. Up till a problem with the heating system could be sorted out.
Among the hundreds of thousands of speculators was Congresswoman Gabrielle Giffords of Arizona. That's because her husband, Mark Kelly, is the shuttle commander.
Now, Giffords left a Houston hospital earlier in the week to travel to Kennedy Space Center. She's been recuperating from a gunshot wound to the head from an assassination attempt in January.
Now, you can just make her out there, boarding the plane to Florida -- seeing her walk, by herself. It's a huge milestone.
(END VIDEOTAPE0 GUPTA: And, lately, I've been doing some digging into what people call a remarkable medical care that Gabby has been receiving. One key part of that was the operation that took place just about an hour or so after being shot. It's something that was developed on the battlefields and it's something that I do all the time at my other job.
GUPTA: Now, the operation Congresswoman Giffords had done is a pretty commonly performed one by neurosurgeons. It's called a craniectomy, specifically a hemi-craniectomy where you're removing almost half the skull on one side of the brain here.
Now, the reason you want to do this is to decrease the swelling from that primary injury. What we heard about Congresswoman Giffords, she had a bullet wound that entered the front over here on the left side and exited somewhere around here. Not much you can do about the bullet injury, but you want to try to decrease that swelling as quickly as possible and you do it typically with a series of drills, this one first where you're actually making holes in the skull, and you take another drill over here, where you actually are connecting the dots between all these various holes.
The goal is to try and get this bone off, again, while minimizing damage to the brain underneath and take that bone off as quickly as possible.
Now, with the brain, unlike other organs in the body, it really has no place to swell if it gets injured. The only place is really down here and what's called a herniation and that's what can be devastating neurologically, can even lead to death.
This bone, interestingly, actually gets stored. It gets saved. It gets put in the refrigerator to be put back in at a later time.
Congresswoman Giffords will have the skin closed at that time of her operation and because she'll have a little concavity, because of the lack of the bone, she may be wearing a helmet until the bone is put back in place.
But even with this bone gone, someone can fly. They can move around. The risk of infection is pretty minimal. And once you get the bone back in, cosmetically, she should look pretty close to what she looked before.
GUPTA: We'll certainly keep you posted with the latest word on her condition.
(BEGIN VIDEO CLIP)
GUPTA (voice-over): We're going to have much more of her remarkable story, those critical decisions, the moments of good luck, you can see it all on my special "Saving Gabby Giffords." That's Sunday, May 8th, 7:00 p.m. Eastern.
(END VIDEO CLIP)
GUPTA: Now on to Alzheimer's disease.
You know, in medicine, we're seeing this explosion of knowledge about diagnosing the disease not matched by ways to cure it. I can rattle of lots of numbers, like number six, for example, among leading causes of death in the United States -- 5.4 million Americans living with Alzheimer's expected to triple in the next 40 years. But, you know, numbers are just that -- numbers. It's the stories that really get to you.
My friend Larry King has collected some really great ones for a special he has this weekend. One, NFL star Terrell Owens, who's been carrying for his grandmother. She got Alzheimer's in her early 60s.
Now, ahead of this weekend's special called "Unthinkable: The Alzheimer's Epidemic," I did meet up with Larry King to talk about a better understanding of what's going on in the brain.
LARRY KING, CNN HOST: All right. Well, how does Alzheimer's affect the brain?
GUPTA: Well, let me show you here if we can look at this animation. When you look deep inside the brain, what you're looking for are neurons. People typically know that word, that's the brain cells, so to speak. And they're conducting signals all the time. This what makes your body --
KING: To the rest of the body, right?
GUPTA: Yes. They go to each other and they go the rest of the body. Then, all of a sudden, you can see what's happened here, Larry. Two things, first of all, you got these proteins called plaques and tangles and those cells in there, not only do they stop working well, but they actually start to die. So, part of your brain actually is shrinking away in addition to not working well.
KING: Is that the memory part?
GUPTA: The memory part is often affected first. But what people don't realize about Alzheimer's is that it really does affect the whole brain. So, people start having all sorts of different problems with movement.
GUPTA: They can have headaches. But their movement, their swallowing, their ability to, you know, have normal respirations, control their heart rate, their heart beat, all of that. So, that's why Alzheimer's is typically fatal.
You know, when you think about someone losing their memory, you say, well, how does that end up, you know, causing someone's death? That affects the whole brain typically in the long run.
KING: So, it doesn't tell the kidney what to do?
GUPTA: Right. The body starts to shut down.
KING: Do we know why someone gets it?
GUPTA: We're not 100 percent sure. It appears to be there's some hereditary component to it. So, you know, it does pass along in families. But it can't be just that, based on everything that we know. There has to be other things at play.
GUPTA: The truth is, we don't know how to cure this and we barely know how to prevent it. For more of these incredible stories, you can watch Larry's special this weekend.
And next up, a young man who was on top of the world, picked in the first round of the NFL league draft. And then, in an instant, the dreams that he had were all smashed to pieces. Now, he's busy putting it all back together again. Don't miss this story, it's straight ahead.
And later, more than a million people have tuned in to YouTube to hear this doctor call sugar a poison. I sure had some questions about this. We'll see what he had to say.
GUPTA: And we are back with SGMD.
You know, this week, NFL teams are choosing their stars of tomorrow. A lot of dreams are going to come true at the draft.
Now, a year ago, Chad Jones was one of those lucky young men picked up by the New York Giants. Thought he had it made. In fact, he was about to face the fight of his life.
And since then, he's learned a lot about what luck really is.
GUPTA (voice-over): Each day, Chad Jones spends hours in the gym working to get in shape so he can play football again. Jones was a star athlete in college. He was dreaming of joining the NFL since he was 7 years old.
CHAD JONES, DRAFTED BY N.Y. GIANTS IN 2010: I just loved it. It was the most important thing ever.
GUPTA: His father was an all-American at Tulane and his older brother was drafted by the Cincinnati Bengals.
Chad is one of only two college players to win a national championship in football and baseball. Last year, the junior from LSU was drafted by both the New York Giants and the Milwaukee Brewers. Jones chose the NFL.
JONES: It was the greatest -- one of the greatest days, you know, feel like an ultimate achievement, you know? That's one of the first times I just cried for no reason.
GUPTA: But the rookie safety has yet to play a single down in the NFL. That's because the day he came home to New Orleans from minicamp, Jones crashed his brand new SUV into a street pole after his tires got caught in the street car tracks.
JONES: When my car actually wrapped around the pole, you know, and the axle split in half and it shot straight up my leg.
GUPTA: Severely injured, he nearly bled to death.
JONES: I shattered my tibia and fibula bone. You know, I sliced all through all veins in my leg, nerve damage. You know, still to this day, I can't feel the bottom of my foot.
GUPTA: Doctors thought they might have to amputate his foot. He says he was told he wouldn't walk again. But Jones had a different plan.
JONES: I knew I was going to be able to walk again. In the back of my mind, I'm going to play football again.
GUPTA: In that first month, he had 12 operations and there are still more to come. Incredibly, less than two months after beginning this intense therapy, Jones was walking again, without crutches. And today, against great odds, he's running. He plans to be back on the field next season.
JONES: You just have to stay the course, you know. Like curveballs are thrown at you, you always have to get up and just keep going.
GUPTA: His physical therapist also told us that Jones' recovery has been pretty amazing, especially considering the type of injuries he sustained. Good luck, Chad.
Coming up, we got an obesity specialist who is not afraid of controversy.
(BEGIN VIDEO CLIP)
DR. ROBERT LUSTIG, "SUGAR: THE BITTER TRUTH": Everybody understands that obesity is you eat too much, exercise too little, right? Wrong.
(END VIDEO CLIP)
GUPTA: The real problem he says, sugar. He says we are literally poisoning ourselves.
We got much more on this right after the break.
GUPTA: Welcome back to SGMD.
You know, there's a controversy out there that's been brewing about the food that we eat. In particular, sugar. I've looked at this whole issue before.
In fact, I did this documentary called "America's Killer Diet,." and found that what we've come to take for granted are some pretty disturbing things, especially about the types of food we eat, how much bad stuff, how little good stuff.
At one point, I met with a group of kids and showed them something pretty surprising.
(BEGIN VIDEO CLIP)
GUPTA: How much sugar do you think you eat in a week?
Typical person in a week?
Would you say it's that much sugar in a week?
OK. How about this much?
That much sugar in a week?
CROWD: Oh, my gosh. Oh! Oh, my gosh!
GUPTA: How many people think it's this much sugar in a week? It is. That much sugar in one week.
(END VIDEO CLIP)
GUPTA: Just think about that for a second. The average American teenager eats about four pounds of sugar a week, 200 pounds a year. There's a backlash.
And right in the middle of this is Dr. Robert Lustig. He's a specialist in childhood obesity at the University of California, San Francisco.
Now, last summer, he posted a lecture on YouTube where he basically said sugar is poison. Not just empty calories, but toxic.
More than a million have watched this video and now, there's a real debate. Is sugar, the thing we eat almost since the moment we're born, is it really that bad?
GUPTA: Now, thanks for joining us.
You've talked about sugar in this academic lecture, I think that's how this all started. And it's been on YouTube and it's had over a million hits.
First of all, are you surprised by the response?
LUSTIG: I'm extraordinarily surprised by the response. First of all, when I gave that lecture, I thought there were going to be about 200 people in the room. I didn't know it was being videotaped. I am absolutely astounded by the fact that this lecture has caught on with the public.
GUPTA: To be clear, you're saying sugar is a toxin, it's poisonous. What exactly -- could you summarize?
LUSTIG: Sure. The question is, is sugar empty calories or is it more than that?
Everybody understands that obesity is you eat too much, you exercise too little, right? Wrong. I don't think that has anything to do with it.
Obesity is a marker for metabolic dysfunction. And the question is, what caused that metabolic dysfunction? Well, if you look at what we're eating, we're not eating any more fat, but, boy, oh, boy, are we eating a whole lot more carbohydrate. And within carbohydrate, the thing that we're really eating more of is sugar.
Our sugar consumption has gone up by six-fold over the past century and doubled in the last 30 years.
And the question is, what does that do to you? Can your liver, which is the only organ that can metabolize this stuff, can your liver handle it? And the answer is: no, it can't.
GUPTA: Does this have more to do with the amount? I mean, you know, because they talk about the dose being so important when talking about potential poisons. At 15 grams, was it as toxic, was it a poison?
GUPTA: Is it more just the amount?
LUSTIG: No. Basically, what we've done is we've overdone it. Each of us probably has a personal threshold beyond which we shouldn't go over. The question, of course, is what is that threshold? What determines that threshold?
So, people who exercise, elite athletes, can pretty much take in all the sugar they want and it doesn't matter. It's one of the reasons why there's high fructose corn syrup in sports drinks. It actually repletes glycogen, liver starch. That's the whole reason for consuming the sports drink, is to get hydration and also to replete your glycogen.
The problem is, what if you're not glycogen depleted? What if you're not an elite athlete? What if you're sedentary? What if you're a fat kid in school drinking a sports drink? That's the question because that's who's drinking it. And the answer then is, if you overdo it, if you end up drinking or eating for that matter, too much of this stuff, faster than your liver can process it, what happens is it builds up liver fat, that liver fat ends up contributing to phenomenon called insulin resistance, which you well know about. And it also ends up causing changes in your arteries, causing them to be less flexible, less stretchy and that contributes to cardiovascular disease.
GUPTA: You know, when you think of a toxin, you think of a poison, you know, people may conjure up images of pesticides or phthalates, things like that. To be clear, you're not putting it in that same category. There's no doubt that people don't exercise as much as they should and there are few elite athletes among us -- but it's not the same kind of poison as that?
LUSTIG: We have three different levels of toxins. We have things where even one part per million can kill you -- for instance, cyanide, sarin gas, ricin.
We have other things where it takes a little more than that. You know, it's going to be like 30 to 40 parts per million. Now, we're talking about like heavy metals, like arsenic.
And then we have things like vitamin A, which in normal doses is good for you. Except in high doses, you can die.
Bottom line, what's the threshold for sugar? What constitutes too much?
Well, guess what? We don't know and part of the reason we don't know is because the USDA, our Department of Agriculture, has never set an upper limit. We have a thing called the dietary reference intakes. We have upper and lower limits for every single nutrient except for one, sugar.
GUPTA: You -- I know you've been aggregating a lot of this evidence for some time. I mean, how have you changed your own diet or your family's diet as a result of what you've learned?
LUSTIG: We try to keep added sugar down to as, you know, rational a minimum as we possibly can. For instance, my kids know to ask what day of the week it is. On Mondays through Fridays, their dessert consists of fruit. On Saturdays and Sundays, we'll let them have a scoop of ice cream.
So, we are by no means food Nazis in our house. We are by no means, you know, rationing the stuff. But at the same time, we're also making dessert special.
GUPTA: You know, in our household, in order to get sweets, especially things like ice cream, we have to walk to the ice cream store. That's something we institute in our home recently. We don't keep those things at home and that's part of our strategy.
LUSTIG: Well, part of the problem is, now, kids are walking from school to the convenience store, which is located within 500 feet of the school entrance, you'd think that exercise would be good for them and help their BMI, it's actually going up because they're making a stop and they're getting you know what.
GUPTA: Even if you're walking, it depends in part where you're walking to.
LUSTIG: You bet.
GUPTA: Doctor, it's fascinating research. Obviously, encourage people to go check your lecture out as well -- 90 minutes, but a fascinating, fascinating thing. So, appreciate you joining us. We'll stay on top of this topic as well. Thanks so much.
LUSTIG: My pleasure.
GUPTA: Coming up, also something remarkable -- at least according to my wife -- marriage and your health. Remarkable to me as well I should say, even if your wedding didn't look like Kate and Williams -- you heard there was a wedding, right -- I think you're going to find this connection pretty interesting. Stay with us.
(BEGIN VIDEO CLIP)
PRINCE WILLIAM OF WALES: I will.
KATE MIDDLETON: I will.
UNIDENTIFIED MALE: With this ring, I thee wed.
(END VIDEO CLIP)
GUPTA: Back with SGMD.
You might have noticed, there was a wedding this week. But what you might not know is how being married can affect your health.
Truth is marriage isn't always easy. It's not always simple.
So, we have psychologist Mark Crawford here to explain what we do know about marriage and your health.
GUPTA: So, my wife is probably going to kill me for asking this. But from a pure medical standpoint, pure health standpoint, marriage -- is it a good idea to stay in a marriage if you're already married?
MARK CRAWFORD, PSYCHOLOGIST: Well, here's what we know -- studies consistently show being in a happy marriage is actually good for our overall health. There are lots of studies. One of the more recent ones was pretty interesting. It studied 9,000 men and women in their 50s and 60s.
This is out of the University of Chicago, and it showed that when one of those individuals lost a spouse through death or divorce, they actually had on average about 20 percent more chronic health issues, like heart disease and diabetes. And it actually seemed that they aged less well. For example, they had more dif itty walking up and down stairs and over long distances.
So, being in a happy marriage is helpful. We think there are a lot of variables that contribute to that. For example, married people tend to be a little bit better off economically because of shared expenses and dual incomes. They have usually better health insurance and better access to preventative health care.
We also think it's helpful to have a spouse encourage us and hold us accountable for healthy behaviors, like getting an annual physical, exercise and diet, and discouraging us from negative behaviors like excessive drinking or smoking.
GUPTA: You know, I guess makes sense to say that marriage is good for you as long as it's a good marriage in some ways. And, obviously, with the royal wedding just taking place, if you discount for those other things, you know, they encourage good healthy habits and shared expenses and all that -- just, you know, being married and that sort of spiritual connection and emotional connection, is there a way of saying that has an impact on health, good or bad?
CRAWFORD: You know, we do know that the emotional connection and the intimacy is very, very important. Simply put: Life is better shared with a partner. There's a lot of research on loneliness and chronic loneliness tends to increase our rates of heart disease and viral infections and all kinds of other health problems.
But being married alone isn't the answer. It's important to work towards being in a happy, satisfying relationship with your spouse. That's the most important thing.
Marriages that are characterized by a lot of conflict and hostility are actually bad for our health. Folks in those kinds of marriages, according to research, actually have lower immune functioning. They seem to heal more slowly from physical injury.
GUPTA: Some of that has been measured.
And marriage versus just having a partner. I mean, does the act of getting married or that institution somehow, you know, does that play an effect?
CRAWFORD: We think the act of being in a committed, intimate, emotional connected relationship does have a buffering factor and a protective factor for our health.
GUPTA: All right. Dr. Mark Crawford, wish the royal couple well as well. Maybe they are listening, get some good advice there. Appreciate it.
CRAWFORD: My pleasure.
GUPTA: I want to leave you with another thought as well on the time that I just spent in Hawaii training for our upcoming Fit Nation triathlon with the rest of our team. You know, training -- the training high has been described as many things, sort of being in the zone, hitting your stride, I've started calling it "the flow."
Several times during my workouts -- which to be honest, have been few and far between until this past trip -- I got to experience this feeling where I literally forget everything else that was going on around me and suddenly found myself in the middle of my run, in the middle of my swim, in the middle of my bike, and it's a remarkable feeling which you don't come by every single day. It's amazing to me how you can relieve stress and escape to another place just by putting yourself out there and getting into the flow of that present moment. For me, it's a spiritual and physical experience that I wish I could bottle up in some way and have at my disposal all the time.
Hope on your next walk, your swim, your bike, your run, whatever it may be, whatever your speed or distance, you feel the flow as well.
Well, that does it for SGMD. Thanks for watching. I'm Dr. Sanjay Gupta.
More news on CNN starts right now.