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HOUSE CALL WITH DR. SANJAY GUPTA
Effectiveness Of Arthritis Supplements; Dr. Mark Hyman Discusses Supplements; American Children May Be Getting Vaccine Against Potentially Deadly Rotavirus; Eating Well At All Ages
Aired February 25, 2006 - 08:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
TONY HARRIS, CNN ANCHOR: And good morning, everyone. We continue to monitor the latest information out of Austin, Texas. Preliminary tests show the potentially fatal poison Ricin has been discovered at a dormitory at the University of Texas in Austin. Two students are reportedly being treated for exposure. We will bring you the latest as the situation develops.
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Do they ever sleep? Some Mardi Gras party goers are probably just now climbing into bed. This is the last big weekend of -- right -- of the annual Carnival season. It wraps up this Tuesday, Fat Tuesday. Tourism officials and business owners hope Mardi Gras will boost the area economy.
On this morning's "HOUSE CALL," senior medical correspondent Dr. Sanjay Gupta takes a look at vitamins, and supplements, fact, fiction, and what you need to watch out for. That's today's "HOUSE CALL." And it starts right now.
DR. SANJAY GUPTA, CNN SENIOR MEDICAL CORRESPONDENT: Good morning and welcome to HOUSE CALL. I'm Dr. Sanjay Gupta. You know, millions of Americans take supplements, but are these pills really doing what they claim? Well on this morning's show, we're going to separate fact from fiction. Let's start with a new study on some popular arthritis and joint supplements.
Christy Feig looks at the bottom line.
CHRISTY FEIG, CNN CORRESPONDENT (voice-over): Osteoarthritis of the knee is one of the leading causes of disability in older Americans. It's caused by the loss of joint cartilage that leaves bone rubbing on bone. Treatment can include physical therapy, pain killers, injections, and joint replacement. And many Americans try dietary supplements like glucosamine and chondroitin, but how well do these supplements work?
That's just what researchers in a study sponsored by the National Institutes of Health wanted to know. So they gave nearly 1,600 patients either 1,500 milligrams of glucosamine, 1,200 milligrams of Chondroitin Sulfate, a combination of the two, 200 milligrams of Celebrex, or a dummy pill every day for 24 weeks.
The results are published in "The New England Journal of Medicine." The conclusion? There was no significant benefit in the entire group. But for some patients who took the supplement combination, there was good news.
ARTHUR WEINSTEIN, DR., WASHINGTON HOSPITAL CENTER: In a subset of the patients with osteoarthritis, those who had more advanced pain or more pain and more advanced disease, it did show a benefit.
FEIG: Glucosamine and chondroitin are both found naturally in the body for cartilage formation and repair, which is why some doctors say these supplements are still an important weapon in the fight against arthritis pain.
JOHN KLIPPEL, DR., ARTHRITIS FOUNDATION: I think it needs to be recognized, these continue to be important considerations for people with this form of arthritis.
FEIG: The Arthritis Foundation recommends talking to your doctor about whether these supplements fit into your treatment plans.
I'm Christy Feig reporting from Washington.
GUPTA: All right, Christy, lots of information there. The recommended doses of these supplements would probably cost you about $1 to $3 a day or up to a thousand dollar a year, which insurance companies aren't going to cover. So even this new study might be leaving you wondering if these pills are really worth the money. A good question.
Helping us to answer that question, Dr. Mark Hyman. He's an alternative medicine specialist. He's also co-author of the best- selling book, "Ultra Prevention." And now he's hosting his first public television special called "Ultra Metabolism," which premieres this coming week.
Welcome to the show.
DR. MARK HYMAN , ALTERNATIVE MEDICINE SPECIALIST: Thank you, Dr. Gupta.
GUPTA: You're a busy guy.
HYMAN: I am.
GUPTA: Look, this was a -- this -- you've seen the study. It was big. It was rigorously controlled. And still, there seems to be a lot of questions as to what this really tells people regarding at least these supplements. What did you take away from the study?
HYMAN: Well, you know, Dr. Gupta, I think no one is more confused about supplements than their physicians and patients. You know, we have a society where we're looking at how we can improve our health, and yet many of us are trying to use supplements without enough knowledge.
And doctors necessarily aren't the best people, because we don't learn about nutrition.
HYMAN: And many of the studies that are done look at how supplements work as drugs, but they're really different than drugs. In fact, the Institute of Medicine reported in their report on complementary alternative medicine that supplements and natural therapies need to be studied in a different way than randomized controlled trials.
And that's because they work as part of the body's normal functioning system. They work as part of the body's ability to repair and heal itself. And we want to use substances that help work with the body, rather than against the body.
And that's why it's important to look at glucosamine. And this particular study, I found it interesting, because it did show a benefit of people who had moderate to severe pain. And there was 60 percent of the people who took nothing that also got a benefit.
So it's a little interesting that people with a placebo also reach a benefit, but that the people who had the actual glucosamine I believe did show more benefit.
And there are many, many other studies that support this. And you have to look at the one study in the context of all the other studies.
GUPTA: OK, so I mean, the bottom line for people out there is it's a good point. Glucosamine might help your body's sort of natural healing powers if you have some arthritic type pain. But a lot of people aren't quite sure whether or not they want to shell out the cash for it yet. The data's not strong on that.
And there was a lot of e-mails coming up basically about that. Let's try and get to some of those e-mail questions now.
One from Beth in California, who wants to know this. "What is the difference between MSM supplements and glucosamine?"
Now doctor, a specific question. Both are touted to help with joint pain, especially arthritis. What do you tell her?
HYMAN: MSM is a sulfur compound. And sulfur is one of the key nutrients in our body that helps our body detoxify, repair, heal, deal with inflammation. So we need it. And it comes in many foods, like garlic, and onions, and broccoli and so forth.
But glucosamine is an entirely different substance. It's made up of the -- actually the shellfish shells, which has the basic building blocks of cartilage.
And in studies, they've shown that those particular building blocks, when they're tagged, for example, with radioactive labels, actually go into the joint space and actually deposit themselves there and help rebuild and replenish the cartilage.
And in two studies, one in "The Lancet" and one in the "Archives of Internal Medicine," they actually found that the joint space didn't narrow in people who took glucosamine, compared to people who took a placebo or even took conventional arthritis medicines and anti- inflammatory drugs, which don't really stop the disease. They just prevent the pain.
GUPTA: OK. So maybe there's some actual evidence there that glucosamine might be of some benefit here.
Let's keep going here, because this is important. Another study that raised questions was about vitamin D and calcium. They've been touted as helping prevent osteoporosis and therefore bone fractures.
But researchers studying post menopausal women found conflicting evidence. The pills did slightly help with hip and bone density, but did not decrease hip fractures.
Now the one exception, we got to keep up here, because it's confusing, older women over 60 had significantly fewer hip fractures after taking the supplements, but the doses of calcium used were somewhat lower than was recommended.
People are confused. You know, as we've talked about with glucosamine as well. Gale in New York asked this question. "Is it true that calcium supplements do not help slow osteoporosis?"
Doctor, I mean, should people stop taking their calcium based on this study?
HYMAN: No, they shouldn't. I think the study had a number of problems. It was a large women's health initiative, studied many women. But the study wasn't really designed, in my view, to study calcium alone. It was -- using it in women who took hormones. It was giving them a dose of calcium that was lower than ideal. It was given in a form that I don't think is well absorbed, calcium carbonate.
The vitamin D that was given was lower than the doses that are typically recognized now as being helpful. And it was studied in women who were also often taking other calcium supplements, in addition to the ones that were in the study. So it may not have shown an effect.
So I think there are a lot of problems with that study. And the bottom line is that when you take the weight of the evidence out there, calcium with vitamin D, and particularly I think higher dose of vitamin D than we typically expect, do benefit the bone density.
GUPTA: All right. We're talking with Dr. Mark Hyman. Lots of good information. Lots more questions, coming up. Stay tuned. (BEGIN VIDEO CLIP)
UNIDENTIFIED FEMALE: We're getting to the facts about vitamins and supplements. Can saw palmetto help you? What about black cohosh? The facts behind the claims, coming up.
First, take today's quiz. How long does it a take for vitamins and supplements to have a noticeable effect? That answer, coming up.
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(BEGIN VIDEO CLIP)
UNIDENTIFIED FEMALE: Before the break we asked, how long does it take for vitamins and supplements to have a notice about effect? The answer, it can take up to 90 days for the benefits to appear.
(END VIDEO CLIP)
GUPTA: Important information because experts point out consistency is the key to gaining the benefits of any supplement or almost any medication as well.
And back with us talking about vitamins and supplements is Dr. Mark Hyman. He's an alternative medicine specialist. He's also author of the soon to be released book "Ultra Metabolism: The Simple Plan for Automatic Weight Loss." A lot of people will be interested in that, I'm sure.
Doctor, lots of questions coming in on this topic. Let's get to our inbox with a question from John in Miami, who writes this. "'A New England Journal of Medicine' report shows saw palmetto does not help prostate enlargement. Is this true?"
And Dr. Hyman, John, let me explain that study, first of all, for the rest of the audience. Then we'll get Dr. Hyman's take. Saw palmetto has been shown in previous studies to help with symptoms of an enlarged prostate.
But this month, a study that John's talking about found the supplement was no more effective than a dummy pill, a placebo.
Researchers did point out more studies are needed to find out if different doses or formulas of the medication might be more effective.
Dr. Hyman, I mean, jump in here. What is your opinion or the take away from this sort of study?
HYMAN: Well, I think it's a very important study, because it shows that what we thought was working wasn't working in this particular study. It contradicts a lot of other data. And a lot of other data help us to understand how this supplement works, that it seemed to be as effective in the study of many other studies we call meta analysis, that analyzed 3,000 men, 18 studies that did show benefit.
So you know, we have to take into context of all the other research. In my view, I think it's worth taking because we still have no evidence it has any risk. And there's a large potential benefit, even despite this recent study.
GUPTA: So John, so if you can afford it, John, I guess keep taking it. A possible benefit. Little risk. Another e-mail coming from Mickey in Pennsylvania, who asks this.
"Is black cohosh effective in relieving hot flashes? Are there any side effects?"
And Dr. Hyman, you know, when the HRT study came up, a hormone replacement therapy study came out, a lot of people said well, we need an alternative to take enough hormones. And black cohosh was high on the list. What do you say about it?
HYMAN: Well, first, I say that lifestyle changes are the most effective way to treat hot flashes, giving reduction in alcohol, caffeine, smoking, exercise, a healthier diet, less saturated transfats, less sugar and so forth.
But if you need to take an herb, black cohosh has significant use, particularly in Europe. And it seems to show some benefit in some smaller studies. There's certainly needs to be more research. And the risks seem to be very low in taking it.
GUPTA: OK. We got time for one more e-mail. I think this one coming from Jamie in Minnesota. "Hoodia seems to be all the buzz." I've heard about this, too. "Are there any side effects? Will hoodia really help me lose weight?"
And I mean, doc, Hoodia is the newest hot weight loss supplement. It seems a lot of people are talking about it. What is it? Does it work?
HYMAN: It's probably great if you can get it, but you have to grow it for four years in a desert at 122 degrees. And it's usually used by the Kalahari bushmen.
Unfortunately, it's hard to grow. It's -- the most of the supplements out there don't contain any measurable Hoodia. And it seems to have a glycoside called P-57, that does affect the brain's sense of appetite. It can't suppress appetite, but I don't think that what we're seeing out there in the market is the real deal.
GUPTA: You're not ready to endorse Hoodia.
Let me ask you something more general speaking about vitamins and supplements. More of the supplements. What is it going to take, you think, for what you do no longer to be called alternative medicine? I mean, what -- is it going to require studies, you know, studies and big universities and hospitals for that to happen?
HYMAN: That's a great question, Dr. Gupta. You know, there's 730,000 research papers that are on the online database of the National Library of Medicine on Supplements, Herbs, and Alternative Medicines. So there has been plenty of data out there.
I'm -- work with a group that teaches doctors how to work in this new field of nutrition called functional medicine. And that field helps us understand the role of nutrients in the context of health.
So we have enough information to solve many health problems. And many researches are out there doing this work. So I feel like what's happened is that doctors aren't educated in this. And we just need to reeducate physicians on how to do this.
That's why "The Textbook of Functional Medicine," which I contribute to...
HYMAN: ...really leads the way in this field.
GUPTA: It is remarkable, because you typically think of doctors sort of, you know, educating their patients. But in this case, patients and the general public seems to be get a lot of information, a lot of traction as well, when it comes to alternative medicine.
Good information from Dr. Mark Hyman. Stay where you are at home as well. When we come back, do you really get what you pay for when it comes to vitamins?
UNIDENTIFIED FEMALE: Does high price equal high quality? Find out if your vitamins are up to snuff.
Plus, find out which foods you need to eat for optimal health as you age.
But first, this week's medical headlines in "The Pulse."
FEIG (voice-over): American children may soon be getting the vaccine against a potentially deadly rotavirus. A federal advisory committee is recommending all infants between two and six months old be vaccinated against the virus. More than 55,000 kids are hospitalized with rotavirus every year.
The bird flu continues to march across the world map. According to the World Organization for Animal Health, the H5N1 virus has now been confirmed in birds in at least 27 countries.
The human cases have been reported in just seven countries, mainly the Mideast and Southeast Asia. Officials say still no human- to-human transmission is being reported. India is now launching an offensive against bird flu, killing an estimated 300,000 chickens after the virus was found there.
Christy Feig, CNN.
GUPTA: And for more information about vitamins and supplements, click on the office of dietary supplements Web site. That's at ods.od/nih.gov. You got that straight? There you're going to find supplement fact sheets and the latest nutritional recommendations.
And we are talking about vitamins and supplements, separating fact from fiction, and trying to clear up sometimes conflicting studies you do here in the news.
That's our job here. And helping us do that is Dr. Mark Hyman. He's an alternative medicine specialist. He's also co-author of the best-selling book "Ultra Prevention: The Six Week Plan That'll Make You Healthy for Life."
You know, it's amazing, doctor, the number of questions we've got on this topic. Let's jump back in. Our e-mails -- a question from Greg in New Jersey who writes this. "I've been told to take flaxseed because of its omega-3 content. Recently, I heard that omega-3 has no benefits. Who's right?"
Greg, first of all, I think you're talking about a recent study which concluded fish oil supplements did not appear to reduce a person's risk of developing cancer.
But Dr. Hyman, Greg also heard they had no benefits. What's your take on that?
HYMAN: That's misinformation, unfortunately. Certainly that last study in The New England Journal showed there was not a big evidence base to support that it prevents cancer.
However, it is critical for our normal body's function. It's one of the raw materials our body needs to survive. And it's important in brain development in children. It raises their I.Q. It prevents heart attacks better than any medication. It helps reduce depression. It helps to improve skin health. It helps to reduce blood clots and arrhythmias and strokes.
So there's enormous benefits to omega-3 fatty acids.
Flaxseeds may or may not be the best source, because many people can't use the flaxseed component, which is ALA, and convert it into the active fish oil components, which is EPA and DHA in the body, which has most of the benefits.
So I recommend people take regular fish oil supplements that are clean...
GUPTA: The actual supplements.
HYMAN: ...and pure and filtered.
GUPTA: OK. All right, let's keep going here. Janet in Oklahoma has this question. "Are high priced vitamins and supplements any better for you than what you can buy at the local chain store?"
And Dr. Hyman, "Consumer Reports" magazine, you probably saw this recently, found some dollar and discount store brand multivitamins didn't contain everything that the label said. And so maybe lack of regulation there. How big of a problem is this?
HYMAN: Absolutely. Absolutely. People have to realize that drugs have regulations that govern what's in the pills. Supplements don't. So you have to be more aware as a consumer what you're getting.
And I would wish that all supplements were created equal and we could get the cheapest ones to have the benefit. But for many people, that's not true.
So I encourage people to search out the best quality supplements and to find those companies that will provide them with an independent analysis of what's in the pill.
If you do that, you'll be assured you're getting the actual ingredients on the label.
GUPTA: Get what you pay for, I guess, to some extent.
GUPTA: All right.
GUPTA: Stay with us. We're going to be checking in with wellness guru Dr. Andrew Weil. It's coming up, after the break.
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UNIDENTIFIED MALE: Women can't just suddenly wake up at age 50 and say "I better start worrying about my bones."
UNIDENTIFIED FEMALE: Find out the most important vitamins and minerals you need in your 30s, 40s, and 50s. That's coming up on HOUSE CALL.
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GUPTA: We're back with HOUSE CALL. We're talking about vitamins and minerals this morning. And our "Bod Squad" recently checked in with an expert about what you need to know as you get older.
ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT (voice-over): Are certain foods, certain nutrients especially important at certain times of your life? We asked author Dr. Andrew Weil, head at the University of Arizona's Integrated Medicine Programs. He said your 30s or even earlier is the ideal time to eat well to keep diseases at bay in the decades to come.
ANDREW WEIL, DR., AUTHOR, "HEALTHY AGING": Women can't just suddenly wake up at age 50 and say I'd better start worrying about my bones and take calcium now. Your bone health is really determined by how you've lived mostly up to your mid 30s. You know, that's when you build bone.
COHEN: Then once you hit 40, your chances of hypertension go way up.
WEIL: You avoid eating or reduced consumption of processed and refined foods, which are often high in sodium, and eat more fruits and vegetables, which are high in potassium, that has an opposite relaxant effect on blood vessels. Calcium and magnesium can also help lower blood pressure somewhat.
COHEN: By your 50s, Weil suggests eating lots of magnesium rich foods to keep your heart healthy.
WEIL: It has a protective effect of heart rhythm. It stabilizes the heart electrically.
COHEN: And your 50s is a good time to think about preventing Alzheimer's disease. The omega-3 fatty acids in some fish has been shown to possibly help stave off Alzheimer's.
And while supplements can sometimes be helpful, experts agree that getting your nutrients through fresh food is the best approach.
Elizabeth Cohen, CNN, Atlanta.
GUPTA: All right, Elizabeth, thanks. We have been talking with Dr. Mark Hyman, who studied with Dr. Weil, I understand, as well.
Doctor, which is better -- getting your vitamins from food or getting them from supplements?
HYMAN: Well, dietary supplements are called supplements, not dietary replacement. So you can't have your cheeseburger, french fries, Coke, take your multivitamin and expect to be healthy.
And you know, I outline this in my book "Ultra Metabolism," which is coming out this month, which is that we need to eat a whole foods diet, which contain most of the raw materials in terms of vitamins, and minerals, and nutrients we need for life.
However, however, because of the stress we're under, because of the nutrients that are depleted in our soil, because the food isn't the same quality that we had when we were hunters and gatherers, and contains the same amount of nutrients, we do need dietary supplements I believe in this day and age. We need a good multivitamin. I do believe we need calcium, magnesium, and D. And I think most of us should take a fish oil supplement for good health.
GUPTA: Really good information, Dr. Hyman. And we're such a quick fix society. We need to get this stuff in a pill, it seems. Listen, lots of good information. Thanks for answering all of our questions this morning as well, Dr. Mark Hyman.
Coming up, we're going on tour. Stay tuned to find out if I'm coming to a town near you.
UNIDENTIFIED MALE: Obesity is the epidemic of this century.
BILL CLINTON, FORMER PRESIDENT OF THE UNITED STATES: The bottom line is that we got too many kids, too overweight. And they're walking time bombs.
GUPTA: We're launching our biggest initiative ever to help build a more fit nation. Join us on college campuses like this one all across America.
UNIDENTIFIED MALE: I know I'll make it.
GUPTA: We have been committed to bringing you the facts behind the numbers about obesity in children, teens and adults. The struggles and the success stories as well. Now we're coming to your backyard, trying to get the business leaders, educators, and the youth of this nation motivated to get involved in what we think is a very important fight.
So keep an eye out for me in the next few weeks. I'm headed to Spellman College in Atlanta, then to my alma mater, the University of Michigan in Ann Arbor. In Philadelphia, I'm going to speak at Temple, and then on to Iowa State in Ames, Iowa. And that's just March.
After that, we're going to head west and then to south as well. That's all in April. Tune in next week for our tour kickoff, and a candid look at where we stand on the obesity struggle in this country. Plus, we'll have the full list of tour dates through the end of April. That's next weekend at 8:30 a.m. Don't forget to e-mail us your questions at firstname.lastname@example.org
Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.
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