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WHO's Global Forum on Urbanization & Health; How Clean is the Air We Breathe?; The Effects of Urban Living on the Human Brain; What Fish Provides the Most Omega-3 For Your Diet; Surviving an Earthquake

Aired November 20, 2010 - 07:30   ET


DR. SANJAY GUPTA, HOST: Ohayou gozaimasu and good morning. I'm Dr. Sanjay Gupta, reporting to you from Kobe, Japan, for a very special edition of SGMD.

Health officials from all over the world had converged here to discuss a very important topic: urbanization. It's an idea that more than half of the world's population now live in cities, that number is expected to grow.

A lot of attractions to living in the city, but there are health challenges as well. For example, how do you disaster-proof your city? And what about the air that we breathe, how do we make it cleaner?

And finally, all the sights and stimulations, what is that doing to your brain?

We got some of the problems outlined, and more importantly, some of the solutions. Let's get started.


GUPTA: But we start with this startling statement, the air in many cities around the world is simply too dirty to breathe. In fact, more than a billion people around the world are breathing in toxic air. It's captured the attention of the WHO. And the question becomes: what can communities do to try and protect their citizens and what can individuals do to protect their own health?


GUPTA: What you're looking at urbanization or at least the consequences of it -- big factories as your neighbors.

Here in Kobe, it's a beautiful city but they suffer from pollution problems like so many cities do. We got 15 factories in this small area and you add to that the exhaust from cars, trucks and busses and you get that smog that hangs over so many cities.

The problem is the air is just too dirty to breathe. And here's the most frightening part: you are likely to not even notice it. Your body becomes accustoms to this after just four days of breathing it in.

These tiny particles are smaller than a strand of hair and inhaled almost like a gas. It constricts the muscles around the airways. Think of it like breathing through a straw. All of it can impair your airway and causing increases in blood pressure, heart attack risk and a chance of heart disease.

You may think health impacts from breathing in toxic air would take years to develop. But that's just not the case. On days when you have particularly bad pollution in cities, they see emergency room visits spike over the next 24 hours.

Ad it's not just adults that are at risk, either. There are studies that show that babies are being born pre-polluted, with more than 230 chemicals in their system at the time of their birth.

Truth is: progress is starting to be made. In fact, there are places in China that I visited where they're starting to move the coal-fired power plants outside the big urban areas into more rural areas where fewer people are around.

And also in New York, there are new laws on idling of busses and trucks.

Of course, there are things we can all do to try and make our lives better -- for example, driving less, using public transportation such as this. That can really help.

Also, keeping in mind when pollution is at its worse. Hot days are going to be worse. Also, during the midday, if you are exercising at these times, you are taking in seven to times as much air, and seven to 10 times as much pollution as well.

And here's something else that may surprise you. Indoor air quality can be often be worse than outdoor air quality -- sometimes 50 percent worse. So, open a window, or at least make sure you have good ventilation.

Look, urbanization is here to stay, no question about it. But these are tips for individuals and for society to try to make the beautiful city that you live in a safe and healthy one as well.


GUPTA: Now, you can't help but watch something like that and wonder what's the most polluted city on the planet. Well, the answer seems to be Linfen, China. Imagine this, spending one day there is like smoking three packs of cigarette.

Back n the United States, Los Angeles and Phoenix are among the most polluted cities. But there are some good news, Pittsburg used to be one of the most polluted cities in the country. Their numbers have gotten better and people can expect to live about 10 months longer on average as a result.

Coming up next: how do you disaster-proof a city against earthquakes, against floods? We found out. We'll have that next.


GUPTA: And we are back with a very special edition of SGMD from Kobe, Japan.

You know, I spent a lot of this past year in the aftermath of disaster zones. After the floods in Pakistan and after the earthquake in Haiti, it really got me thinking, how do you reconstruct a country after it suffered so much devastation, and perhaps, could you prevent some of that devastation in the first place? Those are questions they are trying to answer here in Kobe, a good model because an earthquake happened here 15 years ago.


GUPTA: Would you even know what to do if you found yourself in the middle of that? What we're experiencing here is a 6.9 magnitude earthquake. What I'm trying to do is go into the corner of a room -- structures are the most sound -- stay away from glass as much as possible. Also, cover your hands, cover face. Get under a table if you have to, just something to protect yourself.

Of course, all of this is just a simulation. That's what you need to do as an individual.

Given that so many people live in urban centers across the world, how do you recover and rebuild after something like that?

It's exactly the question they were asking themselves in Kobe, Japan, in 1995, a 6.9 magnitude earthquake just like that one, 20 seconds in length. Two hundred thousand buildings gone, 5,000 lives lost, and a lot of work to do to try and rebuild this place.

Well, Kobe did it in less than 10 years. And now, they serve as a model for the rest of the world.

A lot of lessons have been learned. For example, don't put all your disaster resources in one particular area. Also, try and engage the survivors of an earthquake as much as possible in the rebuilding process. And finally, hospitals, they have to be able to stay open and functioning, even after an earthquake.

Of course, there are the buildings. The awful images like this one -- remember 200,000 went down. This was one of them. We'll take a look at what it looks like now.

This is the same building rebuilt just quickly after the earthquake. What do they do specifically? They use materials here to try and isolate this building from the ground and the shaking that accompanies an earthquake. They also used metal plates to allow the building to move as well as materials that sort of allow this building to sway if the ground is shaking.

It is by no means perfect. And if you ask Kobe officials, they'll say about 80 percent of the city is now rebuilt.

There are problems still -- narrow thoroughfares like this will be tough to navigate in an earthquake and these buildings could come down into the streets, making rescues that much more difficult. But the balance is always there, trying to maintain what has been for 100 years in the middle of all this reconstruction.


GUPTA: You know, one of the things is that it's very much human nature to wait for a tragedy to occur before you want to do anything about it. It's true of things like earthquakes certainly in terms of preparedness. It's also true with our own bodies. Sometimes we wait for an illness before we are reminded to take care of ourselves.

That's exactly what they are trying to address here in Kobe, Japan -- pre-planning to try and reduce the impact of any kind of natural disaster whether it's be an earthquake, floods or all the things that are happening around the world today.

You know, there are things about living in cities that are quite attractive to people. But it does come at a price to some extent as well. What can you do to try and keep your brain as uncluttered as possible? Well, I'll give you a hint. The answers right behind me.

Stay with SGMD.



GUPTA: Life in the concrete jungle, it's what they call it. If you live in a city, you're probably used to something like this.

The problem is, with so many distractions, it's very hard to focus on one particular thing. It's called controlled perception, toggling back and forth between so many things and it can leave you feeling mentally exhausted.

There's no question that living in a city has a lot of advantages. Shops are going to be open all hours of a day. You can buy things. There's also lots of cultural attractions.

What we are finding more and more is all of that comes with a price. And there's an impact on the brain as well. In fact, here in Japan, it's a big topic of discussion.

We're talking about the fact that mental illness is one of the biggest health problems here and they attribute it to this complex, high-tech environment. Suicide rate here in Japan, no secret, is among the highest in the world.

And the thing is that more people live in cities than ever before. They are living in cities longer than ever. So, all of us expect it to get worse.

And here's why: all that stimulation, it can cause spikes to the stress hormone known as cortisol. And as result, it can be very difficult for the brain to hold things and memory, reduce your self- control, dull your thinking, it may even speed up cognitive decline, just from living in a city. Think of it as your brain more rapidly ageing.

But here's the part I like in all this -- getting away from the stress associated with the chaos of the big city can be as simple as finding a place like this. In fact, recent studies have shown just glimpses of green areas will make huge differences to your overall cognitive function. It makes you less distracted, less stressed and more relaxed.

In fact, just a few minutes away from bustling Kobe, Japan, we found this place. It's a very old park. A lot of people come here for a few minutes a day. There are shrines and there are good opportunities to find green space. And that really seems to be the key: find green spaces in your city and make sure to use them as much as possible.


GUPTA: While I was here in Japan, I decided to explore another interest of mine, acupuncture. I have been fascinated by this for some time. It's obviously a traditional Chinese medicine. It's been around for a couple of thousand years.

And here in Japan, they have about 40,000 people practicing this particular art. That's why I decided to visit one of them.

Back in the United States, incidentally, it's also become a much more popular. About 3 million people using acupuncture regularly, 150,000 of them are children. And insurance is also covering this for a lot of people as well.

We decided to come and say hello to Kanda.


GUPTA: Kanda, thanks for having me.

KANDA: Welcome.

GUPTA: So, this is where you practice?

KANDA: Yes, that's right.

GUPTA: And how long have you been practicing here?

KANDA: Ten years.

GUPTA: Ten years?

KANDA: Yes, 10 years.

GUPTA: So, patients come here obviously. These are the needles?

KANDA: Yes, all of them disposable. You have different, you know, thickness and different lengths (ph).

GUPTA: The patients come to see you for what?

KANDA: You know, muscle pain and the joint pain. Well, it's quite a free country (ph). And any other internal problems like a digesting problem, allergic problem, and even psychological problem, like a depression or something.

GUPTA: Headaches even, I understand as well, right?


GUPTA: I mean, this is a -- this is a model, right? This is what you use for your pressure points?

KANDA: That's right.

GUPTA: Can you talk me through this a little bit?

KANDA: OK. You mentioned a migraine, right?

GUPTA: Yes, I suffer from migraines.

KANDA: OK. I would use this point to approach around here to make your circulation better.

GUPTA: So, these meridians are what you're really focused on.

KANDA: That's right, meridians.

GUPTA: These lines over here.

KANDA: That's right.

GUPTA: So, you find a pressure point that could be well away from where something hurts, but actually putting needles in there seems to make a difference.

KANDA: That's right.

GUPTA: Let's take a look at my specific issue if we can. So, I do suffer from headaches. And you were showing the pressure points. So, what do you do?

KANDA: Yes, for example, I have to check, you know, some acupoints. So, let me try.

GUPTA: So, can I try this? Can you show me what you would do?

KANDA: Yes, sure. Sure.

GUPTA: You want me to lie back?

KANDA: Can you -- can you lie down on your back?

I'm just checking the condition of the points. So, it's quite common example for migraine. OK. The thickness of the needles, like your hair -- so, very thin.

GUPTA: Very thin. OK.

KANDA: Very thin.

You're OK?

GUPTA: Yes, I feel fine.

KANDA: OK, it's coming now.

GUPTA: So, I feel it. It did not really hurt going in.


You feel it?

GUPTA: I feel it.

KANDA: A pain or --

GUPTA: It's sharp.

KANDA: I see. Can I give you another one?

GUPTA: Sure.

KANDA: All right.

GUPTA: I say hesitantly.

So, Kanda, most people wouldn't get any benefit right away. It would take some time.

KANDA: Well, sometimes right away. Sometimes it takes a time, next day or, you know, even a couple of days.

GUPTA: All right. So, that's a good example of what --

KANDA: Yes. Yes. Those points are under one same meridian --

GUPTA: A line going all the way up.

KANDA: That's right.

GUPTA: And just really quickly, why do you think this works?

KANDA: Why? OK, you know -- OK. We have so many meridians, like 14 meridians and they're both fine and 20 kinds of meridians. And in all the meridians goes to all your organs, almost -- you know, they cover the whole of your body. And then, so now, I give you this and this and this point and this point. And those two points are very popular for -- you know, a program or upper here, located up here.

GUPTA: And you're trying to restore balance, is that right?

KANDA: Yes, that's right.

GUPTA: So, you got yin, you got yang?

KANDA: Oh, yes, that's right. Yes. You know well. Yes, that's right.

GUPTA: So, is that what acupuncture is about, it's really controlling that balance.

KANDA: That's right.

GUPTA: This is fascinating. And I know sometimes people will put dozens of needles in for one particular treatment. We'll see how this works. I really appreciate it. Thanks so much.

KANDA: No problem. You're welcome.

GUPTA: OK. Thanks.

KANDA: Thank you.


GUPTA: And we are back with SGMD, reporting to you from Kobe, Japan. A very special show today -- looking at the urbanization of our planet.

You know, one thing that I've always been curious about is why do people in some parts of the world live so much longer than in others. Here in Japan, they have one of the highest life expectancies anywhere in the world.

And what doctors and health officials will tell you, it doesn't have as much to do with genetics as it has to do with the environment, and specifically diet. Fish -- it's a big part of the diet here. In fact, fresh fish available in markets like this every single day and people come up and eat a lot of this fish.

There are certain types of fish that people pay particular attention to. But you have, obviously, crab over here. You have big clams, small clams.

But there are certain fish that are particularly good in terms of increasing people's life expectancy. Mackerel, for example, lots of omega-3 fatty acids in that. Well, salmon, as well, another great fish.

But this fish that people eat every single day, about one to two servings a day, as compared to the United States, where they eat a serving per week. What they're focused on is something known is omega 3 fatty acids. Think of this as a longevity substance, something that decreases your risk of heart disease, decreases your chances of developing clogging in your arteries, decreases your chances of stroke.

By the way, tuna, as well, over here. Tuna another good source of the omega 3 fatty acids. The price is, you know, obviously, expensive here -- about $8 to $10 for that piece of tuna.

But it's also the omega fatty acids that seem to make a difference. Here in Japan, people start eating fish at a young age and they continue eating that fish throughout their entire lives.

Also, other types of foods -- you know, seaweed, for example. It'd be hard-pressed to find that in many places, many groceries in the United States. Find it pretty easily over here. It's a great source of antioxidants.

A lot of people hear about omega-3 fatty acids and say, great. But I simply don't like to eat fish. There are other sources as well, soy products for example, tofu, walnuts, flax seed -- that can help meet your requirements for omega-3 fatty acid acids. But keep in mind, again, one to two servings per day here in Japan as compared to one serving per week.

Heart disease is the biggest killer of men and women in the United States. Here, the rates are about half of what they are back in the United States.

You know, there's something else they told me about here in Japan, which I think is really important, as well. And that is this idea that you push the plate away before you're entirely full. You never stuff yourself.

Here in Japan, they call that hara hachi bu, push that plate away. It's good advice whether you live here in Kobe, Japan, or really anywhere else around the world.

We have much more SGMD right after this.


GUPTA: And we are back with a very special edition of SGMD, reporting to you from Kobe, Japan. What a fascinating week it has been trying to look at lessons learned to apply to cities all over the world. The concept is urbanization. It's an idea that more people live in cities now around the world than do not.

And by the year 2030, they expect that number is going to go up to 60 percent, three out of five people living in cities. So, how do we make ourselves safer, healthier, more prosperous?

Like I said, there's lessons all over the world. For example, in Mumbai, they recognize that simply being a pedestrian, even not during an earthquake, can be a dangerous thing. So creating walkways, skywalks, like the ones you see there, keeping those pedestrians safe. That's a model.

Also in Brazil, recognizing you can't always find green space and spaces of tranquility all over the city. So, they're going to the second largest city in Brazil into some of the poorest neighborhoods and giving those neighborhoods more than just a fresh coat of paint.

And in Lagos, Nigeria, recognizing that sanitation so important you've got to protect yourselves and the air and the water pollution that is such a big problem in so many cities. Mobile toilets like the ones you're seeing there, it can really help with that.

And back here in Kobe, you know, again, they suffered a significant earthquake 15 years ago. The rebuilding has been such a process here, but they did it, they did it quickly, and they made the city safer and better than it ever was before.

One of the things it's a little bit non-intuitive is this idea of incorporating communities. After the earthquake, they incorporated the survivors and they've always really respected the elderly, making sure, for example, that the walkways were very safe for pedestrians. But they had long enough walkways. There was designated seating for people so they can enjoy the city as much as possible. It's a lesson that we can learn no matter which city we live in anywhere around the world.

Unfortunately, that's all the time we have for today. If you missed any part of the show, you can check out my podcast at

Also, always set your DVR for 7:30 a.m. Eastern, SGMD.

And more news on CNN starts right now.