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SANJAY GUPTA MD

Let's Talk About Sex; Supreme Court Compromise on Gene Patients; Eating on the Wild Side

Aired June 16, 2013 - 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: Hey, there, and thanks for joining us.

Supreme Court just said you cannot put a patent on a natural human gene. Today, we're going to see what that means for you. I tell you, there are huge implications for medical care starting with cancer patients. We'll explain.

Then, as you know, I always say to eat your fruits and veggies, but some of them aren't as good for you as they used to be. I'll tell you what that's all about and what to watch for.

But first, Plan B, the controversial morning-after pill, it's back in the headlines.

(BEGIN VIDEO CLIP)

GUPTA (voice-over): The drug works to prevent pregnancy, if it's taken within three days of having sex. It works best taken within 24 hours. When the current version was approved, anyone under 18 needed a prescription. But this spring a federal judge rejected the age restriction on Plan B.

As recently as late April, the Obama administration still wanted to require a prescription for anyone 14 or younger. But this week, they gave that up as well and said they would accept the ruling.

So, starting soon, Plan B will be available over the counter for everyone.

(END VIDEO CLIP)

GUPTA: If you see this news with your kids, it's going to make a lot of people nervous, but I think that might be good.

You know, we've got two leading sex and relationship experts with us today to talk about this. Joining us from New York, Ian Kerner and Logan Levkoff.

Thanks to both of you for joining us. Happy Father's Day weekend as well.

IAN KERNER, FOUNDER, GOODINBED.COM: Happy Father's Day.

LOGAN LEVKOFF, AUTHOR, "THIRD BASE AIN'T WHAT IT USED TO BE": Thank you.

GUPTA: I wanted to ask some of these questions in that context to some extent thinking about this as a dad of young girls, I know we all have kids. As far as I can tell there really no medical issues here specifically. I mean, the drug is considered safe, but Plan B seems to be more controversial because of the context of talking kids and sex. And again, all three of us are parents of young children.

But a recent report found that fewer than a third of parents are talking to their kids about safe sex.

Logan, let me start with you. How young is too young here? What are we talking about here?

LEVKOFF: Well, there is -- brace yourself -- there is never a too young when it comes to talking about sex and sexuality. From the time we're born, we're shaping how our kids see the world, how they see themselves and gender and different types of families.

It is our responsibility to talk to our kids about sex and safety and protection and sense and responsibility. And we have a huge opportunity to do so whether we use the recent media news as a stepping-off point or whether we just start a conversation at home, but it is our job to do it.

GUPTA: Yes, you know, it's funny -- again, I think you're right. And I have -- you have a 4-year-old girl, Logan, I have a 4-year-old girl, I also have a 6-year-old girl, and an 8-year-old girl and I think this is consuming me. I mean, I'm thinking about this all the time.

And, Ian, I mean, kids are reaching puberty as well, I think, on average, 8 -- 9 or 10 for boys, even younger for girls. Are they mentally and emotionally ready to have the conversation that Logan is talking about?

KERNER: It's funny, Sanjay. I mean, I have son. He's in fourth grade. He's just turning 10 years old. He's nowhere near hitting puberty. But, you know what, other kids in the fourth, other kids in the fifth grade, they are hitting puberty.

So, whether he is ready or not, these conversations are in the air. These conversations are being talked about.

So, as a parent, my job, I feel like, is to be responsive and, you know, for example, as Logan was just saying, recently in the news, for example, everybody was talking about Michael Douglas and the fact that HPV can be transmitted orally. Well, you know, my phone, my e-mail, I have been receiving scores, dozens of e-mails from moms, dads, parents, sons, kids, men, women, saying, "Is this true? What do I need to do? Tell me more about it."

So, I think that's an example of a teachable moment where nobody was necessarily prepared to have that conversation, but we have to be responsive parents.

GUPTA: Yes. No, it's true. And, Logan, let me ask you this last question. As a father of three girls, Father's Day weekend, I want my girls to like themselves. I want them to respect themselves. I mean, and maybe the answer's obvious here, but how do we give girls the self-confidence and self- esteem to create and protect their own boundaries?

LEVLOFF: We have to tell them that it's important to speak up for themselves, to know that they are not -- their worth is not measured by what they look like but what they're -- who they are and their character and their contribution to the world.

And it means that we challenge the little messages as they come up. My 4-year-old is obsessed with princesses and it's very hard to get away from that. But the one thing I say to her is that, you know, princesses go to work, princesses have to have careers and the most beautiful princesses are the ones that use their brains. And it sounds silly and a little bit like brainwashing on my part but it seems to do the trick and it is our role to step in and say, you know, you might see beauty in one way, but there's a lot of versions of beauty, and it mostly comes from inside not outside.

GUPTA: I love that. I'm spending some individual time with my kids. We all have more than one child and finding the individual time I think is so important, and maybe having some of these conversations.

Thanks so much. I love watching you both. Thanks so much for joining us this morning.

LEVKOFF: Thank you.

KERNER: Thank you very much.

GUPTA: Coming up, we're going to see what's next now that the Supreme Court has decided who owns your genes.

But, first "The Human Factor."

(BEGIN VIDEOTAPE)

GUPTA (voice-over): As long as twins Evan and Eric Edwards can remember, they had allergies. The official diagnosis when they were 3.

ERIC EDWARDS, HAS ALLERGIES: We were allergic to all egg products, all seafood, including shellfish and fish, all peanuts, all tree nuts, and most antibiotics.

GUPTA: Plus, seasonal allergies as well.

EVAN EDWARDS, HAS ALLERGIES: We didn't have pets growing up. We were allergic to dogs and cats.

GUPTA: To top it off, for them, school was a huge challenge.

ERIC EDWARDS: We were those guys who had to be placed at a special table at lunch to try to insure that there was no potential for contamination.

EVAN EDWARDS: If you have an allergy, there's a stigma, you are kind of weird, or, you know, we were the weird kids at the end of the cafeteria table.

GUPTA: With the near constant threat of anaphylaxis, which is a severe life-threatening allergic reaction, the twins had to have EpiPens at all time. It's a pen-like device that injects a dose of epinephrine to stop a sharp drop in blood pressure in serious breathing problems. But they both thought their EpiPens were too bulky and they often didn't carry them. Both have had three really close calls. So when they left high school, they decided to invent a smaller, more portable device.

ERIC EDWARDS: This was about us trying to take our experience and then develop another option for these million are at risk.

GUPTA: They tailored their college classes around the new invention they were designing. Evan took engineering courses. Eric took the pre-med route. After college, they started their company, Intelliject. And last year, the FDA approved Auvi-Q. It's an epinephrine auto-injector. It's about the size of a credit card and it's the first to talk you through an injection.

COMPUTER VOICE: To inject place black end against outer thigh.

GUPTA: Now, as parents themselves with children of severe allergies, their message is simple.

ERIC EDWARDS: Don't give up hope. Know that more treatments are coming available. More research, the awareness is growing. People understand this more than ever.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

GUPTA: We have an update now on 10-year-old girl whose family went to court to force their way on to the organ transplant list to get her a new pair of lungs.

Earlier this week, Sara Murnaghan found a match and got new lungs in a six-hour operation and they came from an adult and I want to explain why that can be a challenge. When you're the size of Sara you can't get lungs from a six foot tall grownup, for example, there simply isn't enough room. Let me show what I'm talking about specifically here. What she had specifically was a lobar lung transplant. So instead of taking the whole lung from the adult, they actually just took lobes of the lung as you see here, bottom lobes here and over here and that actually is more reasonably in terms of actually trying to size that for someone who is much smaller.

As with any type of transplant still, you still run the risk of infection, the chance of rejection, and all of the health problems that can occur when you are on immune suppressing drugs. Now, for the average lung recipient and this is always important stats to keep in mind, there's a 50/50 chance that the patient survives five years later after that transplant. For a child like Sara, it's really hard to say, there's just very little experience with children her age. But part of a transplant certainly is offering hope. We're certainly all rooting for this little girl to do well.

The Supreme Court made a big call this week on Myriad Genetics. That's a company that patented the BRCA1 and BRCA2 genes. Those are the genes that can determine your likelihood of developing breast or ovarian cancer. Now, Myriad created a test to assess your risk and their patent on those genes gave them the exclusive rights and that brought some intense criticism, and then the Supreme Court weighed in.

There's a lot to talk about here, it's very important in the world of medicine, and Dr. Valerie Montgomery-Rice, the dean of the Morehouse School of medicine, and she is back on the show to talk about this.

Welcome, doctor.

DR. VALERIE MONTGOMERY-RICE, DEAN, MOREHOUSE SCHOOL OF MEDICINE: Hi, how are you doing?

GUPTA: I know you've been following this case for some time. I think we talked about it last night who were here as well. What they said, the court said, is that, if something is simply a product of nature like your own genes a company can't say we want to patent that, we want to own that, but they did still uphold the rights to exclusively market the test, which, by the way, costs about $4,000.

It's interesting, it was a nuanced decision. I know you read it as well. How does that work? And what do you think this means for patients, your patients, for example?

MONTGOMERY-RICE: Well, you know, it was a very interesting decision. They protected Myriad's right, but they also gave patients rights also, and that is, to say that, you know, nobody really owns your genes.

But still, I think there's some level of recognition that in order to get to a product that we can do a test against, that there is some innovation that goes in to that and so that is of value. And so, when you're using what they described I think as -- I think the term they used was synthetic, synthetic gene, then you could definitely patent that.

Now, what that's going to mean for patients, we believe, is that we're going to see an increase in the research being done on genes in general to see if there are sequences that we can isolate and describe their gene and then to see if there was a mutation in that, that leads to an increased risk of disease. So, we won't see the limitation in that. So, I think it will raise the amount of competition that we see and hopefully will end up lowering the cost of some of these tests.

GUPTA: So maybe more patients, more woman, for the BRCA1 and BRCA2 can afford it. It's interesting. So, you can't patent the gene but as you point out you can patent the template that you make from that gene to create the test. Other companies can make their own template and that's sort of what drives this competition. Cost is also a factor I think and it's still going to be a factor even if it's cheaper because we're still talking about expensive technologies.

And that brings up the question: who should get this test, Dr. Rice?

MONTGOMERY-RICE: Well, the people, of course, who should get this test who have a high risk for breast cancer in their family, that is, they have a mother or sister who had breast cancer, particularly if those women were diagnosed with breast cancer before the age of 50.

They have a family member who also has colon cancer, a mother or father and someone who has had ovarian cancer, if they are of a special racial descent (ph), (INAUDIBLE), should also be considered high risk, and particularly if they are seeing patients who have someone in their family who were diagnosed with breast cancer at an early age, even if there had not been a family history before that person, because we know the mutation starts somewhere. And so those are the people we will recommend who would definitely want to get this test.

GUPTA: Always a pleasure, Dr. Rice.

MONTGOMERY-RICE: Always.

GUPTA: We know you're on the road, I appreciate you making the time for us.

MONTGOMERY: I appreciate for you all having me. Have a nice day.

GUPTA: Now, I want to turn to a doctor who did something that many people frankly thought was impossible. He led the effort to eradicate smallpox. Remember, well into the 1970s, smallpox killed 30 percent of its victims and there was no treatment whatsoever. To wipe it out took thousands if not millions of health care professionals and volunteers.

But for D.A. Henderson, it became his life's work.

(BEGIN VIDEO CLIP)

DR. D.A. HENDERSON, LED WHO SMALLPOX ERADICATION: Smallpox is a virus which throughout recorded has been the most lethal infection that mankind has been subject to. This is the only disease for which there are specific deities for this particular organism because they were so greatly feared. And, first of all, the thing that strikes you is the odor, it's a sort of sickly sweet odor, you'd never forget it.

To look at these people and look back at you almost pleading for something to be done, then you knew there was absolutely nothing you could do, nothing whatsoever.

Could we get rid of it in India? That was really going to be the acid test. I think it hit me really it was about five, six months since India's last case. Indira Gandhi, the prime minister congratulated India on its 28th year of freedom and the first months for India that it had been free of smallpox in written history.

I think that was when it really hit me, to think about that. In written history, this is -- goes back that far, and these are the first months without smallpox.

(END VIDEO CLIP)

GUPTA: And that was D.A. Henderson there. Dr. Henderson, thank you so much for all you've done.

Are you eating as well as you think you are? Super foods versus super myths. We've got that, next.

(COMMERCIAL BREAK)

GUPTA: As you probably know, we talk a lot on this program as food is medicine, but my next guest said if you want to get the most out of our fruits and veggies, we have to choose the right varieties. This is very important.

Jo Robinson is author of "Eating on the Wild Side: The Missing Link to Optimum Health."

You know, I think this is going to probably change the way that I buy my groceries now reading this book.

JO ROBINSON, AUTHOR, "EATING ON THE WILD SIDE": I hope so.

GUPTA: You said we've been breeding the nutrition out of our foods, not just for the last 50 or 100 years but for 10,000 years.

ROBINSON: That's right. We used to eat wild plants and wild game for like 98 percent of our time on this planet and then 10,000 years ago, we became farmers and looked at each other and said, hey, we can do better than this bitter food that we're eating, this chewy tough food, let's go gardening, but what we did was we selected the sweetest, the lowest in fiber, the lowest in antioxidant, and highest in sugar foods that we could find because we like the way they tasted, same as we do today.

GUPTA: I think this is so timely. And you brought some examples -- again, these are common foods that people might buy. What should we know about some of these foods?

ROBINSON: Something important to know is that plants are not creating these antioxidant for us. They're doing it because they have to defend themselves against the sun and other external threats.

GUPTA: That's a good point.

ROBINSON: And they do it by creating, these are two apples, these are both galas, same kind, but this one grew with full exposure to the sun and it had to create all this botanical sunscreen, all these anti- thiamine, and this one is shaded and didn't have to produce us. When we eat the redder one, we absorb that protection and it protects us.

GUPTA: That's a great tip.

ROBINSON: Yes.

GUPTA: The skin itself here is full of the good stuff you're talking about.

ROBINSON: Exactly. Most of the nutrients in most foods are in the skin because that is what is exposed to the elements and where the plants have to have the first line of defense.

GUPTA: Right. Love my salad. So, I'm suppose to stay here.

ROBINSON: This is the most popular salad in -- green in the United States. We make --

GUPTA: Iceberg.

ROBINSON: -- 450 million metric tons a year. This is iceberg.

Now, what we need to know here is that these leaves on the outside have a fair amount of antioxidant, but in the inside, they have been sheltered from the sun, and so, they have 1-100th as much.

GUPTA: Wow, 1 percent you're saying.

ROBINSON: That's right.

GUPTA: That's the part that everyone eats, I mean.

ROBINSON: Yes, yes. So this is a very low nutrient lettuce and it's our most popular. What people need to look for is one that has open leaves, exposed to the sun, this is botanical sunscreen. And when we eat it and we get protection against inflammation and cancer, all these things that antioxidant are proving to be important for.

GUPTA: That's a great tip. Great tip. What about carrots?

ROBINSON: Oh, this is also a good example. Lot of people are eating these baby carrots.

GUPTA: Right.

ROBINSON: They're not baby carrots, they're big carrots which are misshapen and they're just trying to use them up, you know, make -- not have to throw them away, so they whittle them down until they're this shape. But they've gotten rid of that outer part that is the most nutritious. In fact, if you just peel a carrot, put the peels here and the carrot there, the peels are as nutritious as what you have left.

So, they've whittled this down to the point where there's very little left.

GUPTA: And, again, this is presumably in the interests of trying to make it more palatable, more tasty and in the process have taken away the nutritious value. ROBINSON: That's right. It's looked as a good economic move, which it is.

GUPTA: Yes.

ROBINSON: But now we're learning that it's taking away the medicine.

GUPTA: It's a great book. I think people will change the way they buy their food. I know that I will. Thank you very much.

ROBINSON: Thank you.

GUPTA: And still ahead, chasing life with an underappreciated super food, kale. It's coming up.

(COMMERCIAL BREAK)

GUPTA: I'm not going to pretend that cooking is my area of expertise, although I'd love for it to be. It is something I love to do also with my daughters, and I want to share something that's one of our favorite healthy recipes, I think I can teach it to you. It's pretty quick, easy. It's going to help you chase life.

Kale chips, they are perfect when you are craving something crunchy to snack on. Now, as you may know kale is a leafy green vegetable, you may not have heard of it but it's commonly sold in the produce section of most grocery stores. To turn them into kale chips, what you do is break off the stems over here and break them into chip-size pieces like this.

And take a small amount of olive oil, some sea salt perhaps and bake them in the oven until they get crisp. There you have it, kale chips. Even I can't mess this up.

The question is why are kale chips better than the rest? Well, they contain less than 50 calories, one gram of fat. They are low carb, but also high in fiber and protein and they have no cholesterol and saturated fat, they are packed with vitamins A, C, and K and as I just showed you, you can make them here pretty easily.

That's going to wrap things up for SGMD today. Stay connected with me at CNN.com/Sanjay. Let's keep the conversation going on Twitter @DrSanjayGupta.

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