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HealthWeek Show No. 117

ANNOUNCER: Funding for HealthWeek is provided by the Howard Heinz Endowment and the Teresa and H. John Heinz III Foundation.

SHARYL ATTKISSON: Today on HealthWeek... Zapping away the wrinkles. How lasers are putting a new face on cosmetic surgery. The needless tragedy of childhood bike accidents. Why isn't more being done? And an herb expert who's showing others how to open nature's medicine chest.

LANNY KAUFER, HERBOLOGIST: These leaves are actually kind of dry.

SHARYL ATTKISSON: Hello, I'm Sharyl Attkisson. Welcome to HealthWeek.

FATS
Today, we begin with news about the role of fat in our diets. You think you're doing everything right. You always drink skim milk, buy lean cuts of meat and use oil-free salad dressings. That blanket approach to low-fat eating will earn you high marks from many health experts. But others say not so fast, there may be much more to it than that. HealthWeek's Andrew Holtz has details from Portland, Oregon.

ANDREW HOLTZ: Low fat here, low fat there. It's a message we keep hearing: follow the low-fat road to better health.

WILLIAM CONNOR, MD, OREGON HEALTH SCIENCES UNIVERSITY: The big point is that we can prevent certainly many of the chronic diseases that Americans are afflicted with and are dying from, particularly coronary heart disease.

ANDREW HOLTZ: But in a debate appearing in the current New England Journal of Medicine, other experts say Dr. Connor's simple message against fat may be too simple.

WALTER WILLET, MD, DrPH, HARVARD SCHOOL OF PUBLIC HEALTH: The American public has been led to believe that all fat is bad, and that fat in a diet will make us fat. Unfortunately, this just isn't true. There's good fats and bad fats, and also it's excess calories, not fat, that makes us fat.

ANDREW HOLTZ: In his diet, Dr. Willett uses lots of olive oil. It's full of fat, but it's unsaturated fat. Studies indicate olive oil and other vegetable oils may help lower levels of the so-called "bad" cholesterol without reducing levels of "good" cholesterol. In contrast, cutting back on all fat can lower both "good" and "bad" cholesterol.

Starting to sound complicated? Well, it is. So a key issue for experts is: at what point does more detailed, and perhaps more accurate, diet advice about fats, saturated, unsaturated and so on, end up over-saturating our brains so we just tune it all out?

Indeed, this dietary fat debate has less to do with what scientists have learned than it is about just what to tell the rest of us to eat.

WILLIAM CONNOR, MD: The public obviously needs to hear a clear voice of what people should do, from the medical profession, and it has that clear voice from all the health agencies which have considered this matter for a long time.

ANDREW HOLTZ: But clinging to clarity may sell short the public, according to those on the other side.

WALTER WILLET, MD: Unfortunately, some people in the nutrition community have felt that the public's just too dumb to understand the difference between good fats and bad fats. But this is really the most important distinction, because eliminating good fats can actually be harmful.

ANDREW HOLTZ: Meanwhile, both sides say don't despair. Beyond their debate over fat strategy, there's broad agreement that you should stay away from the sugary seductions of most so-called "fat-free" treats. And instead, stick to fruits and vegetables.

SHARYL ATTKISSON: So if you'd like to try getting more "good" fats into your diet, how do you go about it? Here with some guidance is Robyn Webb, an author and nutritionist.

Your advice is not to load up on so-called good oil.

ROBYN WEBB, NUTRITIONIST: That's right. If you're going to choose an oil for your diet, what I would recommend is to concentrate on a particular type of oil, monounsaturated fats. And that would include olive oil, peanut oil or canola oil.

SHARYL ATTKISSON: When you're looking for olive oil and you see all these different types, there's virgin, extra virgin and so on, what does all that mean?

ROBYN WEBB: The terms can be quite confusing. First of all, something called extra virgin olive oil comes from the first pressing of the olives, virgin comes from the second, and pure comes from the third, and extra virgin olive oil is going to be your tastiest. Cold pressing, what that means is when the olive oil is made, very little heat is applied to the process. The oil is then filtered and bottled, and also that is a very good tasting olive oil.

SHARYL ATTKISSON: For people who don't care for the taste of olive oil but would like to get some of that into their diet, they might like the pure then, it sounds like.

ROBYN WEBB: They might like the pure, or they might enjoy, which has been on the market in recent years, something called extra light or light olive oil. This does not mean it's lower in fat grams or lower in calories. What it means is it's lighter in taste. And this is also good for baking where you wouldn't want the very heavy taste of olive oil.

SHARYL ATTKISSON: You brought two recipes here in which you've used olive oil. Can you describe those for us?

ROBYN WEBB: Absolutely. These are Mediterranean-based dishes. The first one that we have here is a chicken dish. It could be served hot; it could be served cold, with lots of vegetables. And the olive oil, how we used it in here is to mix it in a dressing with a little bit of lemon juice and a little bit of herbs. The second dish I that have here is a bean dish. This is a wonderful vegetarian dish that could be used as a main dish or as a side dish. This has navy beans, all kinds of vegetables, and again the olive oil is used as a dressing. I would prefer to use olive oil more in cold food preparation, as examples with these two recipes, versus actually applying heat to the olive oil.

SHARYL ATTKISSON: It's just more difficult to cook with?

ROBYN WEBB: Well, it's a little bit difficult to cook with because it has what is known as a low smoking point. So, in other words, if you keep the pan on heat for a prolonged period of time, your pan could burn. So it's better to really do it in cold food preparation.

SHARYL ATTKISSON: In our final seconds, olive oil on the shelf at the grocery store looks so much more expensive, for example, for a tiny little jar than the vegetable oil.

ROBYN WEBB: Right, that's correct. Well, sometimes the olive oils are expensive, particularly if they have herbs or spices added to them, so you can do that yourself.

SHARYL ATTKISSON: All right. Robyn Webb, thank you so much.

If you would like more information, Robyn's recipes or anything else you've seen on HealthWeek, you can call our toll-free number shown at the end of the program.

Thank you so much.

ROBYN WEBB: You're very welcome.

HEALTHNOTE
Olive oil has a shelf life of six months if stored in a cool, dark place.

SHARYL ATTKISSON: Now, for a story about the quest for eternal youth... or at least the appearance of it. New laser techniques have made surgery an appealing way for some people to erase years from their faces. But critics warn that these "cut-free" procedures are not "risk-free." HealthWeek's Cindy DiBiasi reports.

LASER COSMETIC SURGERY
CINDY DIBIASI: You see it everywhere. Americans love affair with youth and beauty.

ELLEN BAKER, PATIENT: "I couldn't stand looking in the mirror. Every time I looked in the mirror, all I saw was terrible wrinkles."

CINDY DIBIASI: But for thousands of women, the face they see in the mirror, and the one they envision in their minds, don't match.

TINA ALSTER, MD, DERMATOLOGIST, GEORGETOWN UNIV: "Women in particular will say I hate these lines around my mouth. I look just like my mother and I really don't want to look like that."

CINDY DIBIASI: And now doctors say you don't have to. This is the sound of years being erased from a woman's face. It is laser surgery, a procedure that literally vaporizes wrinkles and does some minor tightening of the skin without ever making a cut. And the buzz over cosmetic laser surgery is just beginning.

ROBERT ADRIAN, MD, DERMATOLOGIST, GEORGETOWN UNIV: "Carbon dioxide laser resurfacing will most likely go down as one of the most significant advances in cosmetic surgery in the last 30 years."

CINDY DIBIASI: The newest lasers, ultrapulse carbon dioxide, or C02 lasers, emit a diffused beam of light to the outer layer of the skin. While a traditional face lift tightens a sagging face, it doesn't always work on fine wrinkles. And that is Ellen Baker's problem, those tiny wrinkles that come from a lifetime of bad habits like sun exposure and smoking. She's turned to Dr. Tina Alster for help.

ELLEN BAKER: "I don't want to look younger, I want to look better. I don't think it's going to make me look younger, but perhaps a little healthier. And it's going to take away a lot of the damage from sun and smoking."

CINDY DIBIASI: At first glance, the surgery seems like a cinch. Patients are put under a light anesthesia, and in about 45 minutes wrinkles are removed.

DOCTOR: "See, she really doesn't look like she has any wrinkles around her eyes anymore."

CINDY DIBIASI: But is it really that simple?

ROBERT ADRIAN, MD: "I've had people come in to me and ask if I could remove their wrinkles because they had a dinner party tonight. They really have no concept of what's going on."

CINDY DIBIASI: The first few days following surgery can be tough. The skin is raw and must be repeatedly cleansed to prevent infection. Patients may need to sleep sitting up, their faces packed in ice.

TINA ALSTER, MD: "Usually at post operative day number two and three people are pretty miserable and they require the use of pain medications."

CINDY DIBIASI: That was the case for 48-year-old Carol Sullivan, who had the procedure done five months ago.

CAROL SULLIVAN: "It just felt like a real uncomfortable sunburn. It's kind of red and very swollen and oozing; it's really yucky. Only about seven to ten days where you're saying, 'I don't know what came over me, I wish I hadn't done this.'"

CINDY DIBIASI: Healing takes four to six weeks and skin redness may continue for as long as 6 to 12 months. During that first year, some of the wrinkles may return, but usually not as deeply.

That's when the surgery works. But there can be complications if doctors delve too deeply and scar the skin, for example. Another possibility is infection. This woman, who wants to remain anonymous, had laser resurfacing performed by a doctor who failed to give her the proper medication to prevent infection.

WOMAN: "I felt like my face was on fire. I had never felt that kind of excruciating pain in my life."

CINDY DIBIASI: Her new doctor has been able to control the infection and hopes to clear up the scarring.

While most doctors are vigilant and properly trained, patients need to be aware that this is a new procedure and there are no regulations governing the use of lasers.

DOCTOR: "Watch this very carefully. You'll see with this pulse the degree of collagen contraction."

RICHARD GREGORY, MD, AMER SOC FOR LASER MEDICINE: "A person can buy a laser, and put it in their office and declare themselves a laser surgeon simply by hanging a shingle out that says that on it."

CINDY DIBIASI: In the last few years, thousands of doctors have started to do laser facial resurfacing, usually in their offices. Everyone from plastic surgeons and dermatologists to dentists and ophthalmologists.

RICHARD GREGORY, MD: "I think that the reason why laser surgery is so hot right now can be summed up in one word: money."

CINDY DIBIASI: It's really no surprise why so many doctors are jumping on the cosmetic laser surgery bandwagon. Since this is an elective procedure, most insurance companies won't cover it. The good news for doctors is that they don't have HMO's or insurance companies telling them what they can or cannot do. And most cosmetic patients pay cash -- up front.

And this beauty does not come cheaply. A full face resurfacing can run up to $8,000. Touch-ups start at $1,500.

For Carol the expense and pain were well worth it. This was Carol before resurfacing. And this is what she looks like after shedding a decade.

SHARYL ATTKISSON: If you like what you've seen and are considering laser facial resurfacing, one of the most important decisions is your choice of a doctor. Be sure to look beyond the ads: many good laser surgeons don't advertise. It's usually smarter to choose a surgeon who's recommended by your family doctor or by friends who've had the procedure. Also, it's a good idea to talk to several surgeons before making your final selection.

Here are some questions to ask them: What's your experience with this procedure? How many have you done? Can I see before and after photos of your patients? What are the risks of the procedure? What are the costs, and will insurance cover it? And one more very critical question: What will you do if the procedure doesn't work?

BIKE HELMETS
Whether you're young or old, it's hard to beat bicycling as a good way to exercise. But if you're careless, it can be a dangerous form of exercise. In this HealthWeek quiz, we test your bike safety I-Q. Our first question: Head trauma is the most common serious injury from bike accidents. True or false? And bicycle injury rates are highest among children under 16. True or false?

If you answered "true" to both of those questions, you're probably up to speed on bike safety. Unfortunately, all too many people still don't know the value of wearing a bike helmet. Each year, many children suffer tragic head injuries that could have been prevented if they had simply worn bike helmets. HealthWeek's Marcia Brazda has more.

MARCIA BRAZDA: For Katrina Carter every day is a test of endurance, a tiny step forward in her lifelong rehabilitation process. Katrina is recovering from a bicycle accident in which she wasn't wearing a helmet.

SANDI CARTER, KATRINA'S MOTHER: "She lost control of her bike and flipped head first over her handlebars and landed on the blacktop."

MARCIA BRAZDA: Katrina was an active four-year-old when the accident happened near her home in Seattle, Washington. The blow to her head caused internal bleeding. Pressure on her brain led to a series of strokes. She was in a coma for five months.

SANDI CARTER: "If she did come out of it, out of the coma, they told us, well, you can expect her to be blind and she won't have any intelligence. She won't have any academics, and she has far, far exceeded all of their expectations."

MARCIA BRAZDA: Eleven years after the accident, Katrina is still struggling to regain her speech and motor skills. She's an honor student with one burning cause: to persuade others to wear bike helmets.

SANDI CARTER: "It scares her because she's afraid what happened to her could happen to anybody that doesn't wear a bike helmet."

MARCIA BRAZDA: Katrina's neighborhood crusade is a small part of the most successful bike helmet campaign in the country. In Seattle, 55 percent of children and 85 percent of adults wear bike helmets compared to the national average of 15 percent. Pediatrician Abraham Bergman helped create the Seattle campaign a decade ago.

ABRAHAM BERGMAN, MD, HARBORVIEW INJURY PREVENTION CTR: "When we started, three percent of children in Seattle were wearing helmets. We did studies to find out why."

MARCIA BRAZDA: The studies found that parents didn't know bike helmets could protect their children from brain injury, that helmets were too expensive, and that children wouldn't wear them if their peers didn't.

ABRAHAM BERGMAN, MD: "The most important objectives are to acquaint parents with the need, the danger of bicycle head trauma. The fact that brain injury is a long lasting, serious disability and that it can be prevented."

MARCIA BRAZDA: Getting that message out became a community-wide effort involving local businesses, the health department, bike clubs, medical facilities and the media.

ABRAHAM BERGMAN, MD: "We have found that 85 percent of brain injuries can be prevented. We've seen a concomitant decrease in the number of head injuries in Seattle as a result of our campaign. I can't understand why this isn't being done all over the United States."

MARCIA BRAZDA: Lack of federal funding is the main reason say safety experts.

WILL HATCHER, NATL BRAIN INJURY ASSOC: "We don't have legislation at a federal level that would mandate the requirement of using bicycle helmets, and I think once you have that in place then people will place a higher priority on that, and then I believe funding will follow that legislation."

MARCIA BRAZDA: In the meantime, fifteen states have taken matters into their own hands passing laws requiring children to wear helmets.

C. EVERETT KOOP: "Only half of all parents make sure that their children wear bike helmets on every ride and that's not good enough."

MARCIA BRAZDA: In the absence of a federal effort, celebrities like C. Everett Koop are leading a private initiative called the National Safe Kids campaign. The coalition of 240 groups lobbies for state laws, teaches bike safety and gives away bike helmets in inner cities. They've also developed a series of public service announcements aimed at children.

PUBLIC SERVICE ANNOUNCEMENT: A fall from a bike can hurt your brain so that you have a hard time seeing, smelling, walking or thinking.

MARCIA BRAZDA: Eleven-year-old Brian Longworth is a spokesperson for Safe Kids. He was hit by a truck two years ago while riding his bike without a helmet.

Brian has gotten the attention of lawmakers, including his Senator, Bob Graham, of Florida.

SENATOR GRAHAM: "You took a real bad thing that happened to you and turned it into something good for thousands of children."

BRIAN LONGWORTH: "Yeah, I learned that lesson the hard way."

MARCIA BRAZDA: The question is whether Brian's lesson and Katrina's and thousands of children like them will ever reach the entire country.

ABRAHAM BERGMAN, MD: "A brain injury is serious business, and the fact that we're not preventing these injuries, not making every effort to prevent them is criminal."

SHARYL ATTKISSON: Here to show us the right way to buy and use bike helmets is Kathy Wood with the National Safe Kids Campaign and Marcus Dorsey, who is going to help in our demonstration.

First of all, show us how to pick the right helmet to buy for our child.

KATHY WOOD, NATIONAL SAFE KIDS CAMPAIGN: The first thing you want to do is make sure that the helmet meets safety standards. And inside the helmet there is a sticker that will say ANSI Snell or ASTM, and this applies for adults as well as for children.

SHARYL ATTKISSON: All right, just because it has the sticker on this inside though does not mean this is the helmet that will fit your child. So tell us about that.

KATHY WOOD: That's absolutely correct. So the fit is very important. This helmet is too big for Marcus. And we can show you here. Marcus, shake your head. Look how it falls back and forth. Another test to do, when I do this, it exposes the forehead; when I do this, he can't see.

SHARYL ATTKISSON: And that's not something that could be corrected just by tightening the chin strap.

KATHY WOOD: Absolutely not. It's too big inside.

SHARYL ATTKISSON: All right. So then show us a helmet that we have fitted properly to Marcus.

KATHY WOOD: This helmet has got bigger pads in it. And when I push down on it, I can feel some resistance, and that's very important.

SHARYL ATTKISSON: How does that feel, Marcus?

MARCUS DORSEY: Much better than the other one.

SHARYL ATTKISSON: It's tighter, right? It's tighter on the inside.

MARCUS DORSEY: Yes.

SHARYL ATTKISSON: Okay.

KATHY WOOD: And the straps come down in a V over the ears, and the same is true, now if you shake your head, we'll see it stays pretty much in place.

SHARYL ATTKISSON: And then if you knock it, it doesn't fall the same way. Which part of the head are we trying to protect? Because we see kids wearing these helmets way back here on the back of their heads. They shouldn't be, right?

KATHY WOOD: No. It should be over the forehead, no more than one or two finger breadths above, and it is to protect the base of the skull. Because you want to protect the brain.

SHARYL ATTKISSON: Tell us a little bit about the cost. In general, is a more expensive helmet a better helmet?

KATHY WOOD: Absolutely not, as long as it meets the safety standards, it's acceptable.

SHARYL ATTKISSON: And we used to see bicycle helmets only for sale in specialty shops and bicycle shops. Now you see them all over the place. It doesn't matter where you buy them as long as they have the sticker on the inside.

KATHY WOOD: That's true. And you can get them as cheap as $15, $10 even, some places.

SHARYL ATTKISSON: The final obstacle for some parents may be getting the child to want to wear the bicycle helmet. In Marcus' case, his parents have told me that you don't want to wear your bicycle helmet. In fact, you haven't been wearing it, right?

MARCUS DORSEY: Yes.

SHARYL ATTKISSON: Why not?

MARCUS DORSEY: Because sometimes it doesn't feel comfortable.

SHARYL ATTKISSON: And so they don't let you ride your bicycle anymore if you don't have your helmet on.

MARCUS DORSEY: Yes, they won't.

SHARYL ATTKISSON: So what we're going to do, courtesy of the National Safe Kids Campaign, is send Marcus home with this helmet that he likes. Will you wear this one do you think?

MARCUS DORSEY: Yes, I will.

SHARYL ATTKISSON: Okay, good. What do you think are some other tips about getting children to want to wear that helmet? Because they are sort of oblivious sometimes to the safety aspects.

KATHY WOOD: It's important for them to be able to pick out the helmet that they like. It's also important for parents to be consistent and set rules and set examples, to be role models, because it's very important for parents to wear helmets, and children will follow what their parents do.

SHARYL ATTKISSON: If there's one final message that people can take away from this interview regarding bicycle safety, what would it be?

KATHY WOOD: That it's important to wear bike helmets, but also the rules of the road and other bicycle safety information is also very important.

SHARYL ATTKISSON: Kathy Wood, thank you so much for giving us the safety tips, and Marcus, thank you for the demonstration. Good luck to you.

DOCTOR'S CORNER
DR. BRUCE DAN: I'm Dr. Bruce Dan. There are more than 25,000 medical journals. Some of what's published makes the news, but most of it doesn't get much further than your doctor's desk.

For example, did you know that chewing gum can act as a laxative?

The British medical journal Lancet reports the case of a 32-year-old flight attendant who had up to 10 episodes of diarrhea a day for seven years. Laboratory tests and x-rays failed to find anything wrong.

Her doctors were stumped until they found out more about her personal habits. It turns out she chewed lots of sugarless gum, 60 pieces a day, to be exact.

Sugarless gum contains the artificial sweetener Sorbitol, which acts as a laxative. As few as eight pieces can have an effect. So when she stopped chewing the gum, her problem went away.

The medical mystery was solved. But what's still unknown: Why would anyone chew that much gum?

With Doctor's Corner, I'm Dr. Bruce Dan.

HERB WALK
SHARYL ATTKISSON: To most of us, they're just weeds: scruffy plants we pass without a second glance. But to others, they're a marvelous, free pharmacy. HealthWeek's Pat Anson takes us on a walk through the mountains of California for a look at the herbs that heal.

PAT ANSON: Matilija Canyon, a wildlife preserve in Ventura County that's long been a favorite of hikers and nature lovers.

This group of hikers is about to learn more about nature's power to heal.

ZACHARIAH: "Mama!"

PAT ANSON: When four-year-old Zachariah skins his knee, hike leader Lanny Kaufer is quickly there with first aid -- not with a Band-Aid, but a leaf.

LANNY KAUFER: "See how it sticks right on there?"

PAT ANSON: The leaves are from a plant called pearly everlasting, once used by Native Americans to heal open wounds.

Zachariah is not badly hurt, and the hike continues.

The first aid lesson helps Kaufer make an important point. Plants most of us consider weeds, he sees as medicine.

LANNY KAUFER, HERBOLOGIST: "Discovering herbs as medicine, as food, that's part of that whole trend towards living a life, a less polluted, less tainted life closer to nature."

"These are saponins. These are a naturally occurring detergent."

PAT ANSON: Kaufer has studied herbs for thirty years, and is eager to share what he's discovered.

On herb walks, he encourages hikers to use all their senses, touching, smelling, even tasting.

WOMAN HIKER: "Very pleasant."

PAT ANSON: Herbologists believe that the same natural oils and resins that protect these plants from drought and disease can also be used to protect humans, giving a boost to our immune systems to fight disease and infection.

The fact that some doctors take a dim view of this doesn't stop Kaufer from spreading the word about herbs.

LANNY KAUFER: "Pretty easy to identify this. There are not too many flowers that look like a fried egg."

PAT ANSON: He says poppy leaves can be used to fight athletes' foot, white sage makes a good antiseptic, and bark from a willow tree can reduce fever and headache.

But it takes a trained eye to know the difference between a beneficial plant like blackberry and a dangerous one like poison oak.

HIKER: "I've been in and out of this canyon a million times and I never knew what I was seeing."

PAT ANSON: Helping others rediscover herbs is just one of Kaufer's goals.

He wants people to reconnect with nature and to a healthier, more natural way of living.

SHARYL ATTKISSON: Remember, it's not a good idea to set out on an herb walk without an expert. Many wild herbs are hard to identify; some even have poisonous look-alikes.

That's all for this week. Next time on HealthWeek, we'll show you some new alternatives to hysterectomies, and give you a heads-up on the hidden dangers of lead in the home. And if it's a major battle to get your kids to take their medicine, you'll want to see how one father-son team is tackling that problem.

Until next time, thank you for joining us. I'm Sharyl Attkisson. Be well.

ANNOUNCER: For general information about stories in this edition of HealthWeek, please call 1-888-562-8300. Or write to the address on your screen: HealthWeek, Maryland Public Television, 11767 Owings Mills Blvd, Owings Mills, MD 21117.

Funding for HealthWeek is provided by the Howard Heinz Endowment and the Teresa and H. John Heinz III Foundation.

To order a video or a printed transcript of this program, call 1-800-338-8440. Please ask for the program number on your screen. Program No. 117.


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