well, just put on a breathe right strip and pow! it instantly opens your nose up to 38% more than cold medicine alone. so you can breathe and sleep. shut your mouth and say goodnight mouthbreathers. breathe right time now for "sunday housecall". >> welcome. joining us dr. marc siegel professor of medicine at nyu. >> and dr. david samadi chairman and professor of urology at lenox hill hospital. >> great to see you. >> we start housecall today with a new report that americans

while shelling out more money on health care than any other industrialized nation but we have one of the lowest life expect achbscys. >> before people panic, i would say they're living to the age of 79 now approximately which is much better than we ever did. decades ago it was 60. we're up to 79. but japan's up to 83 and western europe is up to 82, great britain around 82. why? why are we lagging behind? >> can i guess? diet. >> absolutely. i think number one reason is the obesity epidemic in the united states. wouldn't you be shocked to find out that in japan 1.5% of the population is obese? in france 6% is obese. united states? 36% of us are obese. why are we obese? well, david and i talked about this before the show. we eat -- there's a lot of processed foods we eat. we don't eat enough fruits and vegetables. we talk about the mediterranean diet. we don't eat it. we add antibiotics and chemicals

to our food. all of these -- hormones. all of these things cause us to bloat up. then we're chasing our tail because we get diabetes sarltd of getting obese. then spend a lot of money treating diabetes. so we spend a lot of money on diseases we could avoid if we exercised and ate right and didn't eat processed foods. one good thing i want to say is we are possibly number one in the world in emergency care and we're very close to the top in cancer care because doctors like dr. samadi, great technology that we have, but also the emphasis on screening we have. we've talked about it on the show many times. we catch cancer early here. that's something we should continue. >> so it's very interesting because it's a very complex topic. i'm not sure if there's one answer for this. 17% of the gdp in this country is spent on health care. what does that get you for your care? in certain things such as cancer, mammograms, breast cancer, prostate cancer, colon

canc cancer, we're doing better than other countries. but overall health, we're lagging behind. a lot of it could be we see the price of drug manufacturers, we see that our emergency rooms are basically filled up because of poverty. not everyone has insurance. and the insurance prices are different for everyone. our health care system is completely different than some of those in england and denmark and scandinavian countries. it's very important i've traveled all over the world, done surgery in france, the middle east, i've been here. what i want to distinguish is our health care versus health. i think in health care when it comes to innovations, robots, mris, keem therachemotherapies, best. when it comes to health, obesity, your self-discipline, the environmental factors that go, is our food contaminated or not? are we putting too much fructose and other things we spoke about last week in our food?

in that we're not doing well. >> what should we do? you mentioned france. they've got red wine. >> but something to the point, i don't want to get political, but you mentioned france and the other countries. we're talking about health care prices. they have a one system there. again, i'm not talking about politics. i'm asking does that help? >> it doesn't help because what happens is the doctors have no reason to really go -- yes, the quality is going to be affected because they look for any excuse to cancel things. in canada, in europe you want to get an mri? we're getting those patients. it's one of the reasons we're getting so many international patients from there. they're coming here because you get diagnosed with prostate cancer in june, the next available surgery is december and you can wait and wait. the hospitals don't have enough room. people wait for a long time. whereas now they can -- >> but it seems they're on to something. you talk about france, the fresh food. >> that's -- >> japan and rice and beans. >> here's the key.

this is to your point, we're a disease-oriented system. we've got the middleman waiting, the insurance company, waiting to profit -- and this is political -- off of us getting sick. true prevention is on the treadmill, on the elliptical, eating fruits and vegetables. it will cost the system a lot less if you eat fruit and vegetable instead of fattycarbo. you ghetto bees. the reason you get diabetes when you become obese, we only have a certain amount of insulin in our bodies. >> go to a restaurant, it's over the plate. >> it's not all about obesity. i want to go back to, when you have one health care system that covers everybody, i'm totally against it but there are some benefits to that because a lot of these poor patient that's have no access, can't take care of themselves, may not go for screening, they show up at very late stage in our emergency room

or hospital that's going to cost a lot more. >> what should they do at that point? >> i think everybody in the country -- if i was running and i interviewed ben carson and i think he has good things to talk about, if as a doctor i would say everybody should have some sort of a catastrophic insurance. everybody should have access to health care. you should be in charge of your own health. we talk about obesity or diabetes. you should self-discipline. for example, if you go for an mri, it should come out of your pocket, not the third payor who tells the doctor what you're going to get paid. you pay for it. we're paying a lot more insurance companies. if you're in charge, you have an incentive to lose weight and be healthier. >> it's disparity. poor people aren't getting enough care. but it's also the food we eat. our diet is loaded with suit. we get high blood pressure from all the salt and processed food. then we get heart disease. 700,000 people in the united states dying of heart disease every year. this could be predevelopmented. >> but the best health care system in the world and i know it will get a lot of flak, it's

still here. >> if you have a heart attack, get sick, absolutely. >> despite traveling all over the world, this is still the best health care system. we don't want to go backward. we want to fix the system we have so we have the innovations, have companies that have an incentive to come up with the next -- >> i guess bottom line, you are what you eat. >> absolutely. >> very true. it's true. >> thank you. so no doubt surgery can be a very serious under taking. now a growing debate about whether some patients should undergo mandatory therapy. we're going to ask our doctors what they think about this. i was out for a bike ride. i didn't think i'd have a heart attack. but i did. i'm mike, and i'm very much alive. now my doctor recommends a bayer aspirin regimen to help prevent another heart attack. be sure to talk to your doctor before you begin an aspirin regimen.

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undergo mandatory therapy before or after undergoing the knife? that's what a lot of doctors and surgeons are asking themselves. what's behind this trend? dr. samadi, i want to start with you. you're talking about giving them a psychoanalysis before or after surge surgery? >> yes. there's a study coming from canada, a bariatric surgery we're talking about for obese patients. the same exact thing is correct for some of the surgeries like gender changes, gender assignment. even the rhinoplasties for nose jobs. there may be patients who have issues with their body image. they may go for surgeries that aren't necessary, plastic surgery, weight loss. 6,000 patients from canada followed for five years, they find these obese patients have a higher chance of hurting themselves. they're depressed. they may go to the emergency room because of committing suicide, et cetera. the whole message is, as a surgeon in our field i see it

and i use it to help me. you walk into the room and as a surgeon you cannot just be a mechanical person. it's not about taking a prostate or uterus out. what happen to the follow-up? just like postpartum depression. there's post-surgical depression and follow-up is extremely important. assessing before the surgery psychologically, are they ready to go for surgery or not? and what happens afterwards? these are key points from the study and if you are really going through a tough time, you don't have the social net wroshg to support you, ask for help. when you're in the doctor's office, say, doctor, i'm not doing well. i need help. >> what do you think, dr. siegel? >> i don't like the word "mandatory." but what i do like, last segment we talked about insurance bloat and how it leads to health care costs. this time i want to say insurance companies are doing a good thing because before bariatric surgery, they want a cardiologist to see them, lung doctor to see them. they want a psychological evaluation. a lot of insurances won't cover

it unless you have one. but the problem is after the surgery. they lose track of the patients. the patient has to have a drastic change in lifestyle now. suddenly -- it's not they fix it with bariatric surgery. now you have to watch what you eat. the amount you eat diminishes greatly. people get depressed. in the second and third year after these surgeries we're seeing a lot of people ending up in the emergency room with self-harm or drug abuse. this is not something being caught up on because we lose track of them. >> it affects your social outings as well if you have one of those surgeries where you have a lap band, your stom sack is smaller. i know situations where people have to excuse themselves from the table because they can't eat. >> they get stigmatized. they don't think of themselves the same way. maybe they get a better self image that they've lost weight. but in other ways they've more self conscious. >> i think because of such a sudden change. losing so much weight in a short period, society is judging them.

it puts a lot of pressure on them. it's true that because of the weight loss you have to monitor your sugar level, your endocrine an hormones. that follow-up is essential because in the first couple of years after surgery is when we see these guys start to self-harm. that's a key point. >> one more point. it's not only this surgery. david and i were talking about this. it's all surgeries. the more extensive the surgery, the more this is a risk. that's why we like minimally invasive surgery, robotic surgery or a cardiac stent. you don't even notice anything different the next day. the less invasive the better. the more expensive the surgery, the bigger risk. >> it's interesting you bring this up. a lot of times the minimally invasive patients end up going home earlier and the less time you sfend in the hospital, less depression. >> good idea to think about therapy after surgery. it can affect you in many ways you wouldn't realize. >> coming up, we'll have an eye-opening new study on the benefits of sex. that's right. could sex be the key to a healthier immune system?

we're going to want to hear all about this. the doctors will fill us in. it's one of the biggest indicators of how healthy you are. we will also talk about what a low white blood cell count means for all of our health.

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we talk about everything that worries us. one viewer writes, my white blood count has been low the last three times taken. my primary care doctor suggests i see a hematologist. should i be concerned? dr. siegel? >> maybe. maybe be concerned but we don't know the underlying reasons. the regular blood test you get from your doctor, this is one of them. what is a white blood cell. it is a cell that looks into -- looks at a foreign bacteria or virus coming in and either engulfs it and destroys it or secrets an antibody to kill it, a chemical that kills it. we need them to function. if they don't function, we end up with infections and we have a problem with that. it can be caused by a virus, by cancer, and several other thing s, but basically a lot of drugs

can have side effects that can cause this, so a good internist will look at that, a sherlock holmes and say why is this happening, is it infection, due to medication, is it something else going on? >> i think you have to look at the source of what white count is coming from. we talk about bone marrow, like a bank with many different currencies, red blood cell platelets, white blood cell, the soldiers that will protect us from any kind of virus or bacteria. if you've gone through, for example, chemotherapy, that can affect your bone marrow. if you have a cancer in the bone marrow, now you're not producing white cells. that's when you have a low white cell. >> certain cancers. >> certain cancers. certainly if you had radiation, if you had inflammatory bowel disease, rheumatoid arthritis, those are reasons why your white count should be low. we talked during the commercial, if you get a number that doesn't make sense, you're perfectly healthy, go to the doctor, you get low white count or high white count, it is always good to repeat your blood test and find out if that's accurate or not.

and there are some injections that we can give you to boost your bone marrow to make more white cell if that's necessary. but one also needs to rule out diseases such as tuberculosis or hiv, that's another reason now. how low is low? >> leukemia and lymphoma. one more thing, if you have this, if you have this, you should stay away from people who are sick. that may seem obvious, but really at higher risk. >> how do you know if your white blood count -- >> you probably don't know it. you may start having erosion on your gums, your hair can fall out, there is ways you can know, you feel fatigued or maybe have no symptoms at all. >> make sure if you have a low white count, cover your mouth, not being crowded, wash your hands, don't use razor, you can get an infection. for women, it is probably advice not to get tampons because that increases risk of infection a and -- >> how does that raise the risk of infection?

>> toxic shock syndrome. >> flu shots i'll still give you. >> we'll talk about that in the coming weeks, that season is coming. >> let's talk about sex, baby, let's talk about you and me. that's coming up next. stick around.

i was out for a bike ride. i didn't think i'd have a heart attack. but i did. i'm mike, and i'm very much alive. now my doctor recommends a bayer aspirin regimen to help prevent another heart attack. be sure to talk to your doctor before you begin an aspirin regimen.

. some good news for couples. a new study finding that having more sex could help boost immunity. dr. samadi, tell us about this. >> i've never seen you get excited about any topic except for this one. >> really? >> it is really helpful to your health. study after study shows having two to three times sexual activity during the week increases your antibodies. iga and immune system. it can prevent you from getting any kind of diseases. a couple of years ago, there was a study came out that said if you're having sex twice a week, it can reduce the risk of prostate cancer. every man out there was asking for a prescription, i'm going to post one of these prescription on facebook, you copy it and take it to your wife and said dr. samadi said i got to have it two to three times a week. we have seen over and over that sexual activity not only helps with your immune system but lowers your blood pressure, reduces the stress, it is great for your heart, and overall it

is not apple a day, it is something else a day, keeps the doctor away. >> what does it do, i mean, you're right, your blood pressure goes up and you get -- >> reduces. >> exercise. >> sex reduces your blood pressure. >> he's right. by the way, i looked at this study closely, didn't see this two to three times a week, but something about frequently. that may be our prescription, two to three times a week. but you know what it does, in terms of the immune system, if you have frequent sex, it improves your immune system's ability to fight off invaders, but at the same time, it improves your immune system to say leave the sperm alone. that's okay. leave the fetus alone. that's okay. a woman's body is very complicated. >> what does that mean in. >> the woman's body learns to not identify the fetus as an invader, only bacteria. your own baby, the immune system leaves alone. sperm, your immune system leaves alone and lets it travel to the egg without attacking it. that's a modern -- that's not a

modern miracle, that's a miracle, an absolute miracle. but at the same time, it is fighting off bacteria and viruses so that women get through that period of time with less infections. >> so the takeaway is what? for men and women. >> that sex has overall health benefits. it is a big systemic effort. and also people who have pain, it releases in your pain, it releases enendorphins, releases pain. the more you enter the tunnel, the higher the chance of delivering those packages. so go ahead. two or three times -- >> the other take home is you can get pregnant even when it is not ovulation time. that's another big take home here. it could be a week after your cycle starts, you can get pregnant then. you're more fertile than you thought you were. >> i'm about to choke that's why i'm not saying anything. >> that's good news. what are the -- what other show will give you a prescription like that.

>> i'm sexy and you know it. >> you've been dying to say that the entire show. this has been a great show. thank you. thank you so much. thanks for watching. >> see you next week. as paul ryan spent the weekend under increased pressure to throw his hat into the ring to replace house speaker john bane, boehner, a former speaker of the houses had a warning for him today. >> first vote and then you get to keeping the government open to a continuing resolution and then the debt ceiling and if you're not careful, by christmas, you resemble john boehner. >> we'll talk it a member of the freedom caucus, mel brooks, about what he believes the next speaker needs to do to get the endorsement of conservative republicans. >> a controversial new development in the case of sergeant bowe bergdahl. his attorneys say an army officer is recommending no jail time despite military prosecutors chargin