i'm arthel neville. time now nor "sunday housecall". >> i'm eric shawn. welcome as always. joining us dr. marc siegel, professor of medicine at nyc language el medical center. >> and dr. david samadi, chairman and professor of urology at lenox hill hospital and chief of robotic surgery. good to see you. >> great to see you. >> as always. we're going to start with something really important today because it is the leading cause of death for both men and women. but doctors point out many people don't even recognize the warning signs of a heart attack. there are several things you

should look out for according to the american heart association. for example, chest zfdiscomfort but they say discomfort in the center of the chest that lasts for a few minutes but goes away and comes back. they say there's discomfort in other parts of your body, arms, neck, back, jaw, even your stomach and of course shortness of breath. there are a lot more, dr. siegel, how do you know if it's not just acid reflux or indigestion or just don't feel that well? and it could be a heart attack. >> you know, you don't know. here's the first thing i want to tell people out there, and i get calls all the time. i'll probably get some tonight. people calling me with chest pain uflt know what i do? i send them to the hospital because i don't know. i don't want to err ever on the side of underreacting to someone with chest pain. if somebody has chest pain ayinde don't know them -- there are scenarios i've worked somebody up ten times they've had stress tests, i know it's see sof jeel and i may not send them to the hospital. nooip times out of ten i will.

if you're having that problem out there, you should look for doctors who will overreact and not underreact. we always say time is brain. time is heart, too. your heart is being suffocated from lack of oxygen and blood flow f. you're having a heart attack, if we get there early, you can go to the cat terization lab and open the artery. >> is it always a wam? some people say it's like an elephant sitting on your chest? >> are the symptoms different for women? >> excellent. that's really important. first of all, let me just say it's the leading cause of death among men and women, 630,000 people die from this. but you're right, the symptoms, the way they present can be completely different for men and women. many in men, could be this heavy elephant chest pain that could be radiating to your arm. that's typically how they present. in women, arthel, it could be very vague. they could have a jaw pain. they may have some fatigue. they may be a little short of breath. they're going to the gym, doing the same workout but today

they're not feeling well. and those are very subtle symptoms and signs that they need to pay attention to. and there are ways to find out because once we see you, with a simple ekg that shows you electrical muls pulse of your heart, a blood chest and x-rays, we can find out what's going on and it can save your life. now, risk factors, diabetes, high blood pressure, bad food, high saturated food, lack of exercise, alcohol, smoking. if you have all of these risk factors, are you at the top of the list to have this. >> let's say you feel like this. what do you do? do you feel your pulse? if your heart is going, are you okay? how do you know? >> rapid heart rate. >> one of the symptoms of a heart attack can be that your heart is racing or you have an irregular rhythm. that comes along with it. when you're not getting enough blood flow, the rhythm may be

off. but david made an excellent point of risk factors. on tof that, men and women are different. but you may just be having fatigue, have an arm similar fom. look for shortness of breath, nausea, radiation to your jaw, to your back. we always think it's the left arm. it can be both arms. here's my point. it can be atypical. you're not feeling like yourself, especially women, fatigued, nauseous, sweating, get on the phone to your doctor and get to the hospital. >> the sweating is interesting. >> that is interesting for sure. dr. siegel, my question is, is it difficult for doctors to misdiagnose? a lot people are walking around with stress right now. >> sure. >> what if you go, doc, i'm feeling this, that, can they nis that you had a heart attack? >> every good doctor should start with the bad news which is the heart attack and rule that out before you go to anxiety or depression or rapid heart rate. once you take care of the heart attack, then you can entertain

other things. but every show we talk about, what do we talk about? the fact there are a lot of saltier foods that can lead to high blood pressure. we're suffering from owe beebesd diabetes. why is that important? because the blood flow to the heart comes through coronary arteries. when you have atherosclerosis, when the blood flow to the heart is not sufficient, you have an attack on the heart, a heart attack. that's why the sooner you diagnose it, you can do an angiogram, put a stent, go on aspirin and other medications to save your life. >> we've talked about two things. i just want to point this out. once we did the calcium scoring point. that can help prevent it. >> i'm proud of you, eric. >> i'm getting ready to go to the doctor and say, get me this, doc. >> that's a $25 co-pay.

just kidding. >> the answer to that is that your coronary arteries are tiny. they're the tiniest arteries in the body feeding the most important muscle in the body. we needs way to know if they could be clog. the calcium scoring test show there's's injury. the c-reactive protein a little more debated, controversial, an indication you're building up coronary artery disease. if you have that disease, you're at risk for heart attack. we have to treat you aggressively, get your cholesterol down, guest your blood pressure under control, make sure you don't have diabetes. >> you can go to the doctor and ask for those two things. >> you can but remember you get a score. if the score is low, that's good. but the plaque isn't always calcified. you may have a soft plaque that's not calcified. know the risk factors. last month we talked about movember. work on exercise, diet, all the things that you and arthel -- >> i'm impressed with the

c-reactive protein test. >> look how skinny they are. they exercise. their weight is down. they eat right. >> not really, no. >> thanksgiving i had all that fried turkey. >> you deserve if. it's okay. >> tried turkey? >> new orleans, that's what we do. >> wow. so you think that you've got your weight under control. but doctors say there is one thing you may not be considering, belly fat. next we're going to reveal why this is a real health problem, even if you think your weight is, quote, normal.

. so you think your weight is fine and you can eat whatever you want. but doctors say there is one big thing you're not considering that could be posing a serious

health. belly fat. dr. samadi, i'll start with you. you see a lot of men, women, too, we get that gut. why is that the dangerous fat? >> for the women, it's not that much of a problem because the fat is around the hips. that can actually be protecting you women. but for men, it's all belly fat and all inside the abdomen called visceral fat. that's the fat that will kill you. how do you know you're really obese? we talk about body mass index. but i want people to know if you take your height in inches, divide it by two, you take your height and divide it by two, that should be your waistline. for men, it should be less than 40 and for women less than 35. we'll post this online. there's another one that just came out, another study, where you can just take your waist, measure your waist, and measure your hip, waist divided by hip should be less than 0.9. if it's more than, that you have a problem. why is belly fat important? because belly fat today, we don't think of it as just

cosmetic. it works like an organ. it can basically excretsecrete inflammatory cells, it can squeezel the liver. it also squeezes the kidneys. then your sodium goes up and you end up with blood pressure. now you have cholesterol, blood pressure, insulin resistance. that's metabolic symptoms that will kill us. >> what's the best way to get rid of belly fat? >> ask him how much weight he's lost on "sunday housecall"? >> he's done great. >> i work out a lot. >> first of all, eric, i think people need to understand that they have to lose -- david has identified all these issues here. these are inflammatory hormones that go right to the heart and give you heart disease, high blood pressure, diabetes. it's not innocent this belly fat. the best way to lose that is

certi exercise, change your diet, cut down on carbohydratcarbohydrate. alcohol is a big problem, they call it beer belly for a reason. visceral fat means fat around the organs, the worst kind. it has all the inflammation and hormones in it that leads right to your coronary arteries, heart disease, diabetes, something called insulin resistance where your insulin doesn't work as well. then it's a vicious cycle because uf get fatter and fat r fatter. inactivity is the bad thing. >> here we are, we've eaten so much after thanksgiving, we're going to be looking toward the christmas meal next. what should we do in the interim to kind of prepare for that? >> well, i was just about to ask, somebody waiching this program will say, these guys are full of it. i've done every exercise, all the diets, and nothing works. what do i do? we talked about liposuction and surgery last week. the bottom line is, the best way to get out of the holidays, it's

portion control. you always want more. one of the tricks is take your plate and use the small one. use chop sticks. it sounds cute, or whatever, but it really work works. self-control. there's nothing better than the self discipline. you want to go for the extra cookie, pull back. do i really need it? just by that, you'll stay away from it. it's so easy to get rid of this. in the morning, drink some cold water with lemon. that really works well. add a little apple and fruit and vegetable. >> great point. i love that. and the belly fat leads right to bad cholesterol that i worry about all day long. if you manage to do what david said in the morning and exercise and drink a lot of water. we love coffee in the morning. lose weight. your cholesterol will be better. >> increase your metabolism. >> what about the fried turkey? >> i invited you to come home, you and lisa, you did not come. >> sounds great. >> once a year you deserve it. >> small portions.

>> did you cook? >> no. my mom. >> that's good. hi, mom. >> oh, boy. we're working on the belly fat. if it's sleep in on saturdays and weekends, you love na, the alarm doesn't go off, you don't have to work so you cash those extra zs? researchers are saying that could actually be a bad thing. plaque psoriasis... ...isn't it time to let the... ...real you shine... ...through? introducing otezla, apremilast. otezla is not an injection, or a cream. it's a pill that treats plaque psoriasis differently. some people who took otezla saw 75% clearer skin after 4 months. and otezla's prescribing information has no requirement for routine lab monitoring. don't take otezla if you are allergic to any of its ingredients. otezla may increase...

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and back now on "sunday housecall." should i worry. we talk about everything that worries us. this week's worrying issue comes regarding a new study regarding the risks of oversleeping. dr. siegel, every saturday, man, oh, man, can't wait, no alarm, sleep late. it is like heaven and now you're going to tell me it is bad for my health. >> i'm going to tell the viewers how hard working you and arthel are. you work as an anchor and as a reporter. >> that's true . >> he's busy working. >> i still like to sleep in on saturday. >> waiting for a little compliment over here. >> we know that dr. samadi is up and in the or by 6:00 a.m. >> i'm teasing you.

>> here is the thing, though. did you grow up with the idea we could do the chipmunk thing. i did. i thought as a kid i could not sleep during the week and make up for it on the weekend like a chipmunk storing nuts. so that sleep i got for the weekend would then help me through the week. studies are showing that's not true. that actually when you try to do that, there is a new study that shows those same inflamatory hormones we're worried about are on the rise you don't sleep regularly. it is the circadian rhythm that matters. you are to sleep seven hours every night. otherwise you risk obesity, depression, high blood pressure and heart disease, the same things we talked about regarding belly fat. >> if you wake up during the week, at 4:00 a.m., 5:00 a.m., can can you sleep a little longer on the weekend? >> if you add a couple more hours, it is perfectly fine. but if we're talking about you're getting four hours of sleep every night and then go to ten and a half hours, and that out of sync can hurt you. why is sleep so important?

diet is the most important thing we spoke about. exercise, absolutely it great. the third pillar of your health is sleep. why? what does happen during while you're sleeping is study after study shows that the csf, cerebral spinal fluid goes up 20 times while sleeping. that's responsible for cleaning up all the things you've done during the day, like the garbage truck that goes around and cleans up all the trash, that's when you clean up all of your brain while you're sleeping. your data goes into your it system in your brain. that's why seven hours of sleep is important. when it is interrupted, whether from sleep apnea or under a lot of stress or whatever it is, that broken cycle of sleep is what put s a lot of pressure on your heart. that's when your hormone goes up, you're hungry, you crave for carb, you wake up, you want the bagel and cream cheese, you're not satisfied. you had a huge bagel ten minutes later hey, i'm hungry again, we

just talked about belly fat, that's when you get and gain weight. >> so many of us aren't getting enough sleep every week. >> it is about sleep timing and about we work in shifts. so when you work in a shift, it is very, very hard to get the same amount of sleep every night at the same time. got to have discipline. >> that's actually quite important. also, all this electricity, this is fake. on top of it, we're not used to our bodies, this kind of electricity, you have your iphone, your ipad, et cetera. >> hard to power down. >> can nap help? >> i think naps help but not with the hormone stuff. naps help because they rejuvenate you, refocus you. it is not a replacement for seven hours of straight sleep. >> i love 20 minutes at 3:00 p.m. something happens at 3:00. >> the one time he doesn't have a case, 3:00 p.m. >> good advice, thank you. it is most commonly performed cosmetic surgery in the u.s. is breast augmentation surgery worth the risk? we'll ask the doctors about that.

and welcome back. breast augmentation is one of the most commonly performed cosmetic surgeries in the u.s. around 286,000 women had the

procedure in 2014 alone. and about three-quarters of those surgeries used silicone implants. dr. samadi, what is safer, silicone versus saline? >> no good answer. it all depends on what you're looking for and what kind of breast size you're looking for and the mileage that you're going to get out of the implants. silicone has been around for a long time. it was gone for about a decade because of all of the leak and some of the scarring and some of the issues. but it is back again. and as we said, most of them are silicone. silicone lasts longer. when you put the implant, you have a capsule around it, and as long as the capsule is not ruptured, it is actually long lasting implant. saline, it is probably may feel a little more natural, but only lasts 12 to 13 years and you may end up with a flat tire and it can burst. and that's a big problem. if that happens, we can take the ole implant out and put a new one in. there is a big debate whether the implant should be under the

breast plant or behind the muscle. and i think one of the most popular ones are right through the trans exscilla because there is no scar. there is a lot of debate in the field, but in the hands of experienced surgeon, these are safe procedures and work really well. if you're on silicone implants, get an mri every three years to make sure there is no leak. >> if you're on silicone. >> if you have silicone implant, get an mri every three years to make sure there is no leak. you may have it and not know about it. >> you can't -- it is not supposed to get a silicone implant if you're under the age of 22. the fda says 22 or above. there is ways around that. fd ax says 22 or above. three out of the four silicone -- i've seen disastrous cases where the silicone ruptured and that becomes a major surgical problem. most of the time it is very safe. they have never been prove en t be associated with cancer. everyone is on the lookout for that. they're coming out with a

national registry, it is a good idea, you can follow them long-term. the biggest problem is they only last ten years. they don't always last longer than that. >> thanks, doc. i'm arthel neville. >> i'm eric shawn. great advice every sunday on "sunday housecall." thank you for joining us as always. good sunday to you. nice of you to be with us. i'm leland vittert. welcome to "america's news headquarters" from washington. >> i'm elizabeth prann in for shannon bream. there is a new report out today about what the shooter may have told police after his capture. we're live on the scene. >> plus, new efforts to lower the tension between russia and turkey after the nato ally shot down a russian military plane that had crossed into turkish air space. >> a brand-new book about the chairman of the board, frank