tavis: good evening. from los angeles, i am tavis smiley. we continue our series with a comprehensive look at the leading cause of death in this country -- heart disease. steven nissen and marc gillinov are experts at the cleveland clinic. they have just released one of the most complete guide to heart health called "heart 411." >> every community has a martin luther king boulevard. it's the cornerstone we all know. it's not just a street or boulevard, but a place where walmart stands together with your community to make every day better.

>> held happens in neighborhoods. learn more. >> and by contributions to your pbs station from viewers like you. thank you. tavis: in case you did not know, february is american heart month. almost all americans either experience heart disease or to the struggle of a friend or family member. it remains the leading cause of death in this country, believe it or not. i am pleased to have to be joined by two of the leading heart health experts in america, steven nissen and marc gillinov. they are authoress of "heart

411: the only guide to heart health you'll ever need." good to have you on the program. >> thank you. tavis: why is heart disease so rampant today? what are the risks some much greater now? >> we think it is a disease of modern society. people back 100 years, we did not drive our cars everywhere. we exercise. the eight natural foods that are high in fiber and low in fat. our modern lifestyle has made as vulnerable. heart disease went from a very -- and not very common cause of death. tavis: i am always troubled when i have these conversations. it is sad to listen to that reality when this is one of

those things that is preventable. >> the most amazing thing is that we understand the causes. you are completely right. we have this done scientifically nailed. we know the causes, yet they are rampant in society. i am a heart surgeon. i operate at the end of the line, but it is preventable. >> smoking, no one needs to smoke. our young people are picking up smoking. not as frequently as they did 20 years ago. obesity is on the rise in america. diabetes, a major cause of heart disease. our diets are not healthy and people are not exercising. if people would just pay attention to those things, we would be out of business. tavis: what kind of burden does this put on our health care system? there has been a great debate about health care.

what a burden does heart disease put on our system? >> the cost of treatment is enormous. it is $200 billion a year, every year, to treat and established cardiovascular disease. the cost of prevention would be so much less. on the economic side and on the tragedies. tavis: what prevents us from getting traction on an issue like this? it makes it too much sense for a not to be the case. what keeps us from getting traction on this issue? >> there are many barriers. the modern society, the modern life we live, the availability of fast-food.

the ability of transportation everywhere. to be able to drivend to visit to your neighbor's a few blocks away. we have adopted a lifestyle and changing those habits is very hard. it is hard to get people to exercise. we are all working hard, we have a lot of responsibility. they do not find time to do these things. tavis: who pays the largest price? >> it is interesting. poverty and health are related. poor people tend to have worse diets because the availability of these inexpensive foods is a major driver of why they are so popular. the lack of access to health care means that people are presenting much too late in the course of their illness. it is true in this case, an

ounce of prevention is worth a pound of cure. if you identify somebody with high blood pressure before they have had their first stroke, all the costs can be prevented. this is why this issue of universal healthcare is so critically important. it is the most important thing you can do since the burden is heavier on people with the least economic strength. tavis: to your point about the need for universal health care, president obama advance the ball further down the field. we note that if the other party has its way, and if they were to win the white house, we would see our retreat on that.

sidestepping the politics, what does that do to this conversation about these kinds of diseases that kill too many americans? >> this tragedy we see in a city like cleveland every day. people in do not have health insurance. there are now 50 million americans who do not have insurance. those people are suffering a terrible toll. the health care reform efforts are an attempt to began to narrow that gap. most physicians i know want to see no patient ever have to suffer from a disease simply because they are poor. one way or another, we will have to solve this problem. my hope is that at least in the very near future, we will solve the problem. i have been a supporter of health care reform.

>> i think we can help by educating people. things like blood pressure checks are not expensive. there are some foods and some diet plans that are good for you and not expensive. to walk for five minutes at a time, that is not going to cost money. as we are waiting for the politicians to figure out the larger societal problem, perhaps it can get some good help the messages to everyone in america. tavis: what kind of advances have remade -- we made medically for treating these kinds of elements? >> the biggest medical advance is the statin class of drugs.

they are so powerful at preventing recurrent or another heart attack or a stroke. it helps those of us who have risk factors to avoid developing heart disease. we were just talking about, there are a lot of americans who are afraid of the drugs. >> even the heart disease is the number-one killer, the progress we have made over the last 25 years is just unprecedented. the rates of heart disease for anybody of a given age have dropped by as much as 50%. it is many different things. better health consciousness, some improvement in reducing saturated fats. it is better controlled. we have done a good job there. we have cut smoking rates in half in america. we developed these new medications. it was not until 1987 that we

have these powerful drugs to lower cholesterol levels. now we have 25 or 30 million americans were able to lower their cholesterol and prevent many heart attacks and strokes. we have not come far enough, but we have come to an enormous weight. we may start to lose ground in the next decade. it appears the progress has been halted by a new epidemic. that epidemic is the epidemic of obesity and diabetes. rates of about -- obesity are rising at a frightening rate. certain states are worse than others. it is pretty bad in the south. because it is bringing on this epidemic of diabetes, we are beginning to lose the momentum that we gained over the last 25 years. two-thirds of americans are overweight or obese. that means we may look at my

children's generation as the first generation ever that has lost ground in terms of longevity. tavis: how do we stack up against other countries? two-thirds sounds like a huge number. how much worse off? we cannot be better off? >> it is worldwide, but we are worse than other countries. it is happening everywhere. what happens is, you know, throughout human history, food was not in abundance. with modern society and all the advances and the availability of agriculture, food is more plentiful. we are not able to control our consumption. obesity is rising, even in countries where we never saw it before. there is a global epidemic of diabetes that is occurring.

it is frightening when you think about down the road to come attend or 20 or 30 years. tavis: i believe in personal responsibility. i am always troubled by the reality that the consumer does not have the chance. there are so many things coming at you. advertisements, specials, rebates. you name it, we have become a consumerist society. i just wonder whether or not the average american even has a shot of being healthy. >> it starts with a five-year- olds. you see any mother and a child and the grocery store. the child once the cereal that is filled with sugar. we need to change our ways.

from the very beginning, we need to make a healthy choice is the desirable choices. perhaps that means we need to reward them. tavis: how do you reward those companies who do the right thing when doing the wrong thing makes them all the money? >> that is the tough part of the problem. that is one of the reasons why we wrote this book. we wanted to equip consumers with the information they need. they can pick up a can of soup and find out that it has 50% salt content that they should get in the entire day. why is there so much salt in soup? you can sell more soup if you make it salty. why are french fries cooked to

be fatty? apparently, they sell better. a lot of these unhealthy things to sell well. the other thing we need to do is we need regulation. regulation has become a dirty word in america. it is not to people like us. there are cities where trans fats -- they are banned at the cleveland clinic. you cannot sell food with trans fats. it is regulation, and not everybody likes regulations. but when it is done wisely, it can protect consumers. tavis: i want to think outside the box. we may have to figure out a way

to reward consumers who do the right thing. what might that look like? howled the rewards every day people? >> one white -- how do you report every day people? >> one way is in the workplace. it will reward you economically if you improve your health profile. if you lose weight, if you exercise, you did a lower health-care premium through the insurance policy. for becomes advantageous you the employees in many ways. you are going to pay less for your premiums. you will not get sick. you will live longer and feel better. you will lose weight. tavis: oftentimes, corporate america does what it should do because the government forces it to do so.

regulation has to be forced on corporate america to do the right thing. there are instances and cases where it is the other way around. corporate america is the head of government. affirmative action. in many respects, there are certain institutions that started to advance the notion of a diverse work place because it was in their best interest to do so. tell me if i am right or wrong. i am starting to see examples of companies did the right thing because bad health is so negatively impacting your bottom line. they have to figure out something before health care costs in san bankrupting the company. how much of this fight will be led by corporate america? >> it is absolutely true.

it takes a village. it takes government, why is government policy, health care reform, and an enlightened group of corporations and understand that if they can make their employees healthy, they will be more productive, they will lower costs for the company. it is in their own best interest. companies are putting in fitness areas in the workplace and encouraging their workers to use those. they're able to show a very good return on investment. this is what we have to do to turn this around. you have to do it at a younger age. the problem is, if our children have bad habits, by the time needed to be adults, it is very hard to reverse it. tavis: the dilemma is that i've looked at the most of these generations of americans. they are the most obese, and we

distill think of -- and we still think of youth be connected to invincibility. >> the parents have got to show some responsibility. parents have to exert some control over the habits of their kids. that means starting with a good diet from the get go. you can do this. my wife has done it with my family. my kids will routinely pick broccoli over french fries. that is what they like because that is what they are used to. exercise with your kids. it is a lot better for you and your kids than sitting in front of the little screen all the time. tavis: the link between poverty and bad health. i never too many parents, i see

them all the time, -- i know too many parents, i see them all the time, my office building is in south-central los angeles, so i see this all the time. i was at a restaurant the other night. people to happen to be poor are already parenting kids they wished they could do more for any way. they wished they could provide more for them. so often, parents did not like to tell their kids to know. -- kids no. did not want to deny them a trip to mcdonald's. they do not want to deny those kids. many parents think that designed their kids is hurting their kids.

they do not see the outcome that you just suggested. >> the greatest love a parent can show is to teach their child the kind of habits that will make them healthy adults. if you raise your kids on fast food, that is what they are likely to eat when they go to college. that is what they will eat as adults. they will be one of our patients. we will see them with a heart attack. we will see them in the operating room. if they can raise children with healthy heart habits, it is the greatest gift they can give their children. >> if you did not the french fries, your opening the door to good health. tavis: i am curious. i am always curious about people when they are passionate.

how did it so passionate about heart health? what is the back story? >> item 49. when i was 16, i watched a couple of my family members go through heart surgery. the next summer, i got a job working at the cleveland clinic in heart surgery. the first time i saw heart surgery, i thought, that was amazing. i got to learn how to do that. i did a little bit more family research. my grandfather died at the cleveland clinic of a heart attack before i was born. with a family history of heart disease, that is incredibly -- i thought, i am going to become a heart surgeon. about 20 years later, i did.

more recently, the back story to this book, after working with the best team in the world, i realized, i am getting to people when they already got it. it is a little bit late, can we are people with the right information so they do not end up in the operating room? tavis: the cleveland clinic probably loves this story. >> it is a big circle. >> it is extraordinary. it is what this partnership works for us. we both at the same passion. i did not have a family story like that, but i spent many years as a fire man. seeing the young man like yourself coming in with a heart attack at a relatively young age, having to talk to their families and their spouse and

their kids. at some point, you say, this is enough. let's prevent a preventable disease. we wrote the book because we want to get to people when we can, before they become our patients. we want to limit the disease so they can live normal and productive lives. if you watch the tragedies that we see, you must develop a passion for preventing the disease. tavis: you take on myths about heart disease. >> that is our favorite parts. until we did the research for this book, i was taking an aspirin a day. i was sure that red wine was better than white wine. i thought fish oil was manna from heaven.

now i know each one of those statements was incorrect. >> what really struck me was i went to the internet and type in heart disease, you get all kinds of information. the vast majority of it is dead wrong. it is terrible. we have people out on the talk- show circuit telling you that there are diets to make you part attack proved. -- heart attack proof. they are advising people not to take the medicines that they need. some wacky diet is going to make them all better. we knew it was the right time to write a book. we would weigh the evidence and look at the science and we would come to a conclusion.

there are things in there we tell you, does not have the answer yet. in areas where we do have the answer, a lot of the information people are getting from popular television is wrong. tavis: the true this year. it is in a book called "heart 411: the only guide to heart health you'll ever need." they are at the cleveland clinic, steven nissen and marc gillinov. thank you for your work. that is our show for tonight. until next time, keep the faith. >> for more information on today's show, visit tavis smiley at pbs.org. tavis: hi, i'm tavis smiley. join me next time for a conversation with lani guinier and a look at the latest challenge to affirmative action.

>> every community has a martin luther king boulevard. it's the cornerstone we all know. it's not just a street or boulevard, but a place where walmart stands together with your community to make every day better. >> the california endowment. health happens in neighborhoods. >> and by contributions to your pbs station from viewers like you. thank you.