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UAF – 2015 – Stop the Sugar Coating of Diabetes

… our next speaker. I’ve worked with Catherine for a couple of years at the hospital when I was working there and she’s such a delight and has a very good approach to the subject of diabetes. So I think you’re going to be really interested in this this evening. So let me tell you a little bit about Catherine. Catherine Messenger is a registered nurse from Wyoming. She has a background in critical care and neuroscience – so she’s super smart. She is currently the director of the Porter Heart and Vascular Center and previously served as a diabetes center coordinator at Fairbanks Memorial Hospital. Catherine has a passion for preventing chronic disease. She definitely understands the connection between lifestyle choices and health outcomes and she enjoys influencing the healthy decisions today that prevent medical issues tomorrow, such as heart disease, stroke, diabetes and obesity. She obtained her nursing degree from Casper College and her master’s in the science of nursing through Waldon University. She’s dedicated to the care of her patients, residents and community. She is a strong proponent that the decisions made today affect the decisions made tomorrow. In fact, she embodies that belief by staying active with her family by hiking, mountain biking, running and gardening. So please help me welcome Catherine Messenger. (applause) Thank you Tiffany. Is this on? Can you hear me? Thumbs up in the back. Okay, great. So speaking of biking, hiking and all that jazz, I just have to point out my friends sitting in the back row… Like this? This? Okay, here we go. Anyway, my friend sitting in the back row – her and I just got done hiking the Pinell Trail. I think we can say “Wooo! WOOO!” (applause) So we’re here to talk about diabetes and more importantly, we’ll stop sugar-coating diabetes. Hold on, am I holding this right? (Yes.) Alright, here we go. (Would you hold it one way or the other because the mike … computer.) Are you sayin’ I’m short!? (laughter) (No, we can’t see you over the computer.) I think it’s super cool that I get to look at my own slide and look at you guys and I’m not like, “And next we have…” Anyway. So, I came from Wyoming. I grew up on a ranch. My parents were fond of childhood labor. Yeah. We got up at 5 a.m. to buck hay. We also ate a very big meal – steak, potatoes, the apple pie – everything. But in this lecture I’m just going to talk about like how lifestyles have changed over the years because my kids, they don’t have the same chores. They clean the cat box and do the dishes. There’s no bucking hay. Anyway, let me tell you a little bit about my addiction. My girlfriends in the back have heard about my addiction to Twizzlers. It’s a serious problem and even Fred Meyer is onto me because Fred Meyer sends me coupons. (laughter) Two for one. Yeah, you buy two – and I don’t buy like the little candy size. No. No, I like the big package and I like the cherry twist ones, the strawberry, the black licorice, the kind that has the little juicy in the middle – those are
really good too – and I just don’t, you know, I’m afraid that they’re gonna go
stale. So I have to eat the whole package that night as I watch TV or read a good, juicy
book, like Fifty Shades of Grey or something like that, and then after that I’m completely satisfied till the next night at 9 p.m. So
there’s my problem and Fred Meyer knows about it. They send me coupons. So some of the objectives we’re gonna go over. We’re
going to go over the physiology of energy, sources of energy, metabolism, the food
industry, and then the decisions we make today affect the decisions we make tomorrow. So, a little bit about the human physiology and energy. So as… As we all know, we need fuel and we get fuel – we get fuel from food. We eat food and then we breathe air, they make this great metabolism, and we have energy. Our body needs energy to – for muscles, for digestion, circulation and breathing. Our cells are the energy producers. Our cells extract energy from foods and using the oxygen, here we have our chemical reaction in the metabolism. Make sense? You’re already falling asleep on me! Don’t fall asleep. Okay. So that’s pretty boring, but it’s very important. And all of this, I will promise you, will get to the diabetes after I flip my page of notes. So. Diabetes inhibits the metabolism process. It prevents the glucose from crossing over the cellular barrier, so no glucose in the cell equals no energy. So, my friend Jenn, she didn’t eat her granola bar. Or she ate her granola bar, but somehow she did not have the energy needed for the second day. It was a slower day. I’m just sayin’. That really had nothing to do with diabetes, but the process is we need energy – Oh! And the altitude, so she had less oxygen to process, to get over the mountain, to get the food. Anyway… Anyway, we need the glucose in the cells. If we don’t have a way of getting the glucose from our bloodstream into our cells, then we can’t have the energy to run a marathon or hike the Pinell Trail. Carbohydrates. Our bodies prefer this source of energy and just like Twizzlers, we love this source of energy. Our favorite breads, chocolates, all filled with carbohydrates – chains of sugars made up of carbon, hydrogen, and oxygen. So sources of carbohydrates. We have some in plants – grains, rice, potatoes are some of them. Carbohydrates are utilized for our body. They are preferred over protein and fats. So, and if you think about it, what is our best habit? We get hungry, we’re reaching for the cracker box or we’re hungry for the french fries, right? What’s your favorite? (Carrots.) Oh! Well… yeah, yeah… that’s a starchy one but at least that’s better than the crackers. Excess carbohydrates – so what do we do with those? Excess carbohydrates are stored in our fat and liver cells with the utilization of insulin. Glucose is the sugar And we’ll get to know insulin. Insulin is one of our favorite hormones. Glucose is the sugar that is the foundation of carbohydrates. Carbohydrates are broken down into sugar by our digestive tract and the liver that enter the cells. So that gets really complicated ’cause then we start talking about the pancreas and the beta cells and all that. But decrease in the blood glucose causes hunger. The hungry feeling – Jenn – the sweats, the grouchiness… anyway, moving on. Other sources of energy. So we have lipids, or fats, sources both in animals and plants. Carbohydrates are converted into fat via
the liver we just talked about that and the liver is like an amazing organism here – or organ. It could probably be an organism as well. Fats are also stored in the liver and the adipose tissues, aka our love handles. Saturated fat, which is
rising from cholesterol, and unsaturated fat, which is the decrease of cholesterol. So we
really, when we’re focusing on our fat content if we focus on unsaturated fat versus fat. Cholesterol. So this is where I get – do you go to your primary care physician and you’re like, “Now which one’s the good one?” So low density is bad. It causes – and this is gonna make your cardiologist excited. So if you realize you you go and you say, “The LDL is the bad one,” your cardiologist will be happy. HDL: high-density. This is your good cholesterol. It reduces the risk for
atherosclerosis. Too much fat increases our love handles and we get weight gain. We know about that – that’s common sense. Other sources of energy – so protein… How many people remember Dr. Atkins? Okay. Anyway, sources of protein – so animal and plant – we have beans, nuts, and meat. I think he was like a favorite of steak or somthin’. Protein is essential for growth, formation of our body tissues, immunity and blood clotting. The amazing liver – the liver can convert protein into energy. Protein is the energy conversion after carbohydrates and fat energy has been exhausted. So our body prefers carbohydrates, then fat, then protein. So, Dr. Atkins, he would say, “Let’s just eat meat, or protein and fat. So have your bacon and eggs every morning.” Right? But the reality is that we really do need carbohydrates. So… the metabolism of carbohydrates, fat for energy. And fat for energy. The body switches metabolizing carbohydrates to fat and back for energy. Shortly after eating, the body – shorty – shortly after eating, sorry, the body metabolizes the carbohydrates. Fasting eight to ten hours, the body starts metabolizing the carbohydrates. Exercising, depending on intensity level, metabolizes carbohydrates and fats. Before the fat – before the meal, the car – okay, this is like where you need to consult your dietitian – But before the meal, the metabolizing of the fat and then the carbohydrates. It’s kind of tricky here, but this is where it comes into we’re testing your glucose two hours after you eat something versus right after you eat something and the level of accuracy that you’re going to get. Diabetes prevents energy and… energy production. So the mechanism for the insulin that is released in a normal pancreatic beta cell – this is the boring part. You’re falling asleep again on me! The beta cell – the insulin production is more or less than the beta cell is – within the beta cell. It releases the trigger by food, chiefly food that’s containing absorbed glucose. Diabetes Type II – the mechanism is essentially broken. So fatigue sets in, uncontrolled hunger, and then weight gain. And we like – it’s like the trigger doesn’t happen, so we eat the whole bag of Twizzlers. So, if we can … say that diabetes is, like, your toxic blood, uncontrolled or chronically high levels of glucose in the circulatory system becomes toxic and the body tries to compensate, but over time the damage will occur. So this is where you’re going to have the cardiovascular disease. You’re going to have the nerve damage, the kidney damage, the your damage, your foot damage, and we’ll talk about some of these. But your skin doesn’t heal, you become – your little vessels in your ears and stuff – hearing impaired, and believe it or not, there’s a huge link from diabetes to Alzheimer’s disease. The balancing act. I don’t care all your friends that say, “You got the diabetes, so stop eating carbohydrates.” Or… it’s not that easy. Your body still needs carbohydrates to function. Your brain needs it. The more mechanisms – basically, the mechanism is disabled to properly break down the carbohydrates so now you have to rely on yourself for self-monitoring your blood glucose. You become dependent on self-administering insulin and then you’re confused on what to eat, when to eat it, how to eat it and trust me, everybody and your neighbor has a recommendation. So… the food industry – we love them. This all started during World War II. What happened during World War II is we started doing a lot of packaging and
processing of food for our soldiers. So they would, like, have I want to say it was like 3,900 calories a day – something like that. It was a lot, it was amazing. Hold on – I have it in my notes. And then on top of that, we had – oh yeah, 3,900 calories – and then on top of that we had the accessibility, the
prepackaging, the suburban lifestyle, the supermarkets and later came along the loaf and jugs… what is it here? Holiday! right. Convenience stores and all of this cheap processed
food. The food industry… the abundance of this cheap ingredients and stimulated the
growth of the food industry and then also made it financially incentive for
the KFC’s and McDonald’s and stuff like that, but it also helped the farmers use the corn
and soy products. And they used the fructose, the hydrated or… hydrogenated oils and cornstarches. So this frequently high food, easy accessible, not to mention – we’re all working families and now it’s pretty much two parents working and you have to go home and cook a meal, so it’s almost easier if we just go through the drive-through, right? So as these come about, most of the fruits and vegetables in the substance, they are more … to grow and harvest and parish quickly. So this made it less profitable for companies and over the… over the years, they started seeing more – oops! Sorry. There you go – more processed stuff because it was cheaper and it lasted longer on the shelf. So technology and innovative- innovators in food processing, in food
packaging, in food preparation allowed us to consume and wide variety of foods that was
easy to cook, easy to clean up and but it was lacking a lot of nutrition. Processed
foods – high in fat, high in sugar. They taste great, so the neural aspect is, is your frontal lobe gets really excited and wants to eat more. They taste great. The scien- and there’s a lot of science involved in this. I have a whole Cheetos thing. You know how the Cheeto is very airy and fluffy? Well, I guess you can get the crunchy or the airy ones, but this is a manipulative effect on you. So you think that you’re eating one Cheerio – er, Cheerio – Cheeto, and you’re thinking that you’re not getting very much substance ’cause it’s just air. But in reality, it’s very highly densed fat and glucose and all of that stuff mixed up together and then you eat the whole bag before you know it because really you thought it was not that much. Your mind, it tricks you and then you buy another bag. Cheetos are evil. (laughter) They’re right up there with Twizzlers. But anyway. So, but this did come in a time when, like, food was scarce. This was a way to deliver food to people that we need to for high calories and stuff like that. So it does have a… it is good. So… but it’s not good for us right now when we do have the ability to pick our vegetables and eat our… eat more, less processed food. And so… what about diabetes? So the choices we make today affect the choices we make tomorrow. And this is where we get down and dirty and talk about what we do today so that we don’t have to worry about tomorrow and dialysis machines and our cardiologist and the whole health care thing. So take action. Take your medications for diabetes as your health pr- and any other health problems even when you feel good. Check your feet every day for cuts, blisters, red spots, swelling and call your healthcare team right away about any sores or anything that don’t go away. Brush your teeth, floss every day… Okay. I go to the dentist and he always tells me I’m not flossing – I swear I floss. Anybody else – do you floss? Colleen flosses. But anyway, and I know checking your feet sometimes becomes cumbersome, but we really do ’cause if you have diabetes, you know you have the neuropathy setting you in. You can’t always feel. If you step on that Lego, well, most of us will feel the Lego, or stub the toe, or whatever. So we have to look at our feet. Taking responsibility and stop smoking. Keep on track
with your blood sugar. You may want to check them more times
during that day, especially if you’re sick. You know, maybe you should check it more
often. Log it. Your healthcare team will love it. And then talk with it, any concerns that you have with your healthcare team. Check your blood pressure and regular basis. Eat well. Make a diabetes meal plan. How many know what a diabetes meal plan is? It’s like, so vague. Everybody’s like, yeah, just do it. Choose your foods that are low in calories, saturated fat, trans fat, sugars and salt. Eat foods that are more high in fiber, such as whole grains, cereals, breads, crackers, rice and pasta. Choose foods such as fruits, vegetables, whole grains, breads, cereals and low-fat skim milk or cheese and drink water instead of juice or milk. This great dietitian I know that may be in the room, if you can read the ingredients on the back of the label, you have a good start. If the words are too big or you have no idea, it sounds like chemistry, just avoid it. If it’s grown in a garden, it’s better than, you know, getting the chips – go for the potato instead of the chips, I guess is what I’m saying. The more natural. So eat well. So, I totally stole this picture. Actually, I stole this picture off the Internet, but it’s a good example. You want half of your plate – and not a huge plate, go with like a six-inch plate in diameter or a salad plate. And here’s the theory – this is all psychology as well, because before you make that plate, that’s small, the more satisfied you will be. Half of it should be fruits and vegetables, the other quarter should be grains and a quarter should be protein and… a cup of dairy, I think, is what that is. Stick with natural foods though. Stick with stuff that hasn’t been processed highly. Stick with your vegetables, your fruit. Be active. Set a goal. We hike the Pinell Trail. Set a goal for activity most days of the week. Start slow – 10 minute walks three times a day, twice a week. Work your increase, or… increase your workout, muscle strength, stretch your arm, do armbands, yoga, gardening, whatever. The biggest take-home message that I read in literature lately is it’s not going to the gym and sweating for a good hour on the treadmill. It’s really actually being
active throughout the day. It’s how many times – so, how many times you get up from your desk,
you want the stairs, you do – you, you go and talk to her friend instead of messaging him or calling him on the phone. That – the activity that you do through the day – is more beneficial for your body than spending an hour at the gym sweating your heart out because then you go home and you’re fatigued, in the long-run. Now, theoretically you could do both and you’d be good. Stay at a healthy weight or have a developed plan to get to that healthy weight. And this is where you’re really gonna want to talk to your
healthcare team to see you where your healthy weight should be at. A good start is your BMI,
or your body mass index, and I really went fast, so we have lots of time for questions. Yes? ( … it’s a way to keep track of your glucose… ) ( … specifically. This is what I eat, this is the time I eat, this is my … ) ( … what’s the relationship? Should I skip the pretzels? Should I skip the, you know, carrots? What’s causing this?) So… (Can you elaborate on that?) So yeah. Actually, technology is… there’s so many things. There’s apps out there, there’ actually And really when we look into… Type 1. So I didn’t really go into Type 1 and Type 2 and but a lot of our youth that are Type 1 are using pumps and with those pumps they’re able to actually monitor their glucose and then they can log exactly when they’re up or down. Now I am sure – I haven’t heard of the Europe and having the little implant – but I am sure that it is possible that you have one that could actually regulate your, or could record your blood sugar all the time. And so you would know – Yeah. Well, no, I totally believe it’s possible. Anyway, and the thing is is you can. You can… Who was that, that came an did a talk at the Expo a couple of years ago? I don’t remember his name either. Anyway, he did a study and he’s a Type 1 diabetic, but he did a study on his blood sugar and the spikes and peaks and developed this whole diet plan, which was crazy, but he knew exactly what foods would spike his blood sugar and what food didn’t. And I think that, you know, even though if you have the implant or the little hair that you were talking about, you could totally tell. Right now, you know, we tell our… we tell our patients, “Check your blood sugar often,” and they’re pricking their finger, but the
strips cost a lot and Medicare only covers so many strips, or DA, or whatever your third
party is, so it’s really hard to really do a self study on what are spiking my blood sugars. But we kind of know that because carbohydrates are immediate energy source that’s gonna spike
your blood sugar. So when we think about the type of carbohydrates that we’re having – is
that complex for the simple – we know that the simples are gonna be the ones that
are gonna spike them higher but other than that we should… I guess we have a background, but I don’t know exactly how to say that multiple people have done this study but they haven’t really
had the technology. There’s tons of apps, a lot of Type 1 people use them, but… I don’t know if I’m answering your question. (Next time.) Next time? Around and around the tree we go. The technology is there. Yes? (How do you feel about, perhaps, a tax on sugar … ) ( … a tax on sugar would reduce the problem of sugar-coating all of this processed food.) (That’s because it would be much more expensive and the same with soda pops – Pepsi and Coca Cola.) (And it’s the sugar that is really addictive. There are other addictive things in those foods, but…) (sugar is one of the main ones.) It’s – yeah – it’s like what our frontal lobe gets excited about and so it’s the sugar, it’s the, even some of the… There’s scientists in a laboratory that are really making up all of these things and seeing how can I get you to eat more of them? It’s the Cheetoh people. But, you’re right. I would love it if they taxed sugar because then maybe all of the potholes in Fairbanks would get fixed. I don’t know. (laughter) But I understand. We’ve done tons of studies where we’re like, if we remove the soda drinks out of the schools, if we remove – if we put in vending machines that delivered apples, if we put in… if we educate people to eat fruits and vegetables and avoid the high-processed foods, but the reality is is our culture is at this point where we are not satisfied unless we have this full plate. We’re not satisfied unless we have all these carbos – carbohydrates, the sugars, the fats. We’re just not accustomed to it. I think even taxing it, they would still buy it because it’s so addictive. And so, even more expensive. I think really what it’s going to do though, if you look at the economical status and the four- like, Top Ramen. Every college student probably has lived off of Top Ramen for awhile, but that’s because they’re cheap, affordable, and filling. And so if you think about it, a lot of our government subsidized programs say, how many Top Ramens can I buy with my food stamps compared to how many apples can I buy with my food stamps? So I like your idea for taxing and I know it’s been something that’s been talked about, but I almost think that we have to turn around and say, “How can we support our people to make healthier decisions?” Maybe food stamps only buy apples and meat and vegetables and whole grains or for kids. You know, if you go
on WIC, you get cereal, but you get- you can choose to buy the Cheerios or you can choose to buy the Fruity Pebbles and we all know our kids will eat the Fruity Pebbles because they’re full of sugar. (… source of information for young people?) (They’re not getting much about their own bodies.) (… should put more emphasis on how to prevent problems rather than how to treat problems.) (… need to teach kids about their own bodies and what they eat and how it …) (Why isn’t that taught in much greater detail in schools? It seems to be that the medical profession should be speaking out more, but they’re inhibited partially because the food industry is so strong-footed.) Well, there’s multiple factors and you’re exactly right because Type II diabetes is getting in younger and younger kids, adolescents. We have overweight, obesity – it’s, you know, it’s amazing. And it is. It’s leading to the, you know, the prepackaged, the easy accessible, the food items, the sweet, the sugar, the fat, the salt – all of the things that we’re excited about. We’re also living in a culture where we’re on demand all the time and fast, we want it now, we need it now. We’re working two jobs or whatever, and high demands for families. Then we also have the concept of our schools and the cuts and the, you know, teachers only have six hours. I really think if you have six hours with my children, then why do they have homework? But the reality is is they’re locked in to so many things and then if you
think about, well, health and education. That’s one of the… that is one of the areas of schools are being cut. It’s like, the physical – it’s like P.E. It’s the arts, it’s the extracurricular activities. So when we’re
making cuts in our schools, we’re actually setting our kids up to sit in a desk,
eat Cheetohs, and that’s where our families and our cultures come down and
we have to say “okay” in the morning – and I’m the worst person to say this my
youngest is a carbaterian and he won’t eat anything other than bread. Bread, yes, crackers in the form of crackers, and so it’s really hard for me to say, “You need to your vegetables. You need to eat your fruits. You need to… eat your meats and your fruits.” Because coming around, you know, I deal with it with the family-wise, he wants the Twizzlers and it’s just a battle. And our culture, our society has framed it that way. ( … good point … ) ( … the things we should do … the importance of exercise, for example … ) ( … relates to, say, people working. Some jobs are desk jobs and they don’t get much work and some jobs are very labor intensive and they may be, may be paid well … ) ( … and discriminated against paying more for women than men, and… because men work harder … ) ( … and women. I mean, it doesn’t make sense. What we have to know is it’s not a circle. It’s not as simple. Everybody’s different depending on how they live their life, especially younger people.) ( … may not get much exercise … ) ( … and yet, they can contribute so much to society, but they’re vulnerable to getting hooked on a lifestyle that is inactive. They have to have some activity – everybody – if they’re going to live well and that means then you have to eat accordingly.) Right. And so, it’s our cul- it comes down to you and you being responsible for yourself. It’s like, okay, you can be a musician and you know that you have to sit, but it’s like, I know I have to go and exercise. I know I have to go out and walk so many miles. I know I have to, you know, I know that every day I go to the grocery store and it’s every day because I also have two teenagers, and I’m faced with the Twizzlers and I have to choose, actively choose not to buy them every day. It
doesn’t matter so much as the discipline if you are the construction
worker that’s working 40 hours a week or if you’re the piano player, or the school teacher.
It is an active decision that you have to make on how you are gonna live your lifestyle. It is – yes, the construction worker maybe have a
heads up because it’s more manual labor – but on the other hand, it’s… he could be eating Big Macs because it’s more convenient than handling twice as much of the junk. Go ahead. (So with the … were you know in the initially
province’s it right to care for pancreas make sure that we can do that that’s all
fine and dandy once we’re past up for it it’s like ok what is my physician
telling me to do if its influence if it’s metformin or whatever what are the
medications with my healthcare team telling me to do I tried to shun and
then exercise you have to exercise to build the muscle its fight on the other
hand it’s harder after the fact for nearly a year and it’s great because even though you don’t get the
cleric and take a picture her you’re still increasing your info need those
fights and then you’re hungry later to fresh fruits are good example of a full
green don’t go into the old-fashioned way with high sugar content because not binding to get up in the morning
it’s it’s it’s a it’s an easy hi a lot of the country to country and it’s
exactly yeah she’s like product what is our normal for orkut and how how
best to make the environment the best optimal way to absorb the nutrients it
needs it so that’s going back to save the more the more natural foods fruits
the best rules the not process substance like the cheese product or corn stuff a
lot of the candies and stuff the kids have their chemistry set so avoiding
those and trying to eat what’s natural your body’s normal for her body robotics consumer and this is where a lot of the
confusion happens we’re thinking we’re going in and where Brian Rosen frozen
blueberries and we’re thinking these are gonna be really really healthy but
genetically modified that is gonna mess with our formals infant being one of
them and through cause information it’s really hard for us we are set up to
almost fell by the food industry the market and even our government for what
they allowed to be put on the market yes it’s going to manipulate your body
if it’s not actively you know if you’re not actively looking to fit where this
is coming from then you wouldn’t even knew that safety my pretty much on
target to tell you that warning notices hey don’t buy this product because
modified advertised and it’s almost a disservice former FDA and porn

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