Division of Diabetes Treatment and Prevention Advancements in Diabetes Seminar December 3, 2013

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Division of Diabetes Treatment and Prevention Advancements in Diabetes Seminar December 3, 2013

Alaskan Natives are the Healthiest People in the World 2

Time of Contact for Alaska Native Groups Aleut/Unangan 1740-1780 Alutiiq 1740-1780 Yup ik 1780-1840 Inupiaq 1850-1870 Tlingit/Haida/Tsimshian 1840-1860 (Interior) Tlingit/Haida/Tsimshian 1775-1800 (Coast) 3

Dietary Variation b/t Region Pre-contact: High, healthy protein diet High, healthy fat diet Low in Carbohydrates 4

Dietary Changes: 1950s Local source of carbohydrates ranged from 20 45% Portion consumed as candy and pop ranged from 15 32% In Adults: 1/3 rd of daily calories were from bread, cereal, grain products 5

Dietary Changes: 1980s 1989: Statewide survey doing 24-hour dietary recall from Alaska Native people On average: MEN WOMEN Protein 19% 18% Fat 38% 37% Carbs 41% 44% 6

A Changing Picture... 7

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Weston Price 9

1933...Traveled to Remote Alaskan Villages...examples of physical excellence and dental perfection such as has seldom been excelled by any race in the past or present. 10

...strong rugged babies 11

Virtually NO Dental Decay, Until......villages with trading posts... store grub... A typical effect of modernization on a growing girl was shown in a case in which the central incisors and 16 other teeth were attacked by dental caries. Sixty-four percent of her teeth had tooth decay. 12

1 st Generation of Children Born After Adoption of Store Grub Dental arch deformities Crooked Teeth Changed facial form We have few problems more urgent or more challenging than reversing these trends. Weston A. Price, 1933 13

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Pottenger s Cats 10 year nutritional study Cats on optimal cat diet: (raw meat, raw milk) thrived- 4 generations later still healthy- Processed diet (canned milk, condensed milk, cooked meats): 1st gen- sick older age 2nd gen- sick middle age 3rd gen- sick from birth, behavior problems 4th gen- NO 4th generation- sterile or aborted fetuses 15

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First, remove obstacle to cure 18

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Vis Medicatrix Nature 23

Let food be your medicine -Hippocrates 24

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Store Outside? 29

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Comparison of Berries 42

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The Effect of Seal Oil/Salmon on Glucose Intolerance Daily Consumption of Seal Oil or Salmon Associated with Lower Risk of Non-Insulin Dependent Diabetes Mellitus and Impaired Glucose Tolerance in Yup ik Eskimos and Athabascan Indians in Alaska. Circumpolar Health 1993:270-273. 45

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Antioxidant Activity Oxidative damage related to a number of chronic diseases Obesity Diabetes Arthritis Cardiovascular disease Preventing oxidants can slow or reverse damage to tissue Treat macrophage cells to determine effects on blocking oxidants Most active species: Brown kelps: F. distichus bladder wrack A. Marginata ribbon kelp S. groenlandica kelp S. Latissima surgar wrack 47

Lipase Inhibitory Activity Lipases are enzymes that digest fat from the diet Our lipases are more active than the amount of lipids we consume Increasing fat in the diet means it is just as easily broken down and digested Main source of circulating lipids in the blood stream Blocking lipase can help lower lipid digestion Decrease obesity (Orlistat) Most active species: Brown and red kelps: F. distichus bladder wrack P. Fallax false laver 48

Glucosidase Inhibitory Activity Glucosidases breakdown starch to sugar We contain a variety of related enzymes in our digestive system Main source of circulating sugars in the blood stream Blocking can help lower glucose metabolism and digestion Decrease glucose levels internally Lower insulin stress, decrease insulin resistance Most active species: Brown kelps: F. distichus bladder wracker A. Marginata ribbon kelp 49

Decrease in Lipid Accumulation Fat cells synthesize and accumulate lipids from the bloodstream Grow larger to accommodate all the lipids, leading to obesity High accumulation levels also increases inflammation, can lead to diabetes Lower levels can help lower obesity risk Decrease lipids circulating in bloodstream Lower inflammation and insulin resistance Fraction from A. marginata (ribbon kelp) and S. latissima (sugar wrack) and P. fallax (false laver) all decreased fact accumulation in cells by as much as 24%. 50

Conclusion and Next Steps Seaweed from Alaska have potential to offset complications of obesity and diabetes Reduce oxidative damage Inhibit digestion of certain dietary nutrients Glucosidase Lipase Reduce accumulation of lipids in fat cells From here to the future Determine active chemicals Elucidate mechanisms of action Investigate clinical and dietary interventions at the community level 51

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Traditional Infant Feeding Guide 59

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