Old Dogs, New Tricks

Next weekend my family is gathering in Kempner, Texas to celebrate my mom’s 80^th birthday. Children and grandchildren will fly in from all parts of Texas and beyond to honor this tiny Texas Aggie. That’s her name, Aggie, short for Agnes.  

We will eat delicious barbecue smoked to perfection by my brother, Steve. We will laugh at tall Texas tales describing Mom’s hilarious escapades told by my sisters, Beth and Amy.  We will listen to sappy songs sung by beloved grandchildren. We will admire a very special gift carefully planned by my brother, Greg. And yes, we will eat cake baked by my sister-in-law, Amy, chef extraordinaire.

It’s not a surprise party. That failed early in the plotting. We had a stream of group texts between siblings, and somehow Agnes got in on it. We didn’t even realize it until she chimed in with a few of her own suggestions. Oops. But then again, Mom could never be surprised. She had an uncanny way of finding things out.  She’d talk to one of her kids, then innocently question another as if she knew nothing. Yes, the planning had to go deep into stealth mode. We kids still have a few tricks up our sleeves.

Mom has always been petite, 5’1 1/2” at her tallest, but has shrunk to a diminutive 4’ 9” not from osteoporosis but from scoliosis. She may be tiny, but she is a vivacious. Apart from arthritis which eventually led to replacements and of both knees and one shoulder, Mom is in great shape. She takes no medicine. She goes to her gym three days a week. She volunteers at the community hospital and takes meals to the elderly. She plays Bunco. She travels.

For eighty years now she has worked hard and played harder. She was never afraid to try something new. She raised 5 kids, added 3 more, ran an ER early in her nursing career, and trained many a doctor, including me.

So a few years ago when I told her the orange juice she was drinking on a daily basis was not good for her, she looked at me cross-eyed. “It’s fruit!” she informed me and continued pouring. Of course, she comes by this misconception honestly. Its what the old dog organizations like the American Heart Association and the American Diabetes Association and the USDA have told us for years and are still telling us to this day: 100% juice is a nutritious choice. Even the hospital from where her husband had been recently discharged, like most hospitals for that matter, suggest orange juice in their post hospitalization, heart healthy diet plans.

I took the hospital where I serve on associate staff to task on this once. I was so adamant that they should not sell or serve any sugary beverages including orange juice that I refused to get the required flu shot in protest that year. I’ll show them! Primum non nocere and all that! I was going to change the world, at least this hospital. I felt exuberant like I did in 1993 when I was chief resident and I protested my hospital’s sale of candy cigarettes. That was when hospitals still allowed smoking. Well, I bought all the candy cigarettes on the hospital’s dime and handed them out to my interns. We moseyed down the halls like James Dean with the packs rolled up in our scrub sleeves and the powdery cigarettes hanging from our lips.

In both instances something changed. Smoking was banned in the Kentucky hospital. And the other hospital cut out deep fried foods shortly after my rant. Now whether I actually had anything to do with those changes is not the point. Old dogs can learn new tricks.

I am so very passionate about avoiding sugary beverages including juice because they give the body a one-two punch.  Yes, juice comes from fruit. But just as you would not eat ten oranges in one sitting, you should not drink the juice of ten oranges in one sitting. The fructose overwhelms the liver and addicts the brain to sugar while the

glucose overwhelms the pancreas, spiking insulin and inducing energy storage. Additionally, the brain does not recognize the calories from sugar sweetened beverages and hunger is not diminished. Ghrelin does not decrease when you drink soda or juice or energy drinks. You are no less hungry, so you keep eating despite drinking hundreds of calories. Over time this firestorm of out of control hormones causes the liver to store fat, and the body goes down the slippery slope of weight gain and insulin resistance all the way to Type 2 diabetes.

I have heard it said 22 teaspoons of sugar a year for 20 years will cause diabetes. But our kids are drinking orange juice and Big Gulps and energy drinks and coffee drinks to the tune of over 40 teaspoons of sugar a day. And as a result, our kids are developing fatty liver and diabetes at alarming rates and at earlier and earlier ages. Not to mention they are hungry all the time.

What you eat can decrease hunger not just due to sheer volume but due to how certain foods activate hormones to talk to your brain. Protein (best from the highest quality your budget allows: grass-fed, free range, or wild) causes the release of GLP1 from the small intestine. GLP1 tells your brain you have had food and you are going to make it for another few hours. GLP1 slows food moving through the gut so you are fuller longer. And GLP1 assists insulin’s work in the cells which gives the pancreas a break. Lower insulin, less energy stored in fat cells. That’s a triple win for weight regulation.

Non-starchy vegetables have fiber. Fiber makes you full and feeds healthy gut bacteria. Healthy gut bacteria can decrease calorie absorption and improve weight regulation. Healthy fats from avocado, olive oil, fish, and nuts and seeds, make you feel full and satisfied and help the absorption of certain essential vitamins.

The message is clear. Eat food. Drink water. And eat food that makes you full: high quality protein, non-starchy vegetables, and healthy fats, and you too can live weigh different.

Happy 80th Birthday, Mom! I love you! And now that you have given up the juice, you’re going to see 100!