How people get to have diabetes or
how so many New Zealanders now have type two diabetes is
not an individual problem. Unhealthy diets and obesity are now our
biggest risk for disease in this country. And they're driving obesity
upwards and that's going to be our biggest health problem
now and into the future. There is now way that
people in this environment are going to be able to
sustain long term weight loss while they live in this world,
which is awash with energy dense food. We know what needs to happen
in terms of changing the environment. It's how to change it in
a way that it's cost effective, politically acceptable, socially acceptable, culturally acceptable and gets the buy
in of society as a whole, ... it turns out to be bloody difficult. We're in the middle of
a type 2 diabetes epidemic a disease that barely
existed 40 years ago. And it's only going to get worse. In 20 years it's predicted half a
million New Zealanders will have it. Experts tell us it's not about
willpower so what are the solutions? Brian Kairau feels solutions
are too late for him. I've got type 2 diabetes and
I've it since the year 2000. You get lots of bugs
when you're on dialysis. I had a bug in my blood and that bug had settled into this infection in my hip. And as a consequence,
I couldn't walk anymore. They got that under control
and it started coming right. Then they looked at one of my toes and
said, 'Unfortunately that toe needs to go.' They say once the surgeons begin
to chop it's pretty hard for them to stop. Now I am desperately
trying to keep it under control. And trying to hang onto these
little tiny limbs that I have left. I'm not on the winning side
of that battle I'm afraid. (Brian) One post amputated foot. I hope all this heals up nicely
and then I can keep my foot. Unfortunately this is what can happen,
you can slowly start getting amputations. I've got these things
showing up on my hands and if they can't find
out what is causing that and if they swell and get infected
then I will lose fingers as well. If they can't control this infection
and it continues to waste my limbs, they have no option
but to remove my legs. I reckon the reason why there's an
epidemic of type 2 diabetes in particular, when I was young we didn't have access to as many fast foods as we do now. I'm guilty of it and brought up my
kids on McDonald's and fish'n chips and Georgie Pie. It's the
economic accessibility of it for me. There is more fast food in
the lower socioeconomic areas because they know, keep your food range nice and cheap and we'll buy it. It's been a month since Brian
had his left leg amputated. It's still hard for him to look at. Unfortunately, the infection caused
by type 2 diabetes has come back. Now he may need to lose the entire leg. Hopefully the antibiotics will get rid of the
infected tissue and I get to keep this. Ha, I'm trying to hang onto this now. Oh... I didn't want this to happen. I didn't come into hospital to
have anything taken off my body. Now I'm stuck here with this and having
to face another possible amputation. You have to deal with a whole lot
of medical issues related to the condition but you carry with it stigma associated with, "I have brought this on myself." The other problem I have is when people
describe this as a 'lifestyle disease.' It suggests the people
choose to become obese and therefore people
choose to have type 2 diabetes, which is of course
is an absolute nonsense. Of course peoples personalities haven't
deteriorated of a 30-40 year period. But there's no doubt that
our physical environment has. So the issue of individual
responsibility is a big one because it’s pushed very
hard by the food industry, it's pushed very hard by governments
and people take it on board. People think, ‘Well, if
I’m fat then it’s all my fault.’ Brian’s son, Joe, doesn’t
have type 2 diabetes but he’s worried that his body
weight has put him on the same path. A year and a half ago
I was 130kgs or something like that and now I’m 220kgs,
so it was like ‘Oh hell.’ I don’t feel good and it’s a lot
harder to do things, energywise. I’m used to being big and
it doesn’t worry me too much. But I know in the long run
it’s going to have a big affect on me. Especially that I’ve got young
kids and I’ve got one on the way. Even just thinking about being
able to just play with them is hard. Obesity for most people is
an entirely normal consequence of having very useful genes and people
who are in a very maladaptive society. So I think, obesity is what we would
expect in today's society, it's normal. It just happens to have very unfortunate
consequences in terms of overall health. Buck Stower's gym
is designed for people who live with obesity
and type 2 diabetes. 203.6kgs (Joseph) I've lost a bit that's good. How heavy were you before? 225kgs Good work bro. I'll show you around
and we'll have a catch up. What we find with our
Maori and Polynesian people is they tend to look after
everyone else and not themselves. Their own health is not a priority and we’ll find that not only
with yourself but with your parents. It's the job to look after your children and the job to look after everyone
else around them is bigger than them. If we don’t change that philosophy of
life then our children will end up like us. And they can’t otherwise
they are going to die early. Unfortunately my brother,
it has to start with you. Someone's got to be a leader
in the family and lead them out of this. Just got to do it. Are you good with that? Yeah, good. When you join at most gyms, half the
people that start there and work there, they don’t know sh*t about
being fat eh, they know nothing. They only know what they
know from a book or from TV. But he's lived it. He’s lived through the same thing
with his mum, that I have with my dad. Genetics Gym is the home
of Big Boys and Big Girls. When there was no gym
around that catered for big people, it became a personal goal to be able to
look after one overly-sized human being. It’s like being encased in a tomb... where you can see everything
that is going on, but you’re dying. When you can’t walk properly because you’ve got gout, you’ve got diabetes, you’re morbidly obese, you’re 250kgs and can’t stand up for over five minutes. I’ve done the whole gym thing
before and I got down to 200kgs. Then I got hardcore
physical and eating healthily. And I lost 80kgs in 18 months. I know exactly what I have to do again. It’s just the starting point, getting the motivation to go hard and stay with it. Hopefully it works out. Hearing my eldest son is making steps
to improve his quality of life is awesome. Sitting here and thinking about it
there is a purpose right there. There is a reason why I should
stick around, to give my son a hand. When you talk to genuine
obesity specialists, they say, it’s nothing to do with willpower, nothing to do with eating less and moving more. One of them said to me,
'This is not rocket science... '...this is much more
complicated than rocket science.' When you look at this
on the individual level, you see that if people
follow mainstream guidelines, they’d be eating less in a predominantly low fat philosophy so they'd be hungry. And they’d exercise more which
would make them even more hungry. People who've lost weight have a
greater drive for hunger to put weight on so they have to consciously work for
years after the weight loss to keep it off. Back in the old days, I
would train, and train, and train and eat basically whatever I
wanted, which has been wrong. Now that I’m older, I keep
my nutrition very, very clean. Here we have eggs, which an egg
is a whole meal, it's not a partial meal. It's not just protein,
it has essential fats in it. It has got all your multivitamins
and minerals inside an egg. It is a complete meal. We’ve got our fibrous carbs, tomatoes, mushrooms, capsicums and spinach. Having diabetes and high
blood pressure is in my family. My blood pressure at 51 years is
high and they're keeping an eye on it. I’m very, very mindful that I
don’t want to become a diabetic. Mum took pills everyday
of her life that I can remember. Mum took pills to keep her alive. She was diabetic, she would feel
dizzy and it would affect her eyesight. She’d was partially blind and
we'd have to turn all the lights off to keep the rooms dark because
she couldn’t see and she’d be in pain. She didn’t want to die and we
would pray for a miracle for mum. I have a choice now to either be
afraid like my mum of dying or fight back and help as many people as I can not
to die in the same way that my mum did. This is a big breakfast, so I will eat half
for breakfast and save the rest for lunch. Every single cell in our body
depends on what you put in your mouth. If you look at it that way
you might think twice before you put toxic
things in your mouth. Some people don’t worry or make the
connection that food is key to everything. What’s happening today is there
is a major injustice with food. They’re selling crap food to our people
and people are becoming addicted. Food has an enormous
effect on people’s health. It’s one of the dominant causes
of cancer, of heart disease, of diabetes, all the big diseases that
we’re burdened with in this country. It affects people’s health by not
only the amount of food that we eat, creating obesity and diabetes,
but also the type of food that we eat. The type of food has a big effect on
cholesterol levels, blood glucose levels, and the ability to clot so there
are lots of metabolic factors in food that have an effect on our system
and drive us towards health or disease. We’ve actually set up society
and we’ve set up the food system to make it very hard for individuals
to choose the healthy foods. We’re in Mangere central, this is
my home, my backyard and my people. It doesn’t take us long
to have a quick look around and see the fast-food outlets
that are in abundance here. The more they insert
themselves into our society, the more it becomes normality to us.
It is normal for us to shop this way, it's normal for us to eat out on foods that deliver no nutritional value for our bodies and that’s something
that we need to address. A lot of my culture has taken on
these products to be part of the culture ...and that's how ingrained it’s gotten. We’re simply overwhelmed
by temptation. It's not that we don’t
know what we need to be eating. If you tap the shoulder of anybody
standing in a queue at Burger King or McDonalds and say,
'Do you think this food is healthy?’ No one’s going to say, 'Yes, I’m
sure this is what we should be eating.’ Everyone knows what they should
be eating, they are just not eating it. Good on the fast food
industry for finding a target. They bitch and moan about
people being overweight and, 'Oh no, we spend so much
money on all these people, diabetics.' But, 'Let’s put another fish'n chip
shop here or another KFC over there.' 'We can’t just leave
that as a gas station... ...we'll make it a gas station
and a Burger King.' It's like, yay more junk food. I think that people should be outraged not only against the industry
that's making us sick because to be honest
we probably buy most of... our unhealthy food
from the supermarket. So, I don’t point my finger
just at the fast food industry. I’m more inclined to point my finger at
government for doing nothing about it. I’m sure you’ve heard of the 'bliss point.' It's to that formula that the packaged
and the processed food is created, to get that best amount of
added fat, added sugar, added salt, so this is highly palatable, hyper
palatable and so what do you expect? They’ve worked out how
to exploit our physiology. The more sugar you get the
more sugar you want. Eating too much sugar interferes
with your hunger fullness hormones. It interferes with pathways in
the brain that makes you want more. And when you are constantly
eating and tasting sweet, it means that you will constantly
seek out that sweet taste. So it does nothing to
change that sweet palate. It’s interesting how difficult it
is for some people to give up sugar. We did a study looking at
patients who had type 2 diabetes and asked them how many
sugar sweet drinks they had. About a third of people
said that they were drinking at least one can of sugary drink per day. These were people
who had type 2 diabetes and included people who
were on dialysis. 20% of people admitted to consuming four sugary drinks a day, So there is a high
prevalence of people who, despite our health messages to stop,
when they have diabetes ...are still consuming a lot. I’m the most impulsive buyer. I’m an impulsive marketeers dream. You put it near the checkout, I’m gonna
buy it. I’m gonna go, ‘Flip, I need that.’ We’re seeing our obesity
rates in children skyrocket. We’re seeing diabetes
in children as well. It’s not a specific population group
that we need to target here, it’s everyone. It’s the
food supply for everyone. Should there be an age for children
to walk into a dairy and buy a V drink? They’re not allowed to buy cigarettes but you’re allowed to buy an abundance
of sugar to prematurely kill yourself. Should there be some
type of governance over how much sugar
is sold to children under 16? We have fantastic data from Mexico
about the efficacy of a sugar tax and in actual fact, in
Denmark we had good data showing the efficacy of a fat tax. The real missing ingredient is
the pressure for action. It’s not knowing what to do.
We know what to do to reduce obesity. Governments have
signed up to it at WHO. It’s been agreed with the evidence and
with the experts and it’s just not done. They’ve now put me
on lifelong antibiotics and they’re hoping that
keeps the infection at bay. Dr Caldwell doesn’t believe it will.
He thinks we’re fighting a losing battle but because I’ve asked
them not to take the rest of my leg, this is their best way around that
to keep me as comfortable as possible so I’m going to
continue to get lots of pain. When it came right down to it,
I’m not gonna get any better anyway even if they were to do the amputation,
I wasn’t going to be cured. I’ve been thinking about,
how do I want to be remembered? And today I’m going to get a chance
to speak to some young people. Brian was a school social worker until he had to give up
when his diabetes got worse. The students who I’m meeting today,
I haven’t seen for two and a half years so they’re all older now of course,
and moved on to high school. So yeah, it’s going to be
interesting to see where they’re at. I know they're will be
surprised to see where I'm at. I'm moved by seeing all the
rangatahi here. I feel the love. I feel the love guys and it’s too much. Good to be back in the whare again,
really awesome. No reira, tena koutou,
tena koutou, ki o mai tatou katoa. The honest truth is I’m dying and
I’m dying a lot sooner than I should of. And I’m not going to be around
to see my grandchildren attend college. The sad fact is that you
guys are in a massive battle about keeping away from this sort
of thing and you don’t even realise it. What I’d like to do is make you
think twice before you make that choice because it seems that it’s normal to buy
these foods that they tell us we can buy. Do you still have the tuckshop?
Yeah. What’s in the tuckshop?
Pies, pork buns, juicees.. All that healthy stuff?
Pork buns too and pies. The school needs to make a
change if that’s all they’re offering and that's the price they’re offering it at, they need to make it easier
for you guys to be healthier. They need to do that.
Even if they offer free fruit on the side. It's easier said than done
for you to change your lifestyle change what you
eat, but it’s hard for us. For me, my family eat a lot
and we never eat really healthy and we go hard out
on the fizzles and everything. Us kids, we have the fish'n chip
shop and every time we go there we always go past the sushi store.
And we know that sushi’s good for us and all the ingredients there are
good for us but you should see the price. The price range is $2.80
for a single sushi, when really, you can go to the bakery and get two
sausage rolls for $1.50 and that’s $3.00. It’s overwhelming for us now
that we’re aware of BJ’s situation and how he’s gotten there. So, I
don’t think anyone’s had the time to think about if we could change that lifestyle. I’m going to make a pledge to no
longer give my grandchildren sweets. It’s just that simple. I can give them
grapes or raisins or something. I just don’t have to give them
what I have been giving them. My son, Joseph in particular,
says to me, "It’s your own fault Dad." And he’s right it is my fault,
my fault that I got into this position but in actual fact I’ve been
told recently that it’s not. That we’ve been, not brain
washed, but we’ve been sort of, taught to believe it’s your
fault, when I really had no choice. The people that
allow these things to happen, they actually controlled
what I bought and what I ate, ...by making it easier for me to buy. We need a public uprising actually. I’d like a civil uprising that
people look around and think ‘Gee it's not my fault after all,
we should have a better environment’ and to start demanding
it of their workplaces, their schools, their councils, and
certainly of the government. I’m sure that people who have lived
their lives themselves with the diabetes, with the diabetes that ends
up in amputation and heart attacks and blindness, would
not wish that on their children. But they’re not exactly marching
in the streets demanding the actions from the food industry
and the government to create those changes in
society so that their children don’t get it. They’re not marching
the streets, so why is that? There's no doubt that the key
driver must be central government because it’s not just about one ministry,
it’s health, it’s education, it’s transport, it’s sport, it’s trade, it’s a whole lot
of areas that have to come together. It needs to be taken seriously. and that's what the WHO
report says as number one. Government must take the lead and
see it as an urgent and serious problem. I wanted to go to the gym
but I know I’ll just go home and just start munching like crazy. I know once I suss out
my eating and just cut down, it will be a lot easier to try and
make those steps in bettering myself. If I eat healthier then
I’ll get energy and motivation to go to the gym and to start walking. It’s hard to eat healthy
because it’s time consuming. It’s easier to just fry
a steak and some eggs. But to actually stand there and
peel the fruit and cut the lettuce. It’s just all convenience.
Just like with life. They’ll sell you a big
bottle of coke for $3.00 but then sell you a little 600ml
for $4.00 because it’s convenient. Eating is all about convenience. Patience... it you suss
that out you'll be all good. I’ve often thought a
lot about my mortality. More so after I’ve had these episodes
in hospital where I’ve had to be revived. Just having a family that you love
and want to be with, does incredible, incredible things for your mind,
when you're hurting and in pain. That distraction of just thinking
about the love and the bond that you have between your
children and your grandchildren. Man, that has been
so intense for me lately.
