00:00:11:14 - 00:00:47:09 Unknown Yeah. And I'm Gail and welcome to women Over 70 Aging Reimagined, our award winning weekly podcast. Visit women over 70.com to learn about how you may become involved and join the Aging Reimagined Circle and enjoy free participation in our online monthly programs. And thanks to our sponsor for today, Plymouth Place in Lagrange Park, Illinois, where senior living is redefined with options and opportunities to fit individual needs and and preferences. 00:00:47:11 - 00:00:48:18 Unknown Thank you for listening. 00:00:48:18 - 00:01:12:05 Unknown And today we're very happy to be talking with Krista Reimer. She has a she's an advocate for women aging. And that series chose a BSN and nursing, a master's degree in health care leadership and advanced training from the Institute of Lifestyle Medicine at Harvard Medical School. From the Institute of Functional Medicine, and from the American Academy at the Functional Medicine. 00:01:12:07 - 00:01:28:10 Unknown So Krista recently became co-chair of the Minnesota Holistic Health Group, which is now under the umbrella of We Care, a nonprofit organization whose mission is to care for our compromised health care workforce. In addition, we care 00:01:28:10 - 00:01:30:02 Unknown also host a large one day, 00:01:30:02 - 00:01:33:04 Unknown wellbeing conference, immersive wellness Retreats, 00:01:33:04 - 00:01:36:16 Unknown and recently launched We Care Well-Being boxes. 00:01:36:16 - 00:01:53:23 Unknown Krystal also hosts the Rebel and Be Well podcast, where you can experience in-depth conversations just with trusted medical and health and wellness leaders to discover what they do to stay well using traditional and traditional health practices. 00:01:54:00 - 00:02:19:19 Unknown And in our conversation today, we could cover many, many topics with Krista. But in our conversation today, we will focus on metabolic health. It's a major issue for older women and an area that is just not well understood. So welcome, Krista. As an advocate for women aging, we want to thank our former podcast guest and your colleague Carolyn Torkelson for referring us to you. 00:02:19:21 - 00:02:45:19 Unknown So let's Krista, let's set some context. You, you've been in health care industry for 25 years or so in and work in, in various areas. And so first, just tell us a bit about what are some of those areas that you've, then engaged in and then if you would tell us about we Care and the various arms that it has took our questions. 00:02:45:21 - 00:03:09:06 Unknown Well, first of all, Catherine and Gayle, thank you for having me on your podcast today. It's an honor to be your guest and goodness, my nursing career. I feel like at this juncture, after being in the field for 25 years, it's more of a book than a chapter. But, I started the first half of my nursing career, as a bedside nurse in a variety of different roles, from orthopedics to telemetry to ICU. 00:03:09:08 - 00:03:42:08 Unknown But pretty early on in my career was starting to get pulled into various leadership roles. And that eventually took me into a few different administrative roles, such as being the, supervisor and director of the primary care clinics in the health care system I was serving, which had roughly 18 clinics at the time, and then going on to becoming the director, job, diabetes and endocrinology, care for four hospitals, and what became 35 clinics that we were serving, and 40,000 patients with type one and type two diabetes. 00:03:42:10 - 00:04:18:15 Unknown And then we also had a prediabetes program in there. It was during this time that I myself really realized that I had neglected my own health, for a number of years, worked a lot of double shifts, evening shifts, night shifts, for meals, bathroom breaks, all of those things, and then went home to my three kids and would then take care of them and kind of had this moment as both of my parents were diagnosed with terminal illnesses that at younger ages, in their mid 60s, that, you know, I needed to start to really pay attention to their health and my own health. 00:04:18:15 - 00:04:47:23 Unknown And, not try and serve from an empty cup and really started to have my own wellness journey and, and looking at how depleted my own body, mind and spirit were. And then also, how did that translate into how I wanted to create a different future for the patients that we were caring for. And I don't think this is necessarily unique to health care professionals, as I think in the US in particular as a culture where go, go, go and do, do, do, and we don't take time to be very often. 00:04:47:23 - 00:05:09:11 Unknown And I wanted to be a leader in a different capacity and spread a different message in that. And so I looked at how I could bring, some lifestyle medicine practices and to the patients we were caring for with diabetes. And that led me to, a number of different working classes in the Twin Cities area, cooking facilities, cult cooks at Crocus Hill. 00:05:09:13 - 00:05:41:09 Unknown And we were the first health care system healthiest was the first health care system of which is now called M Health Fairview to, reach, conversation with a culinary school and culinary facility not just for wellness and well-being, but actually for disease prevention and treatment. So we hosted a series of classes to help individuals who had diabetes or family members of individuals who had diabetes, how things such as food and lifestyle could really be part of managing their disease. 00:05:41:11 - 00:06:19:13 Unknown From there, I also was taking care of my parents, in their term terminal illnesses, and after they both passed, I inherited, as did my sisters, this really beautiful retreat facility, in northern Minnesota, and had always been a place to gather numbers of people together for a variety of reasons. And I thought, you know, this would be the perfect place for us to host retreats, including health care professionals, and really giving them a safe space to honor themselves and taking care of themselves, which I know for many people seems ironic that health care professionals, do not make good patients. 00:06:19:13 - 00:06:48:09 Unknown But we tend to not make good patients who we are really good at caring for others, often at the cost of not taking care of ourselves. So a number of things surrounding we care have been now to support that journey and even a greater capacity. So I took the business I started in 2017 that was to host these immersive, usually three, four day retreats, for a number of people and any profession experiencing, burnout or lack of well-being to come and take care of themselves. 00:06:48:11 - 00:07:12:14 Unknown And then within the We Care umbrella, we've now expanded that to multiple programs where people can come in and take care of themselves. So we have launched a new and innovative line of We Care well-being boxes. They all have a different theme. For example, we've had a metabolic box, mental well-being box, and exercise prescription box, a brain health box. 00:07:12:16 - 00:07:42:20 Unknown And in every box, you'll find products picked out by an expert in that area. And there's also a continuing medical education, presentation in that box. So for health care professionals who need CME credits, they can get a CMU credit, which are sponsored by the AMA, American Medical Association and Minnesota medical Association. But for those who are just wanting to take better care of themselves, they can also enjoy the presentation and apply the learnings and experiment within the new products. 00:07:42:22 - 00:08:10:04 Unknown And from there we acquired the Minnesota Holistic Medicine Group, which, as you know, Doctor Carolyn Torkelson connected us in that. And she had her co-chair, doctor Bill Monahan, asked if I would consider incorporating that in our new nonprofit umbrella. And it seemed to be a great fit as they launched this organization that's now 900 members and their members who really value holistic and integrative care as a way to heal and find improved health. 00:08:10:06 - 00:08:31:19 Unknown So it was a really great fit. In our in our new model of giving our health care professionals more tools in their toolbox to care for their patients and themselves. We hosted a one day wellbeing conference every fall, which we hope to expand in 2026 to being maybe regional, that it's called the we Care conference. 00:08:31:21 - 00:08:56:02 Unknown And then we also host retreats. So I just came back from a women's retreat in Arizona, where what I love about our retreats is we had a woman there, as there was 25 and a woman there who was the age of 80. And we all have this beautiful wisdom that we share with each other to really help support each other's health initiatives, so that we can have this, you know, health span and life span of more health than illness. 00:08:56:04 - 00:09:15:11 Unknown And we do have a lot of health care professionals that come because in everything that we do, we we offer continuing medical education credits. But we love curious minds. And there's so many ways that health care professionals are patients to, you know, whenever someone asks, you know, about the patient part and like, well, we are patients. 00:09:15:11 - 00:09:33:21 Unknown And I could in a lot of ways argue that we're the most neglected patients because we didn't really learn how to take care of ourselves, ironically, in nursing or medical school or any of the mid-level clinician programs, we were taught how to take care of others and more than health, we were taught how to take care of disease. 00:09:33:23 - 00:09:55:20 Unknown So we treat disease that we have. There's so much of it in our country and in our world. But again, disease and well-being care have overlap and they have differences. So we really try and, teach people how to prevent disease versus just always treating disease, both for themselves and for their patients. 00:09:55:23 - 00:10:23:05 Unknown You are one busy woman. Yes, yes, yes, I it is busy and fortunate. We have a really wonderful team. So this is far more than myself. I'm I'm just the one here today representing we care. So, when we talked earlier, we talked what are you could talk about so many different topics and you suggested, focusing on metabolic health for women as we age. 00:10:23:07 - 00:10:30:12 Unknown And I was like, okay, so what does that really involve? What does it encompass? So let's let's go there. Let's have you give us 00:10:30:12 - 00:10:33:07 Unknown lesson on metabolic health as we age. 00:10:33:07 - 00:10:52:20 Unknown well, thank you for that. It is one of my favorite topics. Of course, it ties into the care that we provided to patients with diabetes for a big bulk of my career, but it is one of those topics that everyone should really be tuning into and seriously evaluating where they land in the metabolic, health or disease spectrum. 00:10:52:22 - 00:11:27:17 Unknown There is a recent study out of University of North Carolina, probably our one of our most comprehensive metabolic studies, done in the last five years. And what it concluded is in the top five measurements of metabolic health, only 12% of U.S. adults are metabolically healthy. So it's not just a diabetes thing. It is something we should all be paying attention to and leaning in and listening, metabolic processes physiologically in the body impacts our health and well-being or lack there, in regards to brain health. 00:11:27:19 - 00:11:49:22 Unknown So metabolic health is definitely linked and correlated to dementia, Alzheimer's, Parkinson's, which of course we know the more advanced we get in our age, the more likely we are to develop those diseases. And having, compromised metabolic health, it definitely sets you up to have a higher risk of developing those diseases, things like cancer. We also know our cancer risks go up with age. 00:11:49:24 - 00:12:19:08 Unknown Metabolic processes also have a huge role in cancer, treatment and prevention. So at the root and trying to just kind of generalize cancer, it's cells kind of going haywire within your body and mutating at an abnormal rate. Well, when you're are metabolically unhealthy, you have a much higher propensity for your cells to be, recreating and reproducing and unhealthy patterns, and things like autoimmune disease. 00:12:19:08 - 00:12:52:18 Unknown So when you have autoimmune flares, there's often some element of metabolic disease underlying in that. And to look at it from a really, you know, head to toe systemic, view when you do not have metabolic health, meaning, more directly of higher than normal blood glucose levels in your bloodstream. If you think of your blood flowing from head to toe, and when you have more glucose than you should in your bloodstream, it's causing inflammation throughout your entire body. 00:12:52:20 - 00:13:19:07 Unknown So that's why it's everything from brain to toe that metabolic or how metabolic health can impact if your blood sugar levels are not within the normal ranges and every decade of life, it gets harder and harder to keep your blood sugars in check. For a number of reasons, which I'll go into for women, it's going to affect every single organ, every single body system, insight and, and give you a higher risk of disease. 00:13:19:09 - 00:13:49:15 Unknown And women have to pay attention to this. How do even more so I would say, than men. Because on top of blood sugar disruptions, we are also constantly having hormonal changes. So for women, you know, who are going through paramount perimenopause, menopause and post menopause, the disruption that we have and our estrogen, our progesterone and our testosterone are very deeply correlated with how our metabolic systems are, functioning. 00:13:49:17 - 00:14:15:00 Unknown So we have a couple of stressors in there that put us at a higher propensity to having metabolic disease. As women. So that's why I'm a really big advocate for this in our boxes, our seminars, our conferences, our retreats, I often give our attendees a continuous glucose monitor because it's one of the best ways to get a glimpse into your metabolic health. 00:14:15:02 - 00:14:40:14 Unknown And how are you doing? And it can there are some general rules that apply to all of us, but there's also a lot of personalized data that when you wear a continuous glucose monitor for a few weeks, it's giving your blood sugar readings 24 hours, seven days a week for a two week period. And then you really understand, okay, well, where my blood sugars, rising and falling and when they're going too high or too low, what can I do with my lifestyle to help mitigate those? 00:14:40:16 - 00:15:04:09 Unknown Or where do I maybe even need to take this another step and seek out medical care? Because, that I'm in a state of being very compromised. And it's very common that women going through perimenopause all the way through post menopause have a significant blood sugar disruption to those those monitors need to be a prescription is prescribed or are they available over the counter. 00:15:04:11 - 00:15:32:11 Unknown What what would women do? Or am I going to monitor their blood glucose or sugar glucose screen? That's a good question and a time that I finally have an answer that I'm happy about that I can provide. They have their prescription only, and throughout my career in this area, I will tell you. I mean, we used to have to sit on the phone for hours talking insurance companies to even get them to cover glucose monitors for people with type one diabetes who were very critically ill. 00:15:32:13 - 00:15:54:21 Unknown And now we are finally in a place where they're easier to get, although I would still say they are grossly under prescribed in the medical system for a number of reasons. But now there are two companies that have an over-the-counter continuous glucose monitor. So one is through the company called Dexcom. They now have an over-the-counter continuous glucose monitor called stellar. 00:15:54:23 - 00:16:25:12 Unknown I've worked with Dexcom and Stylo on a number of occasions. It's a wonderful product, great company. As is Abbott. They have now come out with a continuous glucose monitor that's over the counter come lingo. They run anywhere between $50 to $100 over the counter. Now, they are not recommended for someone who has type one or type two, or probably maybe even prediabetes because they have a limited high range that will go to in a limited low range, that it will go to. 00:16:25:12 - 00:16:47:09 Unknown So they are great for a preventative tool for someone who doesn't have significant metabolic disease. But if you have significant metabolic disease, then you would want to, ask your provider about getting a prescription for a continuous glucose monitor so you can really, you know, if you are already hovering at a blood sugar high about 250, that's about where the over-the-counter is. 00:16:47:09 - 00:17:12:23 Unknown They're going to max you out and the prescription monitors go up to say, 500. So that's where you that's the difference in the two. They both have great value. They both give great insight. But if you happen to wear an over-the-counter one and you're like ash, my blood sugars are either really low or really high within that two week study, then that's a good conversation to bring to your provider to see if you need to dig a little deeper. 00:17:13:00 - 00:17:39:23 Unknown Our, our, metabolic panels that doctors do through blood tests, the same kind of thing does. It gives it give the same results. You know, you know, on either categories, it's a macro level. So the labs that we test in clinic or in the hospital are a big high level view, a 3000ft view. The continuous glucose monitor is that micro, precise personalized view. 00:17:40:00 - 00:18:03:04 Unknown So if you went to your doctor and for a lot of your Roman listening, they should be getting A1, C labs done every six months for once a year. Your agency is a three month snapshot averaging out your blood sugars. So if your number in that agency range is running high, it's going to tell you you're having metabolic dysregulation and disease erupting. 00:18:03:06 - 00:18:28:04 Unknown But what it's not going to tell you is what is exactly causing that and when. So you could be having high blood sugars at 8:00 at night after eating, you know, X, Y, and Z. Well, Catherine, you might have blood sugar disruption early in the morning because your liver is having more impact than, say, your pancreas. And that's going to show up in the morning more than after a meal. 00:18:28:06 - 00:18:53:01 Unknown So the continuous glucose monitor gives you such a personalized snapshot, but it's fine to just track and start with that big snapshot. The one thing I do think we miss and traditional health care systems and again, a lot of clinicians, you know, are providing what insurance companies will cover historically, but it's really important to look at A1 C's for, I'd say, any women over 50. 00:18:53:01 - 00:19:20:09 Unknown You should have your A1, C drawn once a year at a minimum. It's also good to get a fasting blood sugar draw once a year, but equally as important and often missed is having your insulin level drawn with that fasting glucose. Glucose, because there's a couple of different differences in those processes. And then end. If you're insulin's high and your glucose is high, then it gives us a little bit more information to work with. 00:19:20:11 - 00:19:50:04 Unknown So those are kind of the three gold standards that most insurance companies cover. Sometimes clinicians don't don't, order that fasting insulin and it is okay to ask for it. I would advocate for you to advocate for yourself, and then discuss the continuous glucose monitor or just go get one. You know, it's not uncommon that even physicians don't know entirely what to do with the data from the continuous glucose monitor, or they don't understand which are covered and which are not. 00:19:50:04 - 00:19:56:14 Unknown Or are they over-the-counter? They prescription. So it's okay to really advocate for yourself and ask questions. 00:19:56:14 - 00:20:04:09 Unknown You mentioned that lifestyle force plays an important factor. And but can you talk about some of the holistic approaches 00:20:04:09 - 00:20:05:08 Unknown that would, 00:20:05:08 - 00:20:08:06 Unknown aid with prevention and being able to 00:20:08:06 - 00:20:10:01 Unknown monitor situations? 00:20:10:01 - 00:20:11:23 Unknown there any particular ones or. 00:20:11:23 - 00:20:14:12 Unknown I know it depends on the person's situation, but. 00:20:14:12 - 00:20:44:17 Unknown You know, some some general rules absolutely apply. And things that I would recommend for women, are having more and more protein in your diet. Protein is a really good blood sugar regulator. So just with every meal, remembering to have a source of protein in there, oftentimes little tips and tricks like eating your vegetables and your protein before your carbohydrate can really even help balance your metabolic health. 00:20:44:19 - 00:21:06:22 Unknown So sometimes patterning your meals different, and, you know, it's tough in the US, we see all these commercials of cereal and bagels and toast and they're all really yummy. I mean, we all love them, but for your blood sugars, they're the worst way you can start your day. Even things like oatmeal with milk and fruit. Very common breakfast. 00:21:06:22 - 00:21:28:18 Unknown Promoted. And I know, I'm so sorry. Everyone's probably like, kidding. Okay, I don't want Hershey's to say, but, that has been probably one of the most impactful lifestyle modifications we make with people with blood sugar. Disruption is don't start your day with a heavy carb meal which oatmeal, milk, and fruit are. I'm not saying don't ever have it. 00:21:28:24 - 00:21:52:20 Unknown I mean, I don't, you know, I'm like, this is not a deprivation thing. But usually our our bodies are better prepared because of our hormones to handle those later in the day than first thing in the day. Now, of course, the continuous glucose monitor can really validate that for you if it's a problem. But things like, you know, even if you're going to have oatmeal, add chia seeds, add hemp seeds, add flax seed, at least you're getting a few more nutrients in there. 00:21:52:22 - 00:22:15:01 Unknown But try and maybe start like, could you have a hard boiled egg, let it sit for a little bit, and then maybe an hour later, enjoy your oatmeal. Protein is going to help neutralize, blood sugars so you can you're better set for the rest of your day. I would also say sleep hygiene is really important. Your body gets very stressed when you do not sleep well. 00:22:15:01 - 00:22:40:03 Unknown And I know sleep is very. We all have so many challenges with sleep. And again, for women, hormones changing and shifting is very sleep disruptive. And that's why sometimes, you know, I get this question like, well, why am I blood sugars so high in the morning? They shouldn't be this high. It's because we have other organs in our body that are working hard overnight, such as our liver, to keep our blood sugars balanced when we're not eating. 00:22:40:05 - 00:23:03:14 Unknown And sometimes stress will give the wrong signals to our liver, and it will let go of too much glucose in our bloodstreams and our our stress hormone called cortisol naturally rises in the morning to wake us up. And it's supposed to do that job. But when we have our cortisol too high in the morning because, say, the day before was very stressful, then we didn't sleep all the night before. 00:23:03:14 - 00:23:26:10 Unknown Our cortisol is going to be so high in the morning that will inevitably end up causing a high blood sugar, because cortisol blocks your body's ability to use its insulin. Well, especially in the morning. So good sleep, lots of protein. And the third thing I would say, and I don't I just I can't say this enough for women in particular, is muscle. 00:23:26:12 - 00:23:55:05 Unknown Muscle helps you metabolize everything better and I think is the women, you know, historically through time, the images we've been shown are tall, lean women. And while if that is your body type, that is great, but muscle is protective for disease and and and helping promote metabolic health for every single woman, every single body type and and as you age, we just lose muscle. 00:23:55:05 - 00:24:09:19 Unknown It comes off every year. So making a concerted effort to keep building muscle will help you have a better, chance towards building metabolic health as you age versus seeing metabolic health decline. 00:24:09:19 - 00:24:21:10 Unknown so, Krista, I have a specific question about protein because I'm one to want to take shortcuts. Protein bars, which are all the rage, are those what do you what do you have to say about protein bars? 00:24:21:12 - 00:24:39:03 Unknown I know, like all good things are not created equal. Sorry, is here just a little bit of a tough question. There's some protein bars on the market that I like. You might as well just eat a candy bar or, you know, anything else you wanted to eat? So I would pay a lot of attention to the carbohydrate content in the, in there. 00:24:39:03 - 00:25:16:04 Unknown And the protein content. So the protein grams should be equal or higher than the carbohydrate grams. And please, I'm not saying all carbohydrates are bad, but I think in our diet and our country we naturally get carbs so easily. I mean fruit, veggies, rice, pasta, breads they all have carbs, lever drinks, have a lot of carbs. So I think we struggle more, you know, generally to get the protein in, if it's going to be a matter of, you know, say, missing an important meal or having a protein bar and you're not intentionally trying to fast, then I think protein bars are great. 00:25:16:04 - 00:25:28:05 Unknown I would just use some discernment and generally speaking, if there's a lot of ingredients on the ingredient list you can't pronounce, I would toss it. You should know more ingredients than you don't know in anything, really. 00:25:28:05 - 00:25:32:10 Unknown Oh my goodness there's so much I want to ask you about all of this. 00:25:32:12 - 00:26:00:12 Unknown And, you know, I think that the work that you're doing, Krista, is just fabulous. And, and I really appreciate it. I have to get on your list so I can maybe come to a retreat or something. Yes. That would be so fun. Love to do that. And, and just the whole idea of, of, well-being and care, you know, how that overlaps. 00:26:00:14 - 00:26:26:09 Unknown That's related to disease and well-being, I think is what you said. Yeah. And, and, you know, endocrinology itself is a fascinating subject for me. Yeah. It is. I mean, you're right. We could probably talk for ten hours about metabolic. So, so saying you get CGM is involved, but. Yes, but thank you for caring about this. And, you know, the sooner we have this information, the better. 00:26:26:09 - 00:26:42:15 Unknown That's what I just, you know, I remind everyone and don't worry about what you didn't know yesterday. Just for you, you know, focus on what you are learning today and carry it forward. Excellent advice. Thank you Krista so much. So thank you Gail. It's been very fun and I hope to see both of you again soon. 00:26:42:15 - 00:27:18:07 Unknown So listeners would like to see more of you at our monthly online programs, Make Your Voice Heard as together we change the conversation about women aging and visit Aging Reimagined circle at women over 70.com and if you enjoy women over 70, we recommend another podcast with host Wendy Green. Boomer banter. Real talk about aging well Wendy takes you on a journey to explore how to live vibrantly and healthily with strong relationships and purpose. 00:27:18:07 - 00:27:30:13 Unknown As we age. Wendy covers topics around financial literacy, mental and physical health, relationships and purpose, and her new subject is metabolic health. 00:27:30:13 - 00:27:32:03 Unknown Thank you for listening, everyone.