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February 20, 2003

Pitt at the Pole

It was during an otherwise routine faculty meeting two years ago that Bret Goodpaster learned he might be traveling to the South Pole.

Andrew Stewart, chief of the Pitt medical school’s Division of Endocrinology and Metabolism, where Goodpaster is an assistant professor, surprised everyone in the meeting room — including Goodpaster — when he said: “I have an announcement to make. Bret may be going to Antarctica.”

“That certainly got my attention,” Goodpaster recalls, with a laugh.

Stewart later explained to Goodpaster that he had been approached by a local outdoor enthusiast, Will Cross, who was planning to hike with a friend from the edge of Antarctica to the Pole. Their two-month, 730-mile trek would be named the Novolog Ultimate Walk to Cure Diabetes after its chief sponsor, which makes an insulin injection system that Cross uses.

The walk had two goals at that point: raising money for the Juvenile Diabetes Research Foundation, and showing that diabetics such as Cross can safely complete physically demanding adventures, provided they plan and execute them properly.

Cross contacted Stewart because he wanted to add a research component to the trip. Could Stewart recommend a Pitt diabetes researcher to accompany the expedition part of the way to the Pole? Stewart thought of Goodpaster, whose research examines how lifestyle changes, especially exercise, can improve muscular metabolism in people with diabetes.

Goodpaster, now 36 years old, says he’s “not an adventurer/explorer type” but he is a competitive cyclist who had completed a triathlon and done some hiking and climbing. Moreover, he was excited by the prospect of going to Antarctica, having read accounts of polar travels such as Sir Ernest Shackleton’s “Endurance,” the Anglo-Irish explorer’s memoir of the ill-fated but heroic attempt he led in 1914 to cross the Antarctic continent.

“Otherwise, I wouldn’t have done it,” Goodpaster says. “Who wants to go to Antarctica if you’re not interested? It’s a cold, desolate, forbidding place in many ways.”

Goodpaster and Cross met over a few beers to discuss the expedition. They agreed that Goodpaster and Cross’s father, 60-year-old Mike Cross of Lincolnshire, England — who, like his son, has Type 1 (juvenile) diabetes — would rendezvous with Cross and his hiking partner, Jerry Petersen, about 120 miles from the Pole. (Petersen does not have diabetes, although his father died of diabetes-related complications. Petersen would serve as a research control.)

Will Cross would wear a heart monitor connected to a wristwatch, allowing him to check his heart rate even as he skied, making sure that his heartbeat was in the optimal range for efficient energy use. He would monitor his blood sugar using a device that warned him if he was getting too much or too little insulin.

Also, Cross and Petersen would record everything that they ate and drank, so Pitt researchers could analyze how efficiently they were burning calories under extreme conditions while subsisting on a specially designed, high-fat diet. Normally, diabetics don’t efficiently process fats and are sensitive to high blood pressure. See accompanying story.

“Frankly, the trip sounded like a pipe dream at first,” Goodpaster remembers. “For one thing, Will set a goal of raising $1 million to cover the trip’s expenses and contribute to the Juvenile Diabetes Research Foundation.”

But potential donors were dubious about having their names, or their products’ names, linked to an expedition that might end in disaster. No diabetic had ever undertaken such a journey before. Will’s father Mike, if he completed his part of the trip, would be the oldest man to walk to the South Pole.

Would the Crosses’ insulin freeze? Would they develop frostbite, a particular danger because diabetics often lose sensation in their fingers or toes and can’t feel the cold?

Then came Sept. 11, 2001, and the related economic downturn. Corporate and foundation funding almost dried up completely.

But Will Cross persisted. He found a Downtown investment counselor willing to serve as the trip’s financial adviser. To prove that he was up to the rigors of an Antarctic expedition, Cross and his partner, Petersen, braved 60-below zero temperatures and the threat of polar bear attacks during a two-week, 100-mile trek to the North Pole in spring 2001.

Ultimately, corporations, foundations and individuals would contribute about $750,000 to Cross’s Ultimate Walk to the South Pole.

Alexandra Shackleton, granddaughter of Sir Ernest, even agreed to be the Ultimate Walk’s honorary patron.

After undergoing a battery of tests in Goodpaster’s lab, Will Cross set out with Petersen for Antarctica on Nov. 18.

Goodpaster followed on Dec. 27, flying to Chile from Orlando, Fla., where he, his wife and their 15-month-old twins had spent Christmas with her family.

“That was the hardest thing about the trip for me,” Goodpaster says, “being gone from my family for that month.”

At the airport in Punta Arenas at the tip of South America, Goodpaster was met by Mike Cross and the guide who would fly them in a Russian cargo jet to the Antarctic entry post at Patriot Hills. The guide said: “Don’t unpack your bags. We may be leaving today.”

Goodpaster recalls: “I had been told that I would probably have to spend two or three days in Punta Arenas, waiting for good weather, before we could fly to Patriot Hills. Mike Cross and I weren’t scheduled to meet up with Will and Jerry until Jan. 3 or 4.

“But within three hours of arriving in Chile, I was on the jet for Antarctica because the weather was so good. Other people had been waiting for two weeks to get this jet.

“This meant that I could spend those extra days at Patriot Hills, hiking, climbing and getting used to the cold” — which dipped one night to minus-28 degrees Fahrenheit with a 60-m.p.h. wind.

“The highest the temperature got was 20 degrees Fahrenheit, which was pretty comfortable,” says Goodpaster. “Keep in mind, it was summer when we arrived.” The sun never set the whole time that he was in Antarctica; it just circled around the sky.

“When you get off the plane in Antarctica, you immediately realize how huge this place is,” Goodpaster says. “It’s hard to describe. I can show you photos, but they won’t give you a real concept of it. As you get away from the coastal mountains and there’s nothing to break up the horizon, it seems even bigger.

“The air is different. It feels clean and pure. Maybe the cold makes it seem even cleaner. You see no trees, no animals, no birds. No vapor trails from jets, which you might see even in the wildest parts of Alaska or northern Canada. For me, one of the amazing things is that there are no borders of any kind. Here in North America, there’s always some indicator that you’re in this state or province, that national park or wherever. But Antarctica is the one great land mass that no one owns.

“Definitely, the climate is drier than it is here. Of course, your skin is always covered up. And I didn’t take a shower for the entire month I was there, so my skin was producing these natural oils that we normally wash away every day. You feel grungy and you smell bad, but at least your skin doesn’t feel dry.”

Goodpaster and Mike Cross originally had planned to meet up with Will and Jerry 120 miles from the South Pole, but the terrain there was too rough so the pilot flew them 30 miles closer to the Pole. “At first, we had this idea of backtracking for two or three days, meeting Will and Jerry and then going back toward the Pole,” Goodpaster says. “We did that for a day, realized how hard it was and decided that Will and Jerry could catch up to us.”

Pulling supply sleds that weighed 150 pounds, the trekkers had to contend with the 10,000-foot altitude and sastrudgi, waves of blown snow as tall as five feet. “For someone like me, who only weighs about 140 pounds, it was tough — especially on my back and shoulders — dragging a heavy sled for seven hours a day over these sastrudgi,” Goodpaster says.

“Another thing is, the snow’s consistency changes. Sometimes, it’s fine and your skis and sled fly along. But other times, the snow is coarse and it’s like you’re dragging your sled along a beach.

“When I got back home, my wife asked how I had spent my time out there. I said, ‘Well, for a third of the day you sleep. You spend another third of the day pulling your sled. The other third, you’re melting ice and boiling water for drinking and cooking.”

Mike Cross was the only expedition member to get frostbite. “Mike had a pretty severe case on his thumb, but he’s okay now,” says Goodpaster.

As the four Ultimate Walkers approached the South Pole, a man wearing a hard-hat walked up to them. “Which one of you is Jerry Petersen?” he asked.

“That’s me,” Petersen replied.

“Here’s a card from your family,” the man said, handing it to him. “I’ve been waiting for you guys for days!” It turned out that the man used to work with Petersen’s cousin at a crane company in West Mifflin before getting a construction job at the South Pole.

“This guy gave us each a beer and took photos of us,” Goodpaster says. “It really is a small world.”

Goodpaster plans to produce at least one paper reporting his Ultimate Walk research findings. “Among the more interesting things we’ll be looking at are how Will’s insulin requirements changed over the course of the trip,” he says. “Exercise and insulin act in very similar ways to cause the body to use blood sugar. When you combine insulin and exercise, they have a synergistic effect. If you exercise after taking too much insulin, your blood sugar can really plummet. If you exercise without enough insulin, your blood sugar can go too high.

“Will used far less insulin during the latter part of the trip than at the beginning, because he was exercising so much. Most kids who are diabetic learn quickly that they should take less insulin when they exercise. We’ll try to point out through this research that during extreme activity, it’s even more important to adjust your insulin use.

“If Will hadn’t done his North Pole trip first, I would have been surprised with how much energy he and Jerry were expending in Antarctica. They were burning calories at an extraordinary rate. We know that their cholesterol levels didn’t change much, which was good given their high-fat diet.”

Goodpaster says he feels privileged to have hiked to the South Pole. “I had an experience that not many people on this Earth get to have. I’d love to go back to Antarctica some day, maybe take my kids when they’re old enough so they can see what it’s like.”

But next time, he’d go as a tourist, Goodpaster says. “As I told my wife, I’m not going back there until they have a Radisson.”

—Bruce Steele


Pritikin, it isn’t.

Atkins, it ain’t.

No, the diet created by Anne Mathews and Juliet Mancino, research dietitians in Pitt’s School of Medicine, isn’t low-fat or low-carb. And it definitely isn’t low-calorie.

The Mancino-Mathews Diet prescribes consuming up to 6,000 calories a day, three times the recommended intake for a normal adult. At least half of the calories should come from fat.

Craving chocolate? Eat all you want! The Mancino-Mathews Diet also encourages pouring olive oil (or, failing that, powdered butter) in your coffee and soup, even over your breakfast cereal.

Snacks may include Slim Jims, Pringles, nuts and energy bars.

Sounds deadly rich, yet a Pittsburgher ate like that for nine weeks and lost 25 pounds. His cardiovascular fitness (already excellent) improved, and his cholesterol and blood sugar levels remained healthy — not bad for a 35-year-old who was diagnosed with diabetes more than two decades previously.

The catch is, the man spent those nine weeks traveling up to 12 hours a day on skis, pulling a 150-pound sled as he journeyed from the Antarctic coast to the South Pole.

Will Cross, a Morningside resident who has Type 1 diabetes, made the trek with non-diabetic friend Jerry Petersen, 36, of Jefferson Hills, who dropped 40 pounds during the trip.

They were on the NovoLog Ultimate Walk to Cure Diabetes, aimed at raising funds for diabetes research and dispelling myths about what diabetics can and can’t do.

Two other men joined the pair for the last 120 miles of the expedition, which reached the South Pole on Jan. 17: Cross’s father, who also has Type 1 diabetes, and Pitt researcher Bret Goodpaster, who was studying how a diabetic would perform under extreme conditions. See story on pages 10 & 11.

During a two-week, warm-up trip to the North Pole last spring (“warm-up” being used advisedly), Will Cross maintained his normal weight while consuming an average of 5,000 calories daily, but his partner Petersen, taking in an average of 2,200 calories, dropped 15 pounds — a dangerously quick weight loss under such physically demanding conditions.

In preparation for their far more challenging South Pole trip, each man intentionally gained 20-30 pounds. They also asked Pitt dietitians to recommend appropriate foods and beverages for them.

“The reason that the diet we developed is so high in fat,” said Anne Mathews, “is that fat is dense in calories. There are 9 calories per gram of fat, compared with 4 calories in each gram of carbohydrates or protein.”

The more calories per mouthful, the less the men would have to eat — and haul on their sleds.

A typical, recommended breakfast included hot museli cereal with powdered butter stirred in, an instant breakfast shake, nuts and a high-energy sports drink. For a mid-morning snack, the men ate energy bars, dried fruit and Pringles.

Lunch consisted of trail mix, granola bars and Slim Jims. Afternoon snacks included more trail mix, dried fruit and chocolate bars (kept close to the travelers’ bodies, or the candy would have frozen hard enough to crack teeth). Another snack was pemmican, a concoction of dried meat and fat — sometimes with dried fruit added — that polar pioneers such as Amundsen and Peary adopted from the Innuits.

Contrary to normal dietary guidelines, dinner was the major meal of the day: thawed freeze-dried entrees and soups (again, with powdered butter added) and big bowls of chocolate mousse.

That was the recommended daily diet, anyway. But it wasn’t until the final two weeks that the travelers could force down all of the food, water and sports drinks that Pitt researchers had urged them to consume.

“The biggest challenge of this diet is simply eating and drinking so much,” Mathews said.

If you’re an average-sized adult who takes in about 2,000 calories a day, imagine consuming enough to gain 100 pounds in nine weeks. That’s how much the polar travelers were trying to ingest, noted Mathews.

“When a world-class cyclist like Lance Armstrong is competing in the Tour de France, he consumes between 7,000 and 8,000 calories a day,” she pointed out.

Like her physician colleague Goodpaster, Mathews still is analyzing data from the expedition. “One of our preliminary findings, though, is that it’s definitely possible for someone with diabetes to safely complete an expedition like this, and to manage their blood sugar with good meal planning,” she said. “We also confirmed that, while he was expending so much energy, Will needed a lot less insulin than he would have needed at home.”

One disappointment for Mathews was that the travelers relied heavily on powdered butter — high in saturated fat — rather than the recommended olive oil, which is healthier for diabetics and others with a heightened risk for heart disease. “The original plan was for [expedition members] to freeze olive oil in ice cube trays before they reached Antarctica, and then thaw it for use as they went along,” said Mathews. But a Canadian company donated a large supply of powdered butter, which was more convenient to use, she said.

—Bruce Steele

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