Moving away from the whole enchilada

Tue, 12/27/2005 - 4:29pm
By: The Citizen

Outreach attempts to woo Hispanics away from diabetes-prone lifestyle choices

By Sarah Krupp
Knight Ridder Newspapers

Blanca Sanchez used to eat 10 tortillas for breakfast. Now, the Oakley, Calif., mother of eight dances to Latin rhythms and jogs most mornings for at least an hour. For breakfast she eats one tortilla and fruit.

In the last two months, the mother of eight has changed her lifestyle as part of an effort to stave off diabetes, a disease that her father suffered from and afflicts seven percent of Americans.

Nearly 21 million people have diabetes, and it is estimated that 41 million are at risk of developing the disease, according to American Diabetes Association. Latinos, African Americans, and Native Americans are more likely to get diabetes than non-Latino whites.

“Before, I liked to make enchiladas, tacos, pozole (a spicy meat and corn dish served with tortillas), tamales. They are all high in fat.”

At least once a week now she makes a low-fat stew with fish, chicken and vegetables. She buys lowfat instead of whole milk.

A study called the Diabetes Prevention Project found that lifestyle changes can delay its onset and reduce the risk of getting the disease by 58 percent, according to the U.S. National Institute of Health. At its worse, diabetes can lead to heart disease, blindness, nerve damage that requires limb amputations and kidney damage.

As the Latino population grows, health organizations are working to get the word out about diabetes prevention.

La Clinica de La Raza, a San Francisco area healthcare group that primarily serves Latinos, began offering classes in Spanish in 2002 for patients who are apt to develop the disease. Kaiser Permanente gives similar workshops in Spanish.

The California Healthcare Foundation and a national Spanish language newspaper distributed 85,000 leaflets in Spanish about diabetes in 2004 and because of demand from various groups, they plan to print 50,000 more copies.

La Clinica doctor Claire Horton said that there is genetic component that makes certain ethnicities more susceptible to diabetes. But lifestyle is a major factor. More than 80 percent of people with the most common type of diabetes are obese.

“(The Latino) diet tends to be fairly high in carbohydrates,” Horton said. “Obesity is a significant problem for Latinos.”

Horton said that immigrants sometimes suffer from depression and culture shock, making them less active and more stressed. They may also live in dangerous areas and avoid walking places, she said.

The first sign that Sanchez was at a significant risk for developing diabetes was in her last pregnancy.

At one of the pre-diabetes sessions at La Clinica in Pittsburg, Calif., Yolanda Rodriguez taught Sanchez and several others about the components of good health — exercise, whole grains, less fat, fruits and vegetables. She also coached them on overcoming cultural obstacles.

Rodriguez said it’s difficult to be the only one in a group who is trying to be healthy. She advised them to spend time with friends and family who will encourage their goals.

The hospitable nature of Latino culture can also make it difficult, said Rodriguez. Guests are expected to clean their plates and eat seconds for lunch and dinner gatherings. And it’s rare to visit a friend or family member without being offered juice, cookies or soda, she said.

“It’s hard to say ‘No’ for fear of offending.”

But she warned that seeming a little rude is a lot better than getting diabetes: “It is not reversible. Once we get sick, from that point we are suffering.”

According to the American Diabetes Association, there are about 20.8 million Americans with diabetes and another 41 million risk of getting the disease.

Ninety-five percent of those with the disease have Type II diabetes, which generally develops in adulthood.

Symptoms include frequent urination, excessive thirst, extreme hunger, unusual weight loss, increased fatigue, irritability, blurry vision. Many people don’t experience symptoms.

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