diabetes education
The Power of Culture to Combat Diabetes
By Myrna Gutierrez

diabetesTapping on the strengths of Latina culture may provide some of the best medicine for preventing and managing diabetes among Latinos.

“With our traditional cuisine, we were eating mostly unprocessed foods, sometimes grown nearby,” says certified diabetes educator Silvia Delgado, MS, RD at the Health Education Department in Kaiser Permanente’s Baldwin Park Medical Center.

Some of those savory time-honored foods, like quinoa from Peru or the vegetable nopal cactus found in Mexican palates, can become part of healthy meal plans. “Nopales are low in calories and can prevent blood sugar from peaking,” says Delgado. With eggs as a breakfast burrito in a whole wheat tortilla, nopales can be a nourishing tradition.

According to Delgado, preventing and managing diabetes calls for eliminating processed foods and choosing healthier foods like whole grains, beans, lots of vegetables and using fruit as dessert. “You can eat a little bit of everything,” she says. “It’s really about portion control.”

Reducing high carbohydrate foods such as beans, rice, and yucca, necessary to control diabetes, may take some resolve. “I am Puerto Rican. I can tell you that I never saw green on my plate,” says Nilka Rios Burrows, MPH, an epidemiologist with the Division of Diabetes Translation (DDT), in CDC’s National Center for Chronic Disease Prevention and Health Promotion. “Eating more salads and vegetables is something that I had to relearn myself.”

To combat the rise of diabetes among Latinas, the CDC is also adopting cultural elements in their educational fotonovelas using “strong family and friendship ties and how these relationships can help to bring people together with one common goal – eating a healthier diet, getting more activity into your life and preventing Type 2 diabetes,” says Burrows.

The battle against diabetes starts with a glucose test in the doctor’s office like that of Dr. Maria Sevilla-Herrera, a Family Medicine Practitioner at Kaiser Permanente Baldwin Park Medical Center.

For her, family ties is a powerful factor in treating diabetes. “If a patient is struggling checking their sugar because of the pain or fear of needles, I encourage them to bring a family member to the office to help them,” she says.

Recognizing that Latinas are the gatekeepers to their family’s health, Dr. Sevilla-Herrera urges Latinas to first take care of their own health so they can continue caring for others—an important part of the culture. She stresses the need to make time for regular screenings for diabetes especially for those over 40, or with a family history of diabetes or gestational pregnancies, or those with a Body Mass Index (BMI) of 30.

“Even if your parents had diabetes you can prevent the onset of diabetes by focusing on exercise and changing eating habits,” says Dr. Sevilla-Herrera.

“Just by losing five to ten percent of their body weight, Latinas can lower their risk by about 58 percent, regardless of whether they have a genetic predisposition or not,” explains Delgado.

Exercising 30 minutes five days a week can lower the risk by 30 percent. It reduces weight and lowers sugar levels, an effect which can last for several hours. Delgado emphasizes that 15 minutes in the morning and 15 minutes in the middle of the day can make a huge difference.

For Latinas, exercise doesn’t have to happen at a gym. “My mom loved gardening and going out to pluck weeds in the yard is just as good exercise,” adds Burrows.

A recent pilot study conducted in South Texas and South Carolina demonstrated that relationships and a Latin beat could get Latinas moving to the level of increasing their physical activity by 56.4 percent, compared to 48.8 percent among control-group women.

“The promotoras – trained community health workers – were essentially trained to do stretch exercises, but the ladies down here really liked doing zumba together,” said Jennifer Salinas, Ph.D., assistant professor of epidemiology in The University of Texas School of Public Health’s Brownsville Regional Campus. “Making physical activity a social thing is something we learned in our communities that would apply to other upper income Latinas.”

Dr. Sevilla-Herrera implores Latinas, “Don’t wait until you are told you have diabetes to make changes. You have to make changes before it happens because diabetes is a preventable disease.”.

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