College of Agriculture, University of Arizona,
Arizona Land and People, Vol. 47, Number 2
Nutrition Classes for People with DiabetesIt's 2:15 p.m. on a hot Thursday in August. The diabetes nutrition class is about to begin on the Pascua Yaqui reservation in Tucson. A beef and zucchini demonstration meal simmers in an electric frying pan as the participants enter the room, some in wheelchairs assisted by relatives. Although today's class has eight participants, normally around 15 will attend, including non-diabetics who attend with their spouses. A colorful array of nutritional literature, including food pyramid descriptions, eating guidelines, and recipes, covers one of the tables in the center of the room. Everyone is friendly and upbeat, but they know what they are facing every day. Diabetes has increased at a frightening rate among the Indians of Southern Arizona: they now have one of the highest incidences of diabetes in the world. Poverty has caused their diet to change over the last century from an abundance of natural, whole foods high in fiber to an emphasis on more processed, low fiber foods high in refined carbohydrates. The resulting blood sugar imbalance now affects young and old alike among the Tohono O'odham, Gila River, Yaqui, and other Arizona tribes. The more serious effects of diabetes include blindness, the need for regular dialysis, and possible amputation of gangrenous limbs. Dietary changes do make a difference, and education can help. The Extension Food and Nutrition Education Program (EFNEP), offered through the University of Arizona Cooperative Extension, provides eating and exercise guidelines to maintain health in those who are already diabetic, and to help prevent diabetes from developing in the rest of the population. In Tucson's Yaqui community, Pat Gomez, an EFNEP nutrition educator with the Pima County Extension, offers a variety of EFNEP nutrition classes to people of all ages, including pre-schoolers, middle and high school students, and adults. Pat, who has diabetes herself, understands how important it is to incorporate the right foods in smaller portions into her diet. "There are a lot of good recipes out there that we can eat," she tells the group, "even though our Mexican and Indian diets can be hard to control because they contain a lot of starch." Pat tries to incorporate as many commodity foods as possible into her food plans. Today's demonstration zucchini and meat casserole includes ground beef, canned corn, fresh cubed zucchini, chopped onion and chopped canned green chiles. Anna Valenzuela, a diabetes support group coordinator from the Yaqui tribe, assists Pat during the class, answering questions and helping with materials. She and Pat serve the meal, and discuss acceptable portion sizes. They use a regular-size serving spoon to demonstrate proper amounts of beans and rice, and paper cutouts for cheese--only a 1-inch square cube is allowed--pies and other foods. Rice portions amount to just half a serving spoon. "White rice has more sugar, so you can just use less of it and add more vegetables," Pat explains. "We have to really visualize the portions of what we're going to eat. I serve myself on a salad plate and I feel like I'm getting full." "Make sure you eat five fruits and vegetables a day, but be careful about your water intake in those vegetables if you are on dialysis," Anna adds. All of the dietary information given is based on the food pyramid, altered to reflect diabetic needs and restrictions. While Pat conducts the class mostly in Spanish, the nutritional literature is available in both English and Spanish. Other classes she teaches in both the Pascua Yaqui pueblo and Pascua Yaqui village may include the Yaqui language as well. Pat works with Yaqui aides to teach five trilingual (Spanish, Yaqui and English) preschool nutrition classes to 100 children. Pat teaches a variety of nutritional classes to meet the needs of different audiences within the Yaqui tribe. These include courses for seniors; people in drug rehabilitation; patients on dialysis; students in middle school; young mothers in alternative high school; and teachers in the Head Start program. The mortality rate among Yaquis with diabetes is 2%. Pat believes this low rate is due in part to these nutrition classes, both for the information they provide and the support they foster among people with diabetes. "The best part is that these classes are free," Pat tells today's class. "I'm learning along with you. It's very depressing sometimes and we have to support each other. All we need is your time, your patience, and your commitment to attend." Document part of 1999 Native American Programs in the College of Agriculture |