GRANT PROPOSAL (2nd DRAFT) for GOHW Mobile Kitchen Program
Native Hawaiian Presentation
1. Diabetes in the
Native Hawaiian
population
Reclaiming traditions to
eradicate disease
By Nina Sayles, Liban Aden, Emmanuel Essien, Kevin Trotman
Food, Lifestyle, and Health
Justice Brandeis Semester
2015
July 24th, 2015
2. What is diabetes?
Chronic disease characterized by high levels
of glucose in the blood
23.6 million Americans are affected (~25% are
unaware)
Inadequate levels physical activity and poor
diet habits
4. Symptoms/Risk Factors
for Type 2 Diabetes
Symptoms include: Extreme thirst,
fatigue, slow wound healing, and
extreme hunger
Risk Factors→ Family history and
race/ethnicity
5. Prevalence of Obesity and Diabetes
● Obesity rates (for all Hawaiian residents)
increased from 10.7%-21.7% between 2004 and
2007
● Native Hawaiians are 3x more likely to develop
diabetes compared to other non-Hispanic whites
14. Loss of Land and Culture
“Culture commodified
along with the land,
so that it is largely
associated with the
tourism industry”
(Ferreira)
15. Native Hawaiian Diet
● High starch, high
fiber, low saturated
fat, low sodium and
cholesterol
● From the root to the
leaves, Native
Hawaiians utilized
taro for a variety of
food and medicinal
purposes
● 10% Fat
● 12-15% Protein
● 75-78% Carbohydrate
16. Loss of Native Food Sources
very healthy native diet
→ immigration and
assimilation → blends of
multiple oriental dishes
becoming modern
hawaiian food
18. Organizational Models
Waianae Diet Program
❏ Education
❏ Diet
Waltham Fields
❏ Youth Crew
Groundwork Lawrence
❏ Community
Involvement
❏ Small Scale and Large
Scale Impact
Joslin Initiatives
❏ Language and
translation
Waianae diet program, Hawaii Medical Journal, Vol. 53, May 1994
19. Culturally relevant diabetes education
Topics to include:
Source of diabetes
prevention
Nutritional facts and information
Cultural clarification:
There is no genetic predisposition to diabetes
Victim blaming must be eradicated
Western Medicine is not the only solution
The traditional Hawaiian diet has served
individuals well for centuries
20. Growing taro, cultivating an active lifestyle
Taro cultivation is hard, active work
A year-round youth crew, modeled after Waltham
Fields Community Farm’s would benefit
participants and the community
21. Opportunity for replication
While taro must be planted in a warm environment, the
moisture level can vary
Taro garden initiatives can be replicated in Hawaiian communities in
the lower 48, especially Florida, Texas, and California
(Map of the US with the states that
have significant
Native Hawaiian/Pacific Islander
populations according to the
Census Bureau)
http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=65
22. Reintegrating taro into the Hawaiian diet
Growing more taro benefits a few, serving
more taro benefits all
Taro must be integrated into popular venues such as
fast food and cafeterias to make the greatest
impact
Leadership and advocacy education for youth
crew
efforts to increase consumption of taro will result in
various life skills gained by youth volunteers
23. Spiritual Enlightenment
Often spiritual totality is disregarded as
being relevant to health
When somebody is spiritually unwell, they are likely
to be stressed
Stress plays a large role in blood pressure, health,
and diabetes risk
“[For Hawaiians,] Diet influences spiritual development. That’s just the
way it is.”
--Ferreira and Lang, 38
start with what/how natives used to eat (poi, taro, luau) (hunter/gatherer)
Action must be taken in order to turn knowledge into a product. We can use studies that prove reasons for diabetes to create solutions
Model Education and diet of the waianae diet program, expand the idea to include hands of cultivation of taro and native vegetables
A non-profit must exist to educate, create policy, and take action, which will be modeled off certain similar, successful programs and organizations
What is unique about the proposed organization is that it is all encompassing
--Diet modification is helpful, of course, but to increase activity en route to diet modification is the holy grail
--Education is important for understanding--If someone is being forced to do something, it is less likely that it will actually happen. When they know why they are being asked to change their diet, they will conform
Using the waianae program for results examples, we would not conduct anything so concentrated, only suggest plans to all in the public (via internet, etc. )
The Waianae diet program is a program that has already existed (no longer) to help hawaiians lose weight by suggesting a diet based primarily on the traditional Hawaiian diet
Not only did the waianae diet program urge participants to change their diets, but they included education sessions in the program which debunked myths, suggested solutions, and motivated participants
Education should exist in person for the general public in Hawaii and for more involved non-profit participants such as a youth crew (to be established, which I will explain in the next slide), and information should be provided online for out of state Hawaiian communities which have been largely ignored by cultural initiatives such as Joslin cultural initiatives
Guest speakers who should donate their time include Terri Shintani--highly regarded nutritionist who has dedicated his life to diet education among native hawaiians and who supports a revisit of traditional native diet, Claire Hughes of Waianae Diet Program
As it has been discussed, taro is an indispensable food sources for native Hawaiians, and policy and action should revolve around the crop in order to increase nutritional, spiritual, and lifestyle health.
a non profit must establish a community garden to grow taro, as well as other healthy, traditional plants and recruit young volunteers who will benefit from the hard, active work required to cultivate taro.
--Taro cultivation:
weeds must be controlled
Taro is mostly harvest by hand
Leaves and root are separated to serve two purposes
--The WFCF youth crew model would make a large impact on a select few (note: it is unfortunate that only a few youth will reap benefits each year, but the benefits would be tangible and and the small, concentrated focus would keep the org. on track in the first few years)
http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=65
While a non-profit would have the most impact on Native Hawaiians in Hawaii, and probably the most support, once there is an established method of using taro gardens as tools to eradicate diabetes, the methods can easily be replicated in Native Hawaiian communities around the country
reintegrating traditional foods will bear results, according to research done by the Waianae diet program http://articles.latimes.com/1992-03-29/local/me-196_1_native-hawaiian-deaths
http://www.papaolalokahi.org/wp-content/uploads/2014/10/shintani1999.pdf
--An exclusively traditional diet is clearly not possible. waianae diet program incorporated a transition diet which includes modern alternative to traditional foods (*these suggestions would prove beneficial in Lower 48 Hawaiian communities without access to all traditional foods) and make the program sustainable
--poi, an easy to make, long lasting dish, could easily be served in schools/fast food
--Hire professionals to work with youth crew to educate the public about the use of taro
--education to include workshops with chefs to integrate taro products/other traditional foods into menus
--Leadership/advocacy is not directly related to diabetes, but:
Those with good interpersonal and social skill are likely do better in school or in the workplace. Both education and income are seemingly linked to rates of diabetes, and therefore, when those involved in youth leadership grow up to be in a higher socioeconomic status than they may have been destined, their risk decreases
Taro is so important that it influenced spiritual health. Spiritualality is closely linked to stress, as incompletness may trigger stress and anxiety.
The indirect results of such a program would complete a trifecta of diabetes prevention--activity, diet, and spirit
--Hawaiians essentially worship Taro--myths/stories depict the plant as the first living thing, the nourishment that sustains all humans, the child of mother earth and father heaven, etc.
--One stories goes that taro is the physical/natural form of the Polynesian God Kane--God of Sunshine and fresh water
http://www.nytimes.com/2003/07/16/dining/poi-the-root-of-all-hawaii.html
http://www.hawaiihistory.org/index.cfm?fuseaction=ig.page&PageID=533
AT THE WAIANAE PROJECT:
--they greeted eachother in hawaiian to honor language and restore culture
--project publication identifies importance of restoration of culture=restoration of health
CONCLUSION:
Like model programs, this ‘low-tech’ low cost program, which uses volunteer labor, and prevents disease and hospital visits, is an upstream approach that will save money that would be spend on medical costs etc.
