Diabetes is a health risk with Pacific Islanders in Utah

Story and photo by JANICE ARCALAS


Jake Fitisemanu Jr., chair of the Utah Pacific Islander Health Coalition.

Type 2 diabetes is a health risk among Pacific Islanders in Utah. According to a Pacific Islander report done in 2011 by the Utah Department of Health,  the rate of Utah Pacific Islanders is at 13.7 percent. This is nearly double the statewide rate in Utah, which is at 6.5 percent.“The biggest risk factor for diabetes is being overweight or obesity which is a huge problem in Pacific Islanders,” said Dr. Kalani Raphael, a University of Utah associate professor of internal medicine, in an email interview. “Of course obesity is related to poor diet quality and low physical activity, so these factors contribute.”

According to the 2011 report, 63.6 percent of Pacific Islanders in Utah were considered obese. Researchers  defined obesity to be a body mass index of over 30. Poor diet and sedentary lifestyle are the main factors that contribute to Pacific Islanders getting diabetes, said Jake Fitisemanu Jr., chair of the Utah Pacific Islander Health Coalition, in an email interview.

Rice is a common food that is in a Pacific Islander’s diet. Rice has lots of carbohydrates, which can spike blood sugars. “Rice is a huge one and is an unfortunate staple of the diet,” Raphael said. “Potato or macaroni ‘salad’ is another one and lots of processed foods.  I also suspect that there is a low proportion of fruits and vegetables.”

Many Pacific Islanders think that since their family members have diabetes there is nothing they can do about it. “My experience is that it is one of the toughest things to deal with. There is a lot of fatalism meaning that a lot of Pacific Islanders think that since their family members had diabetes that there is nothing they can do about it when there is a lot that can be done to lower their risk,” Raphael said. “Same thing for the complications like kidney failure. I hear a lot of people say that they don’t think they can prevent kidney failure because their family had it.”

One complication with Pacific Islanders who have diabetes is language barriers. According to the report, those interviewed in English had lower obesity rates than those interviewed in Tongan and Samoan. The Utah Department of Health also found that those interviewed in English were more likely to perceive themselves as overweight compared to Samoan and Tongan speakers. “Language barriers for providers that don’t speak the language or have access to an interpreter are an issue. Also providers who don’t understand the culture make it challenging,” Raphael said.

A traditional Polynesian diet wasn’t always like this. “The traditional Polynesian diet was plant-based, varied, and very healthy. This was a protective factor that was further strengthened by the very active lifestyle the ancestors lived. Fast forward to today, that healthy lifestyle and wholesome diet has been replaced by modern sedentary lifestyles and sugary diets that increase the likelihood of developing diabetes.” Fitisemanu said.

Resources are available to Pacific Islanders in Utah who have diabetes. “The Utah Department of Health’s Office of Health Disparities developed a brief video in English, Samoan, and Tongan languages that mention some overall health tips that can help prevent diabetes and promote overall wellness,” Fitisemanu said. “There is also a diabetes pamphlet in Samoan that the UDOH Diabetes program has published. Local health providers from our Pacific communities are also good resources, including Dr. Kalani Raphael, Dr. Liana Kinikini, Dr. Kawehi Au, Uaisele Panisi, [and] Karen Mulitalo.”

Raphael mentioned community resources such as the National Tongan-American Society, which assists with diagnosing diabetes and counseling. It is located at 3007 S. West Temple, Bldg. H, in Salt Lake City. Another resource is the American Diabetes Association of Utah, located at 986 W. Atherton Drive, Suite 220, in Taylorsville.

The report of the health needs of Pacific Islanders advises limiting sugary drinks to help control obesity, which is a factor that causes diabetes.

“Our communities need to be aware of the risk factors and symptoms of diabetes so that they can try to reduce their risks and be able to identify diabetes early on, before serious complications occur,” Fitisemanu said. “Our families, social groups, and churches need to take more proactive roles in encouraging healthy living while providing support for those who seek treatment, and acknowledge and incentivize those who comply with treatment and make improvements. Apathy and normalization are the two worst enemies in this fight against diabetes. Because it’s so prevalent in some families and communities, it can become normalized and ‘accepted’ as an inevitable fact of life, and that notion is not only false but also incredibly dangerous to us as a community.”

Diabetes can be overwhelming but there is hope. “Diabetes is a complicated disease that requires a lot of self-care, but the motivated and informed patient can be successful,” Raphael said.

The convenience of college obesity

Story and photos by Blakely Bowers

The United States has the highest obesity rate in the world. Obesity is an issue that reaches far beyond the way someone looks. Medical experts have linked excess weight to everything from heart disease and diabetes to chronic back, hip and knee pain.

According to the U.S. Surgeon General, 74.6 percent of Americans are overweight or obese. For the past decade the rates have risen steadily for Americans of all ages and population groups. The difference between being overweight and obese is determined by a person’s body mass index (BMI). Adults with a BMI between 25 and 29.9 are considered overweight. Adults with a BMI of 30 or higher are considered to be obese. Try calculating your own BMI

Studies performed by the Centers for Disease Control and Prevention show that one in every 50 Americans is obese. This number is significantly higher than it was even five years ago. As the number rises, so do the costs. Chronic obesity costs the individual, but the problem has its impact on others fiscally, as well. “Obesity not only costs the patient a whole lot of extra money, but it costs us as doctors. We spend more time with patients who are overweight. The health issue creates many other issues in which rises the rate of diseases and disorders, which in turn impacts us,” said Dr. Cassandra Quigley.

As the obesity rate increases, so do the rates of obesity-related medical problems. Medical problems such as cardiovascular disease, diabetes, and hypertension affect the cost and availability of insurance benefits, which increase the cost for the average person. The rates also cause government programs to pay enormous amounts for those benefiting from the programs.

The Surgeon General estimates the annual medical costs of obesity are as high as $147 billion. On average, obese people have medical costs that are $1,429 more than medical costs of people of healthy weight. More information regarding the dollar amounts of these medical costs can be found at http://www.cdc.gov/obesity/causes/economics.html

“The increasing amount of obese patients I see, is really getting terrifying,” Quigley said.

“I am learning more details of the personal causes behind this disorder, said Laura Welch, a certified nutritionist and health fitness coach. She graduated from BYU with a degree in nutrition, and has been studying it ever since.

“Most of my clients admit that their issue comes from within. They slowly start feeling bad about themselves and overeating and not exercising is their way of coping. The other major problem underlying obesity is accessibility and convenience to fast food and treats that help pack on the extra pounds.”

We can get online, make an order and wait 15 minutes for our meal to show up at our door. We can drive through the local McDonald’s and have our food within seconds. We have instant macaroni and cheese, instant brownies, instant everything. It has become about convenience and price. Fast foods are always the least healthy, but the least expensive option.

The number of overweight college students has also significantly increased in the past decade. In order to understand the increase, I decided to observe and research the habits of students. College lifestyles have a major influence on obesity. We’ve all heard about the “freshman 15,”, a familiar reference to the standard weight gain new college students typically pack on. Studies have shown that three-quarters of students gain weight their freshman year of college. These students can easily form a habit of overeating and overlooking regular exercise. These habits continue to impact their weight for years to come. Research by science daily.

Some University of Utah students say that “convenience” is the main reason for their unhealthy eating habits. It is hard for students to find the right balance while attending college. In a study performed by researchers at the Mayo Clinic in 2009, researchers found that lack of sleep and skipping breakfast are prominent promoters of obesity among students. A jam-packed school schedule, late nights, early morning lectures and exam cramming leave little room for healthy eating habits. Students often reach for the quickest and cheapest options—fast foods low in nutrients but high in calories, fat, and sugar.

“ I go for whatever is cheapest and fastest during my school breaks. I have all the intentions of eating healthier, but when the time comes I don’t want to spend the extra money, or take the time out of my crazy studying and work schedule to make a healthy option.” Mary Earl, a U freshman said.

Sleep is another factor that affects obesity in college students. When the proper amount of sleep gets cut in half, along with a scattered diet, a body has a hard time sufficiently metabolizing. Students are at the most vulnerable state, and the habits are not a top priority. More sleep and obesity related studies can be found here.

“When healthy food becomes more convenient to pick up and cheaper, that’s when I will start eating healthier during this time in my life. It sounds lazy, but it’s true. Convenience and cost are just the factors that play into these habits for me,” Earl said.


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