Ka Wai Ola - Office of Hawaiian Affairs, Volume 11, Number 2, 1 August 1994 — ʻAi pono, e ola [ARTICLE+ILLUSTRATION]

ʻAi pono, e ola

Eat right and Iwe well

by Dr. Terry Shintani

Loss of traditional ways ruins heaiih worldwide

Are obesity. diabetes, heart disease. cancer and other non-infec-tious diseases in indigenous peoples caused simply by a change froni traditional diet and way of life to a modernized Western lifestyle? Last month, I discussed how this has caused many diseases amona Pacific

Islanders. This article looks at how people around the world are affected by abandoning the diet and way of life of their ancestors. Africa In Africa, many diseases that are so well known today, such as obesity, diabetes, hypertension and heart dis-

ease, were virtually unknown in the past. Physicians monitoring the heahh of Kenyans and Ligandans between 1930 and 1935 reported that they had never seen high blood pressure in an African, and no case of high blood pressure was ever reported until 1941. On analysis of the first 1,000 autopsies of African people in the area in 1936-37, there was no evidence of hy pertension or coronary heart disease, no appendicitis and only one gallstone. By the 1970s lhings had changed substantially, as reports on hospitalized Africans indicated that over 40 percent of these hospitalizations were related to high

blood pressure. Obesity, onee absent in this population, began to emerge in modernized eommunities, and diabetes has become a eommon disease where traditional diet and lifestyles are being replaced by Westem ways. What is quite striking is that manv eommon

digestive diseases were also virtually absent in Africans prior to modernization. Diseases such as appendicitis, hemorrhoids, hiatal hemia, diverticular disease and cancer of the

eolon were very rare. After diet and lifestyle became modemized. all of these diseases increased in these populations. For example, the rate of admissions to large African hospitals for appendicitis increased from Ftve per year in the 1930s to 50 per year in 1952. There are many types of arthritis, and all except those related to manual labor were rare prior to Western contact in Africa. The most eommon types, osteoarthritis, rheumatoid arthritis and gout arthritis were mueh lower in rural communities when compared to urban communities. The higher rate of arthritis is attributed by many researchers to the Westem

diet whieh is rich in animal protein and animal fat. South America Reports on South American natives describe similar findings. Surveys of the indigenous tribes of Brazil whieh measured obesity, blood pressure, diabetes and eholesterol indicate that when these people follow their traditional diet and lifestyle they have very little risk for these conditions. The prevalence of obesity (120 percent of desirable weight) in these people was measured to be 0.9 percent among men and 5 percent among women. Cholesterol levels averaged were 1 54 milligrams per deciliter (mg/dl) for men and 170 mg/dl among women. (Compare this to the U.S. average of a little over 200 mg/dl.) Signs and symptoms of heart disease were not found ai all in this population. In addition, no evidence of diabetes was discovered after historieal surveys and glucose tolerance tests were done on a saniple of the population. Asia In Japan and China, heart disease, diabetes and eolon cancer are rare. In 1951, when the Japanese diet was still relatively untouched by Westernization and contained about 10 to 15 percent fat, the death rate from heart disease was 63.9 persons per 100,000 population compared to 281.6 in the U.S. that year, when

the American diet was about 40 percent fat. Similarly, in China, the heart disease death rate is even lower, averaging 11.5 per 100,000 for men and 9.5 per 100,000 for women. In some counties of China, deaths from heart disease are virtually non-existent. The Chinese diet averages 14 percent fat and ranges to as low as six percent fat. The low rates of disease in these populations are especially significant when you consider that heart disease is the leading killer of Americans today. Diabetes rates are low in Japan. However, when Japanese people move to the U.S. and their children begin eating the Ameiiean diet, the rate of diabetes increases 400 percent.

Clearly, the similarity is striking in what is happening to people's health in Hawai'i as compared to countries around the world. If we don't learn from what is happening to our heahh in Hawai'i when traditional ways of eating and living are abandoned, perhaps we ean leam from what is happening elsewhere around the world. Dr. Shintani, physician and nutritionist, is the director ofpreventive medicine at the Wai'anae Coast Comprehensive Healih Center where a majority of its 20,000 clients are of Hawaiian ancestry. Ifyou have questions on any nutrition topic, eall his radio shows on Sundays, 7 to 9 p.m. on K-108 radio.