Lifestyle change -- with community’s help
When Ana Marie Melo talks to groups in Latino communities in Los Angeles, she reminds them about cactus and beans.
“We come from a very healthy culture,” she says. “When we come to the United States, we change. We eat hot dogs. We forget about apples, squash, wild vegetables and beans.”
Melo is a promotora, someone who provides health information to community members, for Hathaway-Sycamore Child and Family Services. Since 1999, her message, and that of 15 other promotoras at Hathaway, has been basic. Eat right. Exercise. So far, 26,000 Latino adults have attended the six-week programs.
“I never talk about going to the gym,” Melo says. “They will think, ‘I don’t have money to buy the membership.’ I tell them to walk around the house. If they go to the mall ... to park far away.”
Her clients are overweight, at high risk for pre-diabetes, which afflicts about 16 million Americans. Without action, most pre-diabetics will eventually develop diabetes, which has no cure.
But pre-diabetes can be reversed. Losing modest amounts of weight significantly decreases the risk of full-blown diabetes. In a 2002 study, about 1,000 pre-diabetics were taught to eat healthily, exercise more, had lifestyle coaches, were weighed routinely, attended classes over 24 weeks, then were contacted monthly.
They lost an average of 15 pounds in the first year. After three years, they were still almost 9 pounds lighter than when they started. The study found that losing 15 pounds reduced the risk of diabetes by 58%.
Another effort in L.A., the Keck Diabetes Prevention Initiative, targets overweight people in ZIP codes 90022 and 90059, which have the county’s highest rates of obesity and diabetes-related deaths. Surveys there found only 10% of adults were eating enough daily servings of vegetables, and 25% of fruits.
The next phase: nutrition classes and efforts to expand farmers markets, grocery store options and exercise programs. Promotoras, too, will participate.
Melo’s classes meet in schools, churches and community centers. Leaders talk about food: Whole wheat bread, not white. Corn tortillas, not flour. Olive or canola oil, not lard.
They exercise for 15 minutes, and prepare food. Each week, “I ask them to change one thing,” Melo says -- to walk a day or two a week, or eat one more vegetable daily. The next week, she asks them to add another change.
“We know it’s not easy to start,” she says. “But they try.”
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