Nutritionists to Study Diets of Residents of San Ysidro

A team of San Diego researchers has received a $450,000 grant to examine the eating habits of the residents of San Ysidro--a project that is part of the largest private health-promotion effort ever undertaken in the United States.

The San Diego State University team intends to spend three years cultivating nutrition programs in the largely Latino community, hoping in the long run to reduce the community’s high incidence of diabetes, heart disease and other diet-related illnesses.

The project is being funded by a grant from the Henry J. Kaiser Family Foundation of Menlo Park, which is trying to “place community health promotion on the nation’s agenda” by encouraging similar community organizing around nutritional issues nationwide.

“What I personally hope for is that we will have state-of-the-art nutrition- and health-promotion programs which are owned and operated by the community,” John Elder, the associate professor of public health who is heading the project, said Friday.

“This notion of community activation has been going on in the housing field, criminal justice and economic development at the local level,” said Michael Felix of the Kaiser Foundation. “The foundation is trying to do the same thing about health-promotion issues.”

The project is expected to involve nutritional and health-promotion programs rooted firmly in the community, using such institutions as grocery stores, workplace cafeterias and medical clinics to encourage improved eating habits.

Another tool may be a kind of nutritional Tupperware party in which homemakers introduce friends to healthy methods of food preparation--for example, ways of reducing the salt and saturated fat in familiar dishes without altering the flavor.

“We’re trying to be realistic,” said Dr. Greg Talavera of the San Ysidro Health Center, a participant in the project. “ . . . Our goal is not so much to make a change but to develop the methods that can be applied on a larger scale with more money in future.”

Improved Nutrition

The idea came initially from the county’s Department of Health Services, where several employees saw a need for improved nutritional education to counter the spread of diet-related illnesses in minority communities in San Diego County.

For example, diabetes appears to be widespread among minorities, said Elaine Hiel, the department’s public health nutrition manager. Although there may be genetic causes, Hiel said the eating habits of many Latinos appear to exacerbate the problem.

She said there may also be excessive consumption of saturated fats in the form of foods deep-fried in, or made with, lard. Talavera said high salt consumption may be contributing to hypertension, a risk factor for heart disease and strokes.

He said there are few statistics on disease in Latino communities. However, he said one ongoing federal study suggests heart disease and stroke are the leading cause of death, though the risk appears slightly lower than that of the general population.

Other problems characteristic of many low-income communities include high infant mortality rates and low-birthweight babies as a result of inadequate prenatal care.

Hiel and others approached Elder, a psychologist who had run a pioneering health-promotion project in Pawtucket, R.I., in the early 1980s, addressing, among other things, nutritional factors contributing to heart disease in the city’s largely Portuguese population.

One of 11 Selected

Elder and Nadia Hammond of SDSU then applied to the Kaiser Foundation after convening an advisory board for the project, comprised of health workers in the community, county health employees and members of local chapters of national cancer and heart disease groups.

Michael Felix, program officer for the Kaiser Foundation, said the San Ysidro proposal was one of 11 selected out of 675 applicants from the western states. The foundation intends next to set up similar projects in the South.

“By creating the opportunities for communities to decide what is best for themselves, in the long run we think that will help to institutionalize the programs and have an impact on health-care outcomes,” Felix said.

Guidance and technical assistance are being provided through Stanford University, and the Kaiser Foundation has also contracted with a team at the University of Washington to oversee and eventually evaluate the efficacy of each of the programs.

Project Salsa

In San Ysidro, Elder said, he and Hammond will begin by surveying grocery stores, school cafeterias and restaurants and talking to consumers to learn about shopping habits, food preparation and eating.

They will then work with leaders and opinion-makers in the community, perhaps encouraging grocery stores and cafeterias to flag foods that are nutritionally desirable, setting up cholesterol-screening programs and working with clinics to encourage breast feeding.

The San Ysidro program has been titled Project Salsa, a name that Talavera said reflects an emphasis on both nutrition and life-style: Salsa as a sauce (that can be made without salt) and as an Afro-Cuban style of dance representing the cardiovascular benefits of exercise.