Latino Family Values a Staple of Health Message

Latinos should keep on putting those beans on the table, and the tortillas, too. But cooks should leave the manteca--lard--out of them.

That’s one of the messages coming from a grass-roots coalition of San Diego County health groups that has banded together for a month-long campaign called Comida Da Vida, or “Food Gives Life.”

What you eat can reduce your chances of getting cancer, heart disease and diabetes, the campaign is telling Latinos--but it uses traditional Latino family values as the vehicle for the message.

This health education approach is unusual in the state not only because it is culture-specific but also because it unites public, private and Latino community resources in San Diego in pursuit of a common goal.

“There are three really wonderful Latino health programs going on in the county--Vida Sana in Vista, Por La Vida in central San Diego and Project Salsa in San Ysidro--and we have all three groups working together as a coalition to develop this intervention (Comida Da Vida),” said Nadia Hammond-Campbell, project director of Project Salsa.

“I don’t know of any other situation like that in the state. I think San Diego County has something to be excited about,” she said.

Project Salsa is a research and demonstration project through San Diego State University. Por La Vida is a joint project of researchers at SDSU and UC San Diego, in conjunction with the Logan Heights Family Health Center. Vida Sana is run by the Vista Community Clinic. All are funded by state grants.

Helping those three groups in Comida Da Vida are Big Bear Markets in Vista and San Ysidro, and several food industry groups.

These Latino-oriented disease prevention projects are necessary, their organizers say, because generic health messages about the link between eating habits and chronic diseases such as heart disease and cancer are not working in the Latino community.

“We’re seeing an increase in the numbers of people who are smoking among Hispanics, whereas we’re seeing a decrease among Anglos,” noted Lorraine Whitehorse, director of health promotion for the Vista Community Clinic.

“In fact, in most minority groups, we’re still seeing a rise in some of those risky types of behavior where we’re seeing a drop in other, primarily Anglo, groups,” Whitehorse said.

Telling a Latino to eat a low-fat diet and to exercise more doesn’t work if the implied short-term payoff is that a person will be thinner or feel better, health educators say.

“Latinos, like American Indians, don’t react to things as an individual. They tend to see things more in a social context,” Whitehorse said. “It’s not all ‘me, me, me.’ It’s more of ‘How will that affect my family? I will live longer therefore my family will be better off.’ ”

So health promotion posters, for instance, developed for Comida Da Vida feature a picture of a child, mother and grandmother building a tower from low-fat cheeses and low-fat milk, with a legend saying that low-fat dairy products “are the building blocks for a healthy family.”

Getting Latinos to buy reduced-fat milk is a particular issue being addressed in the campaign because Latinos have viewed it as “missing” something important, said Joan Rupp, a UCSD dietitian.

One survey, done by an SDSU student as a thesis project, found that 72% of the people in largely Latino San Ysidro were using whole milk, Hammond-Campbell noted.

Comida Da Vida’s messages are the same ones given in the more general campaigns of the American Heart Assn. and other groups:

* Eat more fruits, vegetables and whole grains.

* Eat lean meats, and less meat overall.

* Eat less fat, especially saturated fats in meats, eggs and dairy products.

The program delivers those messages in both Spanish and English, and makes useful suggestions for how to alter a Mexican diet to make it healthier.

“People know they shouldn’t eat fat, but they want to know ‘How do I not eat fat?’ ” Rupp said.

Recipes suggest variations to traditional foods such as enchiladas or tacos (don’t fry the tortillas in oil, steam them), or beans (serve boiled, refry in vegetable oil or use milk for “refrying” them). Lard in tortillas or other foods is the one ingredient actively discouraged.

Comida Da Vida began Saturday at the Big Bear markets in Vista and San Ysidro. Shoppers are seeing videotapes about low-fat foods and milk; special Comida Da Vida stickers have been put on lean cuts of meat and vegetable displays feature bilingual recipe cards.

Also, on every Saturday through June 2, women recruited from the Latino community will give demonstrations of low-fat, low-sugar food preparation and share tips on working more vegetables and fruit into the Latino diet.

Using familiar faces from the community is an idea pioneered by Southeast San Diego health project, Por La Vida. Over the last two years, the program has been using Latinas influential in their neighborhoods to become lay educators.

Por La Vida calls them consajeras, the feminine form for “adviser” or “facilitator.”

A prospective consajera’s influence, however, is within a Latino cultural context, said Lori McNicholas, who works on preparing culturally sensitive educational materials for Por La Vida.

Where a woman influential in the dominant American society would likely to be working outside the home, McNicholas said, these consajeras are homemakers.

“We’re talking about women who have never worked outside the home. Their main interest is in their children. They walk their children to school, they come home and they have the dinner ready for the husband. But yet these women are looked to by their peers,” McNicholas said.

Project Salsa, too, has adopted the consajera model for disseminating health and nutrition information, Hammond-Campbell said.

“These are women who are known and recognized in the community, versus someone--a outsider or a professional--coming into the community and having to develop a sense of trust and credibility with people,” Hammond-Campbell said.

“If I’m going to my neighbor and I’m telling her about my son’s problems, or lack of money, or whatever . . . I’m more likely to take it to heart when she tells me, ‘Hey, have you ever thought about broiling instead of frying?’ ” she said.

Todd Rogers, director of the Health Promotion Resource Center at Stanford University, said the San Diego Latino health efforts--particularly Por La Vida--are garnering attention in public health circles nationwide.

The Stanford center is compiling a packet of materials developed by Por La Vida for use by health educators in other Latino communities, he said.

“It fills a niche that is so obviously empty: materials designed for and sensitive to the culture of Latinos in this country,” Rogers said. “They just don’t exist in the scope and quantity that we need, to address the health problems of that growing population.”

Rogers says the Por La Vida model has proven its worth and he predicts it will be eagerly embraced in other communities. However, hard data on whether it and the other Latino-directed programs have really changed county residents’ health habits is still lacking.

All three of the health projects in Southeast San Diego, Vista and San Ysidro are preparing reports on results within the next few weeks, organizers say.

Comida Da Vida also will be monitored by industry groups as well as the health educators involved--for instance, they will look to see if purchases of low-fat milk, specific vegetables or lean cuts of meat increase at the two supermarkets, Rupp said.

If so, Big Bear might expand the program to other stores in the chain, Rupp said.

And an ongoing state program of nutrition education, the “5 a Day--for Better Health” campaign, is considering using Comida Da Vida as a model for a Latino-oriented, statewide project, said Brian F. Krieg, marketing director for the campaign.

Funded as a demonstration project by the National Cancer Institute, the 5 a Day program encourages Californians to eat at least five servings a day of fruits and vegetables.