July 28, 2004

"Indians are like the canaries that miners carried into those coal mines to predict disasters. We may start dropping first, but everyone else is going to follow, even the white man."

I remember hearing an Ojibwe elder make this statement quite some time ago. At the time, I did not fully understand its meaning.

But in light of recent media reports about the huge increases in obesity and diabetes rates for the general U. S. population, and the high incidence of diabetes among Natives, I continue to marvel at the prescience of the elder's words.

Since the 1940s, Native Americans have struggled with an unprecedented epidemic of obesity and diabetes in their communities. The incidence of diabetes among native people is more than double that of non-Hispanic whites, and more than 80 percent of those diagnosed are obese. They are also more than four times as likely to die from diabetes-related illness than white people.

Before the 1940s, however, type II diabetes, characterized by high blood levels of glucose and closely linked with obesity, was virtually nonexistent in Indian country.

In the overall U.S. population, current studies indicate that diabetes has increased more than 50 percent since 1980, and currently more than 30 percent of the population is classified as obese. The federal government recently designated obesity as a disease.

When native peoples occupied their original lands, they ate a traditional subsistence diet high in lean meats and complex carbohydrates. A typical lifestyle included high levels of physical activity and, perhaps most importantly, an indefinable spiritual connection to food.

Disenfranchised from land, culture, spirituality and traditional diet and activities, we began to eat ourselves into oblivion.

The government sets the stage for this epidemic by subsidizing processed foods high in empty calories. The fact is that foods full of processed carbohydrates, saturated fats and sugar are cheap and readily available while healthy alternatives are not.

All of this, coupled with a genetic makeup that encourages the body to store fat for times of scarcity, spelled a death sentence for native people.

Now, ironically, all of us are in the same coal mine.

The World Health Organization reports that for the first time in history, there are as many overnourished as undernourished people worldwide.

Fortunately, Native Americans are forging the path to recovery. Tribes are taking this health crisis seriously and are developing innovative approaches not only to diabetes treatment but especially prevention.

The Winnebago tribe of Nebraska has declared war on diabetes. It has created a number of programs, including pre-diabetes screening for children and adults, free access to fitness equipment and programs, as well as an aggressive campaign touting the wisdom of a subsistence diet. Wisely, the tribe's health leaders have recognized the peoples' cultural and spiritual ties to food and are encouraging the community to once again see traditional food as medicine. To that end, tribal members are invited to participate in "talking circles," in which they can safely share their emotions about diabetes and the stress of changing their diets.

Slowly, native communities are beginning to see improvements.

Lifestyle and eating habits go to the very heart of who we are as human beings -- Indian and non-Indian alike. It should be no surprise, then, that changing these habits is not a simple matter of publishing a few reports declaring that large portions of fast food are bad and exercise is good.

Reversing this current trend in weight gain and diabetes will require a huge cultural commitment from the entire community. Traditional native philosophy could be a template for good living. Rather than becoming foretellers of disaster, native people could be the prophets of recovery.

Mary Annette Pember, Red Cliff Ojibwe, is past president of the Native American Journalists Association. She is currently lives and works as an independent journalist in Cincinnati. She can be reached at pmproj [at] progressive [dot] org.