Imagine we are on a river boat cruise. Sailing along, enjoying a beautiful relaxing day in the company of family and friends. None of us notices the changing current. No one has looked ahead to see the rocks or the waterfall we’re approaching. We have no time to turn around or get to the safety of the shore.
Diabetes is like that. We sail along not noticing the rise in blood sugar, sometimes until it is too late. Luckily, there are things we can do now, small steps we can take today, to ensure there’s no disaster awaiting ahead.
“Asian Americans (AA) have the highest rate of undiagnosed high blood sugar. 1:2 people in the AA community have higher than normal blood sugar. These are a few reasons why we (at AADI) do what we do,” said Ka Hei Karen Lau, MS, RDN, LDN, CDCES – Certified Diabetes Care and Education Specialist at the AADI speaking about what makes diabetes such a critical health issue for this community.
51% of diabetes cases were undiagnosed–higher than any other ethnic or racial group.
A study of AAPI health issues noted multiple challenges:
“…the invisibility of the population, a failure to collect data on the population as a whole as well as its constituent subgroups, the diversity within the category AAPI, and simplistic and often unfounded assumptions about the health of this population. Moreover, the stereotype of AAPIs as being the Model Minority has obscured the myriad health problems and the poor health of many in our communities.
Notably, the five major causes of death are the same for AAPI men and women, and diabetes is the fourth most frequent cause of disease. For other ethnic groups diabetes is number six. AAPIs have diabetes rates 2-5 times that of non-Hispanic whites.
AAPI Nexus Vol. 3, No. 1 (Spring 2005): vii-xv
Here in Boston, Joslin’s Chief Scientific Officer, George L. King established the Asian American Diabetes Initiative (AADI) in 2000 to better address the growing public health issue of diabetes in this community. Through research, education, community outreach and a clinic delivering culturally sensitive information and support, the AADI has been a leader in this fight against this silent killer.
For many health issues, we notice symptoms that prompt us to contact our doctor. One of the most dangerous aspects of Type 2 Diabetes, is that by the time you notice symptoms, damage is irreversible. The risks of this disease are high and consequences, severe.
“For Asian Americans our lower body weight is a risk factor. For example, a BMI of 23 for others is good, normal. For Asian Americans this presents higher risk,” notes Lau.
We may think “I’m not overweight” and traditionally, many Chinese believe a little chubby is better than a little skinny. However, our blood sugar could be too high, creeping up and we may have risk factors we’re not aware of.
[Chinese tool: Am I at Risk?
https://aadi.joslin.org/tw/am-i-at-risk]
“When we Asians come to the States, we gain weight. Portion sizes are bigger, we become more sedentary. This is dangerous. This is a progressive disease. The first line of defense is always lifestyle,” says Lau. Knowing the risk factors, knowing what we can do is critical.
The good news is that we can take simple steps, today, to begin decreasing our risk. Turn that boat around!
Apple or pear? Asians tend to store fat around the middle, like the shape of an apple. Where we store fat is important to many health outcomes including diabetes. Are you an apple or a pear?
一步一个脚印。 (Yībù yīgè jiǎoyìn. ‘one step one footprint’) — Every step makes a footprint.
Here are five steps you can take toward managing your blood sugar. AADI has tools and advice to help.
- Return to a more traditional Asian diet.
Traditionally, Asian diets were vegetable-centered, with plant-based protein or seafood or other meats as infrequent accents. A meal may have had higher carb content, but it was often good quality, multigrain or brown rice. Today, we tend toward larger portions, white rice and more meat. Each of these factors make our meals less healthy, increasing our diabetes risk.
Lao cited a study done at AADI looking at the effects of eating a traditional Asian diet vs. a typical Western diet.
“This study was with people who did not have diabetes. Those who ate the traditional diet lost weight…The traditional diet allowed insulin to work effectively. For those on the typical Western diet: insulin-resistance increased, weight increased.” (Insulin is the hormone that helps our body turn sugar into energy. It is a key issue in diabetes management.)
Simply changing our way of eating, going back to a traditional diet is a key step we can take to decrease our diabetes risk. “In this way, we can honor the culture. Not actually changing it or throwing it away,” notes Lau.
Small changes have a big impact. These simple steps can make a big difference:
- Try adding one more vegetable to your meal. Enjoy it at the beginning of the meal.
- Eat soup first; it is both comforting and filling.
- Steaming, light stir-fry are healthier, traditional cooking techniques.
- If making soup, use lean cuts, or skim fat first. (Pro tip: refrigerating broth overnight makes it easy to lift off the fat in the morning.)
- Replace white rice with whole grain or multigrain rice blends. Whole grains make you feel fuller and have more fiber.
- Incorporate more of the wide variety of vegetables available here: mushrooms, all sorts of greens, eggplant.
- Legume-based, fiber and plant-based protein: beans, tofu, tofu skin.
- Train yourself to stop eating before you’re full. 80% full is a good goal. The brain only recognized fullness (satiety) after 20 minutes so it’s easy to overeat. Pause and tell yourself you can have more IF you’re still hungry after 20 minutes.
- If you crave something sweet after a meal, enjoy a piece of fruit.
- Stay active every day; even a little bit counts.
Acknowledging that the pandemic has made many of us more sedentary and even hesitant to go outside, Lau urges“even five minutes of every hour, we can get up and step in place or walk around our apartment or building.” Imagine, only 5 minutes can make a difference!
- Get annual checkups. You need to catch the blood sugar rising, you cannot wait until you feel symptoms. Blood sugar should be checked annually so you can make adjustments to prevent diabetes. Good oral hygiene is important, too. Regular visits with your PCP and your dentist are key to maintaining good health and oral health is directly related to blood sugar management.
- Sleep 7-8 hours a night.
- Quit smoking
Does it seem like too much work? Returning to good, traditional Chinese diet and moving around even just 5 minutes a day? Maybe the risks of doing nothing will convince you.
Complications from untreated high blood sugar include:
- Loss of eyesight
- Kidney disease – prevalent in Asian community
- Heart disease
- Poor wound healing and amputations
- Stroke
- Early death
In this time of fear and hardship (stress is also a factor in diabetes), give yourself the gift of better health. Check your BMI and get your blood sugar checked. Maybe enlist a friend to do the ten-day challenge on the AADI website. Sail on safely and enjoy a long healthy life.
Used with permission. [LINK: https://www.estimatebodyfat.com/what-factors-influence-your-body-weight.html]
AADI’s interactive tool, Drag n’ Cook, let’s you see the components of your meal and their nutritional profile. [LINK: https://aadi.joslin.org/en/drag-n-cook]
[LINK: Tool: Traditional Asian diet in ten-day menu – good to reset. Fresh start.
In Chinese: https://aadi.joslin.org/tw/Education%20Materials/00.%20Traditional%20Asian%20Diet%2010-Day%20Menu_CT.pdf]
[where to add?]
The AADI Taste of Ginger fundraiser is May 16, this year, it’s virtual. [LINK: https://www.joslin.org/patient-care/multicultural-programs/asian-american-diabetes-initiative/taste-ginger]
