WellCommons

Rhonda LeValdo, an instructor in Media Communications at Haskell Indian Nations University, and Teresa Trumbly Lamsam as visiting professor at Kansas university, have teamed up to study how the media frame the diabetes rate among native Americans. by Richard Gwin

When Kansas University journalism professor Teresa Trumbly Lamsam goes to her childhood home in Oklahoma, she takes sacks of groceries with her. She knows she won’t be able to buy the kind of healthy food she wants on the American Indian reservation where she is from.

Health experts say the lack of food stores on reservations is one factor contributing to the soaring Native American diabetes rate. But lack of food options on reservations is not something you’ll often read about, and that’s something Lamsam wants to change.

She and her research partner, Haskell Indian Nations journalism instructor Rhonda LeValdo-Gayton, are studying how the media portray diabetes among Native Americans. The hope is to shed light on the forces shaping the conversation on Native American diabetes and offer guidance for journalists on how to cover the issue to promote better health.

The work is personal for both women. Lamsam is disturbed by research indicating that if nothing changes, diabetes could help wipe out Native Americans in 100 years. LeValdo-Gayton has lost several family members to the disease and has two young children. She is determined to make sure the damaging cycle of diabetes does not touch them.

“I feel like we just really got to step this up,” LeValdo-Gayton said. “I feel like we’re going to lose people that we don’t want to lose.”

Irreplaceable knowledge

Nationally, about 16 percent of Native Americans have diabetes, more than double the rate found in Caucasians. Native Americans are three times more likely to die from diabetes than the general population, according to the U.S. Department of Health and Human Services. The disease is also striking more young people. The number of Native Americans ages 15 to 19 with diabetes increased by 68 percent from 1994 to 2004.

“If that doesn’t scare you, I don’t know what will,” Lamsam said. “What does that do to the lifespan of the population?”

Locally, there are at least three people under 40 on dialysis for diabetes, according to Dr. Dee Ann A. Deroin, a family physician in Lawrence.

“It stems from our change in lifestyle, the unavailability in healthy food and the decrease in healthy activity,” Deroin said.

For those with diabetes, the disease can mean blindness, amputated limbs, heart disease and kidney failure.

In Native American communities, diabetes is taking elders far too young, forcing adults in their 20s and 30s to become the keepers of the culture.

“We shouldn’t be at this point. We should be having them around us a lot longer to teach that next generation,” LeValdo-Gayton said.

She has lost three uncles and worries about what their absence means for her children’s cultural education.

“I am just floored by everything I still have to learn, and I have to seek it from somebody else now,” LeValdo-Gayton said. “I don’t want to see our next generation of people having to deal with death like this.”

Who you blame matters

Studies have shown the federal government is more likely to invest in fighting a disease if the public views the victims of the disease not at fault for contracting it.

Sixty years ago, smoking was seen as an individual’s choice. If you smoked, that was your business, and if smoking destroyed your body, that was your business, too.

But the conversation about smoking changed in the 1960s, when public health officials and the media began to emphasize nicotine’s powers to addict and smoking’s power to destroy. All of the sudden, perhaps smokers weren’t completely to blame. Major public policy changes followed, from surgeon general’s warnings to lawsuits draining hundreds of millions of dollars from the tobacco industry.

That model of framing a health issue — everything from HIV to obesity — as not just being the responsibility of the individual has been pushed by public health officials. It could be a way to combat diabetes.

“Mainstream news does influence public opinion and public policy in this country,” Lamsam said. “How they’re telling the story of diabetes makes a difference to what happens in D.C.”

In their pilot study completed this summer, Lamsam and LeValdo-Gayton found that during the past 14 years, news articles have framed Native Americans as being responsible for contracting diabetes because of bad eating habits or sedentary lifestyles.

Most articles did not look at the larger issues that might contribute to diabetes.

“We find predominately that the media frame the story to place responsibility for having diabetes on the individual,” Lamsam said.

But there are no magic words to make a person live healthier or lose weight.

“Weight loss requires fairly intensive management. We think about it like managing other chronic diseases,” said Christie Befort, an associate professor of preventive medicine and public health at KU’s School of Medicine.

There is a lack of nutritious food available on many reservations. For example, the Standing Rock Reservation in North Dakota has just one grocery store for a population of 8,000 spread over 3,500 square miles.

“The grocery store is very far away,” LeValdo-Gayton said. “It’s OK, but if you look at the selection of vegetables or fruit, it’s very minimal.”

Ultimately, Lamsam would like to see more success stories in tribal newspapers. There have been healthy living programs on reservations, and coverage of those types of things could make a difference.

“We’re talking about a collective culture, not an individualistic culture,” Lamsam said. If people on a reservation see their friends and neighbors are living more healthy, it would probably make it easier for them to live healthy lives as well.

“You don’t have to do it all at once. Just change one bad habit, one at time,” LeValdo-Gayton said. “Then you slowly understand how it can affect you.”

Here's an interesting article from U.S. News and World Report about how "popular cartoon characters are influencing the taste preferences of very young children, and not in a positive way."

"The bottom line is that when kids are presented with a choice of graham crackers, fruit snacks or carrots, and the only difference is that one package has a licensed character on it, they actually think that the food with the character tastes better," said study author Christina Roberto, a doctoral student working at the Rudd Center for Food Policy and Obesity at Yale University in New Haven, Conn.

Do characters and branding influence the way you shop? Will this information affect your grocery decisions for your kids?

According to Live Science, these diet tricks will actually help you keep off the pounds:

Avoid corn syrup

Science shows that high-fructose corn syrup (HFCS) is bad news. One study showed that rats who drank HFCS-sweetened beverages gained significantly more weight than rats consuming the same amount of calories in sugar.

Keep away from junk food -- It's Addictive

Junk food can affect your brain in ways similar to drug abuse.

Structure meal times

Long stretches without food make people crave energy-dense snacks, which can make healthy choices difficult.

Satisfy your body -- especially at breakfast

A protein-rich breakfast leaves you less hungry for the rest of the day. Some fat in the meal can help, too.

Favor foods closer to nature

Favoring whole fresh foods over processed ones will naturally optimize the healthiness of your food choices.

Change your environment

Altering your food environment -- whether this means using smaller plates or keeping seconds out of immediate reach -- can help you lose weight.

Enjoy your food

Food that is eaten mindlessly is neglected food. When you pay attention, you are satisfied in a deeper way.

Calories of each food item appear on a McDonalds drive-thru menu in New York. Calorie counts will have to be listed on restaurant menus under a provision tucked into the massive health care overhaul bill.

Will this law make you think twice before ordering a large mocha or huge burger?

Here's the Associated Press story by Mary Clare Jalonick:

That Caesar salad you’re about to eat? It’s 800 calories, and that’s without the croutons. The fettuccine alfredo? A whopping 1,220 calories. You may choose to ignore the numbers, but soon it’s going to be tough to deny you saw them.

A requirement tucked into the nation’s massive health care bill will make calorie counts impossible for thousands of restaurants to hide and difficult for consumers to ignore. More than 200,000 fast food and other chain restaurants will have to include calorie counts on menus, menu boards and even drive-throughs. The new law, which applies to any restaurant with 20 or more locations, directs the Food and Drug Administration to create a new national standard for menu labeling, superseding a growing number of state and city laws. President Barack Obama signed the health care legislation today.

The idea is to make sure that customers process the calorie information as they are ordering. Many restaurants currently post nutritional information in a hallway, on a hamburger wrapper or on their Web site. The new law will make calories immediately available for most items.

“The nutrition information is right on the menu or menu board next to the name of the menu item, rather than in a pamphlet or in tiny print on a poster, so that consumers can see it when they are making ordering decisions.”

— Iowa Sen. Tom Harkin, chairman of the Health, Education, Labor and Pensions Committee, who wrote the provision

It was added to the health bill with the support of the restaurant industry, which is facing different laws from cities and states. Sue Hensley of the National Restaurant Association says it will help restaurants better respond to their customers.

“That growing patchwork of regulations and legislation in different parts of the country has been a real challenge, and this will allow operators to better be able to provide their information,” she said.

Some meals will be exempt from the calorie counts, including specials on the menu less than 60 days, and other nutritional information in addition to calories will have to be available somewhere else in the restaurant.

The law will also apply to foods sold in vending machines, specifically those that do not have visible calorie listings on the front of the package. The requirements will be enforced by the FDA, with the possibility of criminal penalties if operations do not comply.

New York City was the first in the country to put a calorie posting law in place. Since then, California, Seattle and other places have done so.

The FDA will have a year to write the new rules, which health advocates have been pushing for years. Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest, said it’s one step in the fight against obesity.

“Coffee drinks can range from 20 calories to 800 calories, and burgers can range from 250 calories to well over 1,000 calories,” she said.

Still, it’s unclear what effect the labeling will have. In a study published last year by the online journal Health Affairs, only half of customers in poor New York City neighborhoods with high rates of obesity and diabetes noticed the calorie counts.

The accuracy of the counts could also be called into question, according to a different study.

In January, the Journal of the American Dietetic Association published a survey of 10 chain restaurants, including Wendy’s and Ruby Tuesday, that said the number of calories in 29 meals or other menu items was an average of 18 percent higher than listed. The discrepancies were said to be due to variations in ingredients and portion sizes.