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Nurse-created 'Food for Life’ program incorporates healthy practices rooted in Native American culture

Monday April 9, 2012
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Going back to their native roots has been a brilliant concept for Native Americans in the Southwest who have participated in pilot programs to reduce diabetes and its long-term effects.

Caroline Trapp, RN, MSN, CNP, BC-ADM, CDE, conceived the Native American Food for Life series — where small groups of Native Americans in Albuquerque, Santa Fe, N.M., and Window Rock, Ariz., attended eight classes about cooking and nutrition using plant-based foods.

The results have been gratifying for participants and staff, Trapp said, as Native Americans have learned how to adjust their food choices and cooking style, which has brought about weight loss and blood glucose control.

Native Americans are disproportionately affected by diabetes, Trapp said. In some tribal communities, 30% to 50% of adults have type 2 diabetes, along with complications.

The Food for Life program originated as an outcome of a Physicians Committee for Responsible Medicine study funded by the National Institutes of Health. Trapp, PCRM’s director of diabetes education, said the study demonstrated better health outcomes in people following a low-fat, plant-based diet compared to a more conventional diet. Interestingly, she added, the intervention diet of whole grains, beans, vegetables, fruits and small amounts of nuts looks a lot like the ancestral diet of many Native Americans, before forced relocation and provision of commodity foods.


Cultural focus

“We were also especially fortunate to collaborate with Native American chefs Lois Ellen Frank [Kiowa] and Walter Whitewater [Navajo], who were instrumental in developing regional recipes and providing cooking demonstrations,” Trapp said. Frank provided a historical perspective on how Native American diets have changed — for the worse. For example, she taught participants how to make a healthful “Indian taco,” modifying the traditional fry bread shell to a “no-fry bread,” and covering it with a variety of tasty and health-promoting toppings.

The program involved much collaboration. The Navajo Nation Diabetes Special Projects of the Navajo Division of Health in Arizona and the Indian Pueblo Cultural Center and Institute for American Indian Arts in New Mexico expressed an interest and agreed to host a pilot series of classes.

In each location, a nurse, a physician, a dietitian and many nutritionists helped teach the program. Terri Gibson, RN, MSN, BSN, coordinated the class in Albuquerque, N.M. Gibson is the director of Community Health Advance, a faith-based organization focused on health education. She also is a staff RN at University of New Mexico Hospitals.


Positive outcomes

The cultural approach, Gibson observed, was beneficial; participants received the information positively.

“People often just didn’t know how to prepare the foods that were presented,” she said, “so demonstrating the plant-based foods that are part of their culture and giving ideas on how to fix them was really good.”

Gibson said during the course of the series, participants’ weights and blood sugars dropped — and they felt better.

While Trapp, who is based in Michigan, was not able to attend every class, she did have plenty of opportunities to see how participants responded. She believes giving the program a cultural approach is part of what had made it successful.

“One Navajo told me, “You’re teaching us that the way our ancestors ate was OK. We thought food needed to come from a grocery store, but it needs to come from the ground, the way we used to get it.”

“One woman,” Trapp recalled, “made lots of comments about how labor intensive this way of cooking was. At the second class she complained about how much time she spent chopping vegetables. Then she began to lose weight, and soon she was bringing in recipes! She started out being very vocal about her concerns, and by the end was very enthusiastic.”

Others realized similar outcomes: improved A1C results and responsiveness by family members at home to the dietary changes. One man had lost enough weight to be able to bend over to tie his own shoes, something he hadn’t done for a long time.

“Food for Life is an awesome concept,” Gibson said. “I wish every nurse had the opportunity to work with this program. Compared to all the drugs for health concerns, this kind of program empowers people to take their own healthcare into their hands and make a difference.”

Funding is being sought to create educational DVDs of Food For Life for use by trained representatives from various tribal communities. The curriculum is available at no cost at www.PCRM.org/CurriculumNA.


Karen Schmidt, RN, is a freelance writer. Post a comment below or email editorWest@nurse.com.
Free resources for health educators

Visit www.PCRM.org for downloadable articles, fact sheets, FAQs and more.

Healthy Eating for Life: Food Choices for Cancer Prevention and Survival
Read about the facts that point to choosing a vegetarian diet to help prevent cancer and improve cancer survival.

Nutrition for Your Kids
Ten child-friendly recipes and wonderful "Play with Your Food Art" from Saxton Freymann make this piece a joy to use.

Diet and Diabetes: Recipes for Success
Includes sample recipes, meal suggestions and recommendations for further reading in a four-page fact sheet.

Source: www.PCRM.org