Pima Indians and Diabetes Research Paper

Pages: 12 (3949 words)  ·  Bibliography Sources: 15  ·  Level: Corporate/Professional  ·  Topic: Health

SAMPLE EXCERPT:

[. . .] Indeed the impact of American "fast food" on the Pima has not escaped notice of American journalists. The New York Times reported in 1991 on the plight of the Pima, who had seen their people moving away from traditional foods in favor of "hamburgers, fries, soft drinks and other fatty, sugary, overly refined fast and packaged foods" going back all the way to the 1940s (Brody). These foods have all been exposed by Eric Schlosser as being inherently unhealthy in his book Fast Food Nation: The Dark Side of the All-American Meal. For the Pima, who like many others around the world, latched onto the "all-American meal" throughout the latter half of the 20th century, the repercussions have been devastating: rising rates of obesity and diabetes and a detachment from the traditional culture and diet of their past. Brody reports that "preliminary studies have indicated that a change in the Indian diet back to the beans, corn, grains, greens and other low-fat, high-fiber plant foods that their ancestors depended upon can normalize blood sugar, suppress between-meal hunger and foster weight loss." Thus, as Davis indicated in her study of the natives of the Marshall Islands, diet is important when it comes to addressing the needs of indigenous peoples impacted by the spread of "fast food" culture.

Diet and exercise have been shown to be factors in how healthy populations are by Cunningham-Myrie et al. in their 2015 study of Central American groups. In that study, environmental conditions also were seen to play a role in how populations fed themselves and whether or not they exercised: poorer neighborhoods were some of the worst, health-wise, because of unsafe conditions which do not promote active lifestyles outside the safe confines of one's home. Parks and playgrounds are not used and children do not lead active young lives that discourage obesity. Among the Pima, economic hardship is a factor that the group has to contend with, as Shanta Pandey and Eddie Brown found in their 2004 study of Native Americans in Arizona. Thus, the compounded factors of poor diet, detachment from cultural traditions of the past, and poverty which affects the degree to which residents are active/exercising, could all play a part in the incidence of diabetes among the Pima.

However, there remains the question of why -- if these external factors are true causes -- the stories recounted by the Pima themselves in their thousand-year-long culture tell of the evil witch that "ate up" their children. If these stories are to be believed, a genetic factor may also be to blame.

The Role of Genetics and Gestational Diabetes

Baier and Hanson do point out that "type 2 diabetes and obesity have a genetic basis" (1181). One way to study the extent to which heritability is a factor is to observe the pheontypes associated with diabetes in twins. This type of study has been conducted in populations where enough twins to serve as a suitable sample is available. In the Pima population, no such sample is available, which makes assessing the "degree of heritability" among this group all the more difficult (Baier, Hanson 1181). What researchers can do, however, is to estimate the degree of heritability by analyzing familial resemblance. To that extent, Baier and Hanson have been able to show that there are "a few functional variants in biologic candidate genes" that they have found to be associated with diabetes in the Pima -- "but these are only minor pieces in the multigenic puzzle of type 2 diabetes," the researchers conclude (1186). In other words, it remains a mystery as to how "genetic" diabetes really is among the Pima.

If the genetic answer is still too cloudy to be settled, what could explain the stories about the witch who "ate up" the children of the Pima? One possibility could be gestational diabetes, which is a common occurrence among pregnant women that can have lasting impacts on the child after birth. As Smith-Morris notes, "gestational diabetes is most often symptomless, disappears after childbirth, yet leaves both the mother and infant at greater risk for outright diabetes later on" (7). The stories of the ho'ok may in fact have something to do with gestational diabetes.

What is gestational diabetes? According to the American Diabetes Association (ADA), gestational diabetes occurs in pregnant women who have never had diabetes but "who have high blood glucose (sugar) levels during pregnancy." Nearly one in ten women is at risk of developing gestational diabetes, according to researchers at the Centers for Disease Control and Prevention (Desisto et al.). As the ADA reports, there is no known cause for gestational diabetes. Thus, it could be anything from biology to environmental to lifestyle/dietary conditions. What is known is that it can impact any women who are pregnant. In the case of the Pima, gestational diabetes would help to explain the existence of the witch lore in the population's own history.

Indeed, many studies have shown that gestational diabetes can carry over to the offspring and pose a significant risk for them. Catalano, Kirwan, Mouzon and King conducted a 2003 study that showed children being more likely to suffer from diabetes if their mothers suffered from gestational diabetes. The findings of Reece in a 2010 study supported the study by Catalano et al., stating that gestational diabetes "significantly increases the risk of a number of long- and short-term adverse consequences for the fetus and mother" (199). For the Pima, this could be a critical clue as to why diabetes has plagued the population for centuries. If the women are predisposed to gestational diabetes for an unknown reason, it is very likely that their children would be more prone to developing diabetes at a young age. This would help to explain the witch phenomenon described in the culture's folklore. And the fact that treating gestational diabetes is a relatively new phenomenon could further help to explain why the Pima have long suffered from this disease: they have gone untreated. As the 2005 study by Crowther et al. indicates, the "treatment of gestational diabetes reduces serious prenatal morbidity," which means that if caught soon enough, mothers can reduce the risk that they will pass on their diabetic attack to their offspring. This is the reason so many OBGYN's today in the West test pregnant women for gestational diabetes throughout the course of the pregnancy: it is a part of preventive care that can help the population to reduce the risk of passing on diabetes vulnerability to offspring. For the Pima, who like much of the world, may not have had access to this type of care until modern times, they would have been obliged to explain the phenomenon of diabetes by relying on the cultural cues of their time -- namely, that they had been exposed to the tricks and spells of a witch from an enemy tribe.

Practical Solutions

While the ho'ok phenomenon among the Pima may be explained by modern medical science, the reason why so many Pima are vulnerable to diabetes in the first place remains a mystery. Nonetheless, there are practical steps that may be taken to help reduce the risk of Pima continuing to develop diabetes, as a number of researchers have shown.

Brenda Davis has shown that helping native populations return to their traditional diet after they have been negatively impacted by consuming Western "fast food" diets can significantly reduce their risk of diabetes. In the case of the natives of the Marshall Islands, returning to a traditional diet and partaking in the physical demands needed to produce that diet helped eliminate diabetes completely from the population (Davis). Davis's study suggests that if the same steps were taken among the Pima, risks of developing diabetes could at least be reduced.

In the Islands, such steps could be more practically taken; in the Arizona desert, the steps are not as easy. Nonetheless, with some commitment on the part of the Pima, a reversal in recent trends may be reversed. That reversal starts with taking an active role in monitoring the types of foods that are being consumed and putting in the labor required to cultivate one's own food.

Jane Brody indicated exactly what types of foods the Pima could return to consuming in order to maintain a better, healthier, more traditional diet. For the Pima,

the desirable food ingredients are found in edible parts of such indigenous plants as the mesquite (mes-KEET) tree, cholla (CHOY-a) and prickly pear cactus, as well as in tepary (TEP-a-ree) beans, chia (CHEE-a) seeds and acorns from live oaks. Tribal elders speak fondly of these one-time favorites, which in recent decades have been all but forgotten (Brody).

Focusing on cultivating these plants and other foods would serve two purposes: it would allow the Pima to be more physically active in tilling the… [END OF PREVIEW]

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