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Changes in lifestyle over the last century have resulted in a dramatic increase in the
incidence of diabetes in the United States (U.S.). Mexican-Americans, the largest
Hispanic/Latino subgroup in the U.S., are 1.7x’s as likely to have diabetes as non-
Hispanic Whites. Culturally appropriate approaches for treating diabetes in minority groups have rarely been investigated and traditional interventions have been ineffective.
The purpose of this study was to test whether a culturally appropriate (i.e.,
language, food, and beliefs) diabetes intervention pilot program that focused on
nutrition, physical activity (PA), and self-care for Hispanic participants with diabetes, could improve lifestyle/medical diabetic risk factors. Outcome variables collected pre/post-intervention were servings/day of fruits, vegetables, whole grains; intake of saturated fat; PA (minutes/week); blood glucose, insulin, glycosylated hemoglobin, total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL)cholesterol, triglycerides, and insulin resistance.
This study was unique as the intervention was completed in both urban/rural settings, in a manageable time frame, with outcome variables that included change in diet/exercise, blood lipids, and insulin resistance. The education program (6-10 weeks; 20-25 hours) was offered in Multnomah (MC) and Hood River (HRC) counties using bilingual/bicultural community health workers. Counties selected 1 of 2 ways to
implement the program. Participants were encouraged to bring a friend/family member
for support.
The intervention significantly increased (p<0.05) intakes of whole grains in both
counties, while saturated fat and fruit intake significantly decreased (p<0.05) in MC. No significant changes occurred in PA or blood assessment variables; however, participants in HRC reported a 10% increase in PA (87 to 96 minutes/week) compared to 47% in MC (51 to 75 minutes/week). The 2 counties were different in eating habits, PA, and biomarkers. At baseline, participants in MC ate more vegetables, and those in HRC ate more whole grains, had lower insulin levels, and higher HDL cholesterol levels (p<0.05).
The intervention resulted in modest changes in some outcome variables; however, a longer intervention appears to be necessary to significantly improve lifestyle behaviors and biomarkers for the treatment of diabetes. The participants rated the program highly due to the culturally appropriate approach used. |
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