A diet of white rice, few veggies and sweetened drinks puts Hispanics at greater risk of diabetes

Posted on Sunday, 11.11.12

A diet of white rice, few veggies and sweetened drinks puts Hispanics at
greater risk of diabetes
By Melissa Sanchez
msanchez@elnuevoherald.com

When Arleen Barreiros was diagnosed with Type 2 diabetes at age 27, the
news didn't come as a total shock. She was overweight and had trouble
making the lifestyle choices necessary to drop the pounds. Plus, her
grandmother, mother and father already had diabetes.

But the diagnosis forced her to make immediate changes. As a daughter of
Cuban immigrants, that may have been the most difficult challenge.

"I really had to explore foods that I wasn't used to growing up," said
Barreiros, who is now 35. "Vegetables? We didn't have vegetables. I had
to go away from the traditional Cuban food because it's full of grease,
and everything is fried and heavy carbs. It's hard to balance that, and
balance your blood sugar."

It's a sentiment echoed widely in Miami, where more than half the
population is Hispanic. Experts say that traditional cuisines from
Caribbean, Central and South American countries are often loaded with
simple carbohydrates that have a high glycemic index. The sugars in
these foods, like white rice and white bread, break down quickly in the
body and cause sudden spikes in the blood system's glucose levels.

That kind of diet coupled with a more sedentary lifestyle in the United
States and easy access to packaged foods and soft drinks make for an
unhealthy combination for millions of Hispanic immigrants and their
children. According to a 2010 national study by the Centers for Disease
Control and Prevention, adult Hispanics are 1.7 times more likely than
non-Hispanic whites to have diabetes.

"You take somebody who grew up in Cuba, Colombia or Peru. When they were
there they didn't have diabetes," said Dr. Joseph Gutman, an
endocrinologist at Mount Sinai Medical Center. "They moved here and
started having the fast foods, and the colas, adding a burden that their
bodies cannot handle. Yes, the white rice is terrible, but that just
means you can't have it in the quantities you used to have. You're
adding insult to injury."

Gutman and others who treat diabetic patients and those at risk for
getting the disease say one of their first steps is convincing all
patients — Hispanics and non-Hispanics alike — to eliminate sweet
beverages, like sodas and juices, which have a high glycemic index, from
their diets.

"I've had several patients who drink four to five colas a day and the
only thing we've done is get them to switch beverages," said Dr. Ted
Feldman, medical director of both the Center for Prevention and Wellness
at Baptist Health South Florida and the South Miami Heart Center at
South Miami Hospital. "By cutting it off, they immediately lose weight."

For many of her Hispanic patients, registered dietician Rocio Garcia
said it's especially difficult to understand why they should limit their
fruit juice intake.

"They think because it comes from a fruit it's healthy," said Garcia,
who counsels organ transplant patients at Jackson Memorial Hospital.
"With the juices, you're not getting all the fiber from the fruit. If
you drink six ounces of orange juice, it's as if you were eating three
oranges at once, but without all the benefits."

Fibers are important because the body takes longer to break them down.
As a result, the fruit's natural sugars are absorbed more slowly into
the blood system and the pancreas doesn't have to go into overdrive to
produce insulin to dispose of it right away.

"It's as if you left one window open in your house and had a hurricane,
and the water came in and damaged everything," said Gutman. "But if your
kids came into the house, wet from the pool, you wouldn't have to work
so hard to clean it out."

As for meals, the American Diabetes Association recommends drawing an
imaginary line on your plate, dividing it in two, and then dividing one
of the halves again so that you have three sections. The largest section
of the plate should be devoted to non-starchy vegetables. Then, one
quarter can go to starches, such as multi-grained breads. Finally, lean
meats, eggs or dairy products can fill the last quarter.

Alejandra Cordovez, a registered dietician at the University of Miami's
Diabetes Research Institute, said the greatest challenge with Hispanic
patients is increasing the non-starchy vegetable consumption.

"The Hispanic diet has high portions of refined carbohydrates with low
fiber, like white rice, buñelos, Cuban bread, arepas," she said. "People
ask me if they can have rice. Yes, but you cannot have three cups of
rice, two cups of beans, yucca, malanga and platanitos and some meat."
What worries is Cordovez is that many Hispanic parents children are not
introducing their children to vegetables. Some of her patients are obese
9-year-olds.

"I'm trying to get them to eat a serving of veggies but the parents tell
me, 'Oh, I try to make him eat vegetables but he won't.' Then I ask the
parent: 'Do you eat the vegetables?'" she said.

Too often, she said, the answer is no.

After her diagnosis, Barreiros began to experiment with vegetables in
the kitchen — and actually enjoyed some of them. In fact, she's even
introduced her parents and grandmother to some of these new foods.

"They never even knew what zucchini and squash was until I made some
chili with those vegetables," Barreiros recalled, laughing. "They're
like, 'What's this green and yellow thing?' I had to show them. They'd
seen them in the store but never tried them."

http://www.miamiherald.com/2012/11/11/v-fullstory/3091843/a-diet-of-white-rice-few-veggies.html