Ka Wai Ola - Office of Hawaiian Affairs, Volume 5, Number 8, 1 August 1988 — ʻAi Pono, E Ola [ARTICLE+ILLUSTRATION]

ʻAi Pono, E Ola

By Dr. Terry Shintani, M.D.

Preventing Today's Epiāemie

ln 1804, the Hawaiian people suffered a major tragedy. An epidemic spread ōver all the islands. Some accounts suggest that it destroyed nearly half of the Hawaiian populahon. It was an epidemic of infectious disease imported from the West. The Hawaiians called it ma'i o

ku'u. Some believe that it was a form of plague or cholera. It was so virulent that an individual could be afflicted in the morning and be dead by nightfall, his or her body turning black. It is estimated that hundreds of thousands of Hawaiians died in that plague. Today we have the knowledge and means to prevent such infectious disease epidemics from happening. But did you know that this very day we are faced with another epidemic of Western disease that is now killing over half the Hawaiian people? What I am talking about is nutritionrelated disease such as heart disease, cancer, stroke and diabetes. Evidence shows that the change in diet is the likely cause of this epidemic. One of the most important factors contributing to this problem is the change in the proportion of dietary fat in today's diet as compared to that of ancient times. In ancient times, dietary fat eomprised as little as 10 percent of the caloric intake of Hawaiians. Today, dietary fat represents 42 percent of our caloric intake. A review of world literature reveals that this trend occurs in just about all cultures who give up their traditional diets for more "Westem" fare. And along with this trend eome "Westem" diseases such as heart disease, cancer, diabetes, obesity and strokes. Part of the reason for the low fat content in the traditional Hawaiian diet was that the staple foods of the ancient Hawaiians were very low in fat. Taro,

for example, is about one percent fat. Ulu (Breadfruit) is two percent. The Moloka'i diet study described in Dr. Kekuni Blaisdell's article in this issue put such a traditional diet into practice. In the last issue we featured recipes for kalo. Here are two recipes for ulu (breadfruit) that was used in the Moloka'i diet study courtesy of the organization that conducted this study, Nā Pu'uwai. Steamed Ulu Take one large ripe soft ulu (breadfruit). Remove skin and core. Cut the breadfruit into halves or quarters and plaee them on apan. Steam in a covered steamer for two hrs. or until thoroughly cooked (poke with a skewer to see if it goes through easily). Serve. UIu Poi Take one large ripe ulu (not soft) and cover it with boiling water. Boil until tender, then drain and eool. Remove the skin, core and seeds. Cut into slices. Grind in a meatgrinder. Plaee pulp in a bowl and pound with poi pounder and wooden potato masher to form a smooth paste. Knead by hand, adding water until the consistency is obtained. Strain in cheese cloth and serve immediately or plaee in refrigerator to ripen more. If not refrigerated, use just a small amount of water and plaee in covered bowl. Mix with water as needed. Leaming to eat more traditional foods and less modern fatty foods is one major step toward preventing many nutrition-related diseases. And if we share this way of eating with family and friends, we ean help prevent the equivalent of the disastrous epidemic of 1804 from repeating itself today. Dr. Shintani, Director of Prevention Health Services at the Waianae Coast Comprehensive Health Center, is a physician and nutritionist. He is also coordinator of their Malama Ola preventive health program. A majorify of the Center's clients are native Hawaiians.

CHANGE IN DIETARY FAT Change with Westernization