Ka Wai Ola - Office of Hawaiian Affairs, Volume 6, Number 7, 1 July 1989 — ʻAi Pono, E Ola [ARTICLE+ILLUSTRATION]

ʻAi Pono, E Ola

By Terry Shintarii, M.D.

Welght loss, healih and the Hawallan diet

The Wai'anae Diet Program, based on a traditional Hawaiian diet, will be starting soon. It represents the joined efforts of the Wai'anae coast eommunity, including members of the Wai'anae and Nanakuli homestead associations with the assistance of other

Hawaiians from Moloka'i and elsewhere in the state. In past articles I have discussed how the traditional Hawaiian diet helps to lower cholesterol and to reduce the risk of the number one killer of native Hawaiians — heart disease. The traditional Hawaiian diet also helps us to lose weight and decrease our risk of diabetes. When I tell people that the Hawaiian diet helps people to lose weight, it seems like a paradox. This may be because so many people still believe it was natural for Hawaiians lo be overweight. In fact, this was not the case. In pre-Western contact Hawai'i, (that is, before Captain James Cook arrived in 1778), the average Hawaiian, the maka'ainana, was slender. In 1779, Captain James King, who sailed with Cook, stated in the ship's log, "The eommon people are of a slim rather than full habit . . ."

How is this possible when we see so many obese individuals today? One of the reasons is that diet has changed drastically since that time. The ancient diet consisted of kalo, 'ulu (breadfruit), 'uala (sweet potato), uhi (yams), limu (seaweed), i'a (fish) and hua'ai (fruit). Total dietary fat was only 9 percent of the calories. Today, with foods such as SPAM, beef, pork, macaroni salad, cheese, french fries and fast foods as our staples, dietary fat is up to 42 percent, In a previous eolumn, I discussed how "starch makes you skinny, and fat makes you fat." A 1985 study graphically illustrates this point: oniy three percent of miee who were fed a 13 percent fat diet became obese, or excessively fat. However, almost half of the miee who were fed a 45 percent fat diet became obese. This pattem of increased obesity in high fat diets is found all over the world when people change from their low fat traditional diets to a high fat western diet. These studies suggest that dietary fat is directly related to the obesity found among people of the modem world, including Hawaiians. Obesity also increases the risks of heart disease and cancer, and in the case of diabetes, raises the risk by 290 percent. In ancient times, diabetes was practically unknown in Hawai'i and in other traditional cultures. With the change to a modem high fat western diet, obesity and diabetes have both increased dramatically. Today, Native Hawaiians have a diabetes rate

300-500 percent higher than that of the general public. Does reducing dietary fat also decrease obesity and thereby reduce diabetes? A study in Samoa, a culture with a traditional diet similar to the Hawaiian diet, has found this to be the case. An individual who was placed on a 10 percent fat diet (similar to the fat content of his traditional diet) decreased his insulin requirement significantly within one month. While such a study is only preliminary, it is certainly encouraging to people with diabetes. The Wai'anae Diet Program intends to help the participants lose weight naturally and decrease the risk of diabetes. These objectives are in addition to the objectives of reducing cholesterol and blood pressure, and increasing the survival of all Hawaiian people. If you would like. to know more about the Wai'anae Diet Program, or if you would like to , kokua in any way with ideas or food donations, please eall me at the Wai'anae Coast Comprehensive Health Center at 696-7081. Dr. Shintani, Director of Prevention Health Services at the Waianae Coast Comprehensive Health Center,js a physician and nutritionist. He is also coordinator of their Malama Ola preventive hea!th program. A majority of the Center's clients are native Hawaiians.