Ka Wai Ola - Office of Hawaiian Affairs, Volume 8, Number 8, 1 August 1991 — Hawaiian diet reverses diabetes [ARTICLE+ILLUSTRATION]

Hawaiian diet reverses diabetes

Can the Hawaiian diet reverse diabetes? Last month we discussed ! some of the newly published results of the Wai'anae Diet Program. In this and articles to I follow, I will share more of these important

findings. One of the most startling findings of the Wai'anae Diet Program is the diet's effect on diabetes. Diabetes control improved dramatically on the program in the seven individuals who had diabetes. This is an important finding because Hawaiians die of diet-related disease at a higher rate than all other ethnic groups in Hawai'i and perhaps in the nation. Currently, the rate of death from diabetes per 100,000 in pure Hawaiians is 67.4 as compared to all other ethnic groups at 9.8. This means the death rate from diabetes is 588 percent higher in pure Hawaiians as compared to others. The rate for part-Hawaiians is somewhat better but still an alarming 222 percent higher. What is diabetes? Diabetes (actually diabetes mellitus) is a disease in whieh the body fails to control the amount of sugar in the blood. This causes an overload as the kidneys try to filter out the excess blood sugar and results in

excessive urination. This is often one of the first signs of diabetes. Appropriately, diabetes is known in ancient Hawai'i as mimiko or urinating disease (mimi means urinate and ko means sugar). There are two kinds of diabetes mellitus. They are diabetes mellitus type 1 (DM I), and diabetes mellitus type 2 (DM II). T ype 1 usually starts at a young age . Parts of the pancreas that produce insulin are destroyed by the body's own immune system. Why this happens is not yet known. Insulin is needed to control sugar in the blood. Thus, these patients absolutely need insulin shots to survive. Type 1 is not eommon in Hawaiians. Diabetes type 2 (DM II) was also rare in ancient times but is eommon in modern Hawaiians. In this disease, there is insulin in the body but it does not work as effectively as it should. Some researchers believe that this is due to excessive fat in the diet whieh may explain why Type 2 was rare in the past when Hawaiians ate little fat. The result is that in both types of diabetes, the sugar in the blood is poorly controlled. The bad part about this disease is that it causes damage to the small blood vessels and the nerves. In the long run, because of the damage of the blood vessels, people with uncontrolled diabetes get foot infections that don't heal, bleeding in the retina of the eye that causes blindness,

and ean get blockages in the small vessels in the kidney that ean cause kidney failure. They are at mueh greater risk of dying of a heart attack and a stroke than those without diabetes. Because of the nerve problems, they ean have numbness or pain or even partial paralysis in their hands, feet, arms, and legs. This is why it is important to control the blood sugar with diet and medicine. In the Wai'anae Diet Program in whieh 20 Native Hawaiians were placed on a traditional Hawaiian diet for 21 days, the average fasting blood sugar fell from an average of 162 (milligrams per decaliter) to 123 mg/dl. A normal fasting blood sugar is no higher than 120 mg/dl. All those with diabetes had better control of their blood sugar. One pure Hawaiian participant no longer needs medication for diabetes. Before the program started, he required 60 units of insulin. The diet is so effective in controlling the blood sugar of some people with diabetes that I caution anyone who is thinking about trying the diet to do so only under the guidance of a physician. Blood sugars may fall on the first day and an adjustment in medication may be required. Dr. Terry Shintani, physician and nutritionist, is director of preventiue medicine at the Wai'anae Coast Comprehensive Health Center. A majority of its board and its 18,000 clients are of Hawaiian ancestry.

4Ai Pono, E Ola

By Terry Shintani, M.D.