Ka Wai Ola - Office of Hawaiian Affairs, Volume 37, Number 9, 1 September 2020 — Improving Kūpuna Health Through 'Ai Pono [ARTICLE]

Improving Kūpuna Health Through 'Ai Pono

By Dr. Landon Opunui, ND & Miki Wong, RD There are mulhple social and health disparities facing Native Hawaiian kūpuna, such as high rates of lifethreatening diseases, hnaneial hardship, disability, shorter life expectancies and underutilization of services. As a result, it should be no surprise that the data suggests the health care needs of Native Hawaiian kūpuna far exceeds that of their non-Hawaiian counterparts. This leads to heahh equity problems. Hawaiian culture emphasizes care for kūpuna. However, many adult caregivers are less available to care for their aging loved ones because of competing work and 'ohana responsibilities. On Moloka'i, kōkua for caregivers is available via Nā Pu'uwai's flagship Kūpuna Program, the only adult day care offered on the island. The program provides kūpuna with a safe and structured environment to enjoy daily activities with other kūpuna and staff while 'ohana caregivers are at work. The program supports kūpuna to help them remain active and healthy so they ean remain at home as long as possible. Several studies have reported on the heahh benefits associated with a return to a precontact Hawaiian diet. Although

this may be an ideal dietary approach, for many Hawaiians food access and cost limitations may not always allow for this as a practical option, especially for some of our kūpuna who rely on meal assistance. In addition, the high concentration of complex carbohydrates found in native starches, along with the sugar in tropical fruits, may still be problematic for kūpuna challenged with diseases such as diabetes. So on July lst, we launched our kūpuna nutrition program, whieh redesigns meals with the goal of providing high-quality nutrition using flavorful, locally inspired recipes prepared with locally-sourced ingredients. The program was launched under the direction of eook Neil Gonzalez, registered dietitian/ nutritionist Miki Wong, and volunteer chef eoaeh consultant, Ikaika Molina. The menus were designed to support the heahh and wellbeing of our kūpuna, many of whom have chronic health conditions. Gonzalez was inspired to change the menu after making improvements to his own diet. In addition, he developed daily themes to add creativity and fun to meal planning. For example, "Mostly Moloka'i Mondays" showcases island-sourced ingredients — and the kūpuna are enjoying their meals! Many of them were already avoiding rice, citing health concerns. Since introducing cauliflower "rice,"

kūpuna are finishing their plates with their compliments to the eook. Recipes include egg white frittatas, almond-flour waffles, venison stir-fry and beef short ribs with cauliflower mash. Providing delicious and familiar meals also provides comfort to kūpuna who have been isolated. The program has helped Nā Pu'uwai forge partnerships with loeal organizations committed to ensuring the heahh of the community, such as Sustainable Moloka'i whieh provides reduced pricing on produce. We hope to inspire other organizations who have the resources and opportunities to feed our kūpuna to consider consulting with nutrition experts to curate 'ai pono meals that ean be used to combat many of the chronic heahh challenges our kūpuna face today. ■ Dr. Landon Opunui, ND is the newly appointed Medical Director ofNā Pu 'uwai Native Hawaiian Health Care Center wlio offers a shared vision of broadly and comprehensively nourishing mauli ola through integrative health services. Miki Wong, RD is Nā Pu 'uwai 's Registered Dietitian/Nutritionist with a focus on using food as medicine to support patients with metabolic disease.