Re: Pima Indians; Outreach

[Guest guest]

In a message dated 99-11-02 20:40:21 EST, you write:

<< Can we figure out a way to reach out to

them and suggest they adopt our approach to eating? >>

I don't suppose they have 'puters where they are...or do they? How can we

find out?

[Guest guest]

In a message dated 99-11-02 21:02:08 EST, you write:

<<

Didn't Bernstein mention this group??? I've come across it somewhere in my

reading. I haven't time right now to look up the reference, but I think

It's Bernstein. >>

, I don't think it was Bernstein but a couple of years ago -- around the

time of my diagnosis -- there was a major article in the New Yorker. Could

you have read it there? Vicki A.

[Guest guest]

As you probably know, I think our group can " walk on water. " We have done

such a fantastic job on our own health that I know we can reach out and help

others. As many of you know, I am originally from " Garrison Keillor Country "

in northern Minnesota, as is my future husband Rob. Those of us from up

there tend to have an overload of " Decency " ... a sort of missionary zeal.

I have turned Rob on to low-carbing, and he is convinced it has saved his

life. It certainly has saved mine. Rob sent a link about the Pima Indians

that

is heart-breaking. I did not know until I read this article just how serious

their

situation had become:

http://www.azcentral.com/news/specials/pima/

Here is an amazing opportunity for us to benefit others who are in desperate

need with the knowledge we have gained. Our group has too much energy and

knowledge to keep it bottled up. Can we figure out a way to reach out to

them and suggest they adopt our approach to eating?

Time is critical. The Pimas have been devastated by type 2 diabetes, despite

being intensively studied for over 30 years. Half of them are diabetic.

Eighty percent will develop the disease eventually - and even that number is

growing. Some Pimas believe they will become extinct within 75 years if

there is not a dramatic turnaround.

Susie

[Guest guest]

Susie --

Didn't Bernstein mention this group??? I've come across it somewhere in my

reading. I haven't time right now to look up the reference, but I think

It's Bernstein.

I don't know. How many of the Pima's have computers (or access to one)?

I'm thinking goof a letter writing support group for them. It sounds

like they are doing a fair job through the schools to reach the children.

But what of the adults?? I suppose going there might be possible for

some who have the money to travel. But what of establishing trust? This

way of eating is expensive, also. Could they use more cash? or are the

casinos mentioned generating enough? Maybe those on the list could

" adopt " a family to encourage and help with support, suggestions, and cash

as needed and available?

At 08:46 PM 11/2/99 -0500, you wrote:

>

snip

>Here is an amazing opportunity for us to benefit others who are in desperate

>need with the knowledge we have gained. Our group has too much energy and

>knowledge to keep it bottled up. Can we figure out a way to reach out to

>them and suggest they adopt our approach to eating?

>Time is critical. The Pimas have been devastated by type 2 diabetes, despite

>being intensively studied for over 30 years. Half of them are diabetic.

>

>Susie

in Constable

[Guest guest]

There's plenty of information available on the internet regarding the Pima

Indians. I am posting info from an NIH web site regarding the Gila River

Indian Community below, and will publish more web sites if you would like.

The controversy involving the NIH is that, 30-40 years ago when the decision

was made to study diabetes among the Pimas, the NIH selected type 1 rather

than type 2. So $100 million of our tax dollars have been spent already on

last-ditch efforts like kidney dialysis, but attention is not sufficiently

focused on dietary and exercise changes that might prevent the diabetes in

the first place.

The Pimas are an interesting group to study, because diabetes is striking

them much more severely than the general U.S. population - and there is

another Pima Indian group across the border in Mexico that is not similarly

ravaged by diabetes. Of course, many observers concluded that their diet is

too high in fat. But we diabetics who have successfully experimented with

dietary approaches have discovered that, if a person with a family history

including diabetes leads an extremely active life, the diabetes genes can

often be held at bay; but if we lead a sedentary lifestyle, it will often be

necessary to restrict both our caloric intake and our carbohydrate intake

.... particularly the highly-processed grains. We can't move to the cities

and still eat like farm hands.

Susie

**********************

http://www.niddk.nih.gov/health/diabetes/pima/kiddis/kiddis.htm

" The Gila River Indian Community may be the smallest town in the United

States with its own dialysis center, " says Dr. Bill Knowler about this

community of 11,000 people. Dr. Knowler and his colleagues at the NIH

suspect that the Pima Indians share a gene or genes that make them more

likely to develop the kidney disease of diabetes (KDDM) that frequently

leads to kidney failure.

The researchers have found that Pima Indians have over 20 times the rate of

new cases of kidney failure as the general U.S. population, and diabetes is

the culprit over 90 percent of the time. Furthermore, kidney disease is the

leading cause of death from disease among Pima Indians who have diabetes.

American Indians have the highest rates of diabetes in the world. About half

of adult Pima Indians have diabetes, which they get at a relatively young

age. On average, Pima Indians are a mere 36 years old when they get

diabetes, compared with Caucasians, who get it at about age 60. The longer a

person has diabetes, the greater the risk for developing complications, such

as kidney disease. However, recent research shows that keeping blood sugar

as close to normal as possible can slow or even prevent complications.

Under normal conditions, the kidneys, nestled on each side of the body

under the rib cage, maintain body fluid and salt balance and remove waste.

They also help regulate blood pressure and release erythropoietin, a hormone

that tells the bone marrow to make red blood cells.

The filtering units of the kidney, called glomeruli, are made up of clusters

of tiny blood vessels. They act " like a screen that normally lets water and

waste products filter through but holds back most of the protein, " Dr.

Knowler explains. " Early in the course of diabetes, we are seeing changes in

the size of the holes of the screen, so that more protein escapes into the

urine, " he added. Called micro-albuminuria, this excess protein may be one

of the first clues that kidney damage has begun.

When the kidney's filters are damaged, the remaining ones have to work

harder to make up for the loss. As more of the filters are damaged, the

kidneys lose their ability to compensate. When the kidneys decline to only 5

or 10 percent of their original capacity, a person is diagnosed with

end-stage kidney disease.

" The real tragedy of kidney disease is that it leads to kidney failure,

which means that a person must go on dialysis or have a kidney transplant, "

Dr. Knowler says.

But recent studies bring hope that the years of collaboration between NIH,

other scientists and the Pima community is beginning to bear fruit.

For example, the NIH researchers now know that Pima Indians are more likely

to get kidney disease of diabetes if they have high blood pressure, even

before onset of diabetes; if they have microalbuminuria, or a family history

of protein in the urine or kidney disease; or if they have high blood sugar,

or diabetes serious enough to require drug or insulin treatment. If the

impact of these risk factors, such as high blood pressure, could be reduced,

the onset of kidney disease might be prevented or slowed.

Even with this important information, investigators still needed to know

what was happening inside the kidney before they could design treatment

studies, according to Dr. , a researcher from The Cleveland

Clinic Foundation who works with Dr. Knowler.

Dr. explains that studies of patients with insulin-dependent, or

Type I diabetes showed that the kidney filters blood faster and the blood

moves faster within the kidney when diabetes sets in. It is the higher

pressure that comes with those changes that may damage the sensitive filters

and allow protein to leak into the urine.

Scientists thought that if the disease process worked the same in Pima

Indians with Type II diabetes as in people with Type I diabetes, a special

type of drug that reduces blood pressure within the kidney might help

prevent or slow the kidney disease. Such a drug, an

angiotensin-converting-enzyme (ACE) inhibitor, was recently approved by the

Food and Drug Administration for the treatment of kidney disease of Type I

diabetes.

Encouraged by this information, the Diabetic Renal Disease Study group, with

Dr. directing patient care, set out to discover whether the kidney in

Type II diabetes behaves as it does in Type I diabetes. After measuring

kidney function in over 200 Pima Indians, with and without diabetes or

kidney disease, the researchers found that the amount of blood filtered

within the kidney does increase at the onset of Type II, as it does in Type

I diabetes. A large European study of kidney function in people with Type II

diabetes found the same thing.

After several years of studying how kidney disease of diabetes occurs, Dr.

now believes there is enough evidence to conduct clinical studies to

try to prevent its development or progression. A trial using an ACE

inhibitor is now under way. Dr. says that although it seems slow in

coming, the research is a " deliberate process " designed to get the best

information possible in order to give the best care possible.

In the meantime, the best defense against kidney disease of diabetes--in any

group of people--is to try to prevent diabetes from developing at all by

maintaining healthy weight, exercising, and following a healthy diet. This

is the goal of a new NIH Diabetes Prevention Program in which the Pimas and

other American Indians are participating.

Once a person has diabetes, kidney disease might be prevented or slowed by

controlling blood sugar levels and blood pressure, and by maintaining

healthy weight.

Doctors and the Pima Indians continue to work together toward the day when

the Gila River Indian Community will no longer need a dialysis center.

--

[Guest guest]

Here is the URL called " Pima Indians: Pathfinders for Health " . As you will

read, the NIH and the NIDDK have established two pilot programs, but they

are on the wrong track. They realize the importance of exercise, but still

think the culprit in diabetes is dietary fat. Maybe we can come up with

appropriate e-mail info and contact the people in positions of authority to

try to share with them the successes we have had.

Susie

http://www.niddk.nih.gov/health/diabetes/pima/index.htm

[Guest guest]

Here is the URL where you can fill out the form to contact the NIH/NIDDK re

diabetes:

http://www.niddk.nih.gov/tools/mailto.htm

Or you can e-mail them directly at:

Kathy_Kranzfelder@...

From everything I have read on their web site, the focus is all on reducing

fat intake, and the only success stories are those Pima Indians who are

essentially starving themselves into decent b.g. numbers. There is much

discussion of being hungry and all the weight they have lost. That approach

is guarantted not to work for the majority of people, as we know.

Susie

[Guest guest]

,

On pages 159-160 of his book, Dr. Bernstein writes about the Pima

Indians under the sub-heading " The Thrifty Genotype " .

Carolyn in TN

in Constable wrote:

>

>

>

> Susie --

>

> Didn't Bernstein mention this group??? I've come across it somewhere in my

> reading. I haven't time right now to look up the reference, but I think

> It's Bernstein.

>

>

[Guest guest]

At 12:49 AM 11/3/99 -0500, WHIMSY2@... wrote:

>From: WHIMSY2@...

>

>In a message dated 99-11-02 21:02:08 EST, you write:

>

><<

> Didn't Bernstein mention this group??? I've come across it somewhere in my

> reading. I haven't time right now to look up the reference, but I think

> It's Bernstein. >>

>

>, I don't think it was Bernstein but a couple of years ago -- around the

>time of my diagnosis -- there was a major article in the New Yorker. Could

>you have read it there? Vicki A.

No, I don't see the New Yorker that often. I'm pretty sure it was in one

of the books I've read recently, However, a check of the indices in all of

them turned up nothing. So I'm rather stuck as to which author mentioned it.

(See Carolyn Hn's post: )

>,

>

>

>On pages 159-160 of his book, Dr. Bernstein writes about the Pima

>Indians under the sub-heading " The Thrifty Genotype " .

>

in Constable

[Guest guest]

At 12:49 AM 11/3/99 -0500, WHIMSY2@... wrote:

>From: WHIMSY2@...

>

>In a message dated 99-11-02 21:02:08 EST, you write:

>

><<

> Didn't Bernstein mention this group??? I've come across it somewhere in my

> reading. I haven't time right now to look up the reference, but I think

> It's Bernstein. >>

>

>, I don't think it was Bernstein but a couple of years ago -- around the

>time of my diagnosis -- there was a major article in the New Yorker. Could

>you have read it there? Vicki A.

No, I don't see the New Yorker that often. I'm pretty sure it was in one

of the books I've read recently, However, a check of the indices in all of

them turned up nothing. So I'm rather stuck as to which author mentioned it.

(See Carolyn Hn's post: )

>,

>

>

>On pages 159-160 of his book, Dr. Bernstein writes about the Pima

>Indians under the sub-heading " The Thrifty Genotype " .

>

in Constable

[Guest guest]

The report I saw tended to indicate that they are in the position they

are in due to life-style changes. They just don't have to move much

anymore. There is lots of poverty, and their main source of income tends

to be " public money " . Look at any group that relies on welfare, or

government programs to exist and you'll see those who have given up, or

drastically changed the way they live. Note that the study says that " it

is not uncommon for adults to weight 300+ lbs. "

Sedentary lifestyle, wrong choices/availability of foods, the resulting

obesity, and the destruction of the will to maintain their culture as

their forbears knew it is probably at the top of the list of causes for

their state.

OtterCritter wrote:

<<snipped>>

> Time is critical. The Pimas have been devastated by type 2 diabetes, despite

> being intensively studied for over 30 years. Half of them are diabetic.

> Eighty percent will develop the disease eventually - and even that number is

> growing. Some Pimas believe they will become extinct within 75 years if

> there is not a dramatic turnaround.

>

> Susie

--

Dave -- November 3, 1999

dorcutt@...

t2 08/98 Glucophage & Aspartame

Davor's daily aphorism:

Worry : The interest paid on trouble before it's due

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[Guest guest]

Dave Orr wrote:

<< The report I saw tended to indicate that they are in the position they

are in due to life-style changes ... Sedentary lifestyle, wrong choices/

availability of foods, the resulting obesity, and the destruction of the

will to maintain their culture as their forbears knew it is probably at

the top of the list of causes for their state. >>

When the doctor sent me to the dietitians years ago, I got a lecture about

eating too much fat. I protested that my diet relied on " healthy complex

carbohydrates, " and that pretzels were the only snack I allowed myself. The

dietitians eyed each other: " She's lying ... " I was gaining weight like

mad, and yet I didn't think I ate a great deal more than others. What if the

Pimas are just magnified versions of us with European ancestry? We have

heard type 2 described as those people whose systems have not yet evolved to

eat a diet high in processed grains. One Jewish wag commented regarding the

New World, " We already had diabetes when you were still trying to invent the

wheel. "

I'm loathe to blame the Pimas, because many of us type 2's have felt the

sting of accusation as well. If we would have quit the fatty snacks, given

up the desserts, and had some WILLPOWER, we wouldn't be diabetic. A sister

of mine was diagnosed with type 2 in grade school ... and she was a

horse-riding little tomboy. The Pimas have been told for over 30 years to

eat carbs and quit the fats. That is the very diet that failed for many of

us on the list.

After my hysterectomy, I just ballooned. I tried and tried to " diet, " but I

would soon feel weak and HUNGRY ... I couldn't make food restriction a way

of life in that deprived state. Rob is educated and financially comfortable,

and yet he was another insulin-resistant human losing the weight loss battle

and producing truly awful blood test results. People who don't have the

carbohydrate allergy/addiction probably can't imagine the power they have

over us.

I hope that some of the Pimas can be convinced to try low-carbing. The

results could be amazing. By the way, I received a terse " Thank you for your

comments " from the NIH/NIDDK representative today.

Susie

[Guest guest]

OtterCritter wrote:

<<snipped>>

> I'm loathe to blame the Pimas, because many of us type 2's have felt the

> sting of accusation as well. If we would have quit the fatty snacks, given

> up the desserts, and had some WILLPOWER, we wouldn't be diabetic. A sister

> of mine was diagnosed with type 2 in grade school ... and she was a

> horse-riding little tomboy. The Pimas have been told for over 30 years to

> eat carbs and quit the fats. That is the very diet that failed for many of

> us on the list.

>

> After my hysterectomy, I just ballooned. I tried and tried to " diet, " but I

> would soon feel weak and HUNGRY ... I couldn't make food restriction a way

> of life in that deprived state. Rob is educated and financially comfortable,

> and yet he was another insulin-resistant human losing the weight loss battle

> and producing truly awful blood test results. People who don't have the

> carbohydrate allergy/addiction probably can't imagine the power they have

> over us.

None of what you say is inaccurate. Their diet has changed however, and

this just aggravates the problem.

Someone posted the " Nutrition News " article today that pointed out that

walking is a great way of lowing bg levels. Well, yep, we knew that.

Movement of any kind will help. Doing it is another story.

>

> I hope that some of the Pimas can be convinced to try low-carbing. The

> results could be amazing. By the way, I received a terse " Thank you for your

> comments " from the NIH/NIDDK representative today.

" Terse " noted..

--

Dave -- November 3, 1999

dorcutt@...

t2 08/98 Glucophage & Aspartame

Davor's daily aphorism:

Nostalgia isn't what it used to be.

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