Minority populations in Utah struggle with a growing weight problem

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Slathering Crisco on his hands, Randy Enrique Pérez then dipped them into a large bowl of water to wash off the shortening. But as hard as the 6-year-old scrubbed, the slick mess remained on his hands.

The experiment was part of an eight-week nutrition program at Oquirrh View Clinic in Kearns for overweight Latino children and their parents.

Instructor Rita Ballesteros, a nurse who has a masters in dietetics, told the class the point of the demonstration was to show how difficult it is for the body to metabolize hydrogenated fats and how olive oil is a healthier choice. Hydrogenated fats contain a molecule that helps prolong their shelf life. They are present in many processed foods, including cookies, French fries, potato chips and crackers.

Ballesteros is working with Karen Ortiz, a pediatrician and professor at the University of Utah, on a research project on Latinos with weight problems. But Utah's largest minority population isn't the only ethnic group struggling with the battle of the bulge.

In fact, the only group that has fended off sharp increases in weight over the past decade in Utah is non-Pacific-Islander Asians. Every other category, including whites, has seen alarming rises in weight gain.

Obesity in the United States - and in Utah - occurs at higher rates in minority populations such as blacks and Latinos, compared with whites. Women and those with low incomes within minority populations appear to particularly be affected, according to the American Obesity Association, a lobbying and educational group made up of doctors, dieticians and researchers that believes obesity is a disease.

Some attribute the higher rate to genetic predisposition, but most experts agree lifestyle is the main culprit. In poor minority communities in many urban centers, in particular, convenience stores and fast food are abundant but markets or grocery stores with fresh foods are scarce. And with obesity tied to diabetes, heart disease, high blood pressure and some cancers, experts say the consequences will be dire unless something is done.

The U. research project and classes are a step in the right direction, Ortiz says. The project began in January and will last two years, funded by a grant. The classes are free to the families, and they receive gift certificates for groceries if they attend at least four classes.

The kids and their parents learn about the harm in routinely eating fast and processed foods, the importance of fruits and vegetables and the need to get their bodies moving.

Maria Del Coral Rivera, Randy's mother, said his pediatrician recommended the classes to help him lose weight and learn to eat better.

Another student, Angel Lopez, 14, wanted to shed some weight - he's lost about 10 pounds in the program - and avoid heart disease, a condition that has killed many relatives.

"I wouldn't want to die young of heart disease," he said. "I am learning how to eat slow, not eat too much and don't wait to eat until you're starving because you'll eat too much."

His father, Victor Lopez, said the entire family has benefited from the knowledge they bring back from the classes, especially with food choices and meal planning.

But too many others are stuck in inactive lifestyles and are consuming unhealthy foods.

Diabetes threat: Lombardo Palma, a Murray doctor, sees the repercussions of overeating every day. Latinos make up more than 60 percent of his clientele, and most are uninsured.

His greatest concern is the growing number of children who have Type 2 diabetes, which is usually referred to as adult-onset diabetes. Type 2 diabetics have too little insulin or can't use it effectively. Weight problems are a main culprit.

"Type 2 diabetes usually happens in adults only," said Palma, who is a native of Nicaragua. "Now were's seeing little kids with Type 2 diabetes, and most of them are overweight. We've never seen that before. It's a new phenomenon."

He attributes the childhood weight epidemic in part to cultural differences.

"Part of the problem is in Latin America in general there is not enough money to buy food to get fat," he said. "In Latin America, children are skinny, and there is a lot of malnutrition. Then immigrants come to a country where food is available, and they increase their intake without exercising."

One 10-year-old boy he is treating weighs 107 pounds but should be closer to 80 pounds.

"We have to make people aware," Palma said. "But a lot of people don't have insurance, and don't go to the doctor. And there are language barriers and economic barriers. If a dietitian doesn't have an awareness of that culture, they can't help introduce an entirely different diet."

American Indians are having troubles too, with 64.9 percent of the population considered overweight or obese.

The problem for Indians: Lillian Tom-Orme, a research assistant professor at the U.'s Department of Family and Preventive Medicine, grew up on the Navajo Reservation, and has closely watched the changes in physiques and lifestyles there.

She believes wholeheartedly in the universal theory that people are consuming more calories and exerting themselves less. She has a unique perspective from her time on the reservation.

When Tom-Orme was a young girl some 40 years ago, parents expected their children to wake up early to help out with the chores. They fetched firewood and water, tended to sheep, horses and cattle and did other work.

"Most of the children on the reservation don't have physical education programs anymore," she said. "There are not many organized family activities, and the children are allowed to watch a lot of TV. There also are a lot of celebrations where large portions of food are served."

Type 2 diabetes is common among overweight American Indians. Of 15 tribes studied in Oklahoma, 77 percent of adults screened for diabetes were obese, according to the American Obesity Association.

Of Utah's 28,257 American Indians, 7 percent have diabetes, which is higher than whites at 4.4 percent. The Indian Walk-In Center in Salt Lake City offers counseling for diabetics who take advantage of it, but many people are unaware of their condition or don't manage the disease properly.

Diabetes also is a problem among blacks, with 7 percent of Utah's 16,438 residents having it.

Many Type 2 diabetics can successfully control the disease with diet and exercise under the supervision of their doctors.

For many blacks, the Marshall White Center in Ogden provides an inexpensive place to work out. The center encourages everyone in the community to come use its treadmills, weight room, gymnasium and pool. Blacks make up the majority of the clientele.

"We need to set aside time for exercise," Gerod Sawyer, the center's director said. "People have poor diets and sedentary lifestyles. We're just not active enough. We're in the computer generation. We want everything faster, and we're busier."

Perhaps more so than other minorities, Pacific Islanders are gaining weight in extremely large numbers even though they are one of the state's smallest ethnic groups. And experts are puzzled about the reasons why.

Making plans: Seventy-three percent of Utah's 16,438 Pacific Islanders are overweight or obese. Native Hawaiians and Samoans are among the fattest people in the world, according to the U.S. Department of Health & Human Services.

Additionally, Native Hawaiians, Japanese and Filipino adults living in Hawaii were about two times more likely to have been diagnosed with diabetes compared to white residents, according to the Asian and Pacific Islander American Health Forum Health.

Those numbers worry Owen Quinonez. In his new role as coordinator for the Utah Department of Health's Center for Multicultural Health - he was hired in September - Quinonez wants to eventually design programs to focus on obesity among Utah's ethnic populations.

"People are working hard, don't have time to prepare foods, and a lot of parents use fast food as a reward for good behavior," he said. "People also don't walk as much and rely on cars or public transportation more. We need to find solutions, and we need to educate people."

Facts about harmful fats

* Hydrogenated fat: Trans fatty acids are created when food processors "hydrogenate" fat to solidify it.

* Why hydrogenate? Hydrogenation increases the shelf life of many kinds of processed foods.

* Look for the label Food labels show fat content, including trans fat and saturated fat, which is the kind of fat that promotes the formation of cholesterol.

* Behavioral Risk Factor Surveillance System, 1999-2003, ages 18 and over.

** www.obesity.org