She walked to the bathroom with her head lower than her self-esteem. As she looked in the mirror, she lost sight of herself. She did not see her smile, beauty or intelligence. Instead, she saw a chunky girl whose life was about to follow that of her family, of her community. She saw obesity and diabetes.
According to the American Diabetes Association, about 13 percent of Latinos living in the U.S. have diabetes. Only about eight percent of non-Latino whites have diabetes.
Type 2 diabetes has become common within the Latino community, says Dr. Janiel Pimentel, a pediatric endocrinologist at Phoenix Children's Hospital. She has seen patients as young as 11 and 12 years old.
The main factors contributing to the rise of diabetes among Latino youth include genetics, lifestyle and environment, says Erica Soltro, a post-doctoral fellow under Ph.D Gabriel Shaibi, at Arizona State University. Soltro works on diabetes prevention programs in Latino youth funded by the National Institutes of Health.
“The socioeconomic status, access to food and poor dietary habits are contributing to obesity,” Pimentel says. "Obesity can eventually lead to diabetes."
“I believe that eating healthy, maintaining good weight and exercising can delay the development of Type 2 diabetes,” Pimentel says.
However, Pimentel says these families do not have the resources to follow an ideal lifestyle.
For example, in certain areas of the neighborhood, it may not be necessarily safe for the children to play outside or the parks may not be maintained, Soltro says. These families cannot afford a gym membership either.
This makes it difficult for the children to develop good physical activity habits. It becomes even harder to create these habits at an older age.
Also, the families cannot afford to eat fresh. Due to their socioeconomic status, they cannot afford the luxury of buying fresh fruit for breakfast. Instead, it is more affordable to buy sugary cereals for breakfast, Soltro says.
These poor dietary habits ultimately come from a lack of money and lack of knowledge. Soltro says.
These families simply do not have the resources needed to live a healthy lifestyle, Pimentel says, adding that economics is a big part of the diabetes epidemic.
“Parents are fostering an environment that supports unhealthy behavior,” Soltro says.
This leads back to the lack of access to health information and knowledge.
Soltro believes there needs to be a link between the community and medical center. There is a hunger for nutritional knowledge. However, the resources are just not there or they are not well known.
“My main goal in the research I do is to connect them to their resources,” Soltro says.
If diabetes is not maintained properly, it can develop into a much more serious health problem. “We now see people dying younger and younger,” Pimentel says.
According to the American Diabetes Association, diabetes was the seventh leading cause of death among Americans in 2010.
“Fight for your health and fight for your family,” Soltro says. “Every little step counts.”
To help the community take these steps, ¡Viva Maryvale! was created.
¡Viva Maryvale! is a two year family based diabetes prevention research study for Latino families with obese youth living in Maryvale. All the families receive exercise, nutrition and wellness classes for 12 weeks.
The families also work together to develop a community website. This community website documents different community resources that could be used to maintain a healthier lifestyle.
According to a community health assessment conducted by the Maricopa County Department of Public Health, Hispanics believe diabetes is the most important health problem impacting their community.
It is the seventh leading cause of death in Maricopa County, according to the Arizona Department of Health.
¡Viva Maryvale! is a collaboration between Arizona State University, YMCA, Maricopa Integrated Health System and St. Vincet de Paul.
Arizona State University provides the space fro research and evaluation. The YMCA is a used as a place fro affordable family fitness.
Meanwhile, St. Vincent de Paul provides nutritional education and Maricopa Integrated Health System is used as the medical home.
"The idea behind the research study is that by delivering exercise, wellness and nutrition intervention then there will be a reduction of contributing factors to diabetes," says Crystal Ramos, the ¡Viva Maryvale! program coordinator.
There are three main goals behind ¡Viva Maryvale!, reduce diabetes risk for the families participating in the study, measure acceptability of the research studies from the families and measure feasibility in the way the collaborating organizations work together in the research study, Ramos says.
To reach this goal, ¡Viva Maryvale! partnered with Mountain Park Health clinic to assess fasting glucose and insulin. Only the first year of the study has been completed. Once the study has been completed, the data will be analyzed.
This data will determine the effects of the lifestyle intervention on diabetes risk factors and health outcomes.
The study has shown a large acceptance by family feedback, Ramos says. There was 95 percent total attendance for the first year of the research study.
According to feedback from families, it seems they truly enjoy the research study and wish they could have continued longer, Ramos says.
"The youth all enjoy the program and it seems to be a safe place where they are accepted by everyone," she says. "Parents also feel like they have learned a lot from both the nutrition and exercise portion of the research study," she adds.
After the completion of year two, there will be more statistics about the effectivity of ¡Viva Mayvale!
