As we discussed earlier in class, I mentioned the Pima Indian tribe and how obesity is related to type 2 diabetes here is some more insight on this topic that I have researched.
Type II diabetes is most prevalent among Native Americans especially the Pima of Phoenix, Arizona. Another Indian population that’s starting to be recognized for this epidemic is the Navajo Peoples, the largest tribe in the southwest. Both of these tribes are having an increased rate of diabetes among their population especially the younger generations. This increase is causing an exponential spike in health related issues from this disease. It also has put a financial strangle hold on the Indian Health Care programs and facilities. Not only has these two tribes been affected with this disease it has caused a cascading effect of assorted health care issues.
The Pima Tribe has been a part of a thirty year study relating diabetes with obesity. At the start of the study the Pimas incidence rate of having type-II diabetes was rising exponentially. Scientists have proven that obesity is a major risk factor in the development of diabetes. One-half of the adult Pima Indians have diabetes and 95% of those with diabetes are overweight (The Pima Indians). This result for this chronic disorder stems from the Pima and Navajo Indians eating high caloric foods. These foods are processed and refined. For thousands of years these Indian communities relied on hunting, farming, and fishing for food. The Pimas experienced seasonal droughts and hardship causing feast or famine. For these peoples to survive such periodic hardships of famine, scientists theorized they developed a “thrifty Gene.” This gene allowed these people to store fat when they feasted and in times of famine this fat storage would be used as fuel so they wouldn’t starve to death. This was their safety mechanism to survive as long as caloric intake was extremely low. Present day Native American tribes have assimilated to modern-day western lifestyles and diet. The “thrifty gene” began to oppose this new diet (redefined and processed high fat, sodium, and caloric foods), continuing to store calories in preparation for starvation mode. Researchers believe this opposing lifestyle has contributed to obesity. This gene once protected the Native Peoples from starvation but is now the reason behind chronic type II diabetes amongst these tribes.
Today diabetes is an epidemic in this country and is rising with no end in sight. The tribes that I have mentioned above, top the statistics of prevalence of type II diabetes. At least fifty percent of their population has this disorder and it’s starting to affect the younger generations which in turn will reach epidemic proportions among children. With this disease that cause multiple heath issues patient awareness through community education is critical. This in turn would reduce their risk for complications. By understanding the disease process and being aware, people can practice the skills necessary to better control their diets and maintain a more normal blood glucose level. These preventative measures would decrease health problems, obesity issues, and help by decreasing the economic effects on their health care system.
There is no doubt that the Pimas from Arizona were the trail blazers in diabetes studies. With the compiled research found on this tribe it has helped to pave a smoother understanding of how genetics and environmental changes cause such a crazy disease.
This is a very interesting topic and if you are interested in this kind of research I encourage you to read more about this issue with the Pima Indians and their relationship with type 2 diabetes.
Many of our professors here in Arizona have talked about the extreme health crisis that is currently affecting the Pima Indian population. Despite this coverage in our lectures the Pima Indians still seem to have some of the worst health statistics in the world. I wanted to know whether sufficient research is being done to address this health problem. When I did a search for "Pima Indians Diabetes" an astounding 693 articles were generated. Hopefully most of these studies have actually improved the health care of this population. If I was a member of this population I would be afraid that scientists would be using my community just as subjects for research with no intent of improving their health. Do you know if this has led to any hostility against scientific research being done on this population?
ReplyDeleteI also wanted to point out that the Pima Indians have higher rates of diseases that are not directly metabolically related. I found an article which showed that Pima Indians have Rheumatoid Arthritis at rates that are ten times higher than the national average. Hopefully issues such as Rheumatoid Arthritis can also be added to this discussion on the health concerns regarding the Pima Indian population.
Am J Epidemiol. 1989 Jun;129(6):1170-8.
High incidence and prevalence of rheumatoid arthritis in Pima Indians.
Del Puente A, Knowler WC, Pettitt DJ, Bennett PH.
Source
National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Phoenix, AZ.
http://www.ncbi.nlm.nih.gov.ezproxy1.library.arizona.edu/pubmed/2786329
The thrifty gene, once an evolutionary advantage to survive, is creating havoc for the Pima Indians. As stated, the thrifty gene allowed for the Indians to store fat in times when food was scarce. However, food scarcity is no longer a factor, but rather the present problem is an excess diet with little exercise, so the storing of fat is no longer useful and is causing serious weight gain.
ReplyDeleteWhat I most appreciate about this blog is the framework that offers obesity as the initial insult that results in inflammation. A paper discussed in class visited the idea when adipocytes enlarge to a volume that cannot be properly perfused by a blood supply eventually leads to necrosis which then triggers an inflammation response. Without significant reduction in the adipocytes size, we could induce that chronic inflammation would be a plausible outcome to an obese state. With chronic inflammation, we could hypothesize that this state leads into subsequent diseases, for example type 2 diabetes. We also discussed the link between inflammation and Insulin resistance (IR). The pro-inflammatory TNF alpha seems to be a culprit to what leads to IR, which eventually leads to type 2. Thinking about the chronic inflammation that exists in obese individuals, it's easy to understand how obesity is a precursor for type 2 diabetes.
Reference:
O'Rourke RW. Inflammation in obesity-related diseases. Surgery 2009; 145: 255-9.