As a child, Terrol Dew Johnson expected to lose a leg one day. It
was what happened to the elders. They got “bad sugar.” They
became sleepy, their circulation slowed and inevitably
they underwent amputations. It had happened to his
grandmother, and Johnson assumed it was something
that occurred later in life.
<p> Not that the teachers on his reservation in Arizona didn't try to convince him otherwise. The reservation today has the highest rates of diabetes in the world, and in home economics classes, along with other American Indians, Johnson received lectures and brochures on the benefits of eating healthy. All that talk didn't do much good. His reaction was typical of youngsters: "Oh God. Not another pamphlet." Teachers recommended eating more vegetables like broccoli. But to Johnson such talk was "a white thing." "My grandparents didn't teach me to cook broccoli and cauliflower," he says. They cooked the rabbit they hunted.</p> <p> So he kept on drinking a six-pack of Pepsi every day. By the time he turned 25, he noticed he was irritable and sleepy. After a trip to the doctor, he was diagnosed with Type 2 diabetes. </p> <p> For a person with an empty stomach, a normal reading of how much sugar they have in their blood stream is under 110. Johnson had a reading of 500. The nurse who called him at home to tell him the results of his medical exam asked, "Are you still alive, Mr. Johnson? Are you conscious?"</p> <p> Now 32, Johnson runs a grassroots cultural organization on the Tohono O'odham Reservation, 60 miles west of Tucson, Ariz. More than 50 percent of adults on the reservation have the disease, according to Indian Health Service. The epidemic is largely a result of diets high in starch and sugar and lifestyles that don't include much exercise, experts say. Scientists are also studying whether American Indians have a genetic predisposition for diabetes. But health experts contend that it is not a "diabetes gene" that makes Indians vulnerable. "It's how their bodies have changed with the environment," says Janice Thompson, director of the Office of Native American Diabetes Programs in New Mexico. Experts like her say healthier eating and exercise can make a great difference in preventing diabetes and in managing the disease.</p> <p> In response, Johnson's organization is harvesting desert foods like tepary beans that were once common among his people. The foods, low in sugar, harken back to a time when diabetes did not prevail in Indian Country. </p> <p> A similar story is unfolding on the White Earth Reservation in Minnesota, where a group founded by Winona LaDuke is providing foods like wild rice and buffalo meat to about 200 elders who suffer from diabetes and have severely limited incomes. Organizers there also hope that these foods—low in sugar and fat—will help diabetics. It is a hope that carries much urgency for American Indians across the country, among whom diabetes has increased by 50 percent in the last ten years, according to the Indian Health Service. And what happens for Indians and what they do to fight the disease is of particular interest to other communities of color. According to the Centers for Disease Control, African-Americans and Latinos are two to three times more likely than whites to have diabetes.</p> <p> Despite these dire statistics, Johnson is chipper and enthusiastic. A basket weaver and artist, he believes that more native people will soon discover the joy of eating tepary beans—and not just to lower their blood glucose readings. What's his selling point for eating this healthy food? It's good for your cultural identity.</p> <p><strong>Back to the Bean</strong><br> Tepary beans were once in abundance in Arizona for the Tohono O'odham, also known as the Desert People. The beans, which are white or brown, are eaten plain or added to stews. In the 1930s, about 1.3 million pounds of tepary beans were produced on the reservation. By 2001, only 100 pounds were harvested. Much happened in the intervening 70 years. Indians went to fight in world wars, and others went to the cities for jobs. The land fell idle, production dropped and diabetes rates began to soar. </p> <p> The Tohono O'odham reservation straddles the United States border with Mexico, which essentially separated the Desert People into two countries. The reservation, the second largest in the country, is about the size of Connecticut. Along with the high rates of diabetes, it has high rates of poverty and unemployment: 47 percent of families with children under the age of five are living in poverty, and close to 60 percent of people don't have work, according to the 2000 Census. </p> <p> In 1996, Johnson connected with Tristan Reader, a community gardener on the reservation. The two men applied for grant money to start Tohono O’odham Community Action, an organization now better known by its acronym, TOCA. They offer classes in basket weaving and other traditional arts and run a youth and elder program. And they began harvesting desert foods in Reader’s community garden. In 2001, they cleared the 30-acre farm that had once belonged to Johnson’s grandfather, who died from diabetes complications. They began growing and cultivating tepary beans, and last year they harvested 10,000 pounds of the beans. Because Type 2 diabetes is the result of the body not being able to break down sugar, tepary beans, which are low in sugar, are a helpful addition to the diet of a diabetic.</p> <p> The tepary beans are now being sold for about five dollars a pound at Bashas’, the reservation’s sole supermarket, as well as in trading posts throughout the reservation. The organization also gave away surplus crops to about 100 community members at their second annual harvest celebration. But the beans aren’t just for Indians. The white tepary beans are sold online for about $19 for two pounds through <a href="http://www.heritagefoodsusa.com" target="_blank">Heritage Foods USA</a>, a company that sells rare crops and livestock. The profits from selling the beans online have helped TOCA buy more equipment to harvest more foods for the community. Another desert food, the cholla bud, is also sold online. It's similar to the texture of okra and can be roasted or sauteed. Cholla buds are also low on the Glycemic index, because they slowly release the food's glucose into the body so there isn't a sugar rush. </p> <p> Johnson is not just excited about how healthy these foods are. "You're not just seeing these beans," he says. "You're seeing the whole culture. That bean holds our language, our songs, our history." </p> <p> Young Indians, as well as older ones, have been alienated from their own culture, Johnson says, and he thinks these foods can reintroduce them to the traditions. After all, these foods are used in ceremonies and carry the stories of the Desert People. For example, it is said that when Coyote was running with a bag of tepary beans, he tripped and the white beans flew into the sky, creating the Milky Way. </p> <p> Chuckling, Johnson says, "That's all I'm going to tell you because I'm not supposed to be telling legends." But these stories are part of the importance of traditional foods, he argues. "We don't know traditional songs about broccoli," he says and then poses a question that most people would be stumped to answer: What story are you going to tell about broccoli?</p> <p> TOCA now has a staff of seven, and tepary beans are served at the local hospital once a week. The beans will soon be cooked up at the Santa Rosa Boarding School on the reservation, and Johnson is excited to teach kids about their culture through these foods. He and his staff are also talking with the local WIC program about having cholla buds included in a new program that offers alternative food options for mothers and their children.</p> <p> Johnson's own diet has changed since he was diagnosed with diabetes. He doesn't drink soda anymore, and he eats tepary beans twice a week at least. He has begun to work out on the reservation. But he admits he stops at the fast food places near his home in Tucson. There's a bevy of them: Taco Bell, KFC and Jack in the Box. At 6' 2", he weighs 300 pounds.</p> <p> Convincing people to return to any kind of traditional diet could be challenging. Food is much more emotional now than it was a hundred years ago, says Janice Thompson. She is leading research on Indian girls in Albuquerque who don't have diabetes and those whose blood glucose levels are high enough to make them pre-diabetic. Girls and women are more likely to develop diabetes, she says. Research is not conclusive yet as to why, but one reason might be that girls are less likely to be encouraged to exercise, she says.</p> <p> According to Thompson, young people are unlikely to cook or prepare meals at home. So she's not sure that they would take to tepary beans or other traditional foods. She insists on practicality, teaching the young women to eat less when they eat out. Thompson also questions the idea that everything traditional is good. Fry bread, she points out, is fried dough, and it's considered a traditional Indian food.</p> <p><strong>Uncontrolled Diabetes</strong><br> As with many communities, the history of Native Americans can be found in the story of their foods. Hollow Bone, an elder and healer who lives on the White Earth reservation in Minnesota, says that in the migration story of his people, they were told that they “would come to the land where the food grew above the water.” What they found was wild rice, which grows in lakes and rivers in what is now Minnesota. To reach the rice, people go out in canoes and carefully harvest the rice by hand. </p> <p> Of course, besides wild rice, what Hollow Bone’s ancestors also found was the white man, and in the 1800s, as the federal government forced Indians onto reservations, Indians were cut off from hunting and given rations. Thompson relates that the government gave “bags of refined sugar, flour and lard and said, ‘Here, survive,’ because the government was trying to annihilate them. Amazingly, they survived.”</p> <p> So, the diet that developed in Indian Country was one to “stretch the budget,” says Hollow Bone, who grew up in northern Minnesota. Foods like fry bread came to be thought of as traditionally native. So much so that in her column for <em>Indian Country Today</em> native journalist and poet Suzan Shown Harjo wrote to say her new year’s resolution was to ban the fried dough from her own diet. She called on others to follow. Harjo, the president and executive director of the Morningstar Institute, a national Indian rights organization, wrote that fry bread was neither healthy for the body nor the culture, having become a stereotypical image associated with Indians. </p> <p> A diet of “bacon and grease” resulted in increased obesity and a spike in the rate of diabetes among Indians. Today, they are 2.6 times more likely to have diagnosed diabetes than whites, according to the National Diabetes Information Clearinghouse. </p> <p> However, if the disease went unchecked in Indian Country, experts believe it had to do with the message that people received. There’s been a lot of fatalism, says Thompson. “When you’re told by your doctor that you could get diabetes, you don’t hear the ‘could’ part,” she says. “What they hear is that you’re going to die tomorrow because of your race.” </p> <p> That message began to change three years ago with the Diabetes Prevention Program, a nationwide clinical trial funded in part through the U.S. Department of Health and Human Services. The trial established that a diabetic who ate healthier and exercised had better results than one who only took medication and didn’t alter their lifestyle. The research surprised nutritionists, says Thompson. The emphasis in diabetes programs had been on the medication part. Now they knew that diet could make a huge difference.</p> <p> That message, though, has yet to make its way into Indian Country. At the White Earth Health Center, nutritionist Gail Gardner still sees that Native Americans continue to receive mixed messages about what diabetes is. What they see on the news is that diabetes is raging in Indian Country, she says. “It’s not diabetes,” she notes, “it’s uncontrolled diabetes.”</p> <p> About 700 patients at the health center have diabetes, she says. Poverty rates are also high on the reservation. All children at the Pine Point Public School there qualify for free lunches, according to the White Earth Land Recovery Project.</p> <p><strong>Getting the Good Commodities</strong><br> Hollow Bone reports that changing his diet has been hard. The 60-year-old was diagnosed with diabetes ten years ago. At the time, he drank a gallon of milk a day, and even now he concedes that, “when I drive by Dairy Queens, my car automatically turns in.” But the disease has taken its toll. Six years ago, he underwent open heart surgery because of clogged arteries. Since then, he’s had to take insulin every morning and evening. </p> <p> Once a month, he receives a package of traditional foods from the White Earth Land Recovery Project. The package usually includes buffalo meat and wild rice. Sometimes it includes foods that have been donated, like potatoes. It is a welcome relief to elders on the White Earth Reservation, where the median income is less than $10,000 a year. At the supermarket, buffalo meat is just too expensive for most Indians, says Becky Niemi, development director for the White Earth Land Recovery Project, who adds that traditional foods are out of reach for most Indians.</p> <p> The Mino-Miijim, or Good Food, program began in 2001 when Margaret Smith went knocking on doors on the reservation. She wanted to find out how many other elders like herself had diabetes and needed access to healthy food. The program started with 75 people, and four years later it has more than doubled to 180. Elders have to be 55 years or older and qualify for federal assistance like food stamps and social security. If the organization had more financial support, they could easily reach many more people, Niemi says. It takes Smith a week to travel across the reservation with those foods. Many of the elders remember the traditional foods from ceremonies. They call them the “good commodities,” Niemi says. It is a way to distinguish the food from the cheese and canned pork that the federal government gives. </p> <p> Yet, even as the program helps diabetic elders, LaDuke’s group is fighting to preserve the wild rice. The University of Minnesota has finished the genomic map of the wild rice, opening the way, community activists say, for corporations to patent the rice and sell it at a profit—effectively making the rice too expensive for most Indians.</p> <p> It is an issue that infuriates Hollow Bone, who talks about wild rice on his weekly radio show on KPRM-AM (870). He recalls that when he was growing up, he ate the fish his grandfather caught. The family used cans to save the grease from one meal to cook the next. Now, he eats wild rice about two times a week and says that the foods from the Good Food program help keep him on track with his diet.</p> <p> Despite his private ordeal with diabetes, Hollow Bone has maintained his sense of humor. He says laughter is a way of letting the spirit come into the body, and he even jokes about diabetes and how much fry bread his community eats. “The creator must have given us wild rice,” he says, chuckling, “because he knew how much fry bread we were going to eat.”</p>