O'odham Foods and Diabetes

Wheat flour makes me sick!  I think it has no strength.  But when I am weak, when I am tired, my grandchildren make me gruel out of the wild seeds.  That is food.

                                       – Maria Chona, 1933, Autobiography of a Papago Woman


The wisdom and practical knowledge of traditional peoples has often been discounted as anecdotal at best.  However, when 90-year-old Maria Chona spoke these words 70 years ago, she provided an accurate assessment of the effects of nontraditional foods on the health of the Tohono O’odham.


The solution to the diabetes problem among the Tohono O’odham community is both extremely easy to identify and maddeningly difficult to achieve. Maria Chona correctly identified the need for the Tohono O’odham to consume traditional foods in order to be strong and healthy.  A simple return to a more traditional diet and increased physical exercise would surely be a major step in solving a health problem that is devastating the Tohono O’odham community.


Over the past two decades, several scientific studies have confirmed what the Elders had known: traditional Tohono O'odham foods — such as tepary beans, mesquite beans, acorns and cholla buds — help regulate blood sugar and significantly reduce both the incidence and effects of diabetes.  Over the course of many centuries, the Tohono O’odham metabolism had become especially well adapted to the foods of the Sonoran Desert.  Unlike the traditional foods that helped control blood sugar levels and increase insulin production and sensitivity, the “Western” diet overwhelms the O’odham metabolism, leading to high rates of obesity as well as diabetes.


The more desert foods are studied, the clearer it becomes that the co-adaption between the “People of the Desert” and the Sonoran desert extended to nutritional levels. O’odham foods are “superfoods,” high in key vitamins, micronutrients, and fiber. Even sweet desert foods, like agave syrup or prickly pear fruit, have very low glycemic index ratings. (It is for this reason that agave nectar has recently become the “new” sweetener on the market, available from CostCo to Trader Joe’s.)


Research indicates that native foods can prevent the onset of type-II diabetes and obesity endemic in native communities in general and the Tohono O'odham community in specific. While the cause of high rates of diabetes and obesity among the Tohono O'odham/Pima is unclear – theories of "thrifty genes," "New World Syndrome," and geographic/genetic isolation have been suggested– decades of scientific research demonstrate that processed sugars are simply digested differently by Pima/Tohono O'odham than non-native people. As a result, glucose levels and insulin intolerance outpace others.


In other words, junk food is "junkier" for the Tohono O'odham; processed foods affect native peoples more negatively. Soda is the worst. Conversely, native foods do not produce the negative metabolic effects. A number of  studies indicate that tepary beans, for example, seem to provide some protection against the onset of type-II diabetes. (References to technical scientific reports can be found on this page. A general bibliography follows the full article.)


Extensive medical research validate TOCA’s approach -- and Maria Chona’s insight -- regarding desert foods.


Two primary attributes of traditional foods are thought to contribute to reductions in both the incidence and severity of diabetes:


1) The soluble fiber, tannins and inulin in one group of traditional foods (which includes mesquite bean pods, acorns and tepary beans) helps reduce blood sugar levels, slow sugar absorption rates, and improve insulin production and sensitivity.  Indeed, these foods are known to be among the 10 percent most effective foods at controlling blood-sugar levels.


2) A complimentary group of traditional foods (including prickly pear fruits and pads, cholla cactus buds, chia seeds and mesquite bean pods) contain mucilaginous polysaccharides gums that slow the digestion and absorption of sugary foods.


Combined, these two categories of desert foods prevent and reduce the effects of diabetes.  When further supported by increased physical activity, positive health outcomes can be quite dramatic.


Limits of Conventional Medicine


As doctors, we cannot solve the diabetes problem; we can only try to manage and treat the effects.  The solution rests in the people’s hands: the foods that have come from the desert for centuries.

                                                                        – Indian Heath Service Physician, Sells, AZ


As a disease of “modern times,” with no cure, diabetes confronts conventional Western medicine’s limited abilities to effectively respond.  Although there are medicines that can help control blood sugar levels and mitigate some of the worst effects of diabetes, the effectiveness of these treatments is usually overwhelmed by diabetes’ progression.


One indicator of the ineffectiveness of conventional medicine is the number of Tohono O’odham who have experienced severe kidney damage as a direct result of diabetes.  Despite the best efforts of doctors, about 10%  of all Tohono O’odham diabetics are forced to undergo regular dialysis.  Circulatory problems and loss of eyesight are also common among Tohono O’odham diabetics.  All of this has combined to create a situation in which Tohono O’odham life expectancy in more than six years shorter than the national average.  At least as important, the richness and quality of life of O’odham diabetics, their families, and the community is greatly constricted. Diabetes erodes lives, families, and communities, and medical science has no “magic bullet.”


As time passes, these food-related health problems become more severe. A recent study in The New England Journal of Medicine analyzed the longitudinal health data of 4,857 Pima and Tohono O'odham  and Pima children born between 1945 and 1984. The Indian Health Service had records of 40 years of children's vital signs. The average age of the children was 11 years old when they were first examined for glucose levels, BMI, blood pressure, and cholesterol information. Decades later, researchers traced health records of the 4,857 individuals to see how long they actually lived. The mortality rates are sobering. The researchers documented high rates of premature death, with life expectancies cut to only 55 years of age. The adults who, as children, had been measured at the highest body mass indices (BMI) were 2.3 times more likely to die prematurely. Those with the highest glucose levels were 73 percent more likely. The report concludes that "obesity in children, even pre-pubescent children, may have very serious long-term health effects through midlife" ("Child Obesity Risks Death at Early Age, Study Finds," New York Times, Feb. 11, 2010.)


In the article, one researcher is quoted as anticipating similar health problems in the U.S. mainstream, describing the Pima/Tohono O'odham medical trends as "just a decade or two ahead of the rest of the U.S. population." The researcher glosses over unique aspects of American Indian reservation life, including the disproportionately high rates of poverty, alcoholism, and suicide. Moreover, debates about metabolic differences between native and non-native populations cannot be ignored. Numerous studies have demonstrated that Pima and Tohono O’odham metabolize sugars differently, resulting in an increased propensity to gain weight. While the causes are unclear, it is unfortunate that the researcher seeks to analyze the data only in terms of mainstream society. For however poorly this study may predict health in the U.S. mainstream, it clearly warns that today's Tohono O'odham children face a real and deadly threat to living past middle age.

Terrol Johnson, Tristan Reader, Co-founders of Tohono O'odham Community Action