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Discrimination and Diabetes

David Spero

March 25, 2009

The prevalence of diabetes is at least twice as high in some ethnic groups as it is in whites. This is true even among people with similar body mass index (BMI) numbers, a large new study finds. According to a press release about the study (which was published in the journal Ethnicity and Disease), Gertraud Maskarinec, MD, PhD, and associates report that, “the effects of body weight and diet appear to differ depending on an individual’s ethnic background. Moreover, differences in prevalence among different ethnic groups persisted in normal-weight and underweight participants" [emphasis mine]. In other words, there’s a lot more to Type 2 diabetes than weight.

The study reported on data from surveys of nearly 187,000 people in Hawaii and California. Of the total, 11.6% reported having diabetes. However, age-adjusted diabetes prevalence was 16.1% in Native Hawaiians, 15.8% in Latinos, 15% in African-Americans, 10.2% in Japanese-Hawaiians, and 6.3% in whites.

Of course (of course!), the researchers blame the differences on genes. If it’s not fat that causes diabetes, what else could it be? “It is very difficult for us to understand,” said Maskarinec, “but there are different ways for being at high risk for diabetes.” If she had read my book, Diabetes: Sugar-coated Crisis, she would know about some of these ways already. But most scientists just can’t shake the idea that genes and fat are all there is to it.

In the press release about the study, Matt Petersen of the American Diabetes Association (ADA) is quoted saying, “Clearly, genes are involved in allowing Type 2 diabetes to happen. Genes allow you to put on the weight, and a lot of different genes can contribute.” So even with the genes, it’s all about weight to them.

The Stress of Discrimination
The researchers, the ADA, and the reporters all ignore the contribution of stress. As I’ve reported here, here, and here, stress directly causes insulin resistance and abdominal fat. It also encourages people to eat more as a stress reducer.

The reason ethnic minorities, low-income people, and unemployed people have so much diabetes is NOT mainly due to health behaviors. Studies like this one show that all behaviors combined explain less than 40% of the difference between the healthiest and the least healthy groups. The rest of it is due to the higher stress levels of, say, being an immigrant, being isolated, having economic difficulties, or being discriminated against.

Remember that other kinds of discrimination also cause stress. The prejudice against overweight is a good example. Negative social attitudes toward weight could cause more health damage than the weight itself does.

How Can You Protect Yourself?
The billion dollar question is, what can you do to protect yourself and your family from the stress of discrimination, economic problems, and other stresses?

Here are links to two approaches that can help: Learning to cope with stress and learning to reduce stress.

But the only cure would be changing the social conditions that cause stress. That’s the sad reality. The inequality, economic hardship, isolation, and insecurity in our modern society make people sick. I hope we can change some of these conditions.

Breathing and Stress
One of the best ways to cope with stress is through focused breathing. A new study finds that “paced breathing” lowered blood pressure in people with Type 2 diabetes with hypertension.

This study is a bit suspect, because it was paid for by a company that makes the “paced breathing” equipment. Made in Israel, the RESPeRATE device, “interactively guides the user toward slow and regular breathing by synchronizing respiration voluntarily to musical tones for 15 minutes daily,” according to Dr. Moshe Schein, the lead researcher.

Sounds like fun, but you can do the same thing on your own with meditation. I recently started doing seated Qi Gong meditations every day, and I do feel much more relaxed.

I got a DVD that shows you these very gentle exercises — like lifting your arms and moving them different ways. You do it slowly and focus on the breathing the whole time. In part of the program, the instructor has you breathe in, then breathe out 50% of your breath (or 10% or 80% or 30% — he keeps changing it). Then you breathe in again and breathe out fully.

This is called “breath control.” You go through about six of these cycles in 45 minutes. The rest of the time, you’re just breathing deeply, focusing, and moving your hands and arms.

I don’t know what this is doing to my blood pressure yet, but I definitely feel better. It’s just one kind of meditation, but I encourage everyone to try something like it.

Your Take
Ephrenia wrote in last week talking about how much stress there is and how it affects her. I’m sure she’s not the only one. What have you tried for reducing stress? What works for you?



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