In the kingdom of fats and sugar

With limited access to affordable fruits, vegetables and other healthy foods, Mexicans living in New York are frequenting fast food restaurants instead of farmers' markets. The result is a spike in obesity and diabetes among this immigrant group.

This story was originally published in Spanish. Below is the English translation.

Part 3: In a sedentary country

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Sandra Bravo receives a medical checkup. Gerardo Romo/EDLP

New York — When Sandra Bravo gets home after spending the entire day cleaning other people’s houses, she does not have any motivation, or time, to start cooking.

The 28-year-old Mexican, a native of Guerrero and mother of two children (ages 10 and 5), usually buys fast food on her way home. She knows—and admits—that this is not the healthiest option for her family, but says she has no other choice.

“The work itself makes it so that we eat fast food. If I go to work, come back, pick up the children and then have to get home and give them something to eat, then I don’t have time to cook, so I go and buy something quick: McDonald’s or Chinese rice,” said Bravo, who has been living in New York for 10 years.

When asked how often she eats this type of food, she quickly answers: “We eat hamburgers from McDonalds generally once or twice per week, but sometimes three times, when there is no time. ... It is the cheapest food you find here,” she admits.

Although in most cases it is not a voluntary decision, studies have shown that many Mexicans who immigrate to the U.S., like Bravo and her family, trade their traditional diet based on corn, cereals and legumes, for a fast food diet of pizzas, hamburgers and sodas.

According to the Center for Science in the Public Interest (CSPI), which last June 22 demanded publicly that McDonald’s stop including toys in Happy Meals, a lunch or dinner at the restaurant (cheeseburger, French fries and chocolate milkshake) has 700 calories. That is more than half of the 1,300 calories recommended by pediatricians and nutritionists as the daily intake for children 4 to 8 years old.

“The longer they are in the U.S., the more ‘junk’ food they eat. In our analysis, we found that the consumption of fruits and vegetables decreases very much with acculturation,” said Dr. Rafael Pérez-Escamilla, author of the study “The Role of Acculturation in Nutrition, Lifestyle, and Incidence of Type 2 Diabetes among Latinos.”

“More meals are consumed outside the home, and generally in the neighborhoods where poor Hispanics live, the food available on the street consists of hamburgers, fried chicken—relatively cheap foods, extremely high in calories and very low in nutritional value,” adds Pérez-Escamilla, a professor of nutrition sciences, epidemiology and public health at the Yale School of Public Health.

In addition to the large amount of calories, the CSPI says that a Happy Meal contains seven grams of saturated fat (half of the recommended limit of 14 grams), 940 milligrams of sodium (about three-fourths of the 1,200 milligram limit) and 35 grams of sugar (twice the daily amount).

The problem immigrants face with their diets was reflected in a survey of community health conducted in 2007 by the New York City Department of Health. When people were asked if they ate the five or more servings of fruits and vegetables recommended daily, 95% of Hispanics answered “no.”

Dr. Walid Michelen, director of the clinics of Health and Hospitals Corporation in Upper Manhattan, a New York neighborhood with a growing number of new Mexican immigrants, warns that when these people “consume those cheap foods, they end up gaining weight,” and that obesity represents a higher risk of developing Type 2 diabetes.

“A study found that 65% of Mexicans in this country are obese or overweight,” said Michelen.

According to the American Diabetes Association, 2 million Hispanics suffer from Type 2 diabetes (10.2% of all Latinos in the U.S.). Of them, 24% are of Mexican origin, only surpassed by Puerto Ricans at 26%.

Type 2 diabetes is a chronic disease without a cure. It is characterized by the body’s inability to produce or adequately use insulin, a hormone produced by the pancreas that regulates the levels of sugar (energy) in the body. The symptoms are excessive thirst, frequent urination, tiredness and weight loss. If not treated in a timely manner with exercise, diet and medication, diabetes can cause complications like heart attacks, strokes, kidney failure, blindness, amputations and death.

Sandra Bravo does not have diabetes, but she is worried about the disease, which has had grave consequences among her family. “My maternal grandmother died from diabetes, and also because of that one of her legs had to be amputated. Now I have an uncle who is suffering from the same. And my mom, a while back, was diagnosed with juvenile diabetes.”

The young woman, who is uninsured, takes advantage of the free healthcare services offered by the Consulate of Mexico in New York and some hospitals in the metropolitan area to test her cholesterol levels and check her blood pressure. She knows that because of her family history and the type of foods she consumes, she is at high risk of getting the disease. 

Poverty: A determining factor

Experts on the subject state that diabetes is closely linked to poverty. People with fewer economic resources have less access to fresh, healthy foods.

According to the 2007 study “Diabetes in New York City: Public Health Burden and Disparities,” 90% of adults living in poor neighborhoods do not consume the recommended amounts of fruits and vegetables, compared to those who live in areas with higher incomes, who are mostly white. 

“Fruits and vegetables are not so easy for them to get in a low-income community, because there are no large supermarkets, but only bodegas or small stores selling things that are not so fresh. The few vegetables available are expensive, and when you have very limited resources and several children, you try to buy the most while spending as little money as possible,” said Dr. Judith Aponte, professor at the Hunter-Bellevue Hospital School of Nursing.

In the area of Brooklyn County where Sandra Bravo lives, there are no large supermarkets that would provide access to fresh fruits and vegetables. But like in other poor neighborhoods where immigrants live, there are many fast food restaurants. There is no shortage of pizza parlors, Chinese restaurants or chains like McDonald’s and KFC, advertising their cheap hamburgers and French fries and family sized combos of fried chicken.

On the other hand, many of the neighborhoods where immigrants live do not have farmers markets—and if they do, they are available sporadically.

“When the farmers come to Fourth Avenue, we buy fresh things, but they only come during two months, August and September,” Bravo said.

When the family is not there

Most experts consulted for this story agree that a factor influencing the drastic changes in food habits of Mexican immigrants when they arrive in the U.S. is the absence of the family.

“There is a big difference between the immigrant who is here alone working seven days per week, who goes eight hours without eating, and the immigrant who has a family here, who has someone to cook or prepare food at home,” said Jossana Tonda, coordinator of Ventanilla de Salud (Health Window), a program of the Consulate of Mexico in New York

“In Mexico, they are used to eating their three meals per day, because there is always someone at home cooking, but once they get to the U.S. and they are alone, their lifestyle changes and also their diet,” said Dr. Sandra Ayalo, a nutritionist and diabetes educator at Elmhurst Hospital in Queens.

Sandra Bravo agrees with the experts’ opinions. “We change the lifestyle because we come here to work and save, because we want to have one more bill in our purse and send more money to the country [Mexico]. We work many hours and do not eat well, to try to save the most here and send the most over there.” 

Sodas, enemies of the children

Over the past few years, there has been an alarming increase in the cases of Type 2 diabetes in children in the U.S., and Hispanic children are three times as likely to develop the disease as children from other groups, mainly due to the high rates of obesity. The New York City Department of Health estimates that 40% of children are obese or overweight, and 46% of them are Hispanics.

Studies conducted in this city with children from fourth to sixth grade showed that Mexican-American children consume more sugared and artificial drinks than children who are not Latinos, so they are at higher risk of gaining weight.

“Mexicans are the group that consumes the most sugared drinks; soft drinks and sodas,” said Lorena Drago, a nutritionist and diabetes educator at Lincoln Hospital in the Bronx, a county where 12% of residents suffers from diabetes. Drago, who volunteers with the American Diabetes Association, warns that the high concentration of sugar in sodas produces obesity at an early age. “An increase in the waist circumference is considered one of the highest risks for developing diabetes and cardiovascular diseases.”

According to a study conducted as part of the programs to prevent obesity and diabetes at the Children’s Hospital Los Angeles, between 1970 and 2005, the consumption of sugar in the U.S. increased by 19%, and the daily calorie consumption from sodas increased 70%, from 7.8 to 13.2 ounces, resulting in the rate of childhood obesity tripling. The United States is, literally, “drowning in sugar,” said Katrina Kubicek, one of the study’s authors.

Specialists warn that if there is a family history of diabetes, like in the case of Sandra Bravo’s kids, children are at higher risk of becoming diabetic as adults. Because of that, it is recommended that parents speak to a pediatrician about a healthy nutrition plan for their children and make sure that children become more active in their daily lives.

For more information about diabetes, visit these websites: diabetes.org; cdc.gov/diabetes; and ndep.nih.gov.

Pedro.frisneda@eldiariony.com