Ka Wai Ola - Office of Hawaiian Affairs, Volume 10, Number 8, 1 August 1993 — ʻAi pono, e ola [ARTICLE+ILLUSTRATION]

ʻAi pono, e ola

Eat right and live well

by Dr. Terry Shintani

The Hawaiian paradox

Recently, President Bill Clinton and First Lady Hillary Rodham Clinton visited Hawai'i for a number of purposes. One was for Mrs. Clinton, who chairs the President's health reform task force, to learn about Hawai'i's "model" heahh system. Hawai'i is often promoted as

the "health state" because of its unique health-care system and because it ranks first in longevity. Although Hawai'i's model is positive in many respects, its promotion often hides the terrible plight of the Hawaiian people's

heahh. To ensure that the health problems of Hawaiians would not be forgotten, I wrote a paper whieh I called "The Hawaiian Paradox" and presented it at the recent "Food Choices 2000" intemational conference on food, heahh, culture and the environment held at the Ritz-Carlton on the island of Hawai'i July 11-14. I felt it was important to present this paper at the conference

because there were more than 40 international media representatives as well as distinguished researchers such as: Dr. T. Colin Campbell, Cornell University; Dr. Frank Sacks, Harvard University; and Dr. Antonia Trichopoulou, president of the Federation of European Nutrition

Societies. There were also some of the best chefs in the world, and experts on environment and sustainable agriculture present, in addition to over 250 attendees. Following is an excerpt from my paper, "The

Hawaiian Paradox: how ancient ways ean help solve our modern-day health-care crisis." Hawai'i is known widely as a "paradise" and conjures up images of palm trees swaying in the tradewinds, pristine beaches, pounding surf and active volcanos. It is also known as a plaee where the body, mind and spirit are rejuvenated in the gentle hands of nature. In ancient times.

the Hawaiian population flourished, nurtured in the environment of pure water, warm climate and lush vegetation. Today Hawai'i is known as "the health state" for good reason. Hawai'i is the healthiest state in the U.S. in longevity. Yet the tragic irony is that in the healthiest state, the native Hawaiian people have the worst health statistics in the nation. This is the "Hawaiian paradox." Within the Hawaiian paradox, there is a powerful metaphor explaining the cause of today's epidemic of chronic disease around the world, and it suggests a clear solution. The paradox tells us that the destruction of the eultural ways and the abandonment of the traditional diet of the native Hawaiians have resulted in staggering rates of death from chronic disease. The paradox also suggests using ancient ways to cure modem disease. Answer to the health-care crisis: low-cost community intervention. This strategy is low-cost and high-impact. Rather than seeking to employ high-tech, high-cost solutions to our health problems.

whieh are currently running our nation toward bankruptcy, the "Hawaiian paradox" suggests the use of low-cost, culturally rich diet and lifestyle-centered strategies to help deal with the heahh care crisis. In the spirit of "lōkahi," and the belief that we are all connected, the Wai'anae Diet Program employs such principles in a

community intervention eomponent. It seeks to influence the health of the entire community through the use of mukiple ehannels of reaching the public. It makes use of media, works with organizations and propagates itself through personal networks.

In this way it is hoped that the 'ano'ano, the "seed," is planted in the minds of many people to preserve their culture and traditions, and to maintain a healthy diet and lifestyle. In the same way, it is hoped that this brief presentation about the "Hawaiian paradox" plants a seed that fosters an understanding of the cause of obesity and chronic disease. The "Hawaiian paradox," describing what has happened to the health of the native Hawaiian people as a result of the loss of cultural practices and traditional diet is a microcosm of, and provides a powerful metaphor for, what is happening elsewhere. In doing so, the "Hawaiian paradox" suggests a solution to obesity and chronic disease and today's heakh care crisis. Dr. Terry Shintani, physician anā nutritionist, is the director ofpreventive medicine at the Wai'anae Coast Comprehensive Health Center. A majority of the center's 19,000 clients are of Hawaiian ancestry.

The tragic irony is that in the healthiest state, the native Hawaiian people have the worst health statistics in the nation. This is the "Hawaiian paradox."