By Pamela Constable
Washington Post Staff Writer
Tuesday, August 5, 2008
Armed with an array of plastic eggs, grapes, broccoli and a nasty looking cross-section of an artery clogged with cholesterol, Carlos Garcia was demonstrating the hidden dangers of American cooking and eating for a group of young Hispanic mothers in Silver Spring.
"If you buy juice for your baby, check how much sugar it has in it," Garcia explained in Spanish. "If you cook eggs, use the white and throw away the yolk. And if you can't get to a gym, walk for half an hour each day."
Nancy Hernandez, 23, listened closely. The school gym, commandeered for a health fair one recent weekend, was crowded with Latino families getting blood-pressure checks and listening to informative chats about breast cancer.
"I am really trying hard. I bake chicken instead of frying it now," said Hernandez, a Salvadoran American mother of three. "I want to lose weight, and I want my kids to be healthy. We used to go to McDonald's a lot, but now when they ask to go, I tell them 'Mommy is cooking at home tonight.' "
One of the ironies of emigrating from poor rural life in Central America to poor urban and suburban life in an area such as Washington is that it doesn't necessarily make you any healthier -- it just changes the ways in which you are unhealthy, according to health-care providers and immigrant families here.
Instead of weeding fields and walking long distances, which make you burn too many calories, you vacuum floors and take buses, which make you tired and lazy. Instead of cooking rice and beans, which lack many vitamins, you stop off for pizza and fries, which have too much fat. Instead of catching tropical infections, you are at greater risk of developing diabetes and heart disease.
You have acquired the habits of the promised land, and they are slowly killing you.
Nationwide, the rates of obesity and diabetes among Latinos are soaring to record levels, according to the federal Centers for Disease Control and Prevention and other groups. Latinos in the United States live longer than non-Hispanic whites but have higher disease rates. They are almost twice as likely to die from diabetes and have much higher rates of obesity and high blood pressure.
In the Washington region, which is home to more than half a million Hispanics, including immigrants and their native-born children, health agencies are seeing daily evidence of these problems.
"There are so many factors, and some of them are hard to change," said Maria S. Gomez, director of Mary's Center for Maternal and Child Care in the District. "Our families have a lot of stress. They live in dangerous neighborhoods with no place to walk. Their kids get no exercise in school. They come here thinking everything in America must be good for them, whether it is fast food or infant formula. They don't realize the damage all this is doing."
Today, several local agencies such as Mary's Center are reaching out to Latino immigrants with health fairs, free tests for diabetes and high blood pressure, prenatal and infant checkups, videotapes on healthy cooking and after-work exercise classes.
As a result, agency officials said, more working adults are losing weight, more babies are being breast-fed, and more mothers are learning how to navigate the minefield of American convenience food and fend off the blandishments of children's TV-show advertising.
Two sets of reasons -- one stemming from rural poverty, culture and misinformation back home, the other from the temptations and pressures of American working-class life -- tend to conspire against a healthy lifestyle for Latino immigrants and their children.
Throughout Central America and Mexico, it is widely believed that children should be chubby, and a common term of endearment for a spouse is "gordo" or "gordita," which means "fatty." Diets are heavy in starchy food that staves off hunger, but outdoor work and a lack of transportation help burn calories. Fast-food outlets are a relatively new, urban middle-class phenomenon.
"It all starts with our grandparents. We are taught to fill our stomachs, but not to eat the right food," said Jaime Lozano, 56, a health promoter at the Silver Spring fair. "Latino families tend to think that a fat child is healthy and a thin one is not. It is a big problem."
Once immigrant families arrive here, their lives and routines change dramatically. Parents work around the clock at cleaning and construction jobs, and there may be little time to shop and cook. There is constant physical effort but virtually no beneficial exercise, such as jogging or swimming.
Children are kept indoors for safety, often supervised by older siblings and quieted with soda, snacks and microwaved noodles. Television is jammed with ads for sugary cereals and pizza. Hospitals provide high-calorie infant formula. Trips to fast-food outlets, including several Central American chicken chains, become weekend family rituals.
"When you spend all day vacuuming offices or cleaning bathrooms, you think you are getting exercise, but all you are doing is hurting your back," said Eudom Ixthayul, who leads gym classes at La Clinica del Pueblo in Columbia Heights. "Often, both parents work late, and it is so much easier to go to Popeyes or buy frozen pizza for the kids."
Ixthayul's students are mostly middle-aged Central American women who work cleaning homes or offices. For an hour each weekday, he has them lift hand weights, stretch and bend to a disco beat, and then lie on mats, close their eyes and focus on breathing while he plays tapes of soothing classical music.
"This is the first time I have ever exercised in my life. I come here straight from work, and my shoulder always hurts from vacuuming," Elsa Marina, 48, a mother of six from Guatemala, said after class last week. "This helps me relax and sleep better, too."
Health experts say different segments of the Latino population face different health temptations and problems. Adolescents tend to become addicted to video games, fast food and soda. Single male laborers, far from family support networks and often sharing quarters with other men, tend to drink too much beer and high-sugar energy beverages.
"In the first 10 years after immigrating, people gain an average of 12 pounds," said Elmer Huerta, a cancer expert at Washington Hospital Center and longtime host of a daily health advice radio show in Spanish. "They arrive blind to American culture and with little knowledge about health care. They work around the clock and neglect themselves. They live a sedentary life and eat food that is too rich. I tell them to go back to what they ate at home: rice and lentils and fruits. To recover what they have lost."
At Mary's Center, dozens of mothers and babies wait for their checkups each day while a video on infant care plays in the waiting room. Staff members counsel them to breast feed, stock their refrigerators with healthy snacks for kids, and play dance tapes or do exercises in front of the TV set.
One recent morning, Teresa Sosa, 30, an immigrant from Guatemala, was waiting with her son Jorge, 9, for an appointment. She patted his stomach ruefully and said they both needed to lose weight. The boy loves chocolate and pizza, she said, but the doctor had advised her to cook more vegetables and less greasy food.
"In my country, if you are thin, people think you are not healthy, but here it is too easy to get fat," Sosa said. "Americans sit in offices and drive everywhere, but then they go to the gym. We do the hard work, but we don't get any exercise. We need to get more educated and think in a different way. We are not in Guatemala now."