Wearing a red polo shirt and blue scrubs, Laura Bazyler, a licensed dietician and nutritionist, breezes through Sedanos in Homestead like a speed-walking pied piper. She is followed by 13 shoppers who have three things in common: modest incomes, Hispanic roots, and diabetes.
Bazyler, with the Open Door Health Center, and her 13 charges will spend the next hour going aisle to aisle learning to choose healthy foods, one of many diabetic support services offered by the free clinic in Homestead.
You want to do most of your shopping around the perimeter of the store where the unprocessed foods are: the fruits and vegetables, eggs and fresh meat, she says.
Open Door translator Esperanza Perez repeats after Bazyler in Spanish. Other shoppers join the group, interested in the conversation. Bazyler holds up green bunches of cilantro and parsley and colorful peppers to add flavor to your food without salt.
Oldemia Arrasola listens attentively.
I have to be upbeat, says the youthful-looking grandmother originally from Durango, Mexico. Two years ago I was diagnosed with lupus as well as diabetes.
Arrasolas father and grandmother had to have their legs amputated because of the disease. Taking control of her diet with the help of Open Doors free screenings and support group, she is keeping the effects of the diseases at bay.
Most of what is known about diabetes in Hispanic Americans comes from four studies: the San Antonio Heart Study, the San Luis Valley Diabetes Study, the Starr County Study, and the Hispanic Health and Nutrition Examination Survey (HHANES). They show that non-insulin-dependent diabetes is two to three times higher in Mexican Americans than in non-Hispanic whites.
For Open Door clients, Just life is a challenge. Often they dont know theyre diabetic because they lack health care. They might not have transportation for a doctors visit. Many cant read or write English. Some cant speak it, Bazyler says.
The struggles of life on a small income also lead to defeatist thinking: Whatever I do it wont matter. Or magical thinking: My parents lived long, so will I.
But tactical experiences like the shopping tour make a difference. Paulino Gallgos, a single father, loves the tortillas of his native El Limon, Mexico, but these days he fills them with fish and mangoes more often than pork.
Julia Saavedra loads up on tomatoes, green peppers and red onions Better for you than white onions, advises Bazyler and packages of dried beans no fat, no sodium, high in fiber and protein.
I shop for whats on special and have no loyalty to any store, Saavedra says, with good reason: The recession reduced her husband Luiss landscape and construction work to one or two days a week. She holds a nursery job on weekdays and a restaurant job on weekends while he takes care of the kids.
They wake me up at seven with Daddy, its time for breakfast at McDonalds, or at night, Daddy, take us to Dunkin Donuts, says husband Saavedra. Often he takes them, and eats with them. He is the only one in his family with diabetes.
A lively discussion ensues as Marguerita Villa Senor asks about the vegetable oil she routinely uses. Bazyler shows her the word canola its better for you on the Wesson and Mazola brands.
No corn? a chorus of murmurs ripples through the group. Some women look concerned. As provisioners and cooks they have a large and difficult role in their families diets. Canola oil smells like fish, a husband says in an aside to his wife. Only corn oil for me.
Bazyler points to the Goya and Crisco brand lards. Goya makes a liquid corn oil, and liquid is not bad for the heart, she says. But Crisco is solid: Malo, bad.
Were in trouble. We kill pig and eat the lard 7 x 24, says Saavedra. In her cart are three packages of fat back used for flavoring. We dont eat beans without it, she says.
Betty Cortina, a food writer, editor of The Heralds Indulge section, and web producer of NBCs Latina Now, believes flavor can be the key ingredient to a healthier diet, as it was in her fathers case.
His blood pressure was through the roof. Something had to change, Cortina says. She began experimenting with what she calls flavor infusions, for example, using smoked paprika, the main flavor agent of delicious but fatty Spanish chorizo, to make a tasty vegetarian chick pea stew. She also got him to substitute brown rice for the parboiled variety thats a staple of Cuban-Americans diets, by cooking it in low sodium chicken stock and adding onions and garlic sautéed in olive oil for extra flavor.
His numbers stabilized and he dropped 12 pounds, Cortina says.
Back at Sedanos, the tour moves to the cereal aisle. Villa Senor asks about corn flakes, a family favorite. It only has one gram of fiber, says Bazyler. She holds up a box of All Bran with 10 grams of fiber in a half-cup of cereal and 4 grams of protein. As long as you have the word bran, its better for your blood sugar.
Villa Senor nods her head: The difference between the bran and corn flakes is clear.
For her most important point, Bazyler holds up a package of China brand paper plates with three food compartments laid out like a peace symbol. It all goes back to vegetables and lean meat. Starches in the small compartment, vegetables and protein in the two large ones. If most of us ate like that, wed be really healthy, she says.
Back at Open Door, the lights burn into the evening as clients return for testing and medications. It takes time to change, Bazyler acknowledges in her office. I recommend people try to make just one or two simple changes at a time. Because were never done. We can always learn and improve.