A Rutgers graduate student is striving to reduce the chances that his fellow South Asians will acquire diabetes by getting them to alter their traditional, high-carb diet. South Asians are four times more likely than other ethnic groups to develop Type 2 diabetes – one in two go undiagnosed – due to genetics and diets high in refined carbohydrates, such as rice.
As a South Asian immigrant, Sairaman Nagarajan, who immigrated to New Jersey in 2012 with a medical degree from his native India, knows he is in a unique position to effect change.
“I have an edge in understanding the reasons why South Asians have cultural and lifestyle risks, which allows me, as a health care provider, to treat them effectively,” says Nagarajan, who will graduate from the School of Public Health this fall with a master’s degree in epidemiology.
Nagarajan decided to help educate this population about its risk for diabetes after arriving here in 2012. He had received his medical degree at SRM University in Chennai with the goal of becoming a pediatrician while maintaining his focus on clinical research. Since more research opportunities were available in the United States than in India, he enrolled at Rutgers to be near university-affiliated hospitals with strong research programs.
He found himself part of a large South Asian community – New Jersey has the highest proportion of South Asians in the United States, according to the 2010 census – and discovered that although many people he met had relatives who are diabetic, most don’t understand their own risks and the measures they could take to prevent disease.
“Since most people from South Asia are vegetarian, white rice is our go-to food, which means that carb-heavy meals with a high glycemic index are common,” he explains. “To reduce their risk, they have to change their diet as well as understand their genetic predisposition.”
Nagarajan started to put his training into practice. He developed an outreach program to educate the South Asian community about diabetes risk and preventive measures during a recent Bridging the Gaps Community Health Internship Program sponsored by the School of Public Health at the Shri Krishna Nidhi Foundation, an organization based in Hillsborough that promotes wellness among New Jersey’s South Asian population.Along with fellow intern Ozair Rizvi, a South Asian Rutgers New Jersey Medical School student, Nagarajan surveyed a segment of the population and discovered that awareness of the risks of acquiring diabetes is increasing, albeit at a slow rate.
“Older people visit their health care providers, while younger people go to websites like the Mayo Clinic or WebMD to address health issues,” he says. “But when I told them about their risk for diabetes, I sensed some indifference.”
With insights gleaned from the survey, Nagarajan and Rizvi developed printed materials and toolkits for an education campaign. The foundation will start this fall to target diabetes at three stages: prevention, disease management and prevention of complications from long-term morbidity.
Recognizing the challenges health care providers face in trying to change the dietary habits of an older generation, Nagarajan is focused instead on instilling healthier eating habits in children by educating their parents on how to create a more balanced meal with the appropriate proportions of vegetables, fruits, proteins, carbohydrates and fat.
Reducing dietary changes in a culture will take time. “Because I am a South Asian, they know I understand the significance of tradition. I’m not trying to change what they eat when I start this conversation,” he says. “But education at the grass-roots level – starting with the children – can make a personal difference to every family.”
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