Kahnawake's elementary schools are junk food free.

We all eat junk food. Most of us eat too much of it.

However, for six years the elementary schools in Kahnawake have been junk food free, and junk food is discouraged in high schools.

Banning junk food is just one way this Mohawk community near Montreal is fighting type II (adult-onset) diabetes. This type of diabetes is up to five times higher in First Nations communities than in other Canadian communities.

Type II diabetes is associated with:

• high fat diets,
• high carbohydrate diets, and
• poor exercise habits.

Everyone in Kahnawake is encouraged to eat healthy foods and to exercise on a daily basis.

“The main focus of this project is choice,” said Dr. Ann Macaulay of McGill University. “We are not trying to impose lifestyles on adults or children.” She is also scientific director of the Kahnawake Schools Diabetes Prevention Project.

Children in Kahnawake who are taught about diabetes prevention are more physically fit and watch less television, said Dr. Macaulay.

It will be about thirty years before the community knows how the diabetes prevention project has affected the prevalence of adult-onset diabetes.

Dr. Macaulay is also involved with the diabetes research and training program at Kahnawake. The program:

• evaluates how other First Nations communities promote diabetes prevention; and
• trains aboriginal and nonaboriginal researchers.

She stressed that Kahnawake takes a very active role in the research that is done there. In fact, the community is able to direct what kind of research is done and what direction it takes. “There is much more emphasis on research that will help people than on research for research’s sake,” she said.

Another pioneer program

Sandy Lake has the third highest rate of diabetes in the world.

Community direction is also the key to the success of a pioneer diabetes prevention program in northwestern Ontario. Sandy Lake is an Ojibway-Cree community northwest of Sioux Lookout.

“Sandy Lake is typical of many northern communities that are quite isolated,” said Dr. Stewart Harris, of The University of Western Ontario. “You have to fly into Sandy Lake.”

The people of Sandy Lake approached him in the early 1990s with their concern about what diabetes was doing to their community. “We discussed with the community a partnership, a collaboration between academics and the community as full-fledged partners," said Harris. "And it has flourished.”

Community support for diabetic research was so high that initial enrolment for a genetic study was 74 per cent. Subsequent research showed that Sandy Lake has the third highest rate of diabetes in the world, and that many people in the community have a genetic mutation that increases their chance of not only developing diabetes, but of developing it at a younger age.

Many First Nations communities are watching Kahnawake and Sandy Lake very closely. Some would like to start similar programs of their own.

Dr. Harris said funding is not an obstacle. Taking the first few steps seems to be the most difficult part of dealing with the problem.

First Nations people and diabetic researchers met in Quebec City last week for the 2nd National Conference on Diabetes and Aboriginal Peoples.