5 thoughts about Native Hawaiian food and health

Native Hawaiians and Pacific Islanders are at higher risk for diabetes, heart disease, hypertension, chronic diseases, and shorter life expectancy. COVID really exacerbated preexisting health inequities, NHPI communities more social and multigenerational, with larger families, denser communities, and higher numbers of essential workers.

On November 11, 2022, the Future of Food & Agriculture in Hawai’i presented a discussion on “Native Hawaiian/Pacific Islander Health Inequities: Root Causes & Systemic Solutions.” Featured speakers were Joseph Keaweʻaimoku Kaholokula, Ph.D. and Marie Kainoa Fialkowski Revilla, PhD, MS, RDN, LD, IBC, hosted by Civil Beat Reporter, Anita Hofschneider.

I wish I could have been there in person to taste the vegan luau stew, enjoy the live music, and feel the touch of lomi lomi. I am thankful to watch the recording, so that I could close my mouth, open my ears, and feed my mind.

* Food is health. Today, we worry about food insecurity, says Keawe. It’s not just the quantity of the food – do we have enough to eat?; it’s also the quality of the food – will it nourish our bodies? Eating healthier means having access to fresh food and also more time to shop. He asks, how can we make healthy food more affordable, convenient, and a priority?

* Food is spiritual. “At one time, food was tied to kinolau, to our ancestors. It was part of our spirituality as a way to commune with our ancestors,” says Keawe, “and so we were careful in what we ate, even how we harvested the food.” How can we restore our connection to our food?

* Food is identity. We attribute identity to specific foods. SPAM may be part of local cultural identity, Keawe laughs, but “SPAM’s not Hawaiian.” Kainoa and Anita add that after World War II, SPAM became part of Pacific cultures, associated with liberation and freedom. In Hawai’i, the first food that infants ate used to be poi, Kainoa recalls. Parents want to provide nutritious foods, but it’s expensive.

* Healthcare is cultural. In Hawai’i, heathcare providers need to be better trained in local ways of delivering care. We need a workforce that reflects our communities and provide culturally-informed interventions, says Keawe, because “prevention is best done in the community.”

* Health and nutrition starts with families and mothers. Healthy living starts with the family – talking with each other at family meals, caring for elders, and caregivers learning to manage stress and care for themselves too, says Keawe. “Women carry the next generation within you,” Kainoa reminds us, “so you want to eat well to support the next generation.” Organizations can support motherhood with paid maternity leave, so that women can breastfeed and strengthen the mother-child bond.

* Designing better healthcare systems. “Our systems put us at a disadvantage by design,” Keawe declares. People of color are more likely to receive poorer education, poorer health, poorer housing, and lower pay. At the government level, we need policy changes that increase social security without lowering SNAP benefits and increases to the minimum wage.

What foods are part of your cultural identity? How do you balance nutrition and convenience?

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3 takeaways about anxiety and youth

“Even before the COVID-19 pandemic, growing numbers of young people were experiencing high rates of clinical-level anxiety. About 11.6% of kids had anxiety in 2012, up 20% from 2007. But during the pandemic, those numbers nearly doubled, with more than 20% of youth struggling with anxiety symptoms.”

This concern set the stage for “The Epidemic of Anxiety Disorders in Children and Teenagers,” a panel discussion presented by the 2022 Hawai’i Book and Music Festival and the University of Hawai’i Better Tomorrow Speaker Series on October 25, 2022.

I couldn’t attend the live webinar, because Tuesdays are my self-care day right now. So I am thankful that all the discussions were recorded and made available quickly.

Moderator Maya Soetero-Ng, along with panelists Allana Wade Coffee, PhD; Anthony P. Guerrero, MD; and Chayanin Jing Foongsathapron, MD, provided background and statistics about youth stress and anxiety, what to look for when youth experience anxiety, and current access to mental health care.

Here are 3 key takeaways for children, teens, and families:

1. Anxiety is normal. Like a fire alarm, it’s a survival instinct, says Dr. Jing, telling us when to pay attention and when to take action. Anxiety becomes a concern when it is prolonged or intense – when the fire alarm keeps going off or won’t turn off. That’s when youth should seek additional help.

2. We express anxiety differently. It may be a physical sensation, like an upset stomach or headache. It may be anger, aggression, starting fights, depression, or withdrawing from others.

Youth need assurance, information, or clarification – not anger or punishment, says Dr. Coffee. By getting angry or sending a child to their room, adults may be increasing anxiety and withholding the care and connection that youth need.

We also cope with anxiety differently. Dr. Guerrero suggests trying deep breathing, progressive muscle relaxation, and mindfulness to help reduce anxiety. (I wish we had time to go through one or two relaxation exercises.)

3. There are different levels of help. Dr. Coffee reminds us that getting help is a process. We might start with doing our own education and research with credible sources, or do a self-screening. We might first reach out to family, friends, pastors, or mentors, or even try a mindfulness or mental health app. Later, we might reach out to a licensed counselor or therapist. If anxiety persists, then we might seek a psychiatrist or doctor to talk about medication.

At each step of the way, there are people, organizations, and resources who can help us.

What does anxiety feel like to you? How do the children in your life express their anxiety – and what can you do to help mitigate their anxiety?

Expressing feelings through art

September and October were busy months for me. Through timing and coincidence, there were a lot of work-related activities scheduled for Saturdays. My goal was to power through the Saturdays and rest when I could.

When our latest Saturday workshop had to be postponed, I emailed attendees and invited them to take that time for self-care and to do something that would bring them joy.

I decided follow my own advice. I enjoy doing art projects, but most of my projects are gifts for other people. I try to put gratitude and joy into the ceramics I create, but I don’t usually do art to express myself.

At 10 am that Saturday, instead of catching up on email or doing chores, I stopped everything to focus on self-care and self-expression.

What would I do with these two hours? Using art canvases and acrylic paint from past projects, I tried some new painting techniques.

I coated each canvas with white paint. Then I chose colors from my limited selection of acrylic paints.

For a balloon art painting, I poured purple and gold circles. Blowing up a balloon half-way, I dabbed the balloon into each paint circle. Then I used the back of a paint brush to lines connecting the circles, like trailing lines of energy, and added golden eyes. I called this piece “Ideas.”

I used the same balloon art technique for a second piece, but instead of keeping each circle separate, I used the balloon to smudge a background pattern. It felt a little plain, so I outlined flowers in purple and white paint, with golden centers. This piece is titled “Happy.”

For the third project, I poured paints in a zig-zag pattern on a piece of cardboard. I placed a canvas face-down over the paint, pressing it down gently. Then I carefully lifted the canvas up, sliding it across and up to create a sense of blur and movement. I named this canvas “Dreaming.”

They didn’t turn out exactly as I expected, but I had fun and I ended up with three small paintings that reflected what I was feeling that morning.

What are the ways that you like to express yourself? Do you like to dance or do yoga, write poetry or create art, sing or garden? What would you do with an extra two hours?

Building on positive childhood experiences

Our childhood experiences shape who we are as adults.

I remember playing jacks with my grandmother on the kitchen floor. My parents tell me that sometimes my grandmother would come home late at night after working at Kam Bowl, and find me wide awake and ready to play. So she would sit with me and play jacks, even though she was tired and I had to go to school the next day.

There has been a lot of research and talk about Adverse Childhood Experiences (ACEs), and how traumatic experiences in childhood can affect us later in life. The 10 ACEs questions ask about things like verbal or physical abuse, emotional support, enough food to eat, and a safe place to live.

There’s a different way to look at childhood experiences. I recently listened in on “Hawai’i Introduction to HOPE: Healthy Outcomes from Positive Experiences” with Amanda Winn and Amy Myrick. I learned that we can focus on the Positive Childhood Experiences (PCEs) that can help create healthy, thriving adults.

HOPE starts with a presumption of strength. The 7 PCEs questions ask about things like feeling able to talk about feelings, feeling supported, and feeling a sense of belonging.

I grew up with my dad, aunt, and grandparents. I was the only child and only grandchild in my family, no first cousins, and I was the focus of a lot of attention. If one person was upset with me, I knew there was another adult who would stand up for me.

There are four building blocks of HOPE:

• Relationships within the family, other children, and the community. You can connect with the children around you, doing activities together, sharing meals, talking about childhood memories, and asking questions – and paying attention when children talk.
• Safe, equitable, nurturing environments. You can make sure that homes, schools, and parks are safe spaces for all students. Address bullying and teasing quickly, and make people feel included and welcome.
• Social and civic engagement. You can encourage children to participate in community activities, volunteer together, and create a family service project.
• Emotional growth through self-awareness and self-regulation. You can help children name and validate their feelings, let them know that their emotions are normal, and help them learn to manage difficult situations, such as teaching them meditation or mindfulness.

I didn’t have a lot of friends at school, but I had a core group – just one or two people who I felt close to. They were a lifeline for me.

This is how we build community resilience. These positive childhood experiences promote healthy outcomes, protect against adverse experiences, and help to heal from adverse experiences.

I really appreciate this way of looking back on our childhood. It’s not that we want to ignore the adverse experiences in our lives, but that we choose to build on the positive experiences. “People can heal, even after past trauma.”

Parents and kids, you can download a free activity book with word searches, coloring pages, and other fun projects that you can do together and create positive memories.

As a child, did you have people you could turn to when things were hard? Today, do you reach out for help when you need it? How do your nurture the children in your life?

Nurturing self-esteem

“I don’t think I can do that. I’ve never done something like that before.”

That’s what was going through my mind four years ago when our president asked me to take on more responsibility.

If I had seen the job posting for the position, I would not have even thought about applying. I only accepted the position because they agreed to put “interim” in the title. I felt like an “imposter” who was wearing a shirt that was too big for me.

In fact, the first time that I felt like a “real” executive director was months later, when I attended a conference with other executive directors. Most of them had more experience than me and oversaw larger organizations, but they were facing many of the same challenges and opportunities.

Why was it so hard for me to believe that I could do the job?

This experience was running through my mind as I attended a workshop with Clara Priester, “Building and Nurturing Self-Esteem.”

“What is self-esteem?” we asked ourselves. Our common answers were about valuing ourselves and feeling confident in ourselves. We are all inherently worthy, as beings capable of love and being loved, Clara declared.

“Be quiet.” “You can’t do that.” “You’re not good at that.” Often the words we hear when we are children become a self-fulfilling prophecy as we grow up, until we start telling those words to ourselves.

We spent time building up our self-esteem. We wrote down the traits we are proud of about ourselves – my traits are being thankful and seeing the good in people. And we celebrated compliments that make us feel awesome – for me, it was compliments about creativity and helping others and being a good mother.

Then we read aloud some of the negative phrases that hurt us and hold us back. Number two on the list: “I can’t do that.”

Here’s what to say instead: “I can try to do that.”

PS It’s a lot friendlier than the two phrases that changed my mind: “Say yes” and “Do hard things.”

Clara also talked a little about daily affirmations, positive words for something you would like to change or nurture in your life.

I have been doing this Morning Mantra for a few years now, and for me it’s a breath of calm:

I open myself to the world.

I share myself with the world.

I welcome good health.

Is there a negative phrase that holds you back from job opportunities, relationships, or hobbies? What affirmation can you start today to change your thinking?