Toronto pilot project takes aim at South Asian teens at risk of diabetes

University of Toronto researchers are taking a radical approach in the fight against diabetes and focusing on a community that is statistically hard-hit: South Asians in Canada.

Program to change diet and health habits focuses on kids from 13 to 17.

Aditya Raval, left, studies ingredients of a mango lassi drink. He's among a group of South Asian Canadian teens learning how to manage their risk of diabetes. (Yanjun Li/CBC News)

Aditya Raval has been watching his father and grandfather take daily insulin shots for as long as he can remember. Statistically, that's likely his future. 

"Since my dad has it, I'm worried I'm also going to get it as an adult at a young age," said Aditya, 14.

He's not alone. Many young South Asian people have similar fears and stories of older family members struggling with diabetes.

According to University of Toronto researchers, people of South Asian descent living in Canada are three-to-six times more likely to develop Type 2 diabetes, compared to the general population. 

People with Type 2 diabetes are not often born with it, but usually develop it with an unhealthy lifestyle. Diets high in fat and sugar, along with a lack of physical exercise are among the biggest risk factors.

But Type 2 diabetes can also be passed down through genetics, making some ethnicities more likely than others to develop this disease. 

To break that cycle, researchers at the university created the South Asian Adolescent Diabetes Program (SAADAP), which delves into why the community has a generational problem with diabetes.

The SAADAP program uses cooking classes and other hands-on learning to teach teens about nutritious meals and healthy lifestyle habits. (Adrian Cheung/CBC News)

"In our community, we think it's inevitable that we're going to get diabetes at some point in our lives," said Ananya Banerjee, founder of SAADAP and assistant professor at the Dalla Lana School of Public Health.

Diabetes is known to lead to long-term health problems including blindness, heart disease and strokes. 

"What's important is that we start targeting the next generation at a much earlier age ... if they have a parent or a grandparent, the likelihood [of getting diabetes] is very high," Banerjee said.

Banerjee's own family history has driven her to lead the research, dating back to when she learned her own father had developed diabetes early in life. 

Her father's doctor told Banerjee she would probably get diabetes if she doesn't start to take action, which led her to focus on her dietary choices. 

SAADAP recruited 80 teens of South Asian background based in Peel Region.

They were all referred via family doctors. All of the teens range between 13 and 17, with a common thread between them: they all have at least one family member who suffers from diabetes.

The eight-week program takes a hands-on approach to changing the teens' eating and lifestyle habits with trips to grocery stores to learn about the nutritional value of vegetables and fruits, mixed in with breaking down the ingredient labels on their favourite snacks. 

It led to some startling findings for students like Aditya Raval, who learned how much sugar is in the drinks he loves. 

"The average amount of sugar every day for adult men should be 39 grams of sugar. And in a small can of orange drink, there can be 30 grams already in just one of them," he said. 

He's started warning his friends who "drink two of them every day."

Other lessons include cooking classes, where SAADAP researchers teach students and their parents how to use their nutrition knowledge to make better choices in meals at home. 

Ananya Banerjee, founder of SAADAP and an associate professor at the University of Toronto, is driven by her community's high risk of Type 2 diabetes. (Yanjun Li/CBC News)

"Compared to other youth programs, we're not making them sit in a room and we're being didactic and telling them, 'You need to exercise, you need to eat healthy.' We're doing interactive sessions, we're having critical conversations," Banerjee said. 

We're doing interactive sessions, we're having critical conversations.- Ananya Banerjee, founder of SAADAP on programming with South Asian teens

Hands-on learning is a big reason Sherry Lachman enrolled her daughter Rosina into SAADAP. Sherry has lived with diabetes for 23 years and she said lecturing Rosina about her challenges won't be enough.

"If I sit you down and try to tell you about [diabetes], you're not going to listen to me," Sherry said about her daughter. 

"So I figured the classes would help her and that's the way."

CBC Toronto reporter Adrian Cheung speaks to Sherry, middle, and Rosina Lachman on the need of a diabetes-focused program in the GTA. (Yanjun Li/CBC News)

Rosina has taken the lessons to heart, often walking home from school rather than taking the bus and warning her friends about their junk food habits. 

"I've been trying to stay away from processed or packaged food," she said while still admitting that habits are hard to change overnight. 

"I still eat them because I'm a kid."

Risk level 'high' for South Asians

The Government of Canada's website on Type 2 diabetes cites being a "member of a high-risk ethnic group" as being a major risk factor.

According to Banerjee, South Asians from India living in Ontario have a diabetes prevalence rate of 18 per cent, compared to 11 per cent in the general population.

""The rate for diabetes is actually much higher in Canada than those living in India," said Banerjee. 

While SAADAP's team of researchers believe diet is a major factor in the prevalence of diabetes in South Asian communities, they believe the root causes boil down to the roles migration and socioeconomics play in overall health. 

Parents like Sadia Alam, right, joined her daughter Eiman in SAADAP's classes. (Yanjun Li/CBC News)

"A lot of the students say, 'I come from a high income family so I think that will help reduce my risk.' But let's talk about the people in our community who are socially disadvantaged," Banerjee said. 

SAADAP is focusing on communities like Brampton and the wider Peel Region for the initial study. Peel Region's 2011 census shows 20.9 per cent of respondents identified as "East Indian." 

The team is expecting to release the full results in early 2019. In their initial survey, conducted after the pilot program wrapped up, the preliminary results showed the lessons could be lasting. 

That report said 90.91 per cent of teen respondents said they've made healthier food choices after joining SAADAP. More than a quarter claim they've encouraged their own family members to become more active. 

The researchers are now aiming to start similar programs in other GTA neighbourhoods with large South Asian populations, like Regent Park and Thorncliffe Park. 

Banerjee hopes their program will soon empower South Asians in these neighbourhoods "to actually make change and not just wait for the system to create solutions."


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