More Ethiopian immigrants getting diabetes

With sudden introduction to Western diet and plentiful food, the "thrifty gene" works against them.

By JUDY SIEGEL-ITZKOVICH
ethiopian child 298.88 (photo credit: Ariel Jerozolimski)
ethiopian child 298.88
(photo credit: Ariel Jerozolimski)
With 100,000 Ethiopian Jews living in Israel and more than 300 immigrating every month, the growing prevalence of type II diabetes, hypertension and osteoporosis among this group is becoming a significant health problem, according to Dr. Anat Jaffe, head of the endocrinology and diabetes unit at Hillel Yaffe Hospital in Hadera. The first mass aliya of Ethiopian Jews, Operation Moses, occurred in 1984, and the second, Operation Solomon, in 1991; since then, many more, including Falash Mura descendants of forced converts to Christianity, have been immigrating on a regular basis. Eight years ago, Jaffe established Tene Briut, a community-based program for the prevention of chronic disease among Ethiopian immigrants. And 18 months ago she transferred its management to the immigrants themselves, with her and social worker Yossi Gadamo as advisers. Tene Briut representatives were on hand at the Health Ministry-sponsored 11th conference on health promotion, held on Monday at Kibbutz Ma'aleh Hahamisha and attended by over 150 professionals in the field of health promotion. A core group of about 20 former Ethiopian immigrants hold Tene Briut workshops and educational sessions on nutrition, diabetes, exercise and dental health around the country. Funding, Jaffe told The Jerusalem Post on Monday, comes mostly from private donors, with some support from the Health Ministry and other government agencies, and nothing from the health funds, even though Clalit Health Services and Maccabi Health Services insure most Ethiopian immigrants. Jaffe is currently conducting a new study on chronic disease among the immigrants. Her last study four years ago already showed a 17 percent rate of type II diabetes among Ethiopian Jews from the age of 15 and up, compared to 0% to 0.4% when they lived in Ethiopia and 5% to 10% among the general Israeli population. In addition, the prevalence of type I diabetes, which is an autoimmune disease triggered in the womb or in early childhood, is higher among Ethiopian Jews in Israel than any other ethnic group except for Yemenites, said Jaffe. "We have found that Ethiopian immigrants get glucose tolerance that leads to type II diabetes when they are much less overweight than when Caucasian Jews get it," she continued. Type II diabetes is largely due to overweight, improper diet and a lack of physical activity. As with Yemenite Jewish immigrants, who quickly developed diabetes and other chronic diseases almost unknown in their native country when they came to Israel, Ethiopian Jews apparently carry a "thrifty gene," which helped them survive under conditions of great deprivation. But with the sudden introduction to a Western diet and plentiful food, the gene works against them. They do much less physical work than before, said Jaffe, and many - especially the older adults - don't work at all because they can't find jobs. "They sit at home, as do many of the women who are only 30. Even younger women who go out to work have a higher prevalence of diabetes." Although Jaffe's research is not yet complete, she believes that the changes to their diet - an increase in fat and meat consumption and a sharp reduction in the consumption of fish - are responsible for the higher rate of diabetes. While the older immigrants tend to eat more of a traditional diet, younger people, especially those born here, tend to eat a lot of junk food. She has also found that hypertension among Ethiopian Jews is more prevalent than it was in their native country; it was almost unknown there but in Israel affects about a third of them. "We are even beginning to see heart disease among them," she added. Jaffe and colleagues have also noted a significant prevalence of osteoporosis among Ethiopian Jews, due in most part to the lack of consumption of milk products both in their native country and in Israel. Also, many mothers keep their children out of the sun because they don't want their skin to become even darker, she said.