Young Warriors

Bienstar arms youth to fight diabetes

by Ken Rodriguez

Dr. Roberto Treviño noticed an alarming trend. At five clinics in the most impoverished part of town, almost 72 percent of 86,000 patients were suffering from a blood-sugar disorder known as type 2 diabetes. The cost for treating a single patient was nearly as grim: $13,000.

The disease strikes a disproportionately large number of Latino and African-American youth. Childhood obesity is one trigger. Inactivity is another.

"It was time to take off my white coat and go into schools and work with children," Treviño says.

Treviño the internist became an inner-city trailblazer. He created a program to reduce the risk of type 2 diabetes through a combination of exercise, education and diet. Then he took it into elementary and middle schools. Research shows the Bienestar/NEEMA program (named after the words for ‘well-being” in Spanish and Swahili) is working. Blood-sugar levels are falling. Physical activity is rising. Educators and family members are raving.

Barney Perez is a believer. He credits the Bienestar/NEEMA with transforming his grandson, Daniel, a seventh-grader at Zamora Middle School in the South San Antonio Independent School District.

"Daniel used to drink a lot of Big Red," Perez says. "But he quit drinking soda water and now drinks cold water. He eats a lot of fruit, a lot of watermelon and bananas. You can tell the difference. He's more energetic. He studies harder. He does his chores at home."

Bienestar/NEEMA doesn’t work magic. It provides tools for a healthier lifestyle.

Students learn about good nutrition in health class. They perform exercises in P.E. that increase the heart rate up to 130 beats per minute. They are served healthy meals—fruits, vegetables, whole grain products and the like. At day's end, they're supposed to receive parental reinforcement at home. That doesn't always happen.

Roughly 7,300 students in South San Antonio ISD participated in 2008-09. WellMed Medical Management will spend $750,000 to fund Bienestar until 2010-11.

The results after one year pleased Treviño. Blood-sugar levels decreased 10 percent in one group of students whose blood-sugar levels were excessive. Body fat dropped slightly. More children began exercising regularly.

"I am so proud of these kids," Treviño says. "Not only are they changing, they are going up to adults and saying, ‘Coach, don’t drink that Big Red.’ Or they’re going up to their dads and saying, ‘Let’s go for a walk.’"

Perez says his grandson reads food labels. This has too much sugar, don’t buy it. "He used to eat a lot of junk food," Perez says. "Not anymore."

A middle school student named Greta, who is deaf, also benefitted from the program. An initial screening showed her blood-sugar level exceeded 100. After 4 ½ months on the program, her blood-sugar dropped below 90.

"I learned to eat more fruits and vegetables, choose healthier snacks, drink lots of water and get lots of exercise," she said in sign language during a videotaped interview for WellMed. "Bienestar has changed my life."

The testimonies don't surprise Bobby Higle, a Zamora health and science teacher. "Instead of sitting around and talking, the kids in the morning do laps around the courtyard," Higle says. "We’ve opened the gym so they can play organized basketball and volleyball. We have a snack bar here and not many kids are going to get sodas and ice cream."

One year of Bienestar/NEEMA isn’t enough, though. Students must follow through with the program for years, and some will meet resistance at home.

"The hardest thing is to change the parents’ lifestyle," Higle says. "To eat healthier is more expensive. The South San district is a lower income community."

Fighting type 2 diabetes isn't easy. Treviño developed his program years ago but encountered fierce opposition from political forces. He's documented the struggle to implement his program in a new book, Forgotten Children: A True Story of How Politicians Endanger Children.

In 2004, the Texas Education Agency allowed Treviño to implement Bienestar/NEEMA in Texas schools. Five years later, the financial benefits are striking. The cost for implementing the program is $12.50 per student per year. At a doctor's office, the cost for treating a student with high blood sugar is $13,000 per student per year.

"It's a lot more cost effective to prevent the disease," Treviño says, "than to treat the disease."