Mattie Heldenbrand of Fayetteville enrolled in a study coordinated by the Cherokee Nation recently with a goal of maintaining a healthy weight during pregnancy.
“I had weight concerns and questions about eating right,” Heldenbrand, 31, said about her second pregnancy. “I hope to have a healthy baby and that I am healthy at the end of the pregnancy so I don’t have to do too much catching up.”
The Just Right Study isbeing conducted with the University of Oklahoma Health Sciences Center. Study officials track the weight of up to 80 participants, alongwith any pregnancy and labor complications. Each participant’s blood pressure, glucose and exercise regimens also are recorded monthly.
Half of the participantsare offered healthy-cooking and exercise classes. The other half serves as a control group. Its members are monitored but do not participate in the classes.
Sohail Khan, director of Cherokee Nation Health Research, said obesity is a major health concern among American Indians. Khan said the study could show that providing more information and services to pregnant women can affect not only the women’s weights but the babies’ weights as well.
“When a child is born and it is obese at the time of its birth, then it is susceptible to becoming an overweight baby,” Khan said. “This could mean they will be overweight during their childhood and beyond. What if we have a program that actually provides education and nutritional guidance to expectant moms so they can have a healthy child? That will startthem right from the very beginning.”
Dr. Elizabeth Harris, an obstetrician and gynecologist at the Cherokee Nation’s W.W. Hastings Hospital in Tahlequah, Okla., said obesity has become her top concern in her pregnant- and general-patient population.
“There are multiple complications related to obesity,” Harris said.
Pregnant women are more prone to gestational diabetes, hypertensive disorders andcesarean deliveries, for example, Harris said.
An appropriate weight gain is 25-30 pounds during pregnancy, Harris said. However, she said, it varies from patient to patient. For some obese patients, it’s recommended that they not gain any weight during pregnancy.
“I am so excited about this study,” Harris said. The Cherokee Nation “realizes it is a problem, and they are taking steps to make the population healthier.”
Khan said the Cherokee tribe has started investing in resources to reduce obesity. Tribal funds were recently used to build a fitness center in Tahlequah, he said.
Obesity can lead to diabetes, cardiovascular disease, arthritis and cancer, he said. Khan said diabetes is especially a concern, because Cherokees are 2.6 times more likely to have diabetes than members of the general population.
This is the first time the tribe has studied obesity in pregnant women, Khan said.
Heldenbrand said so far she has maintained the proper weight gain during her pregnancy. She said she uses a diary to track her food intake, which has helped her stay on target. The diary is also a part of the study program, Heldenbrand said.
Talking with staff members in the study about healthy eating and exercise has also helped her, Heldenbrand said.
“It helps to have someone to keep you accountable formaking wiser choices in what you are eating,” Heldenbrand said. She said the staff also has provided tips on healthy eating habits.
Jaime Clark, study coordinator, said many of the women have enjoyed taking a nutritional-cooking class, which incorporates traditional Cherokee foods.
Poke sallet and kanuchi are two recipes shared with the women, Clark said.
Poke sallet comes from a leafy-green plant that grows wild in the region, Clark said.
“It is traditionally what they used a long time ago,” Clark said. “It is full of vitamins and rich in folic acid. The nutrients are similar to kale.”
However, there are strict guidelines on how to prepare the dish. The leaves contain toxins and must be parboiled and rinsed several times before they are eaten.
Kanuchi is made by pounding the meat of a hickory nut until it becomes a paste, Clark said. The paste is then formed into a ball and stored in a cool place.
“After storing, you take the ball and put it in water so the hickory oil and the flavor comes out,” Clark said. She said it is then added to rice.
“It has the consistency of Cream of Wheat,” Clark said. “It is mainly a holiday item.”
Khan said adding traditional Cherokee cooking to the classes has had a positive effect.
“Our enrollment just jumped after that,” Khan said. He said he plans to share thistip with other American Indian tribes at a health convention this summer.
Clark said the participants are also provided with cooking utensils and nutrition information.
Khan said 74 women are enrolled in the study, which will continue for a year before the results are analyzed.
There is an expectation that if the results are positive, healthy eating and exercise will become a permanent program for pregnant women in the tribe, Khan said. Also, the study will continue to follow the children of the mothers in the study.
To be eligible for the study, a woman must either be an American Indian or carrying an American Indian baby, Khan said. The woman should be 18-35 years old and have a body mass index of 25-40 when she became pregnant.
Study officials collect participants’ information at Cherokee Nation healthcare centers in Oklahoma. The facilities provide care at no charge to those federally recognized as members of the tribe. Medicaid and private insurances are billed first. Services not covered are then paid for by the Cherokee Nation.
Health services in Oklahoma draw tribe members from bordering states. Several women in the study are from Arkansas, where more than 10,079 Cherokees live, according to the Cherokee Nation Registration Department.
Northwest Arkansas, Pages 15 on 03/23/2014