Type 2 diabetes is increasing rapidly in the United States and Latin America and contributes significantly to the rise in health care spending. Diabetes increases the risk of cardiovascular disease, renal failure and blindness, and leads to other complications. Type 2 diabetes and its complications can be delayed in high-risk individuals through a healthy lifestyle and ongoing medical care. Some research suggests a relationship between diabetes and other underlying metabolic conditions, either as predisposing factors or as adverse outcomes of occupational exposures in farmworkers. UC Cooperative Extension can have a greater impact on the health and safety of California’s workforce by filling in research gaps and strengthening collaborations.

We conducted focus group dis-cussions and a survey to explore diabetes-related health beliefs and to assess educational needs among low-income Latino adults, primarily of Mexican descent. We found that many low-income Latinos served through UC Cooperative Extension programs may be at high risk of developing diabetes. At the same time, many of those at risk lack awareness of risk factors for dia-betes, have never been screened and do not know where to go for advice. Although some were unsure of the true causal connection, 64% of the focus group participants had heard that susto (stress or strong emotion) might be related to onset of the illness. In addition to increas-ing awareness of the disease and reducing barriers to care, nutrition educators can help program partici-pants by identifying ways to alleviate the effects of stress and lower the risk of diabetes through a healthy lifestyle.

We developed a short food behavior checklist (FBC) to evaluate the impact of nutrition education on fruit and vegetable intake among ethnically diverse women in the Food Stamp Nutrition Education Program (FSNEP) and the Expanded Food and Nutrition Education Program (EFNEP). To validate the FBC, interviewers collected three 24-hour dietary recalls as well as responses to 11 FBC behavioral questions about fruits and vegetables from 100 English-speaking, low-income women at baseline. A randomly selected subgroup (n = 59) provided a blood sample for analysis of total serum carotenoids at baseline and follow-up. After 6 hours of nutrition education, the treatment group reported significant improvements in three of the seven FBC questions related to fruit and vegetable intake, while no significant changes occurred in the control group. Furthermore, six of the seven FBC questions were significantly correlated with total serum carotenoids. This short, culturally neutral FBC is a valid and reliable indicator of fruit and vegetable consumption. Compared with the 24-hour dietary recall, it is also less time-consuming to administer, code and analyze, with a reduced respondent burden.

Food security is defined as access by all people at all times to enough food for an active, healthy life. In a study of 212 low-income Latino households in California, 45% were food insecure without hunger; 13% food insecure with moderate hunger; and 3% food insecure with severe hunger. Food insecurity was associated with a decline in household supplies of both nutritious and less nutritious foods. Among preschool children, the number of servings per day of all food groups was significantly correlated with household food supplies. A strong safety net to improve food security in low-income populations must include educational strategies and provision of nutritious foods to support a good diet at home and away from home.