Race to Live

Dogged by diabetes, Zunis are running on a path to prevention.

Albert Chopito's grandmother died with gangrene, her feet blackened with infection, a gruesome consequence of her long fight with diabetes. Just a little over a year after starting junior college on a scholarship, Albert was forced to quit and return home to care for his parents. His father died in 1995, wheelchair-bound and on dialysis, more than a decade into his own fight with diabetes. The following year, his mother died of complications from diabetes while barely into her fifties. "Diabetes has played a big part in my family," Albert says unnecessarily.

So Albert ran. He started in the fourth grade, on his elementary-school cross-country team. Two years later, he completed his first half-marathon. As a sophomore, he was already training with the high school juniors and seniors as a sixth runner on the storied Zuni High School team. Unsatisfied with his progress, he buckled down and ran more, and faster. By the start of his junior year, he was the team's number-one runner, a position he didn't relinquish until graduation. That year, both the boys' and girls' high school cross-country teams won state championships. Albert finished first.

Now 33 years old, Albert cannot stop. He feels the family's disease walking behind him, waiting for him to slow down. "It's the reason I keep running," he says.

Mike Gorman

In the weeks since the September 11 terrorist attacks, those who follow sports -- not to mention many athletes themselves -- have struggled to find relevance in games and sweat. But on the Zuni Tribe's ancestral land, a 500,000-acre dreamscape of soaring red buttes, sudden rock outcroppings and sandy desert hills, you don't have to look far. Here, sport is literally a matter of life and death: You play or, too often, you die.

Type II, or Adult Onset diabetes, a disease characterized by too much sugar in a person's bloodstream, typically evolves in people as the result of poor lifestyle choices: too much bad food, too little exercise. Slowly, it squeezes off the circulation. As the disease progresses, its victims' extremities die from malnutrition. Later, if the heart doesn't stop first, the kidneys fail. Not surprisingly, in a country that spends hours on couches and billions on potato chips, where stadium seats now have to be super-sized to accommodate ever-larger fans, the incidence of diabetes is on the rise.

But no matter how bad diabetes has become among whites, it can't touch the damage it is doing to the country's Native Americans. In tribal populations from Maine to New Mexico, the disease has made inroads that would be considered catastrophic among the general populace. Recent studies show that American Indians are about three times more likely to get diabetes as non-Indians. Most researchers agree that that number is grossly underestimated.

And it's spreading downward. Adult Onset diabetes used to be rare among children, who needed years and years of a bad diet and inactivity to permit the disease to take hold. Today it is alarmingly common among Native American children, some as young as ten years old. One recent study, of Arizona's Pima tribe, showed that thirty years ago, less than three-quarters of a percent of girls between the age of ten and fourteen developed Type II diabetes. Today that number is about 3 percent and growing.

The Zuni are no different; if anything, they're a little worse. Family practitioner Scott Doughty arrived at Zuni Pueblo from medical training in Wisconsin four years ago. A year after he began working at the local health clinic, the job of directing the tribe's diabetes program opened up. No one else wanted it, so he signed on.

A young-looking, angular man with a blond ponytail and small wire-rimmed glasses, Doughty says that nearly one-third of all Zunis over the age of 35 already have diabetes. By the time they reach fifty, about half will have the disease. About 3 percent of non-Indian women develop a particular form of diabetes while pregnant. In Zuni, that number is closer to 15 percent. It is telling that Zuni Pueblo, with a population of just over 10,000, has its own dialysis unit.

There is good reason to believe that genetics plays a role. Although no such gene has been pinpointed, medical researchers have long suspected the presence of a "lean gene" in Native Americans. The theory goes that indigenous people adapted to feast-and-famine cycles by developing the ability to store fat efficiently during times of plenty to carry them through times of scarcity. The problem comes, of course, when famine disappears and is replaced by cheese fries, soda pop and tortillas made with lard.

Another cause of the high rate of diabetes among Zunis is a peculiar confluence of ancient and modern that is common on reservations. Cheryl Ritenbaugh is an anthropologist who studied diabetes among Zuni teenagers in the mid-1990s. Now a researcher in Portland, Oregon, for the Kaiser Permanente Center for Health Research, Ritenbaugh says that for many years, tribal elders spread the word that the local water was responsible for diabetes. And in a way, she says, they were right. About a half-century ago, the tribe's aquifer dried up and a new well was dug. Though safe, the new water was bitter and orange and smelled of sulfur. Many of the residents turned to soda as an alternative -- which has exacerbated the diabetes problem.

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