I met certified diabetes educator and registered dietitian, Constance Brown-Riggs, last year when she presented a lecture on mind/body/spirit at Diabetes Sister's "Weekend for Women." I was intrigued by a health care provider talking about "spirit" as a means to better manage diabetes.
Constance is the author of two diabetes books, the most recent, "The African American Guide to Living Well with Diabetes," in which spirit plays an important role.
Here follows what I'm calling a "Book View." A short interview with an author and brief review of a book that offers an intriguing proposition.
Q: Many chapters in your book end with spiritual principles or a biblical metaphor to help motivate self-care behaviors to manage diabetes. How did you come up with this approach?
Constance Brown-Riggs: My early work was in drug and alcohol rehabilitation. I spent years working with substance abuse patients. I also grew up in the church. My brother is a pastor and my father is a deacon. From both these worlds, and my own strong spiritual belief, I saw the power of spirit to help us overcome challenges. When I became a dietitian I began to see everything about nutrition from a body, mind, spirit space, for instance how we eat, what we eat, why we eat. Now as a diabetes educator, seeing so many people worn down by the "daily-ness" of this chronic condition, I see how when we view ourselves as whole selves, mind, body and spirit, that we find the resources to cope.
Q: I was especially caught by an expression you repeat in the book, "Don't Claim It!" What does that mean?
C B-R: That expression is very common in the church and the African American community. The original meaning is whatever adversity is in front of you, don't give in to it, pull yourself together, pray and use all your God-given resources to tackle whatever your challenge is. However, many people with diabetes take "Don't Claim It!" to mean don't get pulled into your diabetes, ignore it, deny it, pretend it doesn't exist. They may pray but then take no action. People often say to me, "The doctor told me I have diabetes but I'm not claiming it." That means they plan to ignore their diabetes and usually they are in denial.
Q: What one spiritual principle do you think is most inspirational for most patients?
C B-R: Take it one day at a time and take the challenges of diabetes one challenge at a time. There's a song, "One Day at a Time," that can be heard on any given Sunday in African American churches.
Q: In the book you write, "The scripture says truth will not be a burden but a lifesaver." What does that mean in regards to diabetes?
C B-R: We know if diabetes goes untreated people are at risk for serious complications. So having the truth, meaning understanding that you have diabetes and there are things you can do about it, that it's not a death sentence but a second chance at life because you know what you're up against and how to handle it, that's how you save yourself.
Q: You also say "diabetes is a blessing."
C B-R: I look at a diagnosis of diabetes, particularly type 2 diabetes, as a point of renewal. A second chance to reevaluate what you're doing in your life. It may mean losing weight or changing the way you're eating. You can look at it as a blessing to help you stop and identify how to improve your health.
Q: You don't have diabetes yourself, was there a particular reason why you became a diabetes educator?
C B-R: Many members of my family have diabetes and years ago when someone got it, all I associated with it was amputation. As I became more educated and started learning about nutrition, I realized that doesn't have to be the outcome of having diabetes. Unfortunately, a great many people aren't educated about food, nutrition and healthy eating, particularly if they were raised, as so many African Americans are, on traditional Southern cooking.
Soul food is prevalent on African American and other Hispanic and Caribbean tables. Soul foods, like fried chicken, collard greens with ham hocks, macaroni and cheese with full fat cheese, whole milk and butter tend to be very high in saturated fat and sodium. Sunday dinner means candied yams not baked sweet potatoes. The challenge is to learn how to prepare these ethnic foods in a more healthful fashion. I created what I call the Diabetes Soul Food Pyramid which is in the book. I took traditional foods from the South and show how to fit them into the USDA Food Pyramid.
Q: Am I correct in thinking it's also acceptable to be a little heavy in the African American culture?
C B-R: Yes, extra weight is not seen as a problem and the expression "big boned" is common. A woman becomes more attractive with a little meat on her bones. Men are more desirous of a woman with more curves. Female patients often say to me, "Oh, no I can't lose weight, my man won't like that!" I have to let them know that they don't have to lose 50 pounds. If they lose 10 or 15 pounds that will help them manage their diabetes.
Q: I notice when I'm focused on something all of a sudden it seems to show up everywhere. Regarding the spiritual aspect of your book, did you notice any "magical happenings" while you were writing?
C B-R: Actually I continually notice whatever I need tends to show up. It happens all the time.
Q: Is there any single event you can think of when the power of your faith got you through a hard time?
C B-R: Writing this book! This book has a long story behind it. I truly had to be persistent to get it published. We often hear about persistence and never giving up and having faith. My initial publisher for this book fell through and, admittedly, I was disappointed. But I also thought OK this is a test of my faith.
Q: What did you tell yourself to keep going?
C B-R: I told myself it's not meant for me to do this right now. God has something else for me to do. While it was initially a set back, I kept very focused on getting the book published and believed in God's time it would come to pass. One of the things I did was call a friend who had her agent review the manuscript and now we share the same agent and it led to an excellent publisher.
Book Review: The African-American Guide to Living Well with Diabetes - Written by Constance Brown-Riggs with Tamara Jeffries. This book is aimed at the more than 4 million African Americans with diabetes. It covers the basics of food, exercise and medicine, but highlights two things not often found in diabetes books: soul food and spirit. Brown helps readers fold their favorite foods into a healthy eating plan with her own inventive "Diabetes Soul Food Pyramid" and shares pages of calorie, fat and carb counts for traditional Southern dishes, as well as how to read labels and sample meal menus. Most chapters end with a "For Your Spirit" section where spiritual principles and biblical allegories remind readers of their inner resources, that they do not walk alone and may bolster confidence and commitment to meet the challenges of diabetes self-care.
What I like most: The opportunity to pause at the end of a chapter to reflect on life and how to reach inside myself for strength.
My favorite passage: "It's not worth it to quit because your life is priceless. You were put on this earth with a purpose and you are destined to live out your days accomplishing your mission and enjoying the good fruits of your work. You want all the time you can get to enjoy the life Creator has given you -- and the good health that goes along with it.
Strengths of this book: Easy to read, addresses our whole selves and provides practical nutritional information on ethnic foods.
Constance Brown-Riggs is also the author of "Eating Soulfully and Healthfully with Diabetes." You can see more on her website, including her blog "Diabetes: Don't Claim It! Manage It!