Nutrition and Diet as It Relates to Health and Well-Being of Native Hawaiian Kupuna (Elders): A Systematic Literature Review.

PURPOSE: The key to improving the health and well-being of Native Hawaiians is to understand the historical events that have caused change to their diet and nutrition, and identify the connection between food, life, and the land. The purpose of this article is to (a) present a review of the literature addressing nutrition and diet as it relates to health and well-being of Native Hawaiian kupuna (elders) and (b) identify limitations and gaps to promote future research. DESIGN: This systematic literature review focused on 29 studies. FINDINGS: Native Hawaiians have the highest body mass index levels, highest daily energy (kilocalorie) intake, and lowest multivitamin use. They have the highest prevalence of diabetes and hypertension compared with Whites. Traditional Hawaiian diet programs and family support were beneficial to improving health and well-being. CONCLUSION: Future research of traditional Hawaiian diet programs and revitalization of the culture may lead to improving the health and well-being of Native Hawaiians.

Evaluation of the National Kidney Foundation of Hawai'i's Kidney Early Detection Screening program.

PURPOSE: Discussion of the formative program evaluation results of the National Kidney Foundation of Hawai'i (NKFH) Kidney Early Detection Screening (KEDS) program for Chronic Kidney Disease (CKD). The formative program evaluation had 921 participants who enrolled in the NKFH KEDS screening program between 2006-2009. The evaluation included 14 KEDS sites in Honolulu, Maui, and Hawai'i counties. MAIN FINDINGS: Based on the results of the formative evaluation, process changes were made to program recruitment, training, and procedure. A majority of participants were women, between 46 and 75 years old. The ethnic groups represented were: White, Japanese, Hawaiian/Part Hawaiian, Filipino, Chinese, Hispanic, and Other. The three most common risk factors identified were: (1) blood relative with diabetes, (2) blood relative with cardiovascular disease, and (3) self-reported high blood pressure. Participants in Hawai'i County had the highest mean for total risk factors. Ethnicity, gender, and age were significantly associated with selected vital signs, physiological measures, and lab tests. Fourteen percent of KEDS participants had an abnormal albumin:creatinine (A:C) ratio and 12% had an abnormal glomerular filtration rate (GFR), requiring follow-up by a health care professional. PRINCIPAL CONCLUSIONS: The KEDS formative program evaluation findings improved program planning and implementation. Summative program evaluation and implications for conducting research studies in this area will be the next step in the evaluation process.