1. Gestational Diabetes among Filipino American Women
Tricia Bulatao

2. Gestational Diabetes Rates
United States - 2% to 10%
Filipino Americans – 18%
Occur at lower BMI ( )
Why?
Genetic predisposition
Visceral fat

3. Managing Gestational Diabetes
Diet
Adequate macronutrients
Spread throughout the day
Whole grain, fiber, vegetables, low GI, unsaturated, reduce simple sugars
Exercise

4. Filipino Culture
Values
Beliefs
Attitudes
Practices

5. The Philippines Classified as an archipelago Made up of 7000+ islands
Located off the coast of Vietnam and China

6. Ecological Effects on Food
Agriculture
Pigs
Chickens
Vegetables

7. Ecological Effects on Food
Tropical fruits prevalent
Coconut
Pineapple
Guava
Mango

8. Ecological Effects on Food
Seafood
Tilapia
Crab
Oysters
Shrimp
Squid

9. Other Cultures’ Influence
Spanish influence from the 1500’s adds a spicier flare to the food
Asian influence brings about the use of rice and fish

10. Major Religions of the Philippines
Roman Catholicism ~ 80% to 85%
Islam ~ 5% to 9%
Other Christian Denominations

11. History of Religion Animisim Spirits in animals & nature
Interwoven into current ceremonies
Superstitions
Current rituals are very theatrical, patron saints within each town and festivals for harvest, fertility, etc.
Examples of Superstitions: pregnancy (open window = ease delivery), death (sneeze at wake, pinch for good health), marriage (widowed during new moon = marry again soon), health (Sleeping with wet hair makes one crazy.)
Duende were mischievous spirits that inhabited the land. While the name is Spanish, the spirits are Filipino, stemming from our animist tradition. Duende were mischievous and often played pranks on people. They could also be very dangerous if offended, and they were easily offended (as my Mommy Es’ story shows). But if you were good to them, they were very protective of you.
To my foreign influenced eyes, this holiday seems light and fun; a nice way to remember the past, but in the Phils—despite how casual the atmosphere is—there is a real fear that to not pay respect at the grave of a family member would have severe repercussions from the spirit world.

12. Roman Catholicism & Filipino Food
Feast Days
Remembrance of Biblical Events
Congregation of Family
Sharing of Traditional Foods
Christmas
New Year’s Eve
Feast of the 3 Kings
Annunciation of the Virgin Mary
Easter
Ascension of Christ
Assumption of the Virgin Mary
All Saints Day
Immaculate Conception

13. Roman Catholicism & Filipino Culture
Cultural & Moral Influences
Ceremonial Traditions & Rituals
Create meaning & enhance family gatherings
Food is a part of the shared celebration
Contraception policies

14. Filipino Family Fear of hiya(shame)
Value of family and extended family
Value of godparents, sometimes have multiple godparents

15. Health Balanced Living Spiritual Influences, Fate
Alternative Treatments
Power of Eyes
Respect for Profession

16. “Average” Filipino American
Height: 5’0””
Weight: 118 lbs.
Age: 28
BMI: 22.5
Activity Level: Low
Pregnant: Yes, 3rd Trimester
Vegetarian/Vegan: No
DRI: kcal
Meals: Breakfast, Lunch, Snack, Dinner
BMI range:
60% in urban areas
Custom tailored Barong Tagalog for my wedding, made of pina (pee nya) made from pineapple

17. Recommended Macronutrient Intake
Energy
DRI
Range
Total kcal
2220 kcal
Carbohydrates
111 g
40-50%
Protein
250 g
20%
Fat, Total
86 g
30-40%
Adjusted meal plan to within

18. Recommended Distribution of Calories
Breakfast to 20%
Lunch – 20 to 30%
Dinner – 30 to 40%
Snacks – 30%

19. Typical Meal Pattern: Breakfast (6am to 9am)
Tapsilog
Beef Tapa
Sinangag
Itlog
Tomato Salad
Tea
Tapa: Thin beef rubbed with salt, spices and marinated over night and then fried
Si: Garlic fried rice from left over rice
Log: Whole egg either fried or poached
Fresh tomatoes dressed with oil & herbs

20. Typical Meal Pattern: Lunch (Noon to 1pm)
Adobo
Steamed Rice
Mango
Water, Room Temperature
Main meal of the day
Adobo = chicken & pork stewed in vinegar, soy sauce, garlic, peppercorn & bay leaf
Mango = national fruit “Filipino mangos = sweetest on earth”

21. Typical Meal Pattern: Afternoon Snack (3 to 4pm)
Pancit Lumpia

22. Typical Meal Pattern: Dinner (6 to 7:30pm)
Ginataang Tilapia
Rice
Leche Flan
Tilapia ~ coconut milk, fish paste, spices, vegetables
Leche flan ~ made with more eggs and milk than our classic

23. Overview of the Filipino Diet
Strengths
Meets many nutrient needs
Variety of foods consumed
Weaknesses
High consumption of protein  high saturated fat & cholesterol intake
Increase risk for cardiovascular disease
High consumption of white rice
Lack of whole grains
Relative size of meals is large
#1, 3, & 5 causes of death are coronary heart disease, stroke & hypertension.