Culturally-sensitive workouts yield health results for immigrants
On a Sunday afternoon at a small martial arts studio in a Lincolnwood strip mall, a dozen or so South Asian women warm up by marching in step to a thumping merengue beat.
Some of them wear stretchy yoga pants and t-shirts, but several sport traditional headscarves, and long, colorful tunics over billowy pants. Most of them are recent immigrants to the U.S. from India and Pakistan. All of them are at risk of developing Type 2 Diabetes.
With flushed cheeks and glistening foreheads, they keep up with instructor Carolina Escrich as she barks out instructions. They jump, punch, squat, do push-ups and smile.
“I feel happy — I’m so happy,” said Manisha Tailor giddily, after finishing the hour’s workout right at the front of the class.
Tailor is one of thirty women recruited to participate in a 16-week study led by researchers at Northwestern University. She’s been coming to the classes since February, and it was an entirely new experience for her.
“I never danced before,” she said. “So, I like (to) dance. And I feel very comfortable.” She adds that she also lost four pounds since coming to the class twice a week.
Tailor, like most of the participants, said she never exercised in her native India, and the thought of joining a gym was too intimidating. But now she’s considering joining a women-only gym once the study finishes.
For Namratha Kandula, Principal Investigator of the Northwestern study, this is a breakthrough.
“They have a lot of barriers to doing exercise,” she said. “South Asians uniformly are less physically active than other groups. This group has high rates of overweight and obesity, and high rates of physical inactivity.”
Kandula said this directly relates to the prevalence of diabetes among South Asians. Nearly a quarter of these immigrants in the U.S. develop the disease — a rate higher than that of Caucasians, African Americans and Latinos. Kandula’s research at Northwestern’s Feinberg School of Medicine focuses on crafting effective interventions for communities who are underserved and unaware of best health practices.
Kandula said on top of sedentary lifestyles, South Asians are genetically predisposed to developing diabetes. Still, research has shown that individuals can improve their odds of avoiding the disease through healthy eating and exercise.
“The problem is that that research was not reaching the South Asian community in the sense that they weren’t necessarily hearing the same messages, they weren’t getting more physically active,” said Kandula. “And we know that a lot of evidence-based programs — they don’t reach some of the more disadvantaged communities or communities that are isolated because of culture or language or geographic location.”
Kandula’s team is monitoring the women’s weight and blood sugar to see if they show any changes over the course of the program. They partnered with Metropolitan Asian Family Services, a social services agency that works with many South Asian immigrant families on Chicago’s far North Side. MAFS recruited participants and provides them free transportation to and from the classes.
The study aims to educate immigrant women, in particular, about eating healthier and the importance of exercise. In crafting the workouts, Kandula had to consider cultural hurdles that stood in the way for many women who were most at-risk for developing diabetes.
“Modesty is something that’s really important,” explained Kandula, “and women didn’t feel comfortable working out at a regular gym or recreational facility.”
Additionally, many women told Kandula that they prioritized their families over their own health. So she worked that into the design of her program by offering free martial arts classes to their children once a week. The only condition was that the mothers had to come to their workouts at least twice a week.
In fact, many women attend three times a week — and on the days they show up, several will stay for two classes back-to-back.
Rehanna Patel, a 49-year old mother of four, said the class works for her because it is fun and there are no men.
“It’s important for it to be women’s-only and having that secure space,” she said through a translator.
Many other women echoed the thought, saying that they would feel less free to move about in the class if men were included, or if men could walk by and see them.
Patel said the class helped dispel her assumption that exercise is only for younger people.
“I had always thought that these steps would only be done by a 20 or 25-year-old girl,” she said, referring to the dance routine of the class. “But the instructor did a great job.”
Teaching these women was a new experience for instructor Carolina Escrich, too.
“I needed to adjust the class and be careful with the type of music that I should use,
Escrich said it took two months to modify her usual Latin-inspired Zumba workouts into something more appropriate for her culturally conservative students. She modified the song selections to be less explicit, and has shifted the emphasis from sexy dance moves to more of an aerobics routine.
If the program shows significant health improvements, Namratha Kandula hopes they’ll win funding for a wider study. But the women here have a more immediate concern.
“I would feel really sad when the classes end,” said Patel. “The way we do it here, it’s different, we enjoy it, I feel good and my body feels light.”
Patel says even after the study ends she wants to keep exercising at home.