Diabetes Partners in Prevention:

A Publication of the Connecticut

Department of Public Health Winter 2010
Sodium Reduction
By Stephanie M. Poulin, MPH, MT(ASCP), Epidemiologist
Connecticut Department of Public Health

Approximately 27% of all adults in Connecticut have hypertension.1 Of Connecticut adults with diabetes, ap-
proximately 65% have hypertension. Hypertension greatly increases the risk of cardiovascular diseases. Indi-
viduals with both diabetes and hypertension are also at increased risk for complications such as retinopathy and
nephropathy.

Research has shown that consuming excessive amounts of sodium increases blood pressure. Limiting sodium
consumption can reduce blood pressure. Individuals with hypertension are recommended to limit their sodium
intake to 1,500 mg per day, less than half the average amount consumed daily by Americans. Limiting sodium
intake is very difficult. Only about 10% of Americans’ daily intake of sodium is added at the table or during
cooking and about 12% occurs naturally. About 77% of the sodium consumed daily by Americans is added to
processed foods by the manufacturers or is from restaurant meals.

Voluntary efforts to reduce sodium in the U.S. food supply are underway (ex. National Salt Reduction Initiative
coordinated by New York City). In 2008 Congress asked the Institute of Medicine (IOM) to recommend sodium
reduction strategies. IOM concluded that voluntary efforts alone will not substantially reduce sodium levels. It
will be necessary to develop government standards that gradually limit the amount of salt that food manufactur-
ers, restaurants, and food service companies can add to their products. The United Kingdom and Finland have
successfully reduced the amount of sodium in their food supplies demonstrating that sodium reduction is an
achievable goal.

More information on sodium in food can be found on the CDC’s website (http://www.cdc.gov/salt/index.htm).
1
The data source percentage of adults with hypertension is the Behavioral Risk Factor Surveillance Survey
(BRFSS). In the years 2007 to 2009, 20,154 Connecticut adults responded to the BRFSS telephone surveys.

Community Garden Project at Fairhaven CHC, Rebecca Kline, Fairhaven CHCs

In May of 2010 the Fair Haven Community Health Center’s Diabetes Prevention Program (DPP) partnered with
Chabaso Bakery in New Haven’s Fair Haven neighborhood to integrate a gardening component into the already
successful Intensive Lifestyle Intervention that the DPP conducts for patients with prediabetes. The garden re-
flects the shared vision of Chabaso Bakery owner Charles Negaro and wife Nancy Dennett and DPP Director
Dr. Anne Camp and DPP Nurse Practitioner Elizabeth Magenheimer.

The Fair Haven neighborhood is an urban area where roughly 90% of the population lives below the federal
poverty level. With fresh, affordable produce an anomaly, the organic plot was poised to further the program’s
goal to derail type 2 diabetes among program participants. Since May, participants have worked with Garden
Manager Rebecca Kline in exchange for a share of the weekly harvest. The DPP Intensive Lifestyle Interven-
tion’s nutrition and exercise classes come to life when participants take home vegetables ranging from kale to
chard, tomatoes to jalapenos, and cilantro to lemon basil. During these winter months, participants continue to
generate fresh, organic produce for themselves and their families due to a newly donated greenhouse that is
heated by the bakery’s ovens.
Diabetes Partners in Prevention: A Publication of the CT Dept. of Public Health—Winter 2010 Page 2

Chronic Disease Program Now Recruiting Leaders for Spanish “Live Well”
Cindy Kozak, RD, CDE, MPH, Connecticut Department of Public Health

The CT Department of Public Health (DPH) is working with the CT Department of Social Services (DSS) Aging Ser-
vices Division in partnership with the CT Area Agencies on Aging (AAA) in the Western, Southwestern and Eastern
regions to provide the English and Spanish versions of the Stanford Chronic Disease Self Management Program
(CDSMP). This group of partners is recruiting professionals and volunteers to be trained as leaders to teach
CDSMP classes for Connecticut’s CDSMP program called “Live Well.” The CDSMP leaders will be trained to teach
workshop participants techniques to manage their chronic diseases and enhance their quality of life. The program
helps patient participants with chronic diseases such as arthritis, diabetes, and heart disease to deal with pain and
fatigue through a variety of techniques including goal setting, exercise, appropriate use of medications, improved
nutrition and effective communication.

DPH and DSS have been conducting the English version of the program for three years and are ready to implement
“Tomando Control de su Salud”. Spanish-speaking leaders are being recruited for the “Tomando Control de su Sa-
lud” training to learn to teach classes in Spanish without interpreters. This Spanish version of the program is not a
direct translation of the Chronic Disease Self-Management Program, but covers the same subjects with cultural ap-
propriateness for a Spanish-speaking audience. Potential leaders are required to speak and read English and Span-
ish fluently. Patient participants who later take the program must speak Spanish, but they do not need to read Span-
ish. The website to learn more about the program is: http://patienteducation.stanford.edu/programs_spanish/
tomando.html.

Leader orientations for those who would like to teach the Spanish version of the program will be offered statewide:
o Eastern AAA: Tuesday, January 4 at 1 p.m. at 4 Broadway, Norwich.
o Western AAA: Friday, January 7 at 2:30 p.m. at 84 Progress Lane, Waterbury.
o Southwestern AAA: Monday, January 10, 10:30 a.m., location pending.
o Central AAA: Monday, January 10 at 2:30 p.m. at 555 Windsor St., Hartford.
These orientation sessions will review the program and outline requirements for leaders interested in attending the
four-day training that will be offered on February 1, 2, 8, and 9 at the Spanish Community Center in Wallingford. For
more information contact Cindy Kozak at cindy.kozak@ct.gov or 860-509-7737.

For more information about “Live Well,” contact Cindy Kozak at (860) 509 –7737 or cindy.kozak@ct.gov.

VICTORY OVER DIABETES PROGRAM, Denise Smith, Central AHEC

On November 13, 2010, the Central Area Health Educa-
tion Center, Inc. HeartStrong Program in partnership with
the American Diabetes Association hosted the Victory
Over Diabetes Conference for African/Caribbean adults
from the greater Hartford area.
Over the past year, HeartStrong, a heart disease and
stroke prevention program funded by the State of CT De-
partment of Public Health, has conducted health screen-
ings, and prevention education at shelters, food pantries,
faith and community-based organizations in Hartford,
Windsor and Bloomfield, CT. "Over 60% of our clients
present with abnormal blood glucose levels", says Denise 860-920-5149 x114 or www.centralctahec.org.
Smith, HeartStrong Coordinator. "Since diabetes in-
creases a person's risk for heart disease, we are working
with our partners and advisory members to bring atten-
tion to Diabetes Awareness Month and connect our cli-
ents to risk reduction and empowerment resources."
Conference events included a keynote address from
Dr. Roy Kellerman and prevention workshops from Dia-
betes Specialist Leila Bruno, personal trainer Jeff
Shealey, and registered dietician Renae France.
Screenings were conducted by the CT AHEC program
Urban Service Track program and AHEC Primary Care
staff.
For more information about Heart Strong, contact
Denise Smith at dsmith@centralctahec.org or

J. Robert Galvin, MD, MPH, MBA, Commissioner Diabetes Prevention & Control Program
Norma D. Gyle, RN, PhD, Deputy Commissioner 410 Capitol Avenue, MS11APV
Cindy Kozak, RD, MPH, CDE, Diabetes Program Coordinator P.O. Box 340308
860-509-7737 cindy.kozak@ct.gov Hartford, CT 06134-0308