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How Can a Trip to The Grocery Store Change a Life: CCI

CCI’s Jeremy and Kim Howe visit a local grocery store.
How can a trip to the grocery store change a life? That question was raised by team members of Chronic Care International (CCI) during a recent medical visit to Quezon City in the Philippines.
It was February 2024, and CCI team members, comprising medical, health, and education specialists, set out to evaluate patients and their adherence to diabetes and blood pressure prevention and treatment protocols. This was the third such trip to the Philippines for CCI as part of a pilot program in collaboration with Unbound, an international nonprofit organization that focuses on assisting families in Asia, Africa and Latin America out of poverty.
The program’s goal: To train a local health care team to provide high quality, cost-effective chronic disease care to adults living in poverty.
Ultimately, CCI aims to improve health outcomes for people in developing countries who have diabetes and high blood pressure, two leading causes of preventable suffering and early death.
During this particular visit, while health promotors took routine measurements such as height, weight, blood pressure, blood glucose level, medication intake, etc., they also took a look at how much salt patients were consuming. According to the Institute for Health Metrics and Evaluation (IHME), “sodium (salt) is the dietary risk  with the largest impact on health,” due to its contribution to heart disease, high blood pressure and strokes.  In addition, high sodium intake increases the risk of other diseases including gastric cancer, obesity, osteoporosis, and kidney disease.
An estimated two million global deaths each year are associated with consuming excess sodium, and according to the World Health Organization (WHO), the global average salt intake per person is estimated to be 10.8 grams daily, more than double the recommendation of less than five grams of salt per day — the equivalent of one teaspoon.
Common Filipino high-sodium liquid flavoring sauce
“Filipinos are proud of their food culture,” says Dr. Hans Dethlefs, president of CCI. “But their diets are filled with salt-based seasonings, high-sodium soy and fish sauces and sugary, sweet drinks — foods that increase the risk of high blood pressure, diabetes, and heart disease.”
At the time, 91% of CCI’s Filipino patients were being treated for high blood pressure and 100% had diabetes or diabetes. Of interest, half of all adults in underserved communities with diabetes and high blood pressure don't know they have these chronic diseases, which leads to silent harms and permanent health complications.
With this in mind, CCI, whose mission is not only to provide essential medical care, testing, monitoring, and medication for those with diabetes and high blood pressure, but to care for the whole — the patient, the family, and the community at large — recognized that education can transform environmental and cultural factors that contribute to diabetes and high blood pressure.

Field Trip

That’s when the CCI’s healthcare team, accompanied by local health providers, decided to take a field trip to the corner grocery store. Their goal: to empower patients to take control of their health and improve their long-term well-being.

They purchased an array of food items — seasonings, sauces, condiments, and processed food staples — popular products commonly consumed and used in Filipino cooking. Armed with these “props,” the team returned to the clinic ready to educate. Reviewing nutrition labels, serving sizes and raw ingredients with patients and their caregivers, CCI turned mundane product information into a Bingo game actively engaging participants and affording them a personalized, collaborative learning experience. Patients and their families were not only learning how sodium elevates blood pressure and causes chronic disease, but they were also discovering how to shop for and cook with flavor alternatives, such as garlic, lemon, ginger, basil, pepper, and chili powder.
Selection of Filipino processed food
“Our CCI healthcare team came up with a fun and interactive way of teaching nutrition information,” says Dr. Dethlefs. “The exercise was so palpably effective that I'm confident most of our patients will modify their diets in ways that will help lower their blood pressure and thereby reduce their risk of heart attacks and strokes.”
You can learn more about CCI's patient-centered disease care model and how the organization changes lives by visiting its website. Chronic Care International is a 501(c)(3) non-profit organization that depends on volunteers and tax-deductible donations to make a lasting impact on communities worldwide. Ninety-one percent of CCI’s funding goes to programs such as the one outlined above. Please consider donating.

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