In the 19th century the leading causes of death for Hawaiians were communicable diseases like measles and cholera. Since 1900, the leading causes of death have been diseases triggered by diet and lifestyle.

Claire Kuuleilani Hughes is one of the people who are helping to change that.

Born on Kauai, a graduate of Kamehameha and Oregon State University, Hughes became the first Native Hawaiian dietitian at the state Department of Health. In the mid-1980s she worked with Drs. Kekuni Blaisdell and Emmett Aluli to secure passage of the Native Hawaiian Health Care Act of 1988. It was an essential step in improving the health of Hawaiians.

In October, Hughes, 81, received the Rotary Club of West Honolulu David Malo Award, given annually to community leaders of Hawaiian ancestry, for her “lifetime dedication to enrich, nourish and perpetuate the Hawaiian culture.”

JOHN BERGER: What inspired you to focus on diet-related health problems?

CLAIRE HUGHES: The Department of Health put out a report in 1982 which showed that full Hawaiians had a death rate from heart disease that was far above other populations’. Prior to that we did not know how bad off we were.

JB: How did Emmett Aluli and Kekuni Blaisdell get involved in developing the traditional Hawaiian diet?

CH: They decided a cross-cutting issue for heart disease and diabetes and hypertension was diet. Dr. Aluli insisted that we use only the foods that were here prior to the arrival of the ships from Europe and America.

We found that for people who ate the traditional Hawaiian diet over a four-week period of time, the “bad fats” dropped significantly, and the protective fats actually came up.

JB: The “American” nutritional pyramid shows food groups pre-contact Hawaiians didn’t have. Where did they get those vitamins?

CH:Hawaiians didn’t have grains but we had poi. Hawaiians didn’t have cows, but they got a great deal of calcium through leafy greens and limu. They didn’t need the food items we now say are important.

JB: What can Hawaii do to make it easier to follow a more traditional Hawaiian diet?

CH: We‘re up against the challenge of being able to afford healthier food. We need more poi, but the price of poi is astronomical! Taro farmers should get subsidies for growing taro (for poi).

JB: What are you working on now?

CH: The Native Hawaiian Health Care Act has to be reauthorized every so many years. The statistics on heart disease and diabetes are well known, but there are other health issues that we need to get more information on.

“On the Scene” appears on Sundays in the Star-Advertiser. Reach John Berger at jberger@staradvertiser.com.