It is also the time of year that Kuni Frith-Black, as executive director of the Bermuda Diabetes Association, steps up her efforts to get locals to pay attention to what they are eating and how much.With one in four people in Bermuda either having diabetes or at risk of developing it, Bermuda has one of the highest per capita rates of amputations caused by diabetes in the world.“There are over 1,000 amputees that are recorded, but the numbers are said to be as high as 1,200,” said Mrs Frith-Black. “I can tell you 90 percent of the amputations are diabetes related.Tooth decay, gangrene, even an average blister are all minor symptons that can turn nasty for a diabetic, and the BDA and other health organisations are doing their best to make people fully aware of the dangers overeating, and eating badly can bring.“Diabetics need to have regular foot checks because the podiatrist can very well identify an infection that may cause amputation,” said Mrs Frith-Black.“It’s very common. The circulatory system is impaired because of the diabetes and therefore people strike their toe, cut their toe, get blisters from not wearing proper footwear and that blister turns into an ulcer and if left unchecked that ulcer spreads to the bone, then you’re looking at gangrene and then amputation. It happens with a lot of older people who just don’t feel it, they live with a condition known as diabetic neuropathy (damage to the nerves in the body that occurs due to high blood sugar levels).”“Diet is a big part (of diabetes), genetic predisposition is another one and people are living more stressful lives due to the economic climate. But these figures were high even before the downturn, Bermuda is an affluent society yet we have epidemic levels of disease here like Type 2 diabetes, heart disease and cancers.”Even with the amount of information that the BDA makes public the message is still taking time to get across, especially this time of year. Mrs Frith Black won’t shy away from continuing to hammer the message home, even if the approach has got her a nickname or two.“We know that we have young people coming in at ages 11, 12, 13 with Type 2 diabetes, high blood pressure, high cholesterol and we can’t say it enough and will not stop preaching the gospel of good nutrition because it will save your life.“I’ve heard people say ‘oh, there goes Miss Diabetes Association, I don’t want to hear anything about diabetes, I’m going to eat what I want to eat when I want to eat it’. It’s funny how people perceive you. It’s either ‘Miss Diabetes Association’ or the health lady. I’m talking total strangers.“It is denial speaking, guilt speaking, because they know they are not doing the right things.”The BDA’s executive director said that the older generation were the hardest to convince, while also being the largest part of the problem. And an incident at the grocery store one day proved particularly enlightening to the diabetes campaigner.“For every ten people who hear me, one listens, especially this time of the year,” she said. “It’s the oldest generation we have the greatest challenge with. They find it very difficult to let go of old eating habits. They were brought up on particular foods … peas and rice, potato salads, chicken, macaroni and cheese. These dishes are at just about every social function you attend and are a contributing factor to the rate of diabetes.“One evening (in the grocers) this old lady, in her late 60s or early 70s, said to me ‘oh, you’re the lady who comes on the radio. I’m always listening to you’. She proceeded to grab her grocery cart and followed behind me.“I looked around and asked her ‘can I help you with something’. She said ‘yes, go ahead and push your cart, I want to see what you’re getting’.“She followed me around the whole store and was asking ‘why are you buying that’, ‘what is the difference between what you’re buying and what I want to buy?’. She challenged me on everything. She said ‘you’re eating junk’ because she saw me pick up blue corn chips. I explained that the blue corn chips were baked and not fried in grease and heavily salted. She saw me pick up crackers and I explained to her they were organic crackers, made from unbleached flour, whole grains. She had me out straight and wanted to know about everything I put in the basket.”For Mrs Frith-Black though the message is not just about what you eat, but also the portions.“A heap of this and a heap of that, we (Bermudians) just heap stuff on the plate,” she said. “There is a lot of deep frying that goes on, a lot of fast food indulging because mom is too busy to cook.“Diabetes is a non-communicable disease and it is one of the most easily reversed diseases with two simple applications … exercise and proper nutrition. Doctors confirm that and the first two things they will say is increase physical activity and exercise portion control.”With the New Year comes new resolutions, and while Mrs Frith-Black doesn’t believe in those, 'why not now. If you are going to have your binge on Christmas Day so be it, but get back on track after that’, she will be taking advantage of the people that do.The BDA will be holding health programmes in the New Year aimed at women who are concerned about healthy living, and working with schools to combat the rise in youth obesity.“We will be doing two eight-week-long programmes geared towards women who are living with Type 2 diabetes or are at risk for Type 2 diabetes,” she said. “Sara McKittrick will be doing education and physical activity and I will be doing healthy cooking and healthy eating.“We’re looking forward to working with CedarBridge in 2012. We will be going into the school and screening the students because we have such a high rate of obesity among our young people.“I would like to applaud CedarBridge for participating in the health screenings, we do have an issue with our young people and obesity and they are looking to stimulate the awareness and raise the consciousness of young people regarding their health.”Mrs Frith-Black’s approach to food doesn’t mean that she doesn’t like cassava pie, or a host of other Christmas goodies. She does, she’s just found ways of making healthy versions.“I would definitely leave out the butter and the ‘plastic’ margarine which is loaded with saturated fat and hydrogenated oils, colours and preservatives,” she explained. “I use eggs but I use farm fresh eggs. I would go to Windy Bank farm and get my eggs. I use organic cane juice and organic spices instead of regular sugar because the table sugars are chemically processed. I use non-hydrogenated oils and don’t put meat in mine. But every time we have a family function and I bake my pie is the first to go, even without the meat. I use the vanilla beans instead of the extract.“If I go to my in-laws everybody brings a dish and it’s always garden fresh vegetables and you may find some starches. We don’t have a lot of foods that are high in additives and preservatives. You can still have your traditional macaroni and cheese and peas and rice but you just prepare it differently. And you have smaller portions. Portion control is the key.“I have a sweet tooth, but I bake my own baked goods because I want control over what goes in them. I don’t want high fructose corn syrup in my pie, cookies and cakes. I don’t want some dye to give it colour, I want to be able to put what I know is good for my body into what I bake. I bake brownies, cookies and sweet potato pie, pumpkin pie and I don’t use any canned vegetables or canned pie fillers to make my pie. If it is apples it is fresh apple pie, if it is sweet potato it is fresh sweet potato pie. I make everything from scratch.”