By Katie Kerwin McCrimmon

A basketball player as a girl and a jogger all her life, Irma Livingston was stumped when her doctor told her nearly 10 years ago that she had diabetes and would have to take drugs to fight it for the rest of her life.

“I didn’t know what diabetes was,” said Livingston, now 61.

Like up to one-third of Navajos, she had become afflicted with a disease that had been unheard of among

Native Americans just a few generations ago, but now strikes American Indians and Alaska natives at the highest rates in the U.S.

Livingston’s cholesterol also was spiking to dangerous levels.

“My doctor said, ‘Irma, you could have a heart attack. You could have a stroke.’ When he said it was serious, I knew I had to do something because I love life. I want to live to see my first grandchild.”

Livingston gave up fried foods, canned processed food like Spam and trips to Sonic. She planted foods that the Diné — the name Navajos use for themselves — had long loved like squash, tomatoes and chiles, lost 40 pounds and no longer needs diabetes medications.

She became the inspiration for her daughter, Denisa Livingston, and other activists in the Navajo Nation who won a four-year battle against Big Soda and the processed foods industry to establish a 2 percent tax on unhealthy food and drinks last November. The tax took effect in the spring and the first proceeds of about $2.7 million from the Healthy Diné Nation Act are due this fall. The money is slated to fund better access to healthy foods in gardens, grocery and convenience stores, and new options for exercise, like swimming pools and bike paths.

At the same time that Navajo leaders decided to tax unhealthy foods, they also removed a 5 percent tax on fresh fruits and vegetables to make healthy foods more affordable and enticing to people.

“We were fed up. We were hijacked by the processed food industry,” Denisa Livingston of the Diné Community Advocacy Alliance told health policy experts gathered last week at the 2015 Colorado Health Symposium. The Colorado Health Foundation sponsored the event in Keystone.

While the Navajo Nation and residents of the city of Berkeley, Calif., have become the first in the U.S. to establish junk food and soda excise taxes aimed at dramatically hiking the cost of unhealthy products, Colorado lawmakers tried earlier this year to remove small sales taxes on sugary drinks. Some lawmakers attended the symposium, but it’s unclear what legislation could emerge in Colorado in 2016.

Town officials in Telluride also tried to establish a tax on sugary drinks in 2013, but lost overwhelmingly after soda company representatives flew to town, traded their business suits for Patagonia jackets and hiking boots, and convinced voters that the tax would harm local businesses.

In Navajo country, Denisa Livingston and fellow advocate Danny Simpson, a former tribal leader, said it took perseverance and many stops and re-starts to win over tribal leaders.

“It’s a long fight. It’s almost a 24/7 fight to educate our people and educate our leaders,” Simpson said.

The opponents came loaded with cash to try to defeat the measure. Activists with the pro-tax group, the Diné Community Activist Alliance, suspected that beverage industry officials found a way to channel hefty campaign donations to tax opponents even though outside donations are barred in the Navajo Nation.

“There was a lot of misinformation given to the council members. Everything was coming from candy and beverage companies,” Simpson said.

Clean water is also a huge challenge on the sprawling Navajo lands and Simpson said the beverage companies took full advantage of their monster resources.

“In one community near Flagstaff, Coke came in and put in a $30,000 water-filtering system at the main government building. That lawmaker (representing that area) was very outspoken. He talked against our legislation and told our group, ‘You have no right to come before the Tribal Council.’ ”

In the end, however, the overwhelming facts persuaded Navajo leaders to act.

• About one-third of Navajos suffer from diabetes.
• Obesity rates are nearly three times the national average in the U.S.
• The entire Navajo Nation qualifies as a food desert, according to the U.S. Department of Agriculture.
• Unemployment is over 50 percent.

“We have about 10 grocery stores and we are about the size of West Virginia,” Denisa Livingston said. “We travel hundreds of miles to get anything. We have about 30 convenience stores. When you walk into these places, you are bombarded with unhealthy foods.

“A small bag of fresh fruits and vegetables might cost $7 vs. a dollar or two for a can of Spam,” Livingston said. “People have to go off the Navajo Nation to get any healthy food.”

Her group is envisioning a new era.

“We want the Navajo Nation to be a leader in health and to have the highest life expectancies in the world,” Livingston said.

Getting there will mean rediscovering healthy habits from the past.

“Our elders had sumac berries. We made a pudding out of it, which was full of antioxidants. Why did all of these traditions fall away and we are now bombarded by a fast and easy junk food culture?” Livingston said.

The Navajo people were forced off of some of their traditional lands and many died during a harrowing forced migration known as the “Long Walk.” Lack of clean water and refrigeration in the decades since left many Navajos reliant on canned foods, salt, sugar and flour.

This created what Livingston calls “a culture of processed food.”

Dr. Robert Lustig, an expert on soda and junk food taxes, said there’s hidden sugar in much of our food from yogurt to salad dressings and barbecue sauce.

Because sugar is ubiquitous, it clearly is having negative impacts on our society and costing governments billions in health costs, Lustig said. It’s ironic that U.S. taxpayers spend billions subsidizing the sugar industry, and now are trying to tax those players to recoup lost funds and discourage consumption.

But, Lustig said, individuals need help in fighting back.

“You can’t change your behavior on your own because the biochemistry is too powerful,” Lustig said.

And the marketing begins with children. Lustig calls those efforts “morally bankrupt.”

Canada and Europe already have taxes on unhealthy foods and drinks, Lustig said. But the taxes only work if they are very high.

“A 10 percent price increase only reduces consumption by 2 percent. Why? Because it’s so addictive.”

Lustig said 20 percent taxes on soda “would be a big deal.”

Mexico recently enacted a 10 percent tax and Lustig said the beverage industry responded by introducing new sugary drinks that wouldn’t have a benchmark price. That way, consumers might not notice the price hike.

In Navajo country, Denisa Livingston draws hope from her mother and other Navajos who are changing their health outlook.

“My mother overcame diabetes. I was with someone recently who had had an amputation (due to diabetes). This person is now fully recovered.”

Health can be at the forefront of the Navajo Nation.

Said Livingston: “We can reverse this.”