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At first glance, Anh Vu Sawyer wouldn't appear to be someone at high risk for heart disease or stroke.

But she'd be the first to say looks can be deceiving.

"I have a very low body mass index, but I was surprised to learn that I'm already prediabetic and did have high blood pressure," said Sawyer, executive director of the Southeast Asian Coalition of Central Massachusetts in Worcester.

That combination of healthy weight and serious underlying risk factors for heart disease and stroke is not so uncommon, particularly among some Asian populations.

That's what drives Sawyer to help people understand and improve their nutrition. It's one of the many services the coalition provides annually to around 10,000 Southeast Asian immigrants, refugees and long-term residents.

It's estimated that more than half of Asians who have diabetes go undiagnosed because they develop the disease at a lower body mass index than white people.

The problem stems from the way many people of Asian descent distribute fat, often storing more around the waist than on the limbs. This can be associated with Type 2 diabetes. The diabetes risk for Asians comes with a BMI of 23, as opposed to 25 for others, according to the American Diabetes Association.

"Even thin Asian teenagers can have diabetes and high cholesterol levels," Sawyer said.

Sawyer's own prediabetes diagnosis eight years ago was a reminder to eat healthier – and to help her clients. She has found several ways to do that, including a healthy eating group and an urban gardening project. She plans to open a commercial kitchen using, in part, fresh produce from the garden.

Sawyer was 20 when she fled Vietnam to the United States with her family during the fall of Saigon in 1975, so she can relate to newcomers getting used to Western diets.

"Food can be a difficult thing," she said. "We miss our food from home. We used so many fresh vegetables and herbs, many that you can't get here."

But the issue is complicated by feelings of wanting to fit in, said Sawyer, author of Song of Saigon, a book about her life in Vietnam and her assimilation in the United States.

"American food was considered the best because Americans were considered healthy and wealthy," she said. "So we served our families processed food out of love because that's what rich (people) give their families."

In 2017, Sawyer started an urban garden to grow produce, to give elders food they could sell or cook and to brighten downtown Worcester.

"What I hadn't realized was how much the garden would help people mentally," she said. "Being an immigrant can be very isolating, stressful and depressing, and this gave them something enjoyable to do with other people."

Gardeners started with a small downtown space, growing greens, bitter melon, squash and seeds for herbs grown in elders' home countries. Last summer a second, larger plot started growing hot peppers, tomatoes, cabbage and more.

A dozen adults and a dozen students gardened together on the second project and earned money from produce they didn't keep for themselves. They sold 500 pounds of herbs and greens to a local Asian market.

"Lots of good things came out of this program," Sawyer said. "We were able to strengthen bonds between our youth and our elders."

One of the gardeners is Son Ho, a 68-year-old Vietnamese widow (her husband was killed in the Vietnam War) who arrived in Worcester six years ago. She was sponsored by her son, who runs a Vietnamese restaurant in a neighboring city.

"I love planting, like I did at home, and I was happy to be able to eat my own herbs," Ho said through an interpreter. "But also it made me feel peaceful to come and work with other people in the garden. People who speak my language."

Ho said she is enjoying a higher standard of living in the U.S., but still misses Vietnam. She wants to set up shop herself, making Vietnamese breakfasts and lunches to go.

"That's why I'm pushing so hard for our kitchen," Sawyer said. "People like Son have so many incredible cooking skills they want to put to use."

Sawyer would like to set up takeout menus at the center and perhaps do catering and give cooking lessons.

"The food the elders cook is just amazing," she said.

Although, frequent meals from them does force Sawyer to be mindful of her diet.

"I have to stay off the noodles," she laughed. "Once a week, that's it."

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