Nutrition in American Indian CommunitiesKelli Wilson, MS RD LDKickapoo / Mvskoke Creek / Seminole

IHS Diabetes Care and Outcomes Audit, 2011

Access to Nutrition Services

50% of American Indian / Alaska Native (AI/AN) people with diabetes received diet education.

25% were seen by a Registered Dietitian for Medical Nutrition Therapy (MNT).

BARRIERS

Native Americans suffer food insecurity and hunger at twice the rate of the general population.Food Research and Action Center, 2000

Community Food Insecurity

A situation in which all community residents

obtain a safe, culturally acceptable,

nutritionally adequate diet through a

sustainable food system that maximizes self-

reliance and self justice, without resorting to

emergency food choices.

Environment vs Epigenetics

Inadequate maternal nutrition during pregnancy is associated with a range of undesirable outcomes in the offspring, including obesity in childhood JACN 2004; 23

• Maternal diet during pregnancy epigenetically affects child’s adiposity at age 9 yrs Diabetes 2011; 60

• Inverse relationship between birth weight and risk of diabetes JAMA 2008; 300

• Fetuses of obese mothers develop insulin resistance in utero Diabetes Care 2009; 32

• Breastfeeding is most traditional form of feeding for early life nutrition

Documentary – Unnatural Causes

Unnatural causes, is inequality making us sick?

www.unnaturalcauses.org

“Bad Sugar”

California Tribes

Indian Healthcare Delivery System

www.ihs.govCalifornia Area California Rural Indian Health Board

www.crihb.org

Traditional Foods in California TribesGame and Wild Fowl Seafood Nuts and Seeds

Grains and Beans Variety of Vegetables Fruits and Flowers

Common Commodity Foods:- Flour- Lard- Cheese Block- Powdered Eggs / Milk- Canned Meat

Government Issued Foods - Original

Versions of Fry Bread

CULTURE

Family and community are important

Multi-generational households

Elders are valued

Meal planning is the responsibility of the females in the household

Bread is a staple in the diet

Frequent communal meals (feasts, gatherings for cultural and religious purposes)

American Indian Community

Cultural Snapshot

SUGGEST

Switching fat sources – from lard to oil

Eating smaller portions of bread

Decrease sugar-sweetened beverages

Decrease salt intake and cut down on added salts to food

Eating meals on a schedule and avoiding late dinners

Small, gradual changes in eating habits

Increase fruits and vegetables

American Indian Community

Cultural Snapshot

National American

Indian and Alaska Native

Heritage Month

www.ihs.gov/HeritageMonth/

National Diabetes Month

FREE!Various Resources Available- Facts At-a-Glance- Standards of Care- Best Practices- Diabetes Algorithms- Web-based CME Training- Printable Materials- Media Tools- Client Education Tools

www.diabetes.ihs.gov

Indian Health ServiceDivision of Diabetes Treatment and Prevention

www.diabetes.ihs.gov

Indian Health ServiceDivision of Diabetes Treatment and Prevention

www.diabetes.ihs.org

Indian Health ServiceDivision of Diabetes Treatment and Prevention

www.diabetes.ihs.org

Indian Health ServiceDivision of Diabetes Treatment and Prevention

Educator’s Tip Sheet to Use with My Native Plate

Click on Printable Materials – Nutrition

5 Key Focuses:

1. Emotions and Stress2. Finances3. Social Gatherings4. Traditional Foods5. Convenience Foods

www.diabetes.ihs.gov

Indian Health ServiceDivision of Diabetes Treatment and Prevention

www.diabetes.ihs.gov

Downloadable Posters (Legal-Sized)

Click on Printable Materials – Youth Diabetes Prevention

• Breastfeeding Promotion• Childhood Obesity

Prevention• Physical Activity Promotion

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www.diabetes.ihs.gov

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www.diabetes.ihs.gov

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www.diabetes.ihs.gov

Alaska Native Tribal Health ConsortiumStore Outside Your Door

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Native American Initiative | Awakening the Spirit www.diabetes.org/ats

AAIP Policy Brief

MVTO.“Thank You” in Muscogee Creek and Seminole Language

Pronounced “muh-doe”

Question and Answer