Height, weight, and body mass index of American Indian schoolchildren, 1990-1991.

OBJECTIVE: To describe the current height and weight status of American Indian children who live on or near Indian reservations nationwide. SUBJECTS: 9,464 American Indian schoolchildren aged 5 through 18 years. STATISTICAL ANALYSES PERFORMED: Data for height, weight, and body mass index of the schoolchildren were compared with two national reference data sets, the second National Health and Nutrition Examination Survey (NHANES II) and the Mexican-American population of the Hispanic Health and Nutrition Examination Survey (HHANES-MA). RESULTS: The three populations were similar in height, but the American Indian children weighed more, although not at a statistically significant level, and had a statistically significant higher body mass index than the NHANES II reference population for nearly every age and sex group. The overall prevalence of overweight in the American Indian children (exceeding the 85th percentile of the reference population) was 39.3% compared with the NHANES II population and 28.6% compared with the HHANES-MA population. The overall prevalence of underweight in the American Indian sample was substantially less than the expected 15% compared with either the NHANES II or HHANES-MA population. APPLICATIONS/CONCLUSIONS: Overweight is much more prevalent in American Indian children than among other children in the United States at all ages and in both sexes. This may have important implications for chronic disease risk and emphasizes the need for targeting obesity prevention efforts to American Indian children.

The diet of Alaska Native adults: 1987-1988.

Although in the past, rates of heart disease, cancer, and diabetes were lower in Alaska Natives than in US whites, these diseases are now increasing. The rate of iron-deficiency anemia for Alaska Natives continues to be higher than that in the general population. To understand the role of diet in these chronic diseases, seasonal dietary intakes of 351 Alaska Native adults from 11 communities were assessed during 1987-1988. Alaska Natives consumed more energy (19%), protein (39%), fat (21%), carbohydrate (13%), iron (25%), vitamin A (53%), and vitamin C (31%), but less calcium (19%) than did the general US adult population [National Health and Nutrition Examination Survey II (NHANES II)]; Alaska Natives consumed six times more fish but less fruits and vegetables. Results suggest that energy and protein intakes decreased in the last 30 y but the proportion of energy from fat (37%) remained unchanged. High fish consumption and large seasonal dietary variations persisted, which may protect against chronic diseases. However, excess energy and fat and low calcium, fruit, and vegetable intakes may be contributing to recent increases in chronic diseases. Dietary guidelines are proposed.

Obesity prevention.

Given the increased risk of overweight and the fact that many weight-related behaviors acquired during childhood and adolescence are likely to be maintained into adulthood, minority teen-agers are a key group to target for obesity-prevention efforts. This paper reflects on three theoretical elements of behavior change in relation to obesity-related knowledge, attitudes, and food behaviors of minority groups in the United States, and it summarizes the status of individual-, family-, school-, and environment-based efforts to prevent or treat obesity in minority adolescents.

Federal nutrition services for American Indian and Alaska native elders.

American Indian and Alaska native elders have a poverty rate of 61% and a life expectancy between 3 and 4 years less than that of the general older U.S. population. In 1978, Congress enacted a separate title under the Older Americans Act to address some of the special needs of American Indian elders. Since enactment of specific provisions for American Indians, Congress has continued to amend the Older Americans Act to ensure that the nutritional needs of American Indian elders are addressed. Currently, federal nutrition services are provided to American Indian and Alaska native elders through both Title III, Grants for State and Community Programs on Aging, Part C, Nutrition Services, and Title VI, Grants for Native Americans, of the Older Americans Act. In fiscal year 1987, more than 52,000 American Indian and Alaska elders received meals from congregate nutrition sites and/or home-delivered meals.

Nutrition in American Indian health: past, present, and future.

In addition to benefiting from public health programs for all Americans, American Indians and Alaska Natives are eligible for health services from the Indian Health Service (IHS), U.S. Public Health Service. Indian Health Service provides comprehensive health services, including nutrition and dietetics, to American Indians and Alaska Natives living on or near federal Indian reservations or in traditional Indian territory, such as Oklahoma and Alaska. Dramatic improvements have occurred in the health of native Americans since IHS was transferred to the Public Health Service in 1955. Infant mortality rate, maternal deaths, and deaths related to infectious diseases have all decreased. Chronic diseases are now major causes of death. Nutritional factors contribute to at least 4 of the 10 leading causes of American Indian and Alaska Native deaths--heart disease, cancer, cirrhosis, and diabetes--and to the prevalence of overweight, obesity, hypertension, and dental caries. There is still incomplete information on nutritional status and present dietary patterns, nutritive values of native foods, and nutrition education knowledge of the population. Priority nutrition objectives have been developed to address those issues.

Dietetics training for American Indians and Alaskan natives.

The response to training has been enthusiastic. Even in these times of limited funds, applications to attend training exceed the available space. From the first class in October 1968 through September 1982, nearly 1,300 Indian and Alaskan native hospital food service employees and employees representing tribal programs throughout the country have received training from the courses and workshops provided by the Nutrition and Dietetics Training Program. With the increasing involvement of Native Americans in their own health care programs, the need for training in foods and nutrition will continue.

Content analysis: an approach to evaluating nutritional care.

A research panel utilized content analysis techniques for quantifying the content of nutritional care plans developed by senior level dietetic students. The content was organized into six subject matter categories relevant to sociocultural and physical factors: cultural, economic, physical, psychological, religious, and social. The average score of six coders was used in determining the content. Content analysis proved to be an effective method of evaluating the content of nutritional care plans and could be further utilized in dietetic education to help dietetic students apply the theories learned in the classroom to actual patient care.