Bold grocery signage written in Choctaw Indian language points consumers to healthier foods
RESEARCH FEATURE
Native American foods, dietary habits take center stage

As our nation commemorates November as Native American Heritage month, it is important to remember the many valuable contributions of the people who first inhabited what is now the United States.  Among those contributions is a rich variety of natural foods.

Yet, in a bitter twist, many American Indians today have become disconnected from their traditional ways of eating.  Canned meats and sugary snacks have largely replaced healthy diets once rich in fresh fruits and vegetables. That shift, along with increasingly sedentary lifestyles, has dramatically affected the health of many now living in rural communities.

“Nearly 50 years ago, heart disease was virtually unheard of in the Indian community, but rates of the disease are now double the general population,” notes Amanda Fretts, Ph.D., M.P.H., an epidemiologist at the University of Washington who has conducted studies on the dietary habits of the American Indian population.  The studies are part of the Strong Heart Study, the largest and longest epidemiologic study on heart disease and its risk factors among American Indians.  Strong Heart is funded by the National Heart, Lung, and Blood Institute (NHLBI).

“Several studies have shown that unhealthy, nontraditional foods like canned meats and fast-food, are a large part of the problem,” says Fretts, a member of Mi’kmaq tribe. “Many of these processed foods contribute to diabetes, which is a risk factor for heart disease.” 

Now, with support from NHLBI, researchers are exploring ways to improve these diets and coming up with strategies that could help reduce those high rates of disease.  At the same time, people are rediscovering the rich culinary heritage of Native Americans. 

Researchers concede that the challenges helping Native Americans make the shift to earlier—and better—ways of eating are, in many ways, as daunting as they are for the rest of the population. The high costs of eating healthier meals and the additional time needed to prepare them play a role, as they do for many. But the isolated nature of many Native American communities make access to healthier food choices particularly difficult.  In some areas, for instance, the nearest modern grocery store is hours away.

One NHLBI-supported study is trying to tackle these challenges head on. Called THRIVE – Tribal Health and Resilience in Vulnerable Environments – the project targets the convenience stores that people within the Chickasaw and Choctaw Nations of Oklahoma rely heavily on for their food. The idea is to facilitate healthy “makeovers” of these rural stores by encouraging owners to stock more fruits and vegetables and other healthier foods, make those foods easier to identify and access, and lower their prices.  

There are also efforts underway to make food signage more culturally-appropriate. For example, some grocery signs are now written in Choctaw language in addition to English.  A sign at one store reads—in large, bold letters — “Achukmvt i shahli,” which means “Fresh food has arrived.” It stands as a beacon to lure consumers to an array of healthier snack options displayed beneath the sign.

Preliminary results of the THRIVE study, which is ongoing, indicate that these strategies are working.  Sales of fruits and vegetables are on the rise, and people are choosing healthier snacks, according to study leader Valarie Blue Bird Jernigan, Dr.PH, an associate professor at the University of Oklahoma College of Public Health.

“In some cases, healthier foods are selling out,” says Jernigan, a member of the Choctaw nation. The goal now, she says, is to keep up the progress.  “The leadership of both tribal nations have supported these efforts from the beginning, and have continued to help us improve the tribal food environments even when it meant working with new suppliers who could actually get the fresh produce to these remote, rural communities.  It hasn’t been easy, but no one ever gave up.”

Indian Corn Casserole
This Indian corn casserole is an example of delicious and healthy food with Native American origins.
NHLBI researchers say it helps when traditional Native American foods are celebrated broadly and across cultures—and there is some evidence this is happening. Through a growing number of outlets such as food trucks, restaurants, and cookbooks, the traditional foods of American Indians are seeping into the spotlight, and in some places actually becoming trendy. NHLBI has even published a cookbook featuring heart healthy American Indian recipes.

In addition to already-familiar foods like tortillas, salmon, shellfish, and venison, traditional foods containing beans, squash, and corn are getting renewed attention. And they are taking center stage with recipes more in line with today’s nutrition guidelines.

“I think this is a wonderful trend,” says researcher Fretts.  “So much has been taken away from American Indians over the years.  Rediscovering these traditional foods gives people a sense of pride and history, while at the same time promotes healthier eating habits.”

Like other foods that have contributed to the diverse melting pot of the American diet, traditional Native American foods can be prepared using lighter, healthier ingredients and cooking methods, says Kathryn McMurry, a nutrition coordinator at NHLBI.

“You can still choose foods that your family has enjoyed for generations, but you need to align them with healthy eating patterns: less sodium, sugar, and saturated fat; and more vegetables, fruits, and whole grains,” says McMurry.  “Changing one’s diet takes time, but the benefits are potentially life-saving. Simple changes like cooking with vegetable oil instead of butter or lard, and seasoning foods with herbs and spices instead of salt, can really make a difference.”