Diet-related chronic diseases including cardiovascular disease, hypertension, cancer, Type II diabetes, and obesity are the leading preventable cause of death globally (World Health Organization 2011). At the same time, diet-related chronic diseases represent a critical health disparity in the United States among American Indian populations (Satia et al. 2005; Egede et al. 2005). For example, Type II diabetes has been shown to be epidemic among American Indian populations (Egede et al. 2005). Populations with diet-related health disparities display differences in dietary intake, dietary behaviors, and dietary patterns as compared to that of the general population including diets higher in saturated fats, sugar, and salt and lower in fruits, vegetables, and whole grains (Satia et al. 2005).

Previous research by members of the study team on food security, food environments, and diets on the Flathead Indian Reservation highlight that residents show diet-related disparities with notably higher rates of food insecurity compared to the average American population. Approximately 50% of participants out of 79 individuals surveyed reported low or very low food security status while the remainder scored high or marginal food security rates (Byker Shanks et al. Forthcoming). Food security status was found to be significantly related to income with the least food secure populations having the lowest income (Byker Shanks et al. Forthcoming). It was further found the diet of study participants was notably below that of a healthful diet as recommended by Dietary Guidelines for Americans 2010 with a mean Healthy Eating Index-2010 score of 45.5 and range from 20.0 to 78.1 (the total HEI-2010 score is the sum of the scores for 12 components that cumulatively range from 0 to 100, with a higher score indicative of a more healthful diet; Byker Shanks et al. Forthcoming). The aforementioned findings on food security and diets are reflective of our findings on the overall availability, affordability, and quality of food on the Flathead Indian Reservation (Byker Shanks et al. 2015a; Ahmed and Byker Shanks 2017; Ahmed et al. 2018; Byker Shanks et al. 2015b). While daily consumption of fruits and vegetables is widely recognized to be associated with supporting nutrition and health (National Center for Chronic Disease Prevention and Health Promotion), previous research by members of the study team found disparities exist in consumer food environments regarding access to high-quality produce based on location (Ahmed and Byker Shanks 2017). Produce quality as measured by total phenolic concentration scores were lowest for the more rural areas including those on the Flathead Reservation (Ahmed and Byker Shanks 2017) as was sensory desirability of this produce (Ahmed et al. 2018).

This project addresses the aforementioned diet-related health disparities through an integrated social media and nutrition education intervention, titled the Healthy & Sustainable Diets for All Program, which seeks to enhance dietary patterns of low-income residents of the tribal community that are either participants of the Food Distribution Program on Indian Reservations (FDPIR), the Supplemental Nutrition Assistance Program (SNAP), or access local Food Banks. The Flathead Reservation tribal community consists of enrolled members of Confederated Salish and Kootenai Tribes (CSKT), members of other federally recognized tribes, and non-enrolled residents residing on the Reservation.  The Food Distribution Program on Indian Reservations (FDPIR) is a federal food assistance program administered by the U.S. Department of Agriculture-Food and Nutrition Service (USDA-FNS) and locally administered by state and tribal organizations. The USDA provides administering agencies a list of available FDPIR foods and funds for program administrative costs. Eligible low-income households living on Indian reservations and Indian families residing on or near reservations can receive food assistance from the FDPIR as an alternative to the Supplemental Nutrition Assistance Program. Access to fresh fruits and vegetables as well as other healthy whole foods can be improved by making locally produced foods more available through the FDPIR along with other tribal programs, schools, tribal restaurants, farmers markets, community gardens, food banks, and community supported agriculture.

Specific Aims

  1. Determine the impact of an integrated social media and nutrition education intervention titled the Healthy & Sustainable Diets for All Program on food choices and dietary quality of study participants within the Flathead Tribal community
  2. Evaluate the impact of the Healthy & Sustainable Diets for All Program on waist circumference, body mass index, blood pressure, and glucose and insulin levels of study participants

  3. Determine the impact of the Healthy & Sustainable Diets for All Program on nutrition knowledge and perceptions of study participants and integrate data from Specific Aims #1-#3 to elucidate linkages between food choices, dietary quality, health outcomes, nutrition knowledge and perceptions

  4.  Assess barriers and opportunities for increasing the consumption of locally produced fruits and vegetables into tribal diets on the Flathead Nation towards more sustainable food systems

Primary Contact

Virgil Dupuis virgil_dupuis@skc.edu