Usual Dietary Intake and Adherence to Dietary Recommendations among Southwest American-Indian Youths at Risk of Type 2 Diabetes

Abstract

Background: American Indians are disproportionately affected by obesity and diabetes, and American-Indian youths have the highest prevalence of obesity and diabetes among all ethnic groups in the USA. Objectives: The purposes of this study were to assess the usual dietary intake in American-Indian youths who attended a wellness camp program; adherence to the Dietary Guidelines for Americans 2015-2020 (DGA) and to the Healthy People 2020 Objectives; and to compare pre- and postcamp reported diets. Methods: A total of six 24-h dietary recalls were conducted in person with American-Indian youths (aged 10-15 y; n = 26) from 3 different Southwest tribes. Three recalls were conducted before the wellness camp, and 3 were conducted after the camp. A series of 2-factor ANOVA were conducted, using a mixed model, to compare the nutrition differences before and after the health camp using a statistical program, R. Results: Adherence to federal dietary recommendations was low, with few of the youths meeting the DGA recommendations for fruits (15%, average serving 0.69 cup/d) and vegetables (35%, average serving 0.59 cup/d). All of the participants exceeded the DGA recommended limit on empty calories. Nutrient analysis of total fat intake showed a significant decrease in intake after the camp, F (1, 52) = 5.68, P = 0.02. Conclusions: Diet is a modifiable risk factor for obesity and chronic diseases such as type 2 diabetes and needs to be an integral part of any healthy lifestyle intervention. The camp-based nutrition education had a positive effect on youths, as observed through the total fat intake decreasing after camp. To reinforce nutrition education, future nutrition education should involve parents, be delivered beyond the week at camp, and encompass social determinants of health and access to healthy foods.