Manataka American Indian Council








A Major Native Health Issue


Obesity is a disease that affects nearly one-third of the adult American population (approximately 60 million).  Obesity is the second leading cause of unnecessary deaths in America.  Studies indicate that obesity rates in American Indian children, adolescents, and adults are higher than the US rates for all other races combined.  In adult natives the obesity is rate is 35-40% compared to 20-25% for non-natives.

This issue is addressed in a new book by Choctaw author Devon Mihesuah. 
Recovering Our Ancestors' Gardens: Indigenous Recipes and Guide to Diet
and Fitness
has won the Gourmand World Cookbook Award. 


"High incidences of diabetes, high blood pressure, obesity and related physical problems among Indigenous peoples are pervasive consequences of colonialism," Mihesuah says. 


"Natives once gathered, hunted and cultivated foods that kept them physically strong. Now, many Natives across the Americas are sedentary and have lost touch with their traditional tribal knowledge, including methods of cultivating, preparing and preserving foods. Taking charge of our health by boycotting the greasy, fatty, sugary and salty foods that are killing us in favor of the nutrient-rich and unprocessed indigenous foods of this hemisphere is greatly empowering."

"We can only do so much to combat racism and prejudice," Mihesuah notes, "but we can control what we eat, what we feed our families and how much we move around. We must take responsibility for our health and for the well being of our children. In so doing, we pass on a legacy of self-respect and tribal strength to future generations."

Also the U.S. Department of Agriculture (USDA) has been working for several decades to improve health and reduce obesity.  In 1980, USDA joined with the U.S. Department of Health and Human Services (HHS) to develop the first version of a nutrition policy to improve the Nation's health: Nutrition and Your Health: Dietary Guidelines for Americans  The motto for the guidelines is: aim for fitness, build a healthy base, choose sensibly for good health.

The fifth edition, released in 2000, made many important changes including:

Emphasizing the important role of physical activity for better health.

A definition of healthy weight, overweight, and obesity using Body Mass Index (BMI) measures* (below). Showing that fruits and vegetables are the important base of a healthy eating pattern, with new guidelines on eating whole grain products and fruits and vegetables.

By following these dietary guidelines you can reduce the risk of four leading killers of American Indians related to obesity; heart disease, some cancers, diabetes, and stroke that are all linked to diet and physical activity. 

*BMI: Do You Know Yours?

The Body Mass Index (BMI) determines the risks of being overweight. It requires two things: an accurate measure of your weight and height. BMI =Weight [in pounds] x 704.5  / (Height [in inches]) ˛  (To get your BMI, go to

An adult with a healthy BMI range is 18.5 up to 25, overweight is 25 up to 30, and obese is 30 or more.


Being overweight is linked to many serious health complications that affect our Native people. According to the U.S. Department of Health and Human Services being overweight and obese is observed in all population groups, but obesity is particularly common among Hispanic, African American, Native American, and Pacific Islander communities.

While modern science has given remedies to help us overcome serious illnesses related to obesity, such as increased blood pressure, high cholesterol, and diabetes we can also help ourselves by simple changes in what we eat.  Some medicines have serious side effects and their benefits are best saved for people who are very ill.  A better choice for many is to make dietary changes then you run the risk of needing medication, equipment like a glucometer, or more drastic lifestyle changes.

Diets that are high in fiber, vegetables, and fruits and low in fats, carbohydrates, sugars and salt seem to work best.  According to the Journal of American Medical Association a diet that contained nuts and plenty of vegetables and soy proteins did help reduce over all cholesterol.  A diet, called the Dietary Approaches to Stop Hypertension (DASH) is low in cholesterol, high in fiber, potassium, calcium, and magnesium, and moderately high in protein and is intended to help treat and prevent high blood pressure.  For more information see:

Exercise is missing in Indian country.  44 to 60%of Native American men and 40 to 65%of women has reported an inactive lifestyle, which can contribute to the development of obesity.  Prevention of obesity is the best hope for preventing the severe health problems associated with being overweight!

How Much Is Enough?

Check the latest best-seller list and you will find many books that promise a new slimmer trimmer you.  Beyond the hype, you may just find the old-fashioned method of portion control and watching your calorie count may be the way to go after all, a new study suggests.  The American Journal of Clinical Nutrition shows that both portion control and lower-calorie options are safe ways of losing weight.  In fact, cutting calorie concentration without reducing the serving size was more efficient in this study than just using portion control. 

Another way you can lower your over all calories without feeling deprived is to eat foods that are nutrient dense.  This refers to a food's number of calories pound for pound compared to other foods. A pound of apples will fill you up faster and has far fewer calories than a pound of cheesecake.  Try and start meals with heart healthy soups, salads or with a vegetable plate. Studies showed that increasing your exercise to at least 20 minutes per day also made any diet more successful.

Our meal sizes have grown to heaping portions since restaurants have started "super sizing".  The average size of a soda has increased by 50% in the past 20 years.  Going out to dinner at a sit down restaurant with appetizers, a main course and desert can easily add up to an entire days worth of calories in one sitting.  This does not take into account the huge amounts of fat, salt and sugar you consume.  Let's not even get started on the all-you-can-eat-buffet.  Many restaurants have healthy choices you can choose from, just ask.

Understanding portion sizes along with making good choices is a part of healthy eating. Sometimes it can be difficult to imagine what the amounts of food to eat are.  Not knowing how much food you eat may result in eating hundreds of extra calories. This may lead to weight gain.  Here are suggested servings sizes:

3 oz. of meat is the size of a deck of cards or a cassette-tape

Serving sizes for other proteins would be two tablespoons of nut butters, two eggs, or 1/3 cup of dry beans. 

A 1 cup serving of potatoes, rice or pasta looks like a tennis ball. 

A serving of grains is equal to one slice of bread about the size of a
CD case, one ounce of prepared cereal, or just one half cup of pasta, or rice.

A serving of fruit is equal to one piece of fresh fruit, one-half a cup of chopped fruit, or three-fourths cup of fruit juice. 

Vegetables a ˝ cup fresh / frozen veggies or 1 cup leafy greens is a serving. 

A serving of dairy is one cup of milk or one and one half ounces of cheese. 

Buying a kitchen scale may help or see:

KIDS KORNER: Parents and Breakfast Factors Weighed

If both parents are a healthy weight, a child is more likely to have a healthy weight also.  For teens that have an obese parent, the best predictor of whether they will not be overweight is if they eat breakfast every day, according to the results of a study published in the January 2006 issue of "The Journal of the American Dietetic  Association." researchers examined 1,900 youth ages 12 to 16.  Fewer  than 40 percent of children with two obese parents were of normal weight.

The study showed that having breakfast everyday had more impact on weight outcomes than exercise or watching television.  The main finding was that a nutritious start to the day helped our children lead a healthier lifestyle.  Yummy nutritious morning meals to give your kids a days worth of energy include, whole-wheat bagels or toast, egg scrambles with cheese, low-fat yogurt, oatmeal, or fresh fruits.

Breakfast has many benefits for kids in school and can also help them learn better. Because dietary and physical activity practices that are learned at a young age may be carried into adulthood, establishing healthful patterns at an early age is important.  To see the study, go to:

SENIOR SECTION: Medicare Helping Reduce Obesity

According to the National Heart, Lung and Blood Institute, an estimated 18% of U.S. adults older than 65 are obese. Another 40% are overweight, putting them at substantially increased risk for diabetes, hypertension, heart disease and other illnesses. 

Helping Elders stay healthy and active in our families and communities is essential to our culture.  One way we can ensure that the gifts our Elders have to share are available is by working to keep them healthy and active.  The US Government is working with tribes to reduce obesity in Seniors to help keep them with us longer.  Efforts have been undertaken in Tribes, IHS Clinics, and community programs to help provide quality nutrition and healthcare for our older generation. 

In July 2005, the Centers for Medicare and Medicaid Services announced they were changing their rules to designate obesity as a disease and that Medicare would pay for anti-obesity interventions. This has spurred new attention by the medical profession on the treatment of senior citizens who are overweight.

As you are probably aware there have been significant changes in the
Medicare program.  To get more information please go to: or

If you need help with Medicare or other health care issues, you can get free counseling through the California's Health Insurance Counseling and Advocacy Program (HICAP). Counselors can assist you with Medicare claims, and denials, or delays of service or treatment. They can also give you advice about Medicare HMOs, insurance, long-term care insurance, and more. Call (800) 434-0222

Lifestyle Balance Program


United Indian Health Service and the Potowat Health Village has a program in Humboldt and Del Norte counties to prevent the health risks that Native people face by diabetes.  The Lifestyle Balance Program is based on a study that shows that for American Indians who have the highest rates of diabetes, it is preventable.  The main effort of the program is to help you make lifestyle changes to help you avoid

Pre-diabetes is when your blood sugar levels are higher than normal but not yet at the diabetic level. 


According to the American Diabetes Association, some studies show that most people with pre-diabetes go on to develop type 2 diabetes within 10 years unless they make changes, that include better diet and more exercise.  By combining exercise and wise eating habits you can not only drop your blood sugar levels can also lose weight and avoid other health risks as well.  Diabetes is among the leading killers of Native people and many think that if it runs in your family then you will get it.  This is not true!  Diabetes can be delayed or even prevented by losing weight, healthy eating, stop smoking and getting daily exercise.

To be enrolled in the program you must first get a blood sugar test.  Anything over 100 is considered at risk and you are then scheduled for a fasting blood draw.  You must avoid eating for 12 hours and then have your blood drawn.  You are then given a glucose (sugar) drink and then wait for two hours to get more blood taken to see what effect the glucose has had on your blood sugar levels.  While you are waiting you can watch informational videos on healthy eating and getting daily exercise to prevent health problems.  Once your results are ready, usually within a week, you will know if you are pre-diabetic. 

If your test show that you need more follow up you are then enrolled in the Lifestyle Balance Program.  In the program you will become more physically active and learn healthier eating habits.  You will attend 16 weekly classes that will teach you the basics of overcoming your pre-diabetic condition.  You will also work for 3 years with a PAL (Physical Activity Lifestyle specialist) to get more active, lose weight and maintain a healthy lifestyle.

For more information contact Natalie at (707) 825-5070.
( To learn about pre-diabetes please see:


Healthier Mac & Cheese?
Yes it can be done!  This recipe reduces fat in everyone's favorite
comfort food.

2 cups whole wheat macaroni
1/2 cup chopped onions
1/2 cup non-fat milk,
1/4 teaspoon black pepper
1 1/4 (4 ounces) cups cheese, finely shredded sharp cheddar,
low fat cooking oil spray

1. Cook macaroni according to directions. (Do not add salt to the cooking water.) Drain and set aside.
2. Spray a casserole dish with nonstick cooking oil spray.
3. Preheat oven to 350 degrees.
4. Lightly spray saucepan with nonstick cooking oil spray.
5. Add onions to saucepan and sauté for about 3 minutes.
6. In another bowl, combine macaroni, onions, and the remaining ingredients and mix thoroughly.
7. Transfer mixture into casserole dish.
8. Bake for 25 minutes or until bubbly. Let stand for 10 minutes before serving.

To make a meal in one dish just add vegetables and serve with a soup or
salad starter course.

Articles: digest, issue 657



Northern California Indian Development Council
California Native Food & Nutrition Program
241 F Street Eureka, CA 95501
707.445.8451 (voice) 707.445.8479 (fax)
"Obesity Prevention" February/March 2006