TY - JOUR
T1 - Diabetes and Obesity Associated with Poor Food Environments in American Indian Communities
T2 - The Tribal Health and Resilience in Vulnerable Environments (THRIVE) Study
AU - Love, Charlotte V.
AU - Taniguchi, Tori E.
AU - Williams, Mary B.
AU - Noonan, Carolyn J.
AU - Wetherill, Marianna S.
AU - Salvatore, Alicia L.
AU - Jacob, Tvli
AU - Cannady, Tamela K.
AU - Standridge, Joy
AU - Spiegel, Jennifer
AU - Jernigan, Valarie Blue Bird
N1 - Funding Information:
Copyright © American Society for Nutrition 2018. All rights reserved. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com Manuscript received July 3, 2018. Initial review completed September 19, 2018. Revision accepted December 3, 2018. Published online December 5, 2018. Supplemental Tables 1–4 are available from the “Supplementary data” link in the online posting of the article and from the same link in the online table of contents at https://academic.oup.com/cdn/. Supported by grant HL117729 from the National Heart, Lung, and Blood Institute (NHLBI). Author disclosures: CVL, TET, MBW, CJN, MSW, ALS, TJ, TKC, JS, JS, and VBBJ, no conflicts of interest. Published in a supplement to Current Developments in Nutrition. This article appears as part of the supplement “Proceedings of the First and Second Annual Conferences on Native American Nutrition,” sponsored by the Shakopee Mdewakanton Sioux Community’s Seeds of Native Health campaign through a gift to the University of Minnesota. The guest editors of the supplement, Treena Delormier and Mindy Kurzer, have no conflicts of interest. The opinions expressed in this publication are those of the authors and are not attributable to the sponsors or the publisher, Editor, or Editorial Board of Current Developments in Nutrition. Address correspondence to CVL (e-mail: charlie.love@okstate.edu). Abbreviations used: AI, American Indian; BRFSS, Behavioral Risk Factor Surveillance System; CBPR, community-based participatory research; IRB, Institutional Review Board; PPR, prevalence proportion ratio; SNAP, Supplemental Nutrition Assistance Program; THRIVE, Tribal Health and Resilience in Vulnerable Environments; WIC, women, infants, and children.
Funding Information:
This publication was made possible by research supported by grant HL117729 from the National Heart, Lung, and Blood Institute (NHLBI). The contents of this publication are solely the authors’ responsibility and do not necessarily represent the official views of the NHLBI or the NIH. The funding agency did not participate in the study design, data collection, analysis, decision to publish, or preparation of the manuscript. We acknowledge and thank the following members of the IRBs of the Chickasaw Nation and the Choctaw Nation of Oklahoma: Bobby Saunkeah, Michael Peercy, Dannielle Branam, and David Wharton, and directors of the Choctaw Travel Plazas and Chickasaw Nation Travel Stops: Kyle Groover and Chad McCage for their guidance and many contributions during the THRIVE study.
Publisher Copyright:
Copyright © 2018 American Society for Nutrition.
PY - 2019/2/13
Y1 - 2019/2/13
N2 - Background: American Indians (AIs) have significantly higher rates of diet-related chronic diseases than other racial/ethnic groups, and many live in environments with limited access to healthy food. Objective: As part of the Tribal Resilience in Vulnerable Environments (THRIVE) study, we examined the relations between the perceived food environment, utilization of food retailers, fruit and vegetable intake, and chronic diseases, including obesity, hypertension, and type 2 diabetes among AI adults. Methods: Through a community-based participatory research partnership, we surveyed a cross-sectional sample of 513 AIs living within the Chickasaw Nation and the Choctaw Nation of Oklahoma. Results: Only 57% of participants reported that it was easy to purchase fruits and vegetables in their town, and fewer (35%) reported that available fruits and vegetables were of high quality. Additionally, over half (56%) reported traveling ≥20 miles round trip to shop for food. Few participants met the recommended daily intake for fruit (44%) or vegetables (25%). Obesity (55%), hypertension (49%), and diabetes (25%) were commonly reported. Obesity was significantly higher among participants who reported that the price of fruits and vegetables were cost-prohibitive (prevalence proportion ratio (PPR): 1.24; 95% CI: 1.02, 1.50) and those who shopped frequently for food at nontraditional food retailers, such as Dollar Stores (PPR: 1.35; 95% CI: 1.08, 1.69) and small markets (PPR: 1.38; 95% CI: 1.02, 1.86). Diabetes was significantly higher among participants who frequently shopped at convenience stores/gas stations (PPR: 2.26; 95% CI: 1.22, 4.19). Conclusions: Our study found that the use of nontraditional food retailers, including convenience stores, gas stations, and Dollar Stores, as a regular source of food was associated with obesity and diabetes. These results underscore the importance of interventions to improve rural Tribal food environments. Healthy retail interventions in nontraditional retail settings, such as those implemented through the THRIVE study, may contribute to reducing AI health disparities.
AB - Background: American Indians (AIs) have significantly higher rates of diet-related chronic diseases than other racial/ethnic groups, and many live in environments with limited access to healthy food. Objective: As part of the Tribal Resilience in Vulnerable Environments (THRIVE) study, we examined the relations between the perceived food environment, utilization of food retailers, fruit and vegetable intake, and chronic diseases, including obesity, hypertension, and type 2 diabetes among AI adults. Methods: Through a community-based participatory research partnership, we surveyed a cross-sectional sample of 513 AIs living within the Chickasaw Nation and the Choctaw Nation of Oklahoma. Results: Only 57% of participants reported that it was easy to purchase fruits and vegetables in their town, and fewer (35%) reported that available fruits and vegetables were of high quality. Additionally, over half (56%) reported traveling ≥20 miles round trip to shop for food. Few participants met the recommended daily intake for fruit (44%) or vegetables (25%). Obesity (55%), hypertension (49%), and diabetes (25%) were commonly reported. Obesity was significantly higher among participants who reported that the price of fruits and vegetables were cost-prohibitive (prevalence proportion ratio (PPR): 1.24; 95% CI: 1.02, 1.50) and those who shopped frequently for food at nontraditional food retailers, such as Dollar Stores (PPR: 1.35; 95% CI: 1.08, 1.69) and small markets (PPR: 1.38; 95% CI: 1.02, 1.86). Diabetes was significantly higher among participants who frequently shopped at convenience stores/gas stations (PPR: 2.26; 95% CI: 1.22, 4.19). Conclusions: Our study found that the use of nontraditional food retailers, including convenience stores, gas stations, and Dollar Stores, as a regular source of food was associated with obesity and diabetes. These results underscore the importance of interventions to improve rural Tribal food environments. Healthy retail interventions in nontraditional retail settings, such as those implemented through the THRIVE study, may contribute to reducing AI health disparities.
KW - American Indians
KW - community-based participatory research
KW - diabetes
KW - food access
KW - Native Americans
KW - obesity
KW - perceived food environment
UR - http://www.scopus.com/inward/record.url?scp=85074500147&partnerID=8YFLogxK
U2 - 10.1093/cdn/nzy099
DO - 10.1093/cdn/nzy099
M3 - Article
AN - SCOPUS:85074500147
SN - 2475-2991
VL - 3
SP - 63
EP - 68
JO - Current Developments in Nutrition
JF - Current Developments in Nutrition
ER -