Children and Nutrition: The Growing Health Epidemic of Diabetes in Indian Country

Year: 2004

Research Center: American Indian Studies Program, The University of Arizona

Investigator: Johnson, Ben, and Jennifer Perez

Institution: Fort Peck Community College

Project Contact:
Ben Johnson, Sr.
Fort Peck Community College
Rocky Mountain College
P.O. Box 398
Poplar, MT 59255
Phone: 406-768-6300


This paper provides a literature review that examines the prevalence of diabetes among American Indian children, and compares it to the incidence found at the Fort Peck Indian Reservation in Montana. It describes the activities of the Healthy Schools Summit, an effort designed to educate Indian children about the role that nutrition and exercise can take in controlling diabetes, and concludes with recommendations from the Healthy Schools Summit.

American Indians are experiencing a surge in the prevalence of obesity and diabetes. Diabetes, especially adult-onset, or type 2, diabetes, is a growing health problem throughout the region and the country, but indications are that it is more serious on the Fort Peck Indian Reservation and on other Montana Indian Reservations. Risk factors for type 2, or adult-onset, diabetes, include older age, obesity, physical inactivity, and race/ethnicity. However, diabetes is beginning early among American Indians, between the ages of 2 and 5. Approximately 13 percent of American Indian preschool children are overweight, with up to 40 percent of American Indian and Alaskan Native children reportedly overweight. An especially worrisome trend in childhood obesity is the sharp rise in type 2 diabetes, normally found only in adults.

Montana’s American Indians experience a higher prevalence of diabetes, smoking, and obesity compared to whites, according to a report of the Montana State Advisory Council on Food and Nutrition issued in 2001. Diabetes ranks seventh among the leading causes of death for Montanans, but fourth for American Indians.

During spring 2003, health officials from seven reservations in Montana formed the Healthy Schools Summit to address childhood diabetes. The Summit developed strategies to reduce the rate of diabetes and its complications, including early screening and treatment, utilization of Tribal College Wellness Centers for exercise and physical fitness, Indian Health Service clinic visits, and clinical trials to prevent the onset of type 2 diabetes among individuals at most risk for developing the disease.

Dietary habits contribute to development of obesity, with the diet of many American Indians characterized by frequent intake of nonindigenous protein, combined with a high proportion of low-nutrient-density carbohydrates and fats. The Summit worked with three Fort Peck Reservation schools to promote a healthier school food environment. In cooperation with the Indian Health Service, the Summit is developing a software program to track and analyze health-screening data from reservation schools. The Summit also actively collaborated with reservation schools to educate Indian communities about healthier school environments, including educating parents to foster family eating practices that can reduce the incidence of obesity.

Key recommendations resulting from the project include:

  1. Prevention of diabetes on the Fort Peck Indian Reservation should begin in the classrooms and in the home using targeted information appropriate for the intended audience.
  2. All agencies whose mission includes diabetes prevention should build strong coalitions to maximize resources and share information that can be used to educate at-risk populations.
  3. Special efforts should be made to involve all children in physical activity.
  4. Health services need to be designed to engage entire families in physical activities.
  5. Diabetes prevention outreach should target sedentary and at-risk individuals and their families to provide nutrition education and involve them in physical activity.