Love Charlotte V, Taniguchi Tori E, Williams Mary B, Noonan Carolyn J, Wetherill Marianna S, Salvatore Alicia L, Jacob Tvli, Cannady Tamela K, Standridge Joy, Spiegel Jennifer, Jernigan Valarie Blue Bird
Center for Indigenous Health Research and Action, University of Oklahoma-Tulsa, Tulsa, OK.
Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center College of Public Health, Tulsa, OK.
Curr Dev Nutr. 2018 Dec 5;3(Suppl 2):63-68. doi: 10.1093/cdn/nzy099. eCollection 2019 Aug.
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.
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.
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.
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).
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.
美国印第安人（AI）患饮食相关慢性病的比率显著高于其他种族/族裔群体，许多人生活在难以获取健康食品的环境中。
作为弱势环境下部落复原力（THRIVE）研究的一部分，我们研究了AI成年人中感知到的食物环境、食品零售商的利用情况、水果和蔬菜摄入量与包括肥胖、高血压和2型糖尿病在内的慢性病之间的关系。
通过基于社区的参与性研究合作关系，我们对居住在俄克拉荷马州奇克索部落和乔克托部落的513名AI成年人进行了横断面抽样调查。
只有57%的参与者表示在他们镇上购买水果和蔬菜很容易，更少的人（35%）表示可买到的水果和蔬菜质量高。此外，超过一半（56%）的人报告说往返购物距离≥20英里。很少有参与者达到水果（44%）或蔬菜（25%）的推荐每日摄入量。常见的报告疾病有肥胖（55%）、高血压（49%）和糖尿病（25%）。报告称水果和蔬菜价格过高的参与者中肥胖率显著更高（患病率比例比（PPR）：1.24；95%置信区间：1.02，1.50），以及那些经常在非传统食品零售商（如一元店）购物的参与者中肥胖率也显著更高（PPR：1.35；95%置信区间：1.08，1.69），在小市场购物的参与者中肥胖率同样显著更高（PPR：1.38；95%置信区间：1.02，1.86）。经常在便利店/加油站购物的参与者中糖尿病患病率显著更高（PPR：2.26；95%置信区间：1.22，4.19）。
我们的研究发现，将包括便利店、加油站和一元店在内的非传统食品零售商作为常规食物来源与肥胖和糖尿病有关。这些结果强调了改善农村部落食物环境干预措施的重要性。在非传统零售环境中的健康零售干预措施，如通过THRIVE研究实施的那些措施，可能有助于减少AI人群的健康差距。
