U.S. Dietary Guidelines Unfit for Native Americans

Neal D. Barnard, M.D., and Derek M. Brown

Spend some time at a reservation clinic. You will see patient after patient with diabetes, obesity, cancer, high blood pressure, and heart disease. It wasn't always that way. It need not be that way now. A more traditional diet is the prescription for avoiding much of that suffering.

Yet, for Native Americans, current federal dietary guidelines promoting a meaty, cheesy diet amount to, perhaps inadvertently, the nutritional equivalent of smallpox-infected blankets.

The 1995 Dietary Guidelines for Americans, under review for a mid-2000 update, push a "Westernized" diet. They ignore the health needs and cultural practices of Native Americans and other minorities. Meanwhile, the much-adopted Standard American Diet and the fast-food culture—flush with animal proteins, fats, and sugars—exact an increasing toll on Native Americans, as on others.

Unfortunately, the Dietary Guidelines, which govern all federal and many private nutrition efforts, poorly reflect what we know about health. For example, they still promote two to three daily servings of dairy—advice dating to the first federal food guides in 1916. They ignore ample research since the mid-1960s on lactose intolerance among racial minorities. A study on Native Americans published in Gastroenterology in 1977, for example, found 74 percent lactose intolerant. Given that dairy had little place in the pre-Columbian scheme of things, a distaste for it among Native Americans is hardy surprising—nor even something negative.

Lactose intolerance, with its gas, bloating, and diarrhea, is a natural warning like the pain one would feel putting a hand onto a hot stove. Even drinking lactose-free cow's milk or taking lactose-intolerance pills before eating cheese still invites the heart-damaging effects of "doing dairy." There are plenty of good non-dairy calcium sources, including dark-green, leafy vegetables, beans, and fortified orange juice. 

The journal Cardiology in 1991 reported that "with the adoption of Western lifestyles and diet...heart disease has become relatively common among a number of Native American tribes." With cholesterol levels rising, heart disease ranks as the leading killer of Native Americans, causing more than one-fifth of deaths, according to U.S. Indian Health Service (IHS) figures. (It kills one-third of whites.) For both groups, eating a diet laden with fat and cholesterol is a chief culprit. 

Among Native Americans, the cancer death rate rose slightly from 1990 to 1995. As Tim Beyers, M.D., grimly noted in the Journal of the American Cancer Society in 1996, "Nutrition-related cancers are likely to increase in the future among Native Americans [because] of past changes in diet." A more traditional diet could U-turn that trend. Indeed, Dean Ornish, M.D.'s results have shown the power of a pure vegetarian diet to reverse heart disease. 

Obesity also afflicts Native Americans. One possible reason: a "thrifty" gene that stores fat to carry them through leaner times. But a high-fat, animal-product-centered diet makes this plus a minus. Native Americans on a more traditional diet have a much easier time staying slim. Indeed, almost anyone can slim down by dropping animal products, consuming more beans and whole grains, and exercising regularly.

Diabetes kills Native Americans at more than triple the overall U.S. rate, according to IHS. Alcohol, tobacco, and an inactive lifestyle heighten risks. But unwise food choices also add needless risks. Switching to a plant-food diet, and consuming much less fat than current Guidelines suggest, can greatly cut diabetes rates. In 1994, a study published in Diabetes Care reported that diabetes and obesity are less prevalent among Mexican Pima Indians living a "traditional" lifestyle than among Arizonan Pimas in an "affluent" environment.

In the public mind, shaped by Hollywood Westerns, a typical Native American was a big meat-eater—a "killer of buffalo...and stranger to vegetables,"such as the Apaches, few tribes in what is now the United States hunted much (though some fished) before whites came. But hunting went from an exception to a widespread, steady activity after Spanish conqueror Francisco Coronado's 16th-century explorations of the U.S. Southwest introduced horses and guns.

Earlier, vegetables, legumes, and whole grains were dietary staples for many tribes. Iroquois grew 17 varieties of corn (or maize), seven types of squashes, and 60 of beans—a trio of major foods they called the "three sisters." As Captain John Smith, who led the English colony at Jamestown, Va., wrote in 1607, "Settlers would have starved if the Indians had not brought corn, squash, and beans to us." Living in what is now the U.S. Northeast, Iroquois also gathered a cornucopia of 34 wild fruits, 11 nut species, 12 kinds of edible roots, 38 types of bark, 6 fungi, and maple syrup, their main confection, according to the 1991 reference work The Native Americans.

In the western Great Lakes area, Chippewas and Menominees relied heavily on wild rice, and on maple sugar, blueberries, cranberries, raspberries, grapes, cherries, nuts, wild onions, and potatoes. In Mississippi and Oklahoma, Choctaws raised corn, squash, beans, peas, watermelons, sweet potatoes, and fruit trees, and foraged persimmons, plums, hickory nuts, walnuts, pecans, cherries, grapes, and mulberries.

Iroquois chief Canassatego reportedly said, "There are many things to be shared with the Four Colors of humanity in our common destiny as one with our Mother the Earth. It is this sharing that must be considered with great care by the Elders and the medicine people who carry the Sacred Trusts, so that no harm may come to people through ignorance and misuse of these powerful forces." Let's hope that the rule-makers in Washington remember his 18th-century wisdom.

Neal D. Barnard, M.D., author of Foods That Fight Pain and Eat Right, Live Longer, founded the Washington, D.C.-based Physicians Committee for Responsible Medicine (PCRM) in 1985. Derek M. Brown is a writer in Rockville, Maryland. Endorsers of PCRM's call for an end to racially biased federal food guidelines include the Association of American Indian Physicians and the National Indian Health Board.

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