Search

The Sandy Lake school-based diabetes prevention program is a culturally appropriate intervention for Ojibway-Cree students in the 3rd, 4th, and 5th grades. This paper reports the results of the program in changing dietary intake behaviors and related psychosocial factors. Physical activity results are not included. The study was a pretest/post-test, single-sample design conducted during the 1998-1999 school year. A total of 122 students completed all 4 measurements (anthropometry, 24-h dietary recall, and 2 questionnaires), at baseline and follow-up. There were significant increases (P < 0.0001)in dietary intention, dietary preference, knowledge, and dietary self-efficacy, and in the curriculum knowledge scale between baseline and follow-up. Intervention exposure was significantly associated with being in the highest category for knowledge about foods that were low in dietary fat [Medium Exposure odds ratio (OR): 3.4; P < 0.05; High Exposure OR: 6.4; P < 0.05], being in the highest category for dietary self-efficacy (Medium Exposure OR: 3.7; P < 0.05; High Exposure OR: 3.9; P < 0.1), being in the highest category for knowledge about curriculum concepts (Medium Exposure OR: 3.4; P < 0.05; High Exposure OR: 9.4: P < 0.01), and for having met the age + 5 g dietary fiber intake/d (Medium Exposure OR: 2.9; P < 0.1; High Exposure OR: 11.0; P < 0.01). Exposure to the intervention was not associated with dietary intent or the percentage of energy from dietary fat. This program was associated with improved knowledge and the psychosocial factors related to healthy eating and dietary fiber intake of students in a remote First Nations community. KEY WORDS: * school-based intervention * Native American * Canadian Native children * diabetes * health promotion

The prevalence of type 2 diabetes mellitus in the Oji-Cree of northwestern Ontario is the third highest in the world. A private mutation, G319S, in HNF1A, which encodes hepatic nuclear factor-1[alpha] (HNF-1[alpha]), was associated with Oji-Cree type 2 diabetes and was found in [approximately equal to] 40% of affected subjects. The G319S mutation reduced the in vitro ability of HNF-1 [alpha] to activate transcription by [approximately equal to] 50%, with no effect on DNA binding or protein stability. There was no evidence of a dominant negative effect of the mutant protein. The impact of the G319S mutation at the population level was assessed by classifying subjects with type 2 diabetes according to HNF1A genotype and plotting the cumulative age of onset of diabetes. Disease onset was modeled satisfactorily by two-parameter sigmoidal functions for all diabetic subjects and all three HNF1A genotypes. Pairwise statistical comparisons showed significant between-genotype differences in [t.sub.50] (all P < 0.00001), corresponding to the age at which half the subjects had become diabetic. Each dose of G319S accelerated median disease onset by [approximately equal to] 7 years. Thus, the transactivation-deficient HNF1A G319S mutation affects the dynamics of disease onset. The demonstration of a functional consequence for HNF1A G319S provides a mechanistic basis for its strong association with Oji-Cree type 2 diabetes and its unparalleled specificity for diabetes prediction in these people, in whom diabetes presents a significant public health dilemma. The findings also show that HNF1A mutations can be associated with typical adult-onset insulin-resistant obesity-related diabetes in addition to maturity-onset diabetes of the young.

We examined the relationship between usual patterns of food intake, fattiness of food preparation and consumption, and diabetes and obesity status in a Native Canadian reserve in northwestern Ontario. Patterns of intake were estimated using a 34-item food frequency instrument. Scales and scores were developed using factor analysis procedures and were tested for reliability using coefficient alpha. Impaired glucose tolerance (IGT) and diabetes status was determined by administering a 75-g glucose tolerance test. A number of the food groups appear to have a protective effect in regard to IGT and diabetes, including vegetables [odds ratio (OR) = 0.41, confidence interval (CI) = 0.18-0.91], breakfast foods (OR = 0.41, CI = 0.18-0.93) and hot meal foods (OR = 0.29, CI = 0.11-0.78). Most of these foods are relatively high in fiber and low in fat. High consumption of junk foods and the bread and butter group was associated with substantial increases in risk for diabetes (OR = 2.40, CI = 1.13-5.10; OR = 2.22, CI = 1.22-4.41, respectively). These foods tend to be high in simple sugars, low in fiber and high in fat. More fatty methods of food preparation are also associated with increased risk for diabetes in this population (OR = 2.58, CI = 1.11-6.02). This information has been incorporated into an ongoing community-based diabetes prevention program in the community. J. Nutr. 128: 541-547, 1998. KEY WORDS: * Native Canadians * Native Americans * diabetes * obesity * food frequency * food preparation * diet

Community-based studies of body image concepts can be useful for developing health interventions to prevent obesity-related diseases such as diabetes and cardiovascular disease in specific populations. First Nations peoples, in particular, face increased obesity-related health problems as a result of acculturative changes in diet and activity. This study examined body shape perception in an Ojibway-Cree community in Northern Ontario, Canada. A set of figure outline drawings ranging from very thin to very obese were used to examine perceived body shape, body shape satisfaction and ideals of healthiness across sex and age groups. Overall, only 16% of the population were satisfied with their current body shape. People with a higher body mass index (BMI) were less satisfied with their bodies and thought they were less healthy than people with a lower BMI. While females had a significantly greater BMI than males, males and females did not differ significantly in perception of current body shape. On the other hand, females desired relatively smaller body shapes than males (P < 0.05). Older people chose significantly larger healthy body shapes than did younger people (P < 0.05). Differences between our results and those reported for Anglo populations indicate that while both groups prefer body shapes smaller than those they have currently, the Ojibway-Cree tend to prefer relatively larger body shapes. Knowledge of age and sex-related patterns of body image concepts in communities can assist in the design of obesity-reducing interventions targeting specific groups. J. Nutr. 126: 2990-3000, 1996. INDEXING KEY WORDS: * body image * Native Canadians * obesity * community-based study * humans