Food sovereignty and diabetes prevention

Native American elders remember when there was no word for diabetes in indigenous North American languages because it was unknown. Diabetes was so rare among American Indians until the 1950s that some believed indigenous people might be immune. In the past 50 years, however, diabetes has become one of the most common and serious illnesses among American Indians and Alaska Natives (AI/AN).

The incidence of diabetes has reached alarming numbers among non-Hispanic whites. However, diabetes is twice as high in American Indian and Native Alaskan (AI/AN) populations. For AI/AN adolescents, it is 10 times greater. The current Type 2 diabetes epidemic represents an ongoing post-traumatic stress response for many indigenous communities.

European colonizers who met Indigenous people of the Northern Plains described the Natives as vigorous and strong. However, exposure to European diseases had devastating effects. Smallpox killed thousands of Indigenous people, reducing several tribes to 25% or less of their original number. Diabetes has been called “the new smallpox.”

For tribal nations, gathering, planting, or hunting food was integral to physically active and spiritual lives. Decades of racist genocidal federal policies reduced the land and water resources of tribal nations, which in turn radically disrupted indigenous food systems and reduced access to traditional foods.

U.S. Army Corps of Engineers flooding and dam-building resulted in the loss of fertile farming land. The lost land contained wild beans and turnips growing along the river, as well as many medicines that “went under.” 

Native peoples in the United States were forced to move and had to adjust to different lands, climates, and the foods they could raise and gather. The land loss also caused the loss of ways remembered fondly for fostering hard work and family togetherness.

One Native elder spoke of lingering grief and stress and another spoke of “sadness and hurt” in relation to the loss of foods, activities, and cultural ways after “they moved us here, all together” (on reservations to make way for flooding).

Destruction of traditional sources of food, especially the buffalo, by the US Government, created famine and starvation. Commodities, provided by the government since the 1880s, were provided inadequately because they were considered supplemental to foods produced by Native agriculture.

Sometimes called “genocide food,” commodities usually consist of low-grade meat or salted pork, flour, salt, sugar, and coffee, foods typical of the colonized diet. Some traditional foods (bison, blue corn meal, wild rice) were added recently to food assistance programs, but these are not consistently available.

Drinking water as a traditional health practice has been displaced in modern times by drinking sugar-laden carbonated products and other sweetened drinks. Mass media advertising for these products and other highly refined and processed foods program people to consume them indiscriminately.

Challenges to accessing healthy food across Indian Country include isolation and distance (creating food deserts), limited transportation, inadequate supermarkets, environmental contamination, and limited money to purchase healthy foods.

One solution is food sovereignty, the right of people to dictate policies and strategies for food production, distribution, and consumption that is sustainable, equitable, and culturally aware. The goal of food sovereignty is to regain access to land and traditional foods lost through colonization and the atrocities perpetrated against Native populations.

Food sovereignty is directly tied to health through the reintroduction of traditional foods including wild meat, fish, nuts, fruits, squash, corn, and beans that are unprocessed and nutrient dense. For many tribes, the movement is a revival of foods their ancestors cultivated, gathered, hunted, and preserved.

At the local level, tribal gardens are flourishing with blue and white corn, brightly colored chiles, ripe berries, and countless varieties of squash. Wild foods, such as beach asparagus, goose tongue, cholla buds, mesquite beans, saguaro fruit, chokecherries, polk, and Navajo tea, are gathered and prepared by elders and children.

Tribes in the plains and coastal regions are restoring fishing and hunting techniques, while sharing traditional knowledge, stories, and language. As a collective, these programs are providing tribal communities with fresh and healthful food, ecological sustainability, and cultural preservation.

“The Native community is reclaiming our power and one of those ways is through food,” said Amy Warne, a registered and licensed dietician and a member of the Muscogee and Seminole tribes. Warne said diabetes, cancer, and heart disease rates started skyrocketing after the introduction of Indian Boarding Schools.

“Our children were taken from their customary homes with the traditional foods, with their families, and placed into institutions and introduced for the first time to commodity foods and institutionalized nutrition,” said Warne. “We need to get back to the pre-contact diet, with traditional lean game. … Buffalo, bison, deer, [and] fish…”

Warne continued, “I think of fresh fruits and vegetables that are growing seasonally. I’m thinking of our three sisters – the corn, beans, and squash …”

Between 2008 and 2014, as part of the Native Diabetes Wellness Program’s Traditional Foods Project (TFP), seventeen tribal nations created programs to increase access to traditional food. TFP provided modest funding and support to the 17 partner communities who designed their own interventions to meet the needs of their communities.

Honoring local knowledge and traditions, farmers, health care providers, tribal leaders, subsistence gatherers, administrators, evaluators, and community members came together for the shared purpose of improving community health. Strategies included gardens, health fairs, storytelling, and traditional games. Organized activities included traditional games such as stickball, fun runs, restoration work, canoeing, and dancing.

By the end of the project, TFP partners created 415 gardens totaling to 28.4 acres. Two-thirds of partners reported new healthy food options at worksites, stores, and restaurants.

TFP also led to policy changes such as banning sales of sugary drinks and candy at afterschool programs and the addition of physical activity to school curriculums. Individuals reported increases in physical activity, healthy food choices, weight loss, and social support.

One participant wrote: “Thank you for giving me one of my life’s biggest blessings — the chance to be part of this (TFP) group. I ask the Creator to bring us all together again. …I feel like part of a large family of inspiration and affirmation.”

The Standing Rock Lakota Tribe in South Dakota, one of the tribes who participated, incorporated 106 educational events that reached 3,534 individuals including 61 farmers market days. They also created a successful food voucher program that provides fresh produce to elders.

TFP Partners noted the importance of fostering intergenerational knowledge, creating a local food economy, and promoting self-sufficiency and cultural preservation within Tribes. Other benefits included seed saving efforts, water conservation, and improved soil quality. When TFP ended, 11 out of 17 Tribes continued their traditional foods programming. 

TFP researchers concluded, “The food sovereignty movement among American Indians/Alaska Natives and indigenous populations globally offers ways to address public health issues such as… type 2 diabetes. … The way to reclaim health is to reconnect with the land, water, traditional foodways, and all that they mean. … Traditional foods provide an alternative to high-cost, low-quality foods offered in many tribal communities by convenience and grocery stores.”

Linwood Tall Bull (Northern Cheyenne) says that diabetes is a teacher which teaches us the connection between the peoples’ health and welfare and the natural environment. Diabetes also teaches us the need to make decisions with a “long view” toward their impact on the future.

Many Oceti Sakowin communities recite an ancient prayer and rallying cry that unites them in a common purpose: “Hecel lena oyate ki nipi kte” – “So that the people may live.”

As Cissimarie Juan of the Tohono O’odham Nation says, “…good food is power.” Elders who knew a time when diabetes was rare are sharing knowledge that works as a strategy for survival. Traditional ways of knowing have for generations linked physical and spiritual health to traditional foods. The concept is not new.

What is new is the growing food sovereignty movement that reclaims traditional foods in relation to tribal sovereignty, food security and public health. Traditional foods have become, once again, a way to talk about health, ‘Hecel lena oyate ki nipi kte’ – ‘So that the people may live.’

NOTE: For more information about the Traditional Foods Project (TFP), see

www.cdc.gov/pcd/issues/2020/19_0213.ht, “Integrating Culture and History to Promote Health and Help Prevent Type 2 Diabetes in American Indian/Alaska Native Communities: Traditional Foods Have Become a Way to Talk About Health”

(Contact Grace Terry at grace@angelsabide.com)

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