Food-related behavior, physical activity, and dietary intake in First Nations1 – a population at high risk for diabetes

Abstract

Objective. To describe determinants of diet-related behavior and physical activity in First Nations for development of culturally appropriate diabetes prevention programs. Design. Cross-sectional 24-hour dietary recalls (n=129), random household risk factor surveys of primary food preparers/shoppers (n=133), and accelerometry (n=81) were assessed in First Nations adults. Setting. Nine Anishinaabe (Ojibwe and Oji-Cree) First Nations in northwestern Ontario, Canada. Results. Descriptive statistics (mean, SD, range) were calculated for all outcomes (dietary intake, psychosocial determinants of diabetes risk factors, dietary behaviors, physical activity, and body mass index, BMI) and t-tests were performed to examine differences in means between remote and semi-remote communities. Regression models adjusting for sociodemographic factors were also fit for the outcome measures. Respondents reported high-energy intake (2676 and 2060 kcal/day for men and women, respectively) and acquired higher fat/higher sugar/lower fiber foods up to 30 times more often than healthier alternatives. Over 80% of respondents were overweight or obese (BMI >25 kg/m2) with no significant difference between remote and semi-remote communities. Employment and having diabetes or impaired glucose tolerance were positively associated with BMI. Food intention scores were positively associated with healthy food acquisition scores. Younger respondents in semi-remote communities were more likely to have higher knowledge scores. Food intention scores were predicted by outcome expectations; outcome expectations by self-efficacy. Conclusions. Diabetes prevention programs for First Nations should focus on improving physical activity and dietary intake by targeting specific risk group needs. Food knowledge, self-efficacy, outcome expectations, and intention are important factors in understanding those needs.