title: Intake of nutrients related to cardiovascular disease risk among three groups of American Indians: the Strong Heart Dietary Study.
abstract: BACKGROUND
  Although diet is implicated in the elevated rate of cardiovascular disease among some American Indian tribes, the dietary intakes of these individuals have not been described. The Strong Heart Dietary Study compared diets of 10 tribes in Arizona, Oklahoma, and the Dakotas to examine the possible contribution of diet to cardiovascular and other chronic diseases.
  
  
  METHODS
  During 1988-1991, 892 people responded to a 24 hr diet recall questionnaire. Nutrient intake by study area, sex, and age group were compared by analysis of variance, and intakes were compared with nutrient intakes reported by participants in Phase 1 of the Third National Health and Nutrition Examination Survey and with dietary recommendations of the National Research Council, the American Heart Association, and the Healthy People 2000 objectives.
  
  
  RESULTS
  The intake of energy and nutrients varied significantly by sex and age. Men consumed more energy, macronutrients, and sodium than did women (P < or = 0.001). Women's diets were denser in carbohydrate, beta-carotene, vitamin C, and vitamin E than were men's diets (P < or = 0.001). Younger participants consumed more energy, macronutrients, vitamin E, and sodium than did older participants (P < or = 0.001). Older participants had diets denser in protein and beta-carotene than did younger participants (P < or = 0.001). Energy intake did not differ significantly by study area, but men in Arizona consumed more energy from carbohydrate and less energy from total fat than did men elsewhere (P < or = 0.01). Men and women in Arizona consumed more cholesterol and fiber than did other participants (P < or = 0.01) and less of the antioxidant vitamins (P < or = 0.01). Participants in the Strong Heart Diet Study reported diets higher in fats and cholesterol than did participants in Phase 1 of the Third National Health and Nutrition Examination Survey. Few Strong Heart participants achieved dietary recommendations for the reduction of risk of chronic disease.
  
  
  CONCLUSIONS
  Area differences in nutrient intake were observed, but most participants consumed diets associated with increased risk of heart disease and other chronic diseases. Women and older participants in general reported healthier nutrient intakes. Dietary intervention programs should educate American Indians about dietary modifications to reduce the risk of cardiovascular and other nutrition-related disorders.
authors.affiliation: Indian Health Service, Aberdeen Area Office, South Dakota 57401, USA.
authors.forename: E M
authors.initials: EM
authors.lastname: Zephier
authors.forename: C
authors.initials: C
authors.lastname: Ballew
authors.forename: A
authors.initials: A
authors.lastname: Mokdad
authors.forename: J
authors.initials: J
authors.lastname: Mendlein
authors.forename: C
authors.initials: C
authors.lastname: Smith
authors.forename: J L
authors.initials: JL
authors.lastname: Yeh
authors.forename: E
authors.initials: E
authors.lastname: Lee
authors.forename: T K
authors.initials: TK
authors.lastname: Welty
authors.forename: B
authors.initials: B
authors.lastname: Howard
mesh_terms: D017677:Age Distribution; D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage; D002318:Cardiovascular Diseases / Q000208:ethnology / Q000209:etiology*; D003430:Cross-Sectional Studies; D015930:Diet Records; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004043:Dietary Fiber / Q000008:administration & dosage; D002149:Energy Intake; D005247:Feeding Behavior / Q000208:ethnology*; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D012307:Risk Factors; D017678:Sex Distribution; D014481:United States
chemical_list: D000975:Antioxidants; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004043:Dietary Fiber