title: Demographic characteristics and food choices of participants in the Special Diabetes Program for American Indians Diabetes Prevention Demonstration Project.
abstract: OBJECTIVE
  American Indians and Alaska Natives (AI/ANs) suffer a disproportionate burden of diabetes. Identifying food choices of AI/ANs at risk of type 2 diabetes, living in both rural and urban settings, is critical to the development of culturally relevant, evidence-based education strategies designed to reduce morbidity and mortality in this population.
  
  
  METHODS
  At baseline, 3135 AI/AN adults participating in the Special Diabetes Program for American Indians Diabetes Prevention Demonstration Project (SDPI-DP) completed a socio-demographic survey and a 27-item food frequency questionnaire (FFQ). The primary dietary behavior goal of SDPI-DP education sessions and lifestyle coaching is changes in food choices, i.e., increased fruits, vegetables and whole grains, decreased high sugar beverages, red meat, and processed foods. Subsequently, program assessment focuses on changes in food types. Foods were delineated using a 'healthy' and 'unhealthy' classification as defined by the educators advising participants. Urban and rural differences were examined using χ(2) tests and two sample t-tests. Multiple linear regressions and linear mixed models were used to assess the association between socio-demographic factors and food choice.
  
  
  RESULTS
  Retired participants, those living in urban areas and with high income and education selected healthy foods most frequently. Young males, those with low income and education consumed unhealthy foods most frequently. Selection of unhealthy foods did not differ by urban and rural setting.
  
  
  CONCLUSIONS
  The ubiquitous nature of unhealthy food choices makes them hard to avoid. Food choice differences by gender, age, income, and setting suggest that nutrition education should more effectively target and meets the needs of young AI/AN males.
authors: a College of Public Health , University of Arizona , Tucson , AZ , USA.
authors: Nicolette I
authors: NI
authors: Teufel-Shone
authors: Luohua
authors: L
authors: Jiang
authors: Janette
authors: J
authors: Beals
authors: William G
authors: WG
authors: Henderson
authors: Lijing
authors: L
authors: Zhang
authors: Kelly J
authors: KJ
authors: Acton
authors: Yvette
authors: Y
authors: Roubideaux
authors: Spero M
authors: SM
authors: Manson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003920:Diabetes Mellitus / Q000208:ethnology* / Q000517:prevention & control; D004034:Diet Surveys; D005260:Female; D005518:Food Preferences / Q000208:ethnology* / Q000523:psychology; D006801:Humans; D007198:Indians, North American / Q000523:psychology / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
keywords: American Indians/Alaska Natives; diabetes prevention; food choice