title: Dietary Intake among American Indians with Metabolic Syndrome - Comparison to Dietary Recommendations: the Balance Study.
abstract: BACKGROUND
  American Indians have a very high prevalence of metabolic syndrome that increases their risk of developing cardiovascular disease and type 2 diabetes. Dietary habits are of central importance in the prevention and treatment of metabolic syndrome.
  
  
  OBJECTIVE
  The main objective of this article was to describe dietary intake among American Indians with metabolic syndrome and compare it to several dietary recommendations. A secondary objective was to identify certain barriers to dietary adherence experienced by this population.
  
  
  METHODS
  A total of 213 participants with metabolic syndrome were enrolled in the Balance Study, a randomized controlled trial with two intervention groups: Guided Group and Self-Managed Group. Dietary intake was assessed using the Block Food Frequency questionnaire. Dietary intakes were evaluated against the Dietary Guidelines for Americans.
  
  
  RESULTS
  Intakes of saturated fats, cholesterol, and sodium were higher and intakes of dietary fiber, calcium, magnesium, potassium, vitamin A, vitamin D, and vitamin E were lower than recommended. Additionally, intake of many food groups was noticeably low. Economic factors seem to be related to low adherence to dietary recommendations.
  
  
  CONCLUSIONS
  Results showed low adherence by the participants to dietary recommendations for key nutrients and food groups related to risk factors for metabolic syndrome, type 2 diabetes, and cardiovascular disease. Economic factors are related to this low adherence. These findings illustrate a need to develop innovative, focused, and perhaps individualized health promotion strategies that can improve dietary habits of American Indians with metabolic syndrome.
authors.affiliation: Center for American Indian Health Research, University of Oklahoma Health Sciences Center, United States.
authors.forename: Rohaid
authors.initials: R
authors.lastname: Ali
authors.affiliation: Center for American Indian Health Research, University of Oklahoma Health Sciences Center, United States.
authors.forename: Elisa T
authors.initials: ET
authors.lastname: Lee
authors.affiliation: Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, United States.
authors.forename: Allen W
authors.initials: AW
authors.lastname: Knehans
authors.affiliation: Center for American Indian Health Research, University of Oklahoma Health Sciences Center, United States.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Center for American Indian Health Research, University of Oklahoma Health Sciences Center, United States.
authors.forename: Jeunliang
authors.initials: J
authors.lastname: Yeh
authors.affiliation: Center for American Indian Health Research, University of Oklahoma Health Sciences Center, United States.
authors.forename: Everett R
authors.initials: ER
authors.lastname: Rhoades
authors.affiliation: Division of Cancer Control and Population Sciences, National Cancer Institute, United States.
authors.forename: Jared B
authors.initials: JB
authors.lastname: Jobe
authors.affiliation: Center for American Indian Health Research, University of Oklahoma Health Sciences Center, United States.
authors.forename: Tauqeer
authors.initials: T
authors.lastname: Ali
authors.affiliation: Center for American Indian Health Research, University of Oklahoma Health Sciences Center, United States.
authors.forename: Melanie R
authors.initials: MR
authors.lastname: Johnson
keywords: American Indians; Balance Study; Dietary Intake; Metabolic Syndrome