Diet and food play a pivotal role in overall health, well-being and active aging. For the nearly 800,000 people age 65 and older who identify themselves as American Indian, Alaskan Native, and Native Hawaiian and Other Pacific Islander elders in the United States, there is also a connection between traditional foods and health that holds profound significance. Historical challenges, marked by colonization and loss, have set the stage for Native Elders to experience the worst health disparities in the United States (US). However, recent research has linked regular consumption of traditional foods to lower reported rates of diabetes, better nutrition status and higher participation in cultural practices for Native Elders.

Historical context and impact of westernized diet

The historical challenges faced by Native peoples, including the loss of land, language and access to traditional foods, have contributed to the populations' decline in overall health. Further, colonization, forced relocations, and more recently the adoption of a Westernized diet high in fat and sugar and low in grains and fiber, have led to greater health disparities compared to other groups in the U.S.

Prior to colonization, Native diets were centered on crop-based foods such as maize, beans and squash, as well as lean meats and seafood. The shift to a Westernized diet has been detrimental to Native health, leading to higher rates of chronic conditions and infectious diseases. Thus, while traditional foods long served as a cornerstone of Native health, the abrupt shift by many Native populations to the less healthful dietary practices of today has had profound consequences.

Traditional foods as medicine

The First Nations Development Institute defines food sovereignty as the right of Native Americans, Alaskan Natives and Native Hawaiians and Other Pacific Islanders to produce their own traditional foods on their own lands for sustenance. This right existed for thousands of years before European contact ­­and the subsequent disruption of food systems has adversely affected Native health. Reclaiming food sovereignty involves bringing back traditional foods to Native communities and considering traditional foods not just as sustenance but as medicine.

The medicine wheel of Native communities encompasses mental, spiritual, emotional and physical health, and emphasizes the importance of balance. Restoring access to traditional foods becomes a crucial step in rebalancing these realms and promoting overall health and well-being. Often, especially in the many tribal communities in rural and isolated areas, elders must drive an hour or two to access the healthy foods available in a larger supermarket. Bringing food sovereignty into these communities will allow them to produce their own foods, manage food distribution and production, and focus on foods that are part of their unique culture and community.

Data link consuming traditional foods to better health outcomes

Every three years, we at the National Resource Center on Native American Aging complete a national survey of Tribal Older Americans Act Title VI programs. Title VI nutrition programs serve elders living on tribal lands. The results of our survey from 2020-2023 have revealed compelling insights into the relationship between traditional foods and Native elder health. Over half of the 19,744 Native Elders surveyed (56%) did not have access to traditional foods or did not consume traditional foods regularly. Elders who did consume traditional foods five or more times per week reported lower rates of diabetes, better nutrition status, and higher participation in cultural practices, emphasizing the potential protective role of traditional foods.

The word cloud provided displays traditional foods that elders reported consuming, with more commonly reported foods appearing larger. From the word cloud, we observed that fish, beans, meat, corn, deer, salmon, berries and even frybread had the highest reported consumption among our elders as part of their traditional diet. Our survey of elders living in urban areas further highlighted the importance of traditional foods. Urban elders who consumed traditional foods reported better overall health, higher quality of life, and increased socialization compared to those who did not. This points to the significance of consumption of traditional foods extending beyond reservation boundaries.

The revival of food sovereignty through the incorporation of traditional foods into daily diets is essential for Native elder health. Traditional foods serve not only as a good source of nutrition but also as a connection to cultural practices and resilience. Reclaiming control over food production and distribution empowers Native communities to further address historical traumas and restore balance to multiple realms of their health. This in turn can reduce disparities related to high incidence of malnutrition, food insecurity, and nutrition-related chronic diseases. It is crucial to develop such policies in collaboration with Native leaders and elders, to ensure the approaches are respectful, culturally sensitive, and aligned with the values, traditions and expected outcomes of each community. As we navigate the complexities of health disparities among Native populations, the wisdom of the medicine wheel guides us towards a future where traditional foods play a central role in the well-being of Native elders.

For more information, see our recent ICAA webinar or visit the National Resource Center on Native American Aging. For more information on traditional foods, see Nourishing Native Foods & Health | First Nations Development Institute, (72) Traditional Foods for Tribal Elders – YouTube, Tribal Nursing Home Best Practices (cms.gov), and Tribal food sovereignty resources – Community Food Systems (wisc.edu).

Dr. Collete Adamsen is an assistant professor at the University of North Dakota School of Medicine and Health Sciences, serves as associate director for UND’s Center of Rural Health, is the director of the National Resource Center on Native American Aging, and is an enrolled member of the Turtle Mountain Band of Chippewa Indians.

Note: This information is not intended to replace a one-on-one relationship with a qualified healthcare professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from research. The view expressed here are not necessarily those of the ICAA, we encourage you to make your own health and business decisions based upon your research and in partnership with a qualified professional.

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