Bonnie Holy Rock

Bright Start: Description and main outcomes from a group-randomized obesity prevention trial in American Indian children

The aim of the Bright Start study was to develop and test the effectiveness of a school environment intervention, supplemented with family involvement, to reduce excessive weight gain by increasing physical activity and healthy eating practices among kindergarten and first‐grade American Indian children. Bright Start was a group‐randomized, school‐based trial involving 454 children attending 14 schools on the Pine Ridge Reservation in South Dakota. Children were followed from the beginning of their kindergarten year through the end of first grade. Main outcome variables were mean BMI, mean percent body fat, and prevalence of overweight/obese children. The goals of the intervention were to: increase physical activity at school to at least 60 min/day; modify school meals and snacks; and involve families in making behavioral and environmental changes at home. At baseline, 32% of boys and 25% of girls were overweight/obese. Although the intervention was not associated with statistically significant change in mean levels of BMI, BMI‐Z, skinfolds or percentage body fat, the intervention was associated with a statistically significant net decrease of 10% in the prevalence of overweight. Intervention children experienced a 13.4% incidence of overweight, whereas the control children experienced a corresponding incidence of 24.8%; a difference of −11.4% (P = 0.033). The intervention significantly reduced parent‐reported mean child intakes of sugar‐sweetened beverages, whole milk, and chocolate milk. Changes in duration of school physical activity were not significant. Because obesity is the most daunting health challenge facing American Indian children today, more intervention research is needed to identify effective approaches.

Associations of home food availability, dietary intake, screen time and physical activity with BMI in young American-Indian children

OBJECTIVE To evaluate associations between home environmental factors and BMI of young American-Indian children. DESIGN Cross-sectional and prospective study. SETTING School-based obesity prevention trial (Bright Start) on a Northern Plains Indian reservation in South Dakota. Mixed model multivariable analysis was used to examine associations between child BMI categories (normal, overweight and obese) and home food availability, childrens dietary intake and physical activity. Analyses were adjusted for age, gender, socio-economic status, parent BMI and school; prospective analyses also adjusted for study condition and baseline predictor and outcome variables. SUBJECTS Kindergarten children (n = 424, 51 % male; mean age = 5.8 years, 30 % overweight/obese) and parents/caregivers (89 % female; 86 % overweight/obese) had their height and weight measured and parents/caregivers completed surveys on home environmental factors (baseline and 2 years later). RESULTS Higher fast-food intake and parent-perceived barriers to physical activity were marginally associated with higher probabilities of a child being overweight and obese. Vegetable availability was marginally associated with lower probabilities of being overweight and obese. The associations between home environmental factors and child weight status at follow-up were not significant. CONCLUSIONS Findings indicate that selected aspects of the home environment are associated with weight status of American-Indian children. Obesity interventions with this population should consider helping parents to engage and model healthful behaviours and to increase availability of healthful foods at home.

Summer effects on body mass index (BMI) gain and growth patterns of American Indian children from kindergarten to first grade: a prospective study

BackgroundOverweight and obesity are highly prevalent among American Indian children, especially those living on reservations. There is little scientific evidence about the effects of summer vacation on obesity development in children. The purpose of this study was to investigate the effects of summer vacation between kindergarten and first grade on growth in height, weight, and body mass index (BMI) for a sample of American Indian children.MethodsChildren had their height and weight measured in four rounds of data collection (yielded three intervals: kindergarten, summer vacation, and first grade) as part of a school-based obesity prevention trial (Bright Start) in a Northern Plains Indian Reservation. Demographic variables were collected at baseline from parent surveys. Growth velocities (Z-score units/year) for BMI, weight, and height were estimated and compared for each interval using generalized linear mixed models.ResultsThe children were taller and heavier than median of same age counterparts. Height Z-scores were positively associated with increasing weight status category. The mean weight velocity during summer was significantly less than during the school year. More rapid growth velocity in height during summer than during school year was observed. Obese children gained less adjusted-BMI in the first grade after gaining more than their counterparts during the previous two intervals. No statistically significant interval effects were found for height and BMI velocities.ConclusionsThere was no indication of a significant summer effect on childrens BMI. Rather than seasonal or school-related patterns, the predominant pattern indicated by weight-Z and BMI-Z velocities might be related to age or maturation.Trial registrationBright Start: Obesity Prevention in American Indian Children Clinical Trial Govt ID# NCT00123032

Nutrition Beliefs and Weight Loss Practices of Lakota Indian Adults

Abstract Primary objectives were to describe beliefs about diet and health, weight perceptions, and weight loss practices among Lakota Indian adults. In-person interviews were conducted with a total of 219 adults from two reservations in South Dakota. Overall, 55.5% of the sample was overweight. When asked how they perceived their body weight, 6% felt they were “too thin,” 43.4% thought they were “about right,” and 50.2% felt they were “too fat.” When asked what they were doing about their weight, 74% said they were either trying to lose weight or trying to keep from gaining more weight. Reducing the amount of food eaten (90%), eating more fruits and vegetables (86%), increasing physical activity (84%), and skipping meals (82%) were reported to have been used by most of those who had dieted. Of those who felt they needed to lose weight, 78% said they would join a weight loss program if one were offered. Findings indicate that most Lakota adults are concerned about obesity and are attempting to either lose excess weight or avoid gaining weight. Intervention efforts for this population should focus on providing individuals with guidance on effective strategies for weight loss or obesity prevention. Weight loss programs should include features identified as important by survey participants, such as information on how to fit a healthful diet and exercise into daily life.