Dietary Quality Varies Among Adults on the Flathead Nation of the Confederated Salish and Kootenai Tribes in Montana

Intended and Unintended Consequences of a Community-Based Fresh Fruit and Vegetable Dietary Intervention on the Flathead Reservation of the Confederated Salish and Kootenai Tribes

“…These dietary quality findings are congruent with that of low-income adults in the United States that have been shown to have mean HEI scores of 45.4 ( 47 ) compared to the total population of the United States that has a HEI total score of 59 ( 35 ). These findings are further in line with previous research on the Flathead Reservation focused on dietary quality of residents ( 15 ). The low HEI scores for FVs and other foods that are recommended for a healthy diet at the pre-intervention period of Eat Fresh was on par with populations in the United States and globally who overall are consuming more calories than needed, but not adequate amount of calories from recommended food groups including nutrient-dense foods ( 48 ).…”

“…This pilot study provides evidence that study participants on the Flathead Reservation have diet-related disparities with relatively low food security scores compared to the national average as well as dietary quality with regards to national dietary recommendations. The prevalence of low food security scores among participants, who primarily comprise of tribally-affiliated members residing on the Flathead Reservation, is in line with previous research regarding diet-related health disparities among Native American communities ( 15 , 16 , 18 , 20 – 22 ). The food security status of study participants shows a marked health disparity compared to the national average in the United States ( 42 ).…”

“…The food environment is the consumer interface of the food system that influences the availability, affordability, convenience, and desirability of foods and, subsequent food choices as well as health outcomes (4,9). A growing body of evidence supports that residents of tribal and rural communities face disparities in their food environments to accessing healthy, affordable, convenient, and desirable foods (10)(11)(12)(13)(14)(15)(16).…”

“…Increasingly, plant-based diets are recognized for their contribution to supporting both human and planetary health (28). However, accessing fresh, desirable, and high-quality fruits, and vegetables is a food environment disparity in tribal communities in the United States including on the Flathead Reservation of the Confederated Salish and Kootenai Tribes (hereafter "the Flathead Reservation") in the rural state of Montana in the United States (11)(12)(13)(14)(15)(16).…”

Perceptions of food environments and nutrition among residents of the Flathead Indian Reservation

“…Understanding perceptions about healthy diets and the community food environment can inform contextuallyappropriate approaches to improve consumer demand for healthy foods and beverages and aid in transforming larger policies, systems, and environments to support improved dietary quality [39,40]. Participants at times had misinformed ideas about what items comprised a 'healthy diet' (e.g., whole grains or fruits perceived as 'unhealthy'), which may in part lead to poor dietary quality experienced among this community [41]. However, participants shared major resource barriers to exercising optimal choices, such as time and money, that underscore the need for multiple disciplinary public health approaches to improve wages under reasonable working hours in addition to improving access to foods and beverages aligned with the 2015-2020 DGA.…”