Seeds of Health
U alumni, researchers and Native communities come together to fight chronic disease with better nutrition and traditional foods
For Kibbe McGaa Conti, food—access to it, control over it, and respect for it—is a source of power.
Conti (B.S. ’90) is a Lakota woman, a registered dietician with the U.S. Public Health Service Commissioned Corps’ Indian Health Service (IHS), and an enrolled member of the Oglala Lakota community at the Pine Ridge Indian Reservation in South Dakota. She’s on a mission to spread her message that American Indian communities are suffering greatly from what she terms an addiction to “pale meals.”
She says these meals—heavy on processed grains, sugar, and fat—are cheap, filling fare for a population often struggling with poverty. They also damage the health of those eating them.
What Conti has witnessed during her three decades of work as a dietician, including practicing both on and near Pine Ridge, is an ongoing health crisis.
It’s been brought about, she says, in large part by historical damage done to indigenous communities by mistreatment. Before many American Indian communities across the U.S. were forcibly moved to reservations, she notes that their diet, as hunters-gatherers-farmers, focused primarily on unrefined foods, including corn, beans, squash, bison, fish, and wild game, or on gathered fruits such as chokecherries or seed-grains such as wild rice.
Today, however, those foods no longer form the basis for most Native diets. That’s a key factor that Conti and others feel has directly led to ongoing poor health in many American Indian communities in the form of diabetes, obesity, heart disease, and other chronic conditions.
According to the Department of Health and Human Services Office of Minority Health, American Indian/Alaska Native adolescents are 30 percent more likely than non-Hispanic whites to be obese. Adults are 50 percent more likely to be obese. In addition, the Centers for Disease Control and Prevention (CDC) reports that American Indians have a higher risk for diabetes than any other U.S. racial group—a rate that’s twice that of whites. Diabetes is the cause of twothirds of kidney failures for American Indians.
Conti notes that mortality rates within her own community of Pine Ridge are high, and life expectancies for those on the reservation are among the shortest in the country.
“I’m in the trenches and I see it every day, the impact of this food system that Native people are maladapted for,” she says during a visit to Minneapolis. “[Native people are] really the canary in the coal mine in that what happens to us is what happens to the greater population eventually. We’re always the ones who have epidemics first—the diabetes epidemic, the obesity epidemic. They struck us first.”
The issue of how food contributes to a person’s health is deeply complicated, especially in parts of the American Indian community. Limited access to food that is nutritious and affordable combines with systemic factors such as racism, entrenched poverty, a disrupted traditional foodsystem, and often a lack of food sovereignty.
Today, however, tribes such as the Shakopee Mdewakanton Sioux Community and a national campaign it assembled called Seeds of Native Health are demanding across-theboard changes to improve food and nutrition for American Indian people throughout the U.S. They also want tribes to be more able to control their own destinies when it comes to improving food sovereignty and health.
The Mdewakanton community, which is the largest philanthropic benefactor for Indian Country nationally, contributed an initial $5 million in 2015 to start Seeds of Native Health. The nonprofit has three overarching goals: improving access to healthy food, improving nutrition education, and funding relevant research around related subjects that affect American Indian communities.
As part of that endowment, the Mdewakanton community also provided the U of M with an initial $1 million grant, part of which was to be used to create an annual Conference on Native American Nutrition, the only conference in the world devoted to food and nutrition for indigenous peoples.
The group enlisted the Healthy Foods, Healthy Lives Institute (HFHLI) at the U to spearhead the conference. HFHLI, established in 2007, focuses on an interdisciplinary approach to improving food, agriculture, and health via research and community engagement.
Deciphering the Food Distribution Program on Indian Reservations
SINCE 1977, the Food and Nutrition Service, part of the USDA, has operated the national Food Distribution Program on Indian Reservations (FDPIR). Indian Tribal Organizations (ITOs) or state agencies administer FDPIR on a local basis.
The FDPIR program provides households that fall under a certain income level with direct monthly distributions of food. According to the government, some 276 tribes receive benefits under FDPIR and approximately 92,500 individuals on or near reservations receive food from it each month. Direct food distribution is often used instead of the Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps), because of the lack of accessible, full-service grocery stores or other food vendors available to people in those communities.
A June 2016 study of FDPIR by the USDA found that the program serves a low-income group, with many recipients relying solely on Social Security, supplemental security income, or disability insurance payments. The study also found that in 2013, the percent of FDPIR households with low food security was more than four times that of of U.S. households (34 percent compared to 8 percent), and 22 percent of FDPIR households had very low food security, as compared to 6 percent of U.S. households. (Food security refers to having access to good, nutritious, affordable food on a reliable basis.)
Although FDPIR is only intended to supplement a household’s food, for 38 percent of recipients, it is their primary source of food.
Conference organizers say the annual event has been designed to bring together tribal officials, researchers, practitioners, and others to discuss traditional Native knowledge about food, paired with the latest academic research on nutrition and food science, in order to help strengthen indigenous food systems and food sovereignty.
“Getting healthy food and making it both accessible and affordable for people is critical,” says Mindy Kurzer, Ph.D., the director of HFHLI, who has led the efforts to create and run the conference. “When it comes to communities of color and indigenous people worldwide, they have been affected by so many things that have in turn affected their food. Indigenous people … [survived an] attempt at genocide and cultural extinction and assimilation. So, part of their journey is to reconnect with their traditional foods, to learn about them, and to grow them or to have access to them.”
This year’s conference, the fourth annual, is being held at Mystic Lake Center in Prior Lake, Minnesota, from September 15-18. The gathering is expected to draw more than 600 attendees, roughly 60 percent of whom will come from American Indian communities.
Topics at the conference include Foraging for Native Edible Plants; Preparing Healthy Traditional Food, and a wide variety of best-practice panels, the majority led by tribal members. Breakout panels address subjects such as national food policy; empowering and supporting American Indian communities in reclaiming their health through nutrition, and the sharing of both personal and community success stories.
"We're going to have four or five people give a 5- or 10-minute talk about how they've healed through food," says Kurzer, "through their reconnection with traditional food or nutrition or about [food] policies that have personally affected them."
The team behind the conference includes Linda Bane Frizzell, an Eastern Cherokee/Lakota elder and assistant professor at the U’s School of Public Health. She sits on the advisory council for the conference and has been involved as both a planner and participant in the event for the past several years.
Frizzell says topics at the conference cover not only academic research around the subject of nutrition, but also honor the knowledge about foods and food gathering that Native people possess.
Advocating for Healthier Food, Native Producers
EXPERTS SAY trying to improve American Indian health through nutrition is best approached from many directions simultaneously, including political advocacy.
The Seeds of Native Health campaign assembled a Native Farm Bill Coalition, supported by 170 tribes and other organizations, to lobby Congress prior to its enacting the 2018 Farm Bill.
The coalition noted two key factors in assembling the group: First, Native communities have the highest rate of reliance on federal feeding programs. Second, Native food producers represent the key to future tribal food sovereignty and selfreliance, but currently face major regulatory and financial obstacles.
One of the coalition’s priorities was to improve programs such as the national Food Distribution Program on Indian Reservations (FDPIR) by having the Farm Bill support purchasing traditional, locally grown food for food packages. The group’s materials note that “Traditional and locally grown foods from Native farmers, ranchers, fishers, and producers encourage healthy living, cultural sustainability, and traditional practices. They also support economic development, food production, and agribusiness in Indian Country.”
The coalition’s lobbying efforts met with significant success. The finished bill, signed into law by President Trump in December 2018, ultimately contained 63 new food and farming provisions benefitting American Indian communities.
Among the new provisions is a $5 million demonstration project that allows tribes to purchase food for FDPIR themselves. Another provision added “regionally grown” to the traditional foods’ purchasing language under FDPIR. Advocates say these developments will help Native communities begin to more directly influence and affect food security for their own people.
"There’s a lot of indigenous knowledge that relates to even before you plant a food,” Frizzell says. “Whenever we plant our crops, it’s by moon signs and cultural traditions. In addition to that are the spiritual practices. There are different rules for plants that you harvest for what grows below ground, as opposed to above ground, and rules for crops that should be adjacent to one another. And rules for preservation.” Frizzell says she personally belongs to a “rice camp” near the Leech Lake Reservation, and that as part of the traditional, annual harvest of wild rice, a variety of blessings are part of the activity. She also notes that academic research shows the act of gathering wild rice in a traditional manner is good exercise, another factor that could contribute to better health for American Indians.
In keeping with the idea that sharing indigenous knowledge and wisdom helps combat health-related dietary issues, Kibbe Conti and Lakota community elder Bob Chasing Hawk developed a teaching tool based on the sacred medicine wheel. Called the Four Winds Nutrition Model, the image—a circle separated into quadrants—historically represents balance. The duo wanted to use its symbolism to help them visually share the message about better nutrition among American Indian communities.
To demonstrate, Conti grabs a sheet of paper and begins scribbling on it to show how an ideal diet should balance fruit/vegetables, starches, water (rather than sweetened drinks), and lean meat or other protein. In one quadrant, she places the “pale grains” she feels represent too much of a current Native diet—bread, pancakes, pasta, white rice, oatmeal. Then she replaces those options with a few of the Native foods she wants her patients to substitute—blue corn, squash, sweet potatoes, and beans of many colors. “Colorful carbs are low-glycemic, so they’re going to break down more slowly,” she says. “When our food system was based on these starchy vegetables, we didn’t have diabetes, although we were also a very active people, so it’s a combination.”
Jason Champagne (M.P.H. ‘17) readily admits that his past eating habits nearly killed him, despite the fact that he has a background in professional cooking and nutrition.
After high school, Champagne, who is a member of the Red Lake Band of Chippewa, had saved money from working construction jobs to attend culinary school. After graduation, he worked as a chef for Walt Disney World in Orlando, Florida, for three years. While he enjoyed it, Champagne missed having a connection with people— the reason he’d started cooking in the first place.
He returned to school and graduated from the University of North Dakota with a degree in community nutrition and Native American studies, and then earned his master’s in public health at the U of M.
In 2015, Champagne discovered he was facing many of the same issues that plague other members of the Native community: He developed “really, really bad” diabetes; had what he describes as a borderline stroke-level blood glucose reading; high blood pressure; and extremely elevated cholesterol. Despite his education in nutrition, Champagne says he wasn’t eating right, was drinking too much, and wasn’t exercising. He was also taking 12 pills a day to treat his various medical issues.
Champagne decided to change. He quit drinking and began using both his chef’s training and nutrition background to radically transform his eating habits. The most significant change? He began preparing and eating more vegetables and vegetable-based dishes. He also started working out. Today, he says he’s lost about 60 pounds, no longer has diabetes, and doesn’t take any medications.
Motivated by his experience, Champagne started Native Chef LLC, a mobile culinary arts class that he founded in 2017 in Eudora, Kansas. He now works to educate others about how food affects health and he travels around the country to teach other Native peoples—including kids— how to change their eating and cook healthier food. As part of his demonstrations, he includes traditional native foods, but he doesn’t focus exclusively on them.
“I use a lot of wild rice, a lot of beans, a lot of corn, a lot of squash,” Champagne says about cooking with traditional ingredients. He recently made what he calls a Three Sisters Corn Salsa as a demonstration item highlighting traditional Native foods. The salsa featured roasted hominy, squash, and beans, accented with fresh onion and lime.
But while Champagne is a fan of traditional foods, he also spends a lot of time answering questions from audience members about how they can eat healthier when they must rely on supplemental government commodity food, which depends heavily on dry, canned, and frozen items.
Introducting the U's New American Indian Health and Wellness Minor
ACCORDING TO the U’s School of Public Health, there are 573 federally recognized tribes in the U.S., 74 state-recognized tribes, and 34 federally funded Urban Indian programs that collectively are home to nearly 4 million American Indians.
SPH recently created an American Indian public health and wellness graduate minor to train professionals to “thoughtfully and effectively address the unique health needs of this culturally diverse population, as well as understand the government-to-government relationship the federally recognized tribes have with the U.S. government.”
You can learn more about this here: sph.umn.edu/academics/degrees-programs/minors/american-indian-health-and-wellness/
“I think what I’m having with people is a realistic conversation,” Champagne says. “We have to look at the incomes of these families and how much commodities they use. That’s realistically the food that a lot of these people are eating. They’re trying to survive, and commodities help. Fry bread might be that person’s only meal of the day, so I try and help them understand how many calories and fat and carbohydrates are in one of those pieces. I may also show them how they can take their elbow macaroni [from a commodity box] and dice up a zucchini and a red onion and then add a simple vinaigrette to make it a more healthy option.”
Like Champagne, Kibbe Conti knows that encouraging her patients to seek a better diet is complicated by many factors, including familiar, inexpensive, and culturally nostalgic foods such as fry bread, which is dough deep-fried in oil. She also sees that link as further evidence of past wrongs that continue to affect Native communities.
“Our people signed treaties like the Fort Laramie treaty [in 1868], and right in there it said the government was going to issue us flour” in return for them giving up their traditional territory and moving to a reservation, she says. “We’d never seen flour before. We didn’t know how to eat it; we didn’t have ovens; we didn’t have bread. But eventually we got hungry and reports say pioneer women showed us how to make fry bread. So, we ate it. And we still do. That was the beginning to me of this radical shift in our food ways, which led to the chronic disease we still suffer from.”