Abstract
Nutritional characteristics and associated lifestyle factors, e.g. activity level, contribute to at least four (heart disease, cancer, cirrhosis and diabetes) of the 10 leading causes of Native American mortality and morbidity. Over the past three centuries, Native American diet and activity levels have changed dramatically. In the Southwest, high-fiber, nutrient-dense precontact foods requiring a moderate level of regular physical activity to gather, hunt and process have been replaced with readily accessible, low-fiber, high-fat and high-sugar foods and beverages. Changes in diet and activity levels have been accompanied by a shift in epidemiological patterns. Intervention trials among both Native Americans and non-Native Americans demonstrate that consumption of a high-fiber, low-fat diet and regular physical activity can be used not only in the treatment but perhaps more importantly in the prevention or delay of disease onset.