The Diet of Lumbee Indians in Robeson County, NC

Background: Nutrition and dietary patterns are one of the most crucial healthcare concerns, especially because of the close association with chronic diseases, such as obesity, diabetes, hypertension and cardiovascular disease and some cancers. Our study focused on the Lumbee Native American tribe of North Carolina, who have diet-related health conditions and susceptibility to chronic diseases. Our study aimed to identify the dietary patterns of the local community both Lumbee Indians and non-Lumbees living in the area and provide recommendations for future programs and policies. Methods: Our descriptive study explored dietary patterns (food groups and food categories) in Robeson County, NC. We used the National Health and Nutrition Examination Survey (NHANES) Food Frequency Questionnaire to record dietary information. We evaluated participants’ knowledge level of hypertension using the Hypertension Knowledge Questionnaire (HKQ). Results: We enrolled 277 participants, of whom 115 (50.6%) were Lumbee and 112 (49.3%) were non-Lumbee. Most of our participants were female (n= 137; 58%) with a median age of 68.39 (IQR 63.0 -76.0). The comparison of data from our participants and NHANES 2005–2006 reported significantly lower frequency intake among participants for fruits, vegetables, dairy, snacks, mixed dishes, and both alcoholic and nonalcoholic beverages (p<0.05). Our participants had a high consumption frequency of sugar-sweetened beverage in average (2.03 times per day). The consumption frequency of fruits, vegetables, grains, dairy, protein, oil and fat, and sugar was not significantly different across race or chronic disease status (p>0.05). Differences by gender was observed in the average consumption frequency of vegetables (3.46 times per day for female vs. 3.11 times per day for male), fruits (1.92 times per day for female vs. 1.82 times per day for male), and grains (2.47 times daily for male vs. 1.75 times daily for female). Most of our participants could answer more than 16 out of 25 questions on the HKQ correctly, while the correct rate for some food-related questions such as pickles and crackers were relatively low. Conclusions: People of different races and chronic disease status in Robeson County shared a similar dietary pattern in general, which was characterized by a low consumption frequency of fruits, vegetables, and dairy products compared with NHANES 2005–2006. While efforts are needed to address the health disparity in Robeson, policymakers should consider the unique role of the female in education and communication of dietary information. Stronger policies are needed to restrict consumption on low-nutrient and energy-dense food to improve the dietary pattern.