Volume 110, Issue 5, Supplement, May 2010, Pages S44–S51
Culturally Competent Dietetics: Increasing Awareness, Improving Care
Research
The Medicine Wheel Nutrition Intervention: A Diabetes Education Study with the Cheyenne River Sioux Tribe
Abstract
Objective
The
Northern Plains Indians of the Cheyenne River Sioux Tribe have
experienced significant lifestyle and dietary changes over the past
seven generations that have resulted in increased rates of diabetes and
obesity. The objective of this study was to determine if Northern Plains
Indians with type 2 diabetes mellitus who are randomized to receive
culturally adapted educational lessons based on the Medicine Wheel Model
for Nutrition in addition to their usual dietary education will have
better control of their type 2 diabetes than a nonintervention, usual
care group who received only the usual dietary education from their
personal providers.
Design
A
6-month, randomized, controlled trial was conducted January 2005
through December 2005, with participants randomized to the education
intervention or usual care control group. The education group received
six nutrition lessons based on the Medicine Wheel Model for Nutrition.
The usual care group received the usual dietary education from their
personal providers.
Participants
One hundred fourteen Northern Plains Indians from Cheyenne River Sioux Tribe aged 18 to 65 years, with type 2 diabetes.
Methods
Weight,
body mass index (BMI), hemoglobin A1c, fasting serum glucose and lipid
parameters, circulating insulin, and blood pressure were measured at the
beginning and completion. Diet histories, physical activity, and
dietary satiety surveys were measured at baseline and monthly through
completion. Differences were determined using Student t tests, χ2 tests, and analysis of variance.
Results
The education group had a significant weight loss (1.4±0.4 kg, P≤0.05) and decrease in BMI (1.0±0.1, P≤0.05)
from baseline to completion. The usual care group had no change in
weight (0.5±0.5 kg) or BMI (0.5±0.2). There were no between group
differences due to intervention in energy, carbohydrate, protein, and
fat intake and physical activity.
Conclusions
The
culturally based nutrition intervention promoted small but positive
changes in weight. Greater frequency and longer duration of educational
support may be needed to influence blood glucose and lipid parameters.
Copyright © 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.
K.
Conti is in private practice in Rapid City, SD; at the time of the
study, she was a graduate student, Nutrition, Food Science, and
Hospitality Department, South Dakota State University, Brookings.
