Nutrition / Physical Activity

1/3 of American Indian and Alaska Native (AIAN) individuals experience obesity.

Strategy 1 aims to prevent obesity amongst American Indians/Alaska Natives by implementing evidence-informed and culturally-adaptive policy, system, and environmental changes.  The primary objectives of this strategy are to increase access to healthy foods and beverages, increase access to safe and accessible places for physical activity, and increase breastfeeding support for mothers. This strategy is comprised of 3 activities.


  • Improve tribal food and beverage programs/systems (e.g., community gardens, farmers markets, public transportation routes to food stores, access to healthy foods at community venues or schools, using food service guidelines and nutrition standards).
  • Collaborate with partners to improve land use design to connect activity-friendly routes (e.g., sidewalks, bicycle routes, public transit) with everyday destinations (e.g., homes, schools, work sites, parks).
  • Increase continuity of care and community support for breastfeeding by incorporating services into existing community support services, (e.g., early care and education centers, community health centers, home visiting program); establishing culturally-appropriate and accessible lactation support services (e.g., support groups, walk-in clinics, Baby Cafés); and providing breast feeding support training to health care providers, community health workers, peer support providers that work with mothers and babies.


  • Increased number of people with access to healthy foods (e.g., fresh produce, low sodium options) and beverages.
  • Increased number of people with access to safe and accessible places for physical activity.
  • Increased number of breastfeeding mothers who use community services that support breastfeeding.

Zephier E, Himes JH, Story M, Zhou X. Increasing Prevalences of Overweight and Obesity in Northern Plains American Indian Children. Arch Pediatr Adolesc Med. 2006;160(1):34–39. doi:10.1001/archpedi.160.1.34