Diabetes is one of the biggest health threats facing our nation. More than 38 million adults in the United States have the disease. Fueled by obesity, it’s life-threatening and the leading cause of kidney failure in adults. Yet, for American Indians the threat is even worse.

“In my Kiowa tribal language, there is a word for diabetes,” says Elizabeth Battiest. “It translates to ‘sugar sickness.’ This word only came into being after our people were forced to live on a reservation and forbidden to leave for any reason.

“Our traditional, pre-reservation diet consisted of buffalo (the leanest of meat), elk, deer, rabbit, fish and wild fruit with fresh drinking water. These things were our main staple for hundreds of years. Post-reservation, we were given “rations” by the U.S. Army. 

“It has been scientifically proven that Native Americans and other indigenous peoples all over the world have higher rates of diabetes. Our body’s systems are not accustomed to digesting wheat-based products. Our bodies turn it into sugar very quickly. As a result, our people have the highest rate of diabetes in the United States.” 

The Centers for Disease Control and Prevention  and Indian Health Services estimate that in some communities, 60 percent of tribal members may be diabetic. The Pima Indians of Arizona have the highest rate of diabetes in the world. More than half of the tribe has been diagnosed with Type 2 diabetes. Data also shows that American Indians develop diabetes earlier in life and have more complications.   

The Tipping Point

It wasn’t always this way. As Kiowa member Elizabeth notes, before Europeans arrived in North America, American Indians lived off the bounty of the land. Long before “eat local” was a foodie mantra, they reaped the benefits of a diet many nutritionists consider the gold standard. Corn, beans, squash, berries, greens, wild rice, fruits, nuts, seeds and lean proteins including fish, bison and small game were on the daily menu. Together, they provided balanced nutrition for good health.

This balance was upended when new settlers arrived on the continent. They cleared wide swaths of land to grow their crops and raise livestock. In doing so, they wiped out much of the natural food and game Native people relied upon.

Later, Native Americans were forced from their homelands and onto barren reservations. They were banned from leaving to hunt and fish. Stripped of their active hunter-gatherer lifestyle, they had to live on government rations. Lard, flour, rice, coffee, sugar and canned spam were poor substitutes for fresh, lean foods.

Over the years, processed foods were added, making bad nutrition even worse. This dramatic shift in food and lifestyle opened the door to obesity — and with it, diabetes.

Navajo Nation Leads the Way       

Today, many tribes are fighting diabetes. The Navajo Nation created the Navajo Nation Special Diabetes Project  (NNSDP). The outreach program focuses on education about diet, physical activity and other ways to fend off diabetes. It also helps individuals already diagnosed manage their disease to avoid complications. The project also identifies Nation members with pre-diabetes to help stop the advance to full-blown diabetes.

Other tribes are finding ways to battle the disease, too. When the Jicarilla Apache Nation was unhappy with conditions at their local Indian Health Service hospital, they built a new one. They also opened a dialysis center to serve their 3,000 tribe members.

Nurturing Food Sovereignty

Like the Navajo and Jicarilla Apache, many Nations use revenues from oil, gas and casinos to combat diabetes. But they’re doing something else that is equally important. They’re reclaiming their traditional foods and ways to prepare them.

Today, food sovereignty  is a growing movement. Native people believe it’s key to regaining their physical and spiritual health.

“Our reliance on processed foods, which lack both soul and nutritional value, has created a disconnect from the relationship we once had with the plants and animals that sustain us. But those plants and animals are still here,” writes chef Nico Albert,  a member of the Cherokee Nation. “Each time we make the decision to forgo the box or bag of instant dinner, and instead prepare a simple meal with fresh, traditional ingredients, we have an opportunity to recall the significance of those ingredients as we cook. This remembrance through food nourishes our bodies and connection to our culture.”

Cultural connection is also being nurtured on the plains of Montana. There, the Assiniboine and Sioux tribes are working to bring back bison from the brink of extinction. So is the Quapaw Tribe of Oklahoma.

“They teach traditional ways to butcher, cook and use all parts of the animal while also distributing it among their people,” Elizabeth explains. “Tribes of the Northwest are doing the same with salmon. Eastern tribes are reintroducing planting of traditional foods.”

Along with bison ranching, the Oneida Nation in Wisconsin is preserving their white heirloom corn. They teach people how to harvest the corn, braid it for drying, and save its seeds for planting.

“Tribes are also promoting traditional games played for exercise in the same way our warriors of the past trained,” Elizabeth adds.

In every case, these time-honored rituals link modern-day Native Americans with the powerful traditions and rich histories of their ancestors. They do something else, too. They help Native people fight sugar sickness and reclaim better health.

Sources: National Diabetes Statistics Report,  Centers for Disease Control and Prevention, 2024; About Healthy Tribes,  Centers for Disease Control and Prevention, 2024; History on a Plate: How Native American Diets Shifted After European Colonization,  History, 2023; Navajo Nation Special Diabetes Project,  Navajo Nation, 2024; Native Voices: Food, Culture, and Storytelling,  PBS, 2018; Food Sovereignty,  American Indian Magazine, 2018; Native Nations Lead the Way to Returning Bison to Their Traditional Homelands,  World Wildlife Fund, 2023

Originally published 10/13/2017; Revised 2022, 2024