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About the Tribe
Importance of Animal Products
The Pima are a southwest Native American group with the highest obesity and diabetes rates in the US in the 1990s. The traditional Pima diet was minimally processed, including wheat, maize, beans, saguaro fruit, diverse mammals, fish, birds, and worms (82, 93).
Importance of Plants
Transition to Industrialized Food Products
The Pima are a southwest Native American group with the highest obesity and diabetes rates in the US in the 1990s. The traditional Pima diet was minimally processed, including wheat, maize, beans, saguaro fruit, diverse mammals, fish, birds, and worms (82, 93). As western settlers diverted water supplies, they relied on government rations, mainly sugar, white flour, lard, as well as store-bought food. Obesity rose before diabetes. In the early 1900s, some older Pima were obese but no diabetes was identified in two surveys (93). By 1971, most adult Pima were obese (94). In 1976, among adults over age 40 years, males averaged 122% above ideal weight, women 149%. In 1994, average adult BMI for was 35.5 for women and 30.8 for men (95, 96). Adult diabetes prevalence was <1% in 1940 (97), 4% in 1955 (98), 30% in 1963 (94), and 38% in 2006 (99). The greatest rise in diabetes occurred in the late 1950s and early 1960s, when caloric consumption was higher than most Americans (2,780 calories/day), but fat consumption was lower (24%; 61% carbohydrate, 15% protein). Compared to genetically related Pima in Mexico, those in Arizona had a 5.5-fold higher rate of diabetes and 37% higher BMI (99, 100). Mexican relatives consumed a less processed diet and were more physically active than those in Arizona.
In 1973, the medical epidemiologist Peter Bennett argued that the Pima's diabetes epidemic resulted from high sugar or caloric consumption; he was uncertain if it was “sugar specifically or … calories in general, which in fact turns out to be really excessive amounts of carbohydrates (101).” The rise of obesity and diabetes in the Arizona Pima likely reflect some combination of excess calories, refined carbohydrates and decreased activity.