At the heart of this ideology was the radically different paradigm through which the natives peoples


viewed the universe, which considered place and time in a holistic, spatial context (19). Lands and places were one with the supernatural, and it was believed that the spirits and experiences of their ancestors remained. Ceremonies, growing seasons, rituals, harvests, planting, and hunting were all related to the Earth (20). The people’s communion with nature was integral to the land itself. Revelation was a continuous process with adjustments to the natural surroundings (20).


These cultures also developed an elaborate approach to medicine deeply rooted in nutrition and


botanical products (8). By the twelfth century, Aztec physicians and surgeons had sophisticated terminology and classifications for human anatomy, including circulatory and skeletal systems (8). These systems predated by centuries European discoveries of similar concepts. As one would expect, the cultures developed a wide variety of anesthetics, many of which remain integral to modern practices, such as Coca (Erythroxylon coca), which is found in modern cocaine. Peyote was another herbal development used to treat pain (8). Respiratory problems were treated with tonics derived from yerba santa, an herb found in the western states. Guaiacum, ipecac, kaolin, and quinine are likewise AI/AN botanical drugs still in modern use (8). By AD 1100, the Aztecs had recorded the medicinal use for more than 1,200 plants and are believed to be the first to have established a public health care system with hospitals accessible for those unable to pay for services (8). Historians commonly note that early European colonists relied heavily upon Native American medicine to protect them from the unfamiliar germs of the New World, while Native Americans suffered cataclysmic losses due to illnesses carried over from the Old World (8).


The diets of AI/AN have transformed radically since the mid-20th century, as have those of most Americans, shifting more toward processed foods. For the AI/AN community, this compounds the nutritional problems that began when they were moved from ancestral hunting and farming grounds to reservations. A plethora of health problems—including but not limited to diabetes, obesity, and cardiac diseases—are associated with these dietary changes, which are qualitatively comparable to those found in the broader population but quantitatively more significant here. Furthermore, studies indicate that members of the AI/AN communities are slow to recognize obesity and disease risk among their children (20). Individuals planning meals for members of this culture should thus keep in mind the ongoing struggle with nutrition-related health problems, as well as ingredients and recipes which might lend themselves to a positive cultural experience.


On the whole, American healthcare professionals, government agencies, and partners from both the


private and public sectors have, since the early years of the 21st century, taken proactive steps in addressing the impact of nutrition on public health. Multiple resources are available to help individuals in planning meals, and many include an appreciation for cultural differences and ethnic backgrounds.


For individuals working with AI/AN communities, informational resources are available via the


federal government by way of the Indian Health Service (IHS) and, in particular, its Division of Diabetes Treatment and Prevention (DDTP), which has operated the Special Diabetes Program for Indians, an approximated $150-million-per-year grant program, since the passage of the Balanced Budget Act of 1997 (21). The IHS offers fact sheets and menu planning assistance that incorporate practices and customs from all federally-recognized tribes, combining evidence-based research with community-driven implementation strategies (21).


Among the tools offered by the IHS include the My Native Plate educational programming, which incorporates a culturally-sensitive approach to meal planning (22). Tips for preparing meals for the AI/AN


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