AN EPIDEMIOLOGIC REVIEW OF DIETARY-INTAKE STUDIES AMONG AMERICAN-INDIANS AND ALASKA NATIVES - IMPLICATIONS FOR HEART-DISEASE AND CANCER RISK

PURPOSE: Dietary factors play an important role in the occurrence of h eart disease and cancer. While American Indians and Alaska Natives (AI ANs) have unique heart disease and cancer mortality profiles, little i s known about the effect of diet on heart disease and cancer risk in t hese populations. This paper reviews existing nutritional intake data from adult AIANs, and considers the potential impact of diet on heart disease and cancer in these communities. METHODS: A review of the lite rature was conducted using the Medline database system and other refer ence materials. Studies documenting nutrient intakes only were include d in this review. Studies were limited to those among healthy, non-pre gnant adults. RESULTS: A total of twelve reports from 1959 to 1996 wer e found. Sample sizes for the studies ranged from 20 to 575 subjects. Most studies were done among women, and a variety of nutritional asses sment techniques (24 hour recall, food frequency questionnaire, multip le-day food record) were used. Most studies also had limited nutrient intake data, especially for dietary fiber and vitamin E. The majority of studies reported moderately high intakes of fat and saturated fat, and low intakes of polyunsaturated fat: and fiber. CONCLUSIONS: Based on the limited data, diet may play an important role in the heterogene ity of heart disease and cancer mortality in AIAN communities. More re search is needed to assess the impact of diet on heart disease and can cer risk, including more longitudinal data, and data to assess the Val idity and reliability of traditional methods of dietary assessment. (C ) 1997 by Elsevier Science Inc.