The epidemic of obesity in American Indian communities and the need for childhood obesity-prevention programs.

American Indians of all ages and both sexes have a high prevalence of obesity. The high prevalence of diabetes mellitus in American Indians shows the adverse effects that obesity has in these communities. Obesity has become a major health problem in American Indians only in the past 1-2 generations and is believed to be associated with the relative abundance of high-fat foods and the rapid change from active to sedentary lifestyles. Intervention studies are urgently needed in American Indian communities to develop and test effective strategies for weight reduction. The poor success rate of adult obesity treatment programs in the general population points to the need to develop prevention approaches aimed toward children. Because eating and physical activity practices are formed early in life and may be carried into adulthood, prevention programs that encourage increased physical activity and healthful eating habits targeted toward young people need to be developed and tested. To be most effective, interventions must be developed with full participation of the American Indian communities.