The purposes of this project are to determine the nutritional
status of Navajo preschoolers and to document
the impact of recent food assistance changes on the
nutritional and socioeconomic well-being of Navajo
children and their families. Pareo and Bauer assert that
the dietary patterns of preschool children are an important
object of study because they directly reflect the
food choices made by children’s caregivers, providing
indicators of the use of nutrition knowledge and of the
need for nutrition interventions. Also, preschool children
are themselves emerging nutritional decisionmakers,
becoming increasingly assertive about their
food preferences and affecting the family’s
shopping/food procurement approach.
The authors’ specific aims are to:
- determine the proportion of children’s diets that are
made up of USDA food assistance program products;
- determine the patterns and strategies used by families
to obtain food—use of food supplementation
programs, shopping strategies, and decision-making
about the use of these food sources;
- investigate the effects of employment, residence,
and other factors on the above; and
- provide a dataset that can be used to inform discussion
of policy and funding changes contemplated for
food assistance programs, as well as to provide
information on the effectiveness of nutritional intervention
strategies among Navajo families.
The data are similar to those collected in the 1992
Navajo Health and Nutrition Survey (NHNS) through
a collaborative effort by the Indian Health Service, the
Navajo Nation Division of Health, and the U.S.
Centers for Disease Control and Prevention. Results of
that survey, published in 1997, applied to adults and
children over the age of 12. Currently, there are no
similar data available on Navajo preschoolers.
The authors began their research in this area in 1998
(through a small grant entitled “Monitoring Health and
Nutrition on the Navajo Nation”) with a focus on the
accessibility and affordability of healthy, nutritious
foods for Navajo people living in various parts of the
Navajo Nation. They sought first to determine to what
extent and in what areas the healthy choices being
promoted by nutrition education programs such as WIC
are available and affordable. In the current project, they
extend their study to examine dietary intakes.
Pareo and Bauer collected data on a random sample of
171 students who participated in the Head Start
program in the Shiprock Agency of the Navajo Nation
in 1999. Their sample includes children attending Head
Start centers or participating in the Head Start home
base program within the Northeast portion of the
Navajo Nation, including parts of New Mexico and
Arizona. Trained Navajo interviewers administered a
24-hour dietary recall and a nutrition behavior survey
during a home visit. They interviewed the caregiver who
had observed everything the child consumed the day
before the interview. The nutrition behavior survey
included questions about the child’s food preferences,
the family’s food preferences, the family’s food choices
and strategies for obtaining food, and demographics.
An interviewer coded and entered the diet recall data
into the Food Intake Analysis System (FIAS, version
3.99). FIAS uses a subset of the USDA Nutrient
Database for Food Consumption Surveys. The interviewer
and data collection supervisor reviewed all
food records for accuracy and coding consistency. The
- Mean daily intakes of macronutrients and micronutrients;
- Percent of nutrients contributed by food groups;
- Meal patterns;
- Foods consumed that were provided by food assistance
- Percent of mean daily intakes of macronutrients and
micronutrients contributed from foods provided by
food assistance programs.
The authors reported on completed analyses of 84
interviews, with a goal of completing approximately
150 interviews in total.
Their preliminary data show that most respondents
reported not participating in food assistance programs.
The authors note, however, that participation may be
underestimated because many respondents were uncomfortable
with the question. About 50 percent of the
households reported the mother as the primary caregiver.
Many others reported both parents as the primary
caregiver. Over 25 percent of the households were more
than 50 miles from a grocery store. Over 70 percent of
the households included two adults; about one-quarter
had more than two. Most adults other than parents were
children over 18. About 30 percent of households had
two children. Approximately 52 percent of the respondents
were not employed.
The median energy intake for preschool children in the
sample was 1,800 Kcal; about 10 percent reported
intakes greater than 2,900 Kcal. Protein intakes were
well above recommended levels. About 35 percent of
calories were from fat. Three nutrients—vitamin A,
calcium, and iron—stood out as of particular concern.
Vitamin A intakes were very skewed—nearly 50
percent of children sampled did not meet the recommended
intakes, and nearly 25 percent were well
below this level. Twenty-five percent consumed less
than the recommended intakes of calcium and iron.
The foods most frequently consumed were flour
tortillas; fried potatoes; fruit-flavored beverages such
as Kool-Aid, Hi-C, and Gatorade; spaghetti;
Hamburger Helper; and bananas.
The authors also plan to examine differences in
nutrient intakes by age and to measure nutrient
density. They note that high energy intakes found in
the preliminary results do not indicate nutritional
adequacy. They also plan to merge their dietary data
with a Head Start database that includes anthropometric
The authors caution that their data may not accurately
represent the dietary intake of preschool children.
Interviewers reported difficulty administering the
dietary recall because respondents did not understand
the language or concepts used. Interviewers also questioned
whether respondents reported a child’s actual
consumption or what was served.
Seasonal factors are also likely to have affected their
results. Most of the interviews were conducted in the
late summer when Head Start is not in session, and
thus most of the foods reported were prepared at
home. This is also the time of year when most fresh
fruits and vegetables are available at lower cost; even
so, few fruits and vegetables were reported.
Though the analysis is preliminary, Pareo and Bauer
note several implications of their early results. First,
they identify specific food behaviors that could be
addressed in education programs targeting parents and
Head Start staff. Increasing fruit and vegetable intake
and increasing the variety of foods in the diet are
possible areas for attention. High-energy intakes found
for some children also indicate a need to address the
risk of overweight at very young ages. The low reported
use of food assistance in this sample also warrants
further investigation. Finally, Head Start program
administrators and parents are very interested in the
findings and in using the results to improve food assistance
and nutrition services in the Head Start program.