Food environment on the Navajo Nation: Availability of healthy foods by food source

Background: Food, or nutrition, environments are widely believed to contribute to the increasing obesity and chronic diseases. Obesity and diet-related chronic diseases are at epidemic levels among American Indians. However, limited information exists on the food environment in American Indian communities. As part of a USDA-funded healthy stores project on American Indian Reservations, we investigated retail food sources across the Navajo Nation. Methods: Food sources were identified through direct observation across communities on and nearby the Navajo Nation. A food source checklist, which included an inventory of 20 key categories of foods, was used to access the availability of healthy foods (lower in fat and sugar and/or higher in fiber). ANOVA and Chi-square tests were used to compare the availability of healthy foods by source. Results: Of 106 food sources identified, 41.5% were convenience stores, 17.9% small grocery stores, 17.9% trading posts, 10.4% supermarkets, 8.5% medium-sized grocery stores, and 3.8% flea markets. Most food sources carried a limited number of healthy foods. Over 72% of food sources offered £2 kinds of fresh fruits and vegetables, of which most were potatoes and onions. The availability of key healthy foods differed by food source. For instance, while 100% of supermarkets and medium-sized grocery stores offered low-fat milk, only 50% of convenience stores, 32% of small grocery stores, and 13% trading posts did. Food sources on the Navajo Nation had significantly lower availability of healthy foods compared to commonly used food sources on the reservation borders. Conclusions: Initiatives to improve the retail food environment will make a significant impact on the availability of healthy foods on the Navajo Nation.