When Denisa Livingston and a group of Navajo women danced the Zumba in front of their council chamber, it raised a few eyebrows among the North American tribe.
The Latin dance-inspired aerobic workout was just one way of raising awareness about how exercise and healthy food can help an obesity and diabetes epidemic among Native Americans.
"We were the first group to do Zumba in front of the Navajo Council chamber to say 'this is health,'" said Ms. Livingston, an organizer with the Diné Community Advocacy Alliance (DCAA).
The Navajo Nation, the largest North American tribe with some 300,000 enrolled members, spans 27,425 square miles across parts of Arizona, New Mexico, and Utah.
Yet, there are less than a dozen grocery stores, said Livingston, making the area a "food desert" – a term the US Department of Agriculture uses to refer to a region where people cannot easily buy fresh, healthy, and affordable food.
The health implications for the Navajo are dramatic.
More than 80 percent of Native American and Alaska Native adults are overweight or obese and one in two children are too fat for their age, says the government's Indian Health Service.
In comparison, nearly 40 percent of American adults were obese as of 2016, according to the Centers for Disease Control and Prevention.
Native Americans and Alaska Natives are also twice as likely to have diabetes compared to non-Hispanic whites, found a 2012 report by the Great Lakes Inter-Tribal Epidemiology Center.
Junk food tax
The Najavo broke new ground in 2014 when they introduced the first junk food tax in the United States.
The Healthy Diné Nation Act 2014 imposes a 2 percent tax on sugar-sweetened beverages and foods high in salt, fat, and/or sugar such as chips, candy, pastries, and fried foods.
Meanwhile, a complementary law eliminated a 5 percent tax on fresh fruits and vegetables.
The tax has raised more than $4 million for the Navajo Nation since coming into effect in 2015, boosting efforts to reverse a nutrition crisis where diabetes affects one in three people, said Livingston, whose organization spearheaded the law.
As mandated by the law, revenue has gone towards projects the Navajo define as health and wellness, such as vegetable gardens, craft classes, exercise equipment, and walking trails.
However, only half of shops selling such foods comply with the law, said Livingston.
"Imagine if it's 100 percent compliance. People critical of the tax say 'it's a regressive tax' or 'taxation doesn't work' but we're doing it, even in a place where 50 percent or more of my people are living in poverty," Livingston said.
The law is changing people's attitudes, and other indigenous groups suffering from a lack of healthy food could pass similar policies, she told the Thomson Reuters Foundation at an international food festival in the Italian city of Turin.
"Our current vice president was 300 pounds. Now he runs marathons," she said at the September event organized by Slow Food, a global grass-roots organization aiming to prevent the disappearance of local food cultures.
Marion Nestle, professor of nutrition, food studies, and public health at New York University, said taxation was a small measure to help reverse weight gain.
"The most common misperception [on taxation to change people's behavior] is that they won't work. They do," she said.
"But [taxation] is only one measure, and a small one. To reverse weight gain in the Native American population will take many such measures over a long time period."
Zumba and pancakes
Globally, 16 countries and a number of jurisdictions have imposed tax on sugary drinks, but very few tax food high in salt, fat, and/or sugar, experts said.
Such foods tend to be very cheap and targeted towards poor communities.
Those include indigenous people that have "historically been denied their rights to land and rights to adequate food," said Fabio da Silva Gomes of the Pan American Health Organization.
Many are produced using four plants – corn, wheat, sugarcane, and soya – the nutrition adviser said.
This leads to "poor diets and poor and monotonous agriculture," where swathes of land are used to produce vast amounts of a small number of crops, according to Mr. Gomes.
Across Navajo communities, these foods have caused mental, physical, and spiritual damage, as traditional practices were lost for decades, Livingston said.
"My grandmother – she's almost 90-years-old – just recently drew pictures of food she ate that we never even knew of. She started speaking about how she prepared them over the hot coals and fire without any utensils," she said.
These include Navajo pancakes made with goat milk and baking powder and poured into a heap of hot coals, as well as tamale made of yellow corn, blue corn mush, and raisins.
Livingston is hoping the Navajo Nation can leverage such ancestral knowledge, along with Zumba and other fitness classes, to build a healthier community.
"Grandmas say, 'This is club music, Danisa, I would not be here if my grandson wasn't coming,' " she said. "But you see people laughing and being in a positive environment."
This story was reported by the Thomson Reuters Foundation.