In Canada, obesity and associated chronic diseases disproportionately affect First Nations children. The objectives of this research were to assess obesity, physical activity, and perceptions of lifestyle behaviors in Cree First Nations children (5-12 years) in one Alberta reserve community. Levels of obesity (20.0%), abdominal obesity (49.5%), and physical inactivity (64.0%) were high. Most overweight and obese children were also abdominally obese (88.0%). Focus groups interviews indicated

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... cultural/traditional knowledge was overarching and integral to children's understandings of health, food, and activity. Discussions revealed that family members were children's main source of health knowledge. Explanations of the meaning of health included healthy foods and activities, respectful relationships with nature, and the absence of chronic conditions. Children preferred foods and activities they considered to be healthy. Our findings indicate the need to develop local strategies that integrate cultural/traditional practices and ensure family participation to promote healthy weights in First Nations children.