American Indian children are experiencing alarming signs of nutrition-related chronic diseases, such as overweight/obesity, hypertension, and acanthosis nigricans—a skin condition characterized by areas of dark, velvety discoloration in body folds and creases.1 Children who develop acanthosis nigricans are at higher risk for developing type 2 diabetes. This commentary aims to increase awareness of emerging opportunities for registered dietitian nutritionists (RDNs) to help raise a healthier generation of American Indian and Alaskan Native children and adolescents (“youth,” for short).