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This qualitative study used a focus group approach (talking circles) to elicit tribal elder insight on important concepts for the purpose of creating a curriculum to teach tribal youth in South Dakota about nutrition and physical activity in culturally appropriate ways. The focus groups were part of a larger project that is exploring mechanisms for creating culturally relevant nutrition and physical activity education for American Indian youth. A series of “Eat Smart, Play Hard” posters, created by South Dakota State University Extension, served as the starting point for talking circle conversations with tribal elders about teaching nutrition and physical activity to children. Data from the talking circles were analyzed using qualitative content analysis for themes in elder dialogs. In open-ended conversations, elders discussed barriers and success in achieving good nutrition and physical activity, important aspects of the Siouan food culture, and historical relationships with food. They shared insights on food ingredients and methods of obtaining and preparing food that were and are currently important to their communities. These data were used to better understand the Native cultural perspectives on nutrition and physical activity and to create effective educational material for Native youth that could be used to teach them in culturally relevant ways.