Abstract:
Background: American Indian and Alaska Native preschool-aged children experience a high prevalence of obesity, yet are under-represented in obesity prevention research. This study examined obesity prevalence and dietary risk factors among Alaska Native preschool-aged children in southwest Alaska. Methods: The study used baseline data from \"Got Neqpiaq?\" a culturally centered multilevel intervention focused on Yup\'ik Alaska Native children, aged 3-5 years, enrolled in Head Start in 12 communities in southwest Alaska (n = 155). The primary outcomes were BMI percentile, overweight, and obesity. Dietary factors of interest were measured using biomarkers: traditional food intake (nitrogen stable isotope ratio biomarker), ultraprocessed food intake (carbon stable isotope ratio biomarker), and vegetable and fruit intake (skin carotenoid status biomarker measured by the Veggie Meter). Cardiometabolic markers (glycated hemoglobin [HbA1c] and blood cholesterol) were also measured. Results: Among the Yup\'ik preschool-aged children in the study, the median BMI percentile was 91, and the prevalence of overweight or obesity was 70%. The traditional food intake biomarker was negatively associated with BMI, whereas the ultraprocessed foods and vegetable and fruit biomarkers were not associated with BMI. HbA1c and blood cholesterol were within healthy levels. Conclusions: The burden of overweight and obesity is high among Yup\'ik preschool-aged children. Traditional food intake is inversely associated with BMI, which underscores the need for culturally grounded interventions that emphasize traditional values and knowledge to support the traditional food systems in Alaska Native communities in southwest Alaska. Registered with ClinicalTrials.gov #NCT03601299.
摘要:
背景:美洲印第安人和阿拉斯加土著学龄前儿童的肥胖患病率很高,然而,在肥胖预防研究中的代表性不足。这项研究调查了阿拉斯加西南部阿拉斯加本地学龄前儿童的肥胖患病率和饮食风险因素。方法:该研究使用了来自“GotNeqpiaq?”的基线数据,这是一种以文化为中心的多层次干预措施,重点是阿拉斯加土著儿童,3-5岁,在阿拉斯加西南部的12个社区(n=155)参加了HeadStart。主要结果是BMI百分位数,超重,和肥胖。使用生物标志物测量感兴趣的饮食因素:传统食物摄入量(氮稳定同位素比生物标志物),超加工食物摄入量(碳稳定同位素比生物标志物),和蔬菜和水果的摄入量(皮肤类胡萝卜素状态生物标志物由素食表测量)。还测量了心脏代谢标志物(糖化血红蛋白[HbA1c]和血液胆固醇)。结果:在研究中的Yup\'ik学龄前儿童中,BMI的中位数百分位数为91,超重或肥胖的患病率为70%.传统的食物摄入生物标志物与BMI呈负相关,而超加工食品以及蔬菜和水果生物标志物与BMI无关。HbA1c和血胆固醇均在健康水平内。结论:学龄前儿童的超重和肥胖负担很高。传统食物摄入量与BMI呈负相关,这强调了需要基于文化的干预措施,强调传统价值观和知识,以支持阿拉斯加西南部阿拉斯加土著社区的传统食物系统。已在ClinicalTrials.gov#NCT03601299注册。