Hill Courtney M, Paschall M J, Koller Kathryn R, Day Gretchen M, Lee Flora, O'Brien Diane M, King Diane K, Palmer Lea, Domnick Katrina, Thomas Timothy K, Bersamin Andrea
Center for Alaska Native Health Research, Institute of Arctic Biology, University of Alaska Fairbanks, PO BOX 757000, Fairbanks, AK, 99775, USA.
Department of Epidemiology, University of Washington, Seattle, WA, USA.
J Racial Ethn Health Disparities. 2025 Apr 7. doi: 10.1007/s40615-025-02396-8.
American Indian and Alaska Native children experience disparities in obesity. Home caregiver diet and weight status may be important for obesity prevention efforts. The goals of this study were (1) to examine the concordance of diet and body mass index (BMI) between Yup'ik caregivers and preschoolers in remote Alaska and (2) to examine the association of dietary factors with BMI for caregivers.
Study data came from "Got Neqpiaq?", a culturally centered multilevel intervention focused on Yup'ik preschool-aged children (n = 155) and caregivers (n = 144) in 12 communities in Southwest Alaska. Dietary factors of interest were measured using biomarkers: traditional food intake (nitrogen stable isotope ratio), processed food intake (carbon stable isotope ratio), and vegetable and fruit intake (skin carotenoid concentration). Associations among variables were evaluated using confounder-adjusted linear regression with BMI modeled as a continuous outcome.
Dietary biomarkers were highly concordant between caregivers and children, but caregiver and child BMI were not. Among caregivers, traditional food intake was positively associated with BMI (beta = 1.57; 95% confidence interval [CI] = 0.45, 2.68; p = .006), vegetable and fruit intake was negatively associated with BMI (beta = - 0.02; 95% CI = - 0.04, - 0.004; p = .02), and processed food intake was not associated with BMI (beta = 0.74; 95% CI = - 1.07, 2.55; p = .42).
There was high concordance between caregiver and child diet which suggests that dietary-related obesity prevention efforts in Yup'ik communities could focus on family-level interventions. Future work must move beyond a singular focus on obesity and consider holistic health, which aligns with an Alaska Native worldview.
美国印第安人和阿拉斯加原住民儿童在肥胖问题上存在差异。家庭照顾者的饮食和体重状况对于肥胖预防工作可能很重要。本研究的目的是：（1）检查阿拉斯加偏远地区尤皮克族照顾者与学龄前儿童在饮食和体重指数（BMI）方面的一致性；（2）检查照顾者的饮食因素与BMI之间的关联。
研究数据来自“Got Neqpiaq?”，这是一项以文化为中心的多层次干预措施，聚焦于阿拉斯加西南部12个社区的尤皮克族学龄前儿童（n = 155）和照顾者（n = 144）。使用生物标志物测量感兴趣的饮食因素：传统食物摄入量（氮稳定同位素比率）、加工食品摄入量（碳稳定同位素比率）以及蔬菜和水果摄入量（皮肤类胡萝卜素浓度）。使用以BMI为连续结果的混杂因素调整线性回归评估变量之间的关联。
照顾者与儿童之间的饮食生物标志物高度一致，但照顾者和儿童的BMI不一致。在照顾者中，传统食物摄入量与BMI呈正相关（β = 1.57；95%置信区间[CI] = 0.45，2.68；p = 0.006），蔬菜和水果摄入量与BMI呈负相关（β = -0.02；95% CI = -0.04，-0.004；p = 0.02），加工食品摄入量与BMI无关（β = 0.74；95% CI = -1.07，2.55；p = 0.42）。
照顾者与儿童的饮食之间存在高度一致性，这表明在尤皮克族社区与饮食相关的肥胖预防工作可以侧重于家庭层面的干预措施。未来的工作必须超越对肥胖的单一关注，考虑整体健康，这与阿拉斯加原住民的世界观一致。
