Dietary Factors and BMI Among Preschool-Aged Head Start Children and Home Caregivers in Remote Alaska Native Communities.

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusions: 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.