title: Dietary change and obesity associated with glucose intolerance in Alaska Natives.
abstract: OBJECTIVE
  To investigate frequency of food intake, body weight, and glucose intolerance in Alaska Natives.
  
  
  METHODS
  Height, weight, and random blood glucose levels were measured and a frequency-of-food-intake questionnaire was obtained. This questionnaire classified persons as consumers of indigenous foods or nonindigenous foods within three food groups. Those with a random blood glucose measurement > or = 6.72 mmol/L received an oral glucose tolerance test.
  
  
  METHODS
  Community screening in 15 villages in Alaska.
  
  
  METHODS
  Nutrition screenings were done for 1,124 Alaska Native residents aged 20 years or older. An oral glucose tolerance test was done for 202 subjects.
  
  
  METHODS
  Subjects were classified as consumers of indigenous or nonindigenous foods within three food groups. A diagnosis of non-insulin-dependent diabetes mellitus (NIDDM) was made on the basis of World Health Organization criteria. A determination of overweight was made on the basis of National Center for Health Statistics criteria.
  
  
  METHODS
  A chi 2 test with Yates correction, t test, and linear regression, with two-sided P values.
  
  
  RESULTS
  Athabascan Indians had twice the rate of NIDDM as Yup'ik Eskimos with significantly higher frequency of nonindigenous food intake, plus lower frequency of indigenous carbohydrate and fat intake. Subjects < or = 30 years old consumed significantly more nonindigenous protein and fat and low-nutrient-density carbohydrates than those > or = 60 years old. Persons who had glucose intolerance reported significantly greater consumption of nonindigenous protein and less seal oil. Incidence of overweight was significantly higher than was found 25 years ago. Participants with glucose intolerance were significantly more overweight than others.
  
  
  CONCLUSIONS
  A pattern of increased frequency of nonindigenous protein, low-nutrient-density carbohydrate, and fat intake with less indigenous carbohydrate and fat consumption was found in subjects < or = 30 years old and in association with the higher rate of NIDDM found in the Athabascan Indians. Persons with glucose intolerance were significantly more overweight than others.
  
  
  CONCLUSIONS
  Although the nutritional value of indigenous foods for reducing disease risk should be promoted, nutrition education, especially among young adults, should also include building skills to select and prepare nonindigenous foods to attain a healthful diet. Although snacking is a concern, dietary fat was the most significant factor in obesity and NIDDM.
authors.affiliation: Department of Obstetrics and Gynecology, Alaska Native Medical Center, Anchorage 99501, USA.
authors.forename: N J
authors.initials: NJ
authors.lastname: Murphy
authors.forename: C D
authors.initials: CD
authors.lastname: Schraer
authors.forename: M C
authors.initials: MC
authors.lastname: Thiele
authors.forename: E J
authors.initials: EJ
authors.lastname: Boyko
authors.forename: L R
authors.initials: LR
authors.lastname: Bulkow
authors.forename: B J
authors.initials: BJ
authors.lastname: Doty
authors.forename: A P
authors.initials: AP
authors.lastname: Lanier
mesh_terms: D000328:Adult; D000367:Age Factors; D000413:Alaska / Q000453:epidemiology; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000208:ethnology*; D004032:Diet; D004435:Eating; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007198:Indians, North American; D004930:Inuit; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000208:ethnology*; D015995:Prevalence; D012737:Sex Factors