title: Risk factors for obesity at age 3 in Alaskan children, including the role of beverage consumption: results from Alaska PRAMS 2005-2006 and its three-year follow-up survey, CUBS, 2008-2009.
abstract: BACKGROUND
  Prenatal and early life risk factors are associated with childhood obesity. Alaska Native children have one of the highest prevalences of childhood obesity of all US racial/ethnic groups.
  
  
  METHODS
  Using the Pregnancy Risk Assessment Monitoring System (PRAMS) and the follow-up survey at 3 years of age (CUBS), we evaluated health, behavioral, lifestyle and nutritional variables in relation to obesity (95th percentile for body mass index (BMI)) at 3 years of age. Multivariate logistic regression modeling was conducted using Stata 12.0 to evaluate independent risk factors for obesity in non-Native and Alaska Native children.
  
  
  RESULTS
  We found an obesity prevalence of 24.9% in all Alaskan and 42.2% in Alaska Native 3 year olds. Among Alaska Native children, obesity prevalence was highest in the Northern/Southwest part of the state (51.6%, 95%CI (42.6-60.5)). Independent predictive factors for obesity at age 3 years in Alaska non-Native children were low income (<$10,000 in the year before the child was born (OR 3.94, 95%CI 1.22--17.03) and maternal pre-pregnancy obesity (OR 2.01, 95%CI 1.01-4.01) and longer duration of breastfeeding was protective (OR 0.95, 95%CI 0.91-0.995). Among Alaska Native children, predictive factors were witnessing domestic violence/abuse as a 3 year-old (OR 2.28, 95%CI 1.17-7.60). Among obese Alaska Native children, there was an increased daily consumption of energy dense beverages in the Northern/Southwest region of the state, which may explain higher rates of obesity in this part of the state.
  
  
  CONCLUSIONS
  The high prevalence of obesity in Alaska Native children may be explained by differences in lifestyle patterns and food consumption in certain parts of the state, specifically the Northern/Southwest region, which have higher consumption of energy dense beverages.
authors: Department of Pediatrics (GI and Nutrition), University of California San Francisco, San Francisco, California, United States of America.
authors: Janet M
authors: JM
authors: Wojcicki
authors: Maternal and Child Health Epidemiology Unit, Alaska Division of Public Health, Section of Women's, Children's and Family Health, Anchorage, Alaska, United States of America.
authors: Margaret B
authors: MB
authors: Young
authors: Maternal and Child Health Epidemiology Unit, Alaska Division of Public Health, Section of Women's, Children's and Family Health, Anchorage, Alaska, United States of America.
authors: Katherine A
authors: KA
authors: Perham-Hester
authors: Tanana Chiefs Conference, Fairbanks, Alaska, United States of America.
authors: Peter
authors: P
authors: de Schweinitz
authors: Agence de Medicin Preventive, Paris, France.
authors: Bradford D
authors: BD
authors: Gessner
mesh_terms: D000413:Alaska / Q000453:epidemiology; D001628:Beverages; D002675:Child, Preschool; D003710:Demography; D004032:Diet; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D007223:Infant; D008019:Life Style; D016015:Logistic Models; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology*; D011247:Pregnancy; D018570:Risk Assessment; D012307:Risk Factors