title: Diabetes and Kidney Disease in American Indians: Potential Role of Sugar-Sweetened Beverages.
abstract: Since the early 20th century, a marked increase in obesity, diabetes, and chronic kidney disease has occurred in the American Indian population, especially the Pima Indians of the Southwest. Here, we review the current epidemic and attempt to identify remediable causes. A search was performed using PubMed and the search terms American Indian and obesity, American Indian and diabetes, American Indian and chronic kidney disease, and American Indian and sugar or fructose, Native American, Alaska Native, First Nations, Aboriginal, Amerind, and Amerindian for American Indian for articles linking American Indians with diabetes, obesity, chronic kidney disease, and sugar; additional references were identified in these publications traced to 1900 and articles were reviewed if they were directly discussing these topics. Multiple factors are involved in the increased risk for diabetes and kidney disease in the American Indian population, including poverty, overnutrition, poor health care, high intake of sugar, and genetic mechanisms. Genetic factors may be especially important in the Pima, as historical records suggest that this group was predisposed to obesity before exposure to Western culture and diet. Exposure to sugar-sweetened beverages may also be involved in the increased risk for chronic kidney disease. In these small populations in severe health crisis, we recommend further studies to investigate the role of excess added sugar, especially sugar-sweetened beverages, as a potentially remediable risk factor.
authors.affiliation: Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, WA. Electronic address: joseph.yracheta@mbiri.com.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Yracheta
authors.affiliation: Division of Renal Diseases and Hypertension, University of Colorado, Aurora, CO; Colorado Research Partners LLC, Aurora, CO.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Lanaspa
authors.affiliation: Division of Renal Diseases and Hypertension, University of Colorado, Aurora, CO; Colorado Research Partners LLC, Aurora, CO.
authors.forename: MyPhuong T
authors.initials: MT
authors.lastname: Le
authors.affiliation: Division of Gastroenterology and Hepatology, Duke University, Durham, NC.
authors.forename: Manal F
authors.initials: MF
authors.lastname: Abdelmalak
authors.affiliation: Division of Renal Diseases and Hypertension, University of Colorado, Aurora, CO.
authors.forename: Javier
authors.initials: J
authors.lastname: Alfonso
authors.affiliation: Colorado Research Partners LLC, Aurora, CO; Laboratory of Renal Physiopathology and Department of Nephrology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
authors.forename: Laura G
authors.initials: LG
authors.lastname: Sánchez-Lozada
authors.affiliation: Division of Renal Diseases and Hypertension, University of Colorado, Aurora, CO; Colorado Research Partners LLC, Aurora, CO.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Johnson
mesh_terms: D001628:Beverages; D003920:Diabetes Mellitus / Q000208:ethnology*; D005518:Food Preferences; D006801:Humans; D007198:Indians, North American / Q000523:psychology / Q000706:statistics & numerical data*; D007674:Kidney Diseases / Q000208:ethnology*; D009765:Obesity / Q000208:ethnology*; D013549:Sweetening Agents
chemical_list: D013549:Sweetening Agents