title: Beverage consumption in an Alaska Native village: a mixed-methods study of behaviour, attitudes and access.
abstract: BACKGROUND
  American Indians/Alaska Natives (AI/AN) have the highest prevalence of obesity for any racial/ethnic group. Previous studies examining risk factors for obesity have identified excessive sugar-sweetened beverage (SSB) and inadequate water consumption as major risk factors for this population group. The historical scarcity of water in rural Alaska may explain consumption patterns including reliance on SSBs and other packaged drinks.
  
  
  METHODS
  Our study was designed to assess SSB, water and other beverage consumption and attitudes towards consumption in Alaska Native children and adults residing in rural Alaska. During summer 2014, 2 focus groups were conducted employing community members in a small rural village more than 200 air miles west of Fairbanks, Alaska. Interviews were completed with shop owners, Early Head Start and Head Start program instructors (n=7). SSB and total beverage intakes were measured using a modified version of the BEVQ-15, (n=69).
  
  
  RESULTS
  High rates of SSB consumption (defined as sweetened juice beverages, soda, sweet tea, energy drink or sports drinks) and low rates of water consumption were reported for all age groups in the village. All adolescents and 81% of children reported drinking SSBs at least once per week in the last month, and 48% of adolescents and 29% of younger children reported daily consumption. Fifty-two per cent of adults reported consuming SSBs at least once per week and 20% reported daily consumption. Twenty-five per cent of adolescents reported never drinking water in the past month, and 19% of younger children and 21% of adults did not consume water daily.
  
  
  CONCLUSIONS
  Alaska Native children and adults living in the Interior Alaska consume high amounts of SSBs including energy drinks and insufficient amounts of water. Interventions targeting beverage consumption are urgently needed for the Alaska Native population in rural Alaska.
authors.affiliation: Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Deena
authors.initials: D
authors.lastname: Elwan
authors.affiliation: Chief Andrew Isaac Health Center, Tanana Chiefs Conference, Fairbanks, AK, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: de Schweinitz
authors.affiliation: Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA; Wojcicki@gmail.com.
authors.forename: Janet M
authors.initials: JM
authors.lastname: Wojcicki
mesh_terms: D000293:Adolescent; D000328:Adult; D000413:Alaska; D000072957:Alaska Natives / Q000706:statistics & numerical data*; D001294:Attitude to Health; D001628:Beverages / Q000706:statistics & numerical data*; D002253:Carbonated Beverages / Q000706:statistics & numerical data; D002648:Child; D061215:Energy Drinks / Q000706:statistics & numerical data; D002149:Energy Intake; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000453:epidemiology; D012424:Rural Population; D011795:Surveys and Questionnaires
keywords: Alaska Native; nutrition; obesity; sugar-sweetened beverages; water