Back to Basics: Addressing Childhood Obesity Through Traditional Foods in Alaska

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Back to Basics is a mixed-methods intervention trial to reduce the prevalence of obese Alaska Native children by increasing the proportion of nutrient-dense traditional and non-traditional foods consumed, and decreasing consumption of sugar sweetened beverages (SSBs). This 5-year intervention trial targeting 0-5 year olds is conducted in partnership with Rural Action Community Action Program, Inc. (RC) Head Start, Early Head Start, and Parents as Teachers programs in 12 rural Alaskan communities, where each site is assigned to either a 9-month nutritional education and meal program intervention or a standard education and meal program repeating annually. Once a nomadic population that lived entirely off the land, river, and sea, Alaska Native people have experienced an abrupt nutritional shift towards greater consumption of store-bought manufactured foods and a more sedentary lifestyle. A recent study of dietary adequacy among Alaska Native women in western Alaska found that traditional foods accounted for only 17% of calories, but provided 34% of protein, as well as disproportionately large amounts of essential vitamins and minerals. SSBs were consumed more than any other dietary item and accounted for 8% of calories. Over the past three decades, childhood obesity has emerged as a serious public health problem, increasing three-fold across all races and ethnicities. Obesity is highest among Hispanic and Alaska Native/American Indian (AN/AI) children and adults, with 41% of Alaska Native children 2-5 years of age overweight or obese in 2009. Substantial evidence suggests that obesity in early childhood, ages 0-5 years, is a critical factor in the development of adolescent and adult obesity. Obesity, in childhood and adulthood, is a major risk factor for serious immediate and long-term life-threatening health conditions, such as glucose intolerance, hypertension, diabetes, and cancer. Back to Basics has an unprecedented opportunity to incorporate the lessons learned through past research (Store Outside Your Door) and build on previous study designs and interventions (Hip-Hop to Health, Jr.) in implementing an effective intervention to improve dietary quality through promotion and reincorporation of traditional foods in at-risk young children and their families. A home-based nutrition education curriculum and Head Start center-based meal service focused on traditional foods, will serve as the foundation of the intervention. If effective, this strategy can be adapted and implemented by other Head Start programs across the state to further improve diet quality of all Alaska Native children.