Reduction of risk factors for Obesity and linked Chronic Diseases in Native American employees of the Twin Arrows Casino through a culturally-relevant micronutrient-dense plant-rich (mNDPR) dietary in

与非西班牙裔白人相比，美国原住民肥胖的可能性高出50%，而且 被诊断为糖尿病的可能性增加了一倍。肥胖和饮食质量差是主要的危险因素。 导致II型糖尿病，美洲原住民受贫困的影响不成比例 身体健康结果。我们建议开发一种与文化相关的微量营养素-密集 富含植物(MNDPR)的饮食方案，然后我们将在试点、随机对照试验中使用 (RCT)测试改善美国原住民员工健康和福祉的有效性 双箭赌场。这项研究将培养和雇用北方美洲原住民学生 亚利桑那大学(NAU)执行我们的协议，并担任 干预。我们假设该方案将在(I)改进人体测量学方面有效 测量(体重、腰围)、心脏代谢测量(胆固醇、甘油三酯、 血糖、糖化血红蛋白(HbA1c)、空腹胰岛素、hsCRP、IGF-1和血压)， 和健康指标(焦虑、压力、睡眠质量、抑郁症状和情绪)； (Ii)降低双箭赌场美国原住民员工的医疗成本1- 一年期间。与国家少数民族健康研究所的具体目标和 健康差距，这个项目将解决一个服务不足的健康和健康问题 肥胖和相关疾病对人口的影响不成比例。与一致 学术提升研究奖的指定目标，这项计划将 显著增加健康科学学生的研究机会，提供 培养技能和发展事业所需的专业知识和经验。该公司的雇员 双箭赌场将被随机分配到为期12周的面对面试验组或 等待名单的对照组将被分配一个12周后的开始日期的试验组。 两组将在研究第0周(基线)接受相同的健康和健康测量 第13周(实验组干预后)。在26周内(实验 小组将接受后续饮食分析，轮候名单控制将接受所有措施 健康和健康)。两组的医疗保健利用率数据将在第52周收集。 前12个月末干预组与对照组的差异有统计学意义 两组的基线和干预后结果之间的差异， 将展示这一计划在减少肥胖和相关风险因素方面的有效性 美洲原住民雇员的疾病。还将评估这两组人的医疗费用 而显著的差异将表明该计划的成本效益。

Native Americans are 50% more likely to be obese compared with non-Hispanic Whites and are twice as likely to be diagnosed with diabetes. Obesity and poor diet quality are major risk factors for developing Type II diabetes, and Native Americans are disproportionately impacted by poor physical health outcomes. We propose to develop a culturally-relevant micronutrient-dense plant-rich (mNDPR) dietary protocol, which we will then use in a pilot, randomly-controlled trial (RCT) to test the effectiveness of improving health and wellness of Native American employees of Twin Arrows Casino. This study will train and employ Native American students of Northern Arizona University (NAU) to implement our protocol and serve as Lifestyle coaches for the intervention. We hypothesize that the protocol will be effective in (i) improving anthropometric measures (weight, waist circumference), cardiometabolic measures (cholesterol, triglycerides, blood glucose, hemoglobin A1c (HbA1c), fasting insulin, hsCRP, IgF-1, and blood pressure), and wellness measures (anxiety, stress, sleep quality, depressive symptoms, and mood); and (ii) reducing healthcare costs in Native American employees of Twin Arrows Casino over a 1- year period. Consistent with the specified aims of the National Institute on Minority Health and Health Disparities, this project will address health and wellness issues in an underserved population that is disproportionately affected by obesity and related diseases. Consistent with the specified objectives of the Academic Enhancement Research Award, this project will significantly increase research opportunities for students in the Health Sciences, providing the expertise and experience needed to develop skills and advance their careers. Employees of the Twin Arrows Casino will be randomly assigned to a 12-week in-person experimental group or a wait-list control group that will be assigned a start-date 12 weeks after the experimental group. Both groups will undergo the same measures of health and wellness at study week 0 (baseline) and week 13 (post-intervention for the experimental group). During week 26 (the experimental group will undergo follow-up diet analysis and the wait-list control will undergo all measures of health and wellness). Healthcare utilization data will be collected at week 52 for both groups. Statistically significant differences between the intervention and control at the end of the first 12 weeks, as well as differences between baseline and post-intervention outcomes for both groups, will demonstrate the effectiveness of this program in reducing risk factors for obesity and related diseases in Native American employees. Health-care costs of both groups will also be evaluated and significant differences will suggest cost-effectiveness of the program.