The prevalence of obesity in American Indian/Alaska Native (AI/AN) populations has increased dramatically over the past 30 years. Although AIs are not a homogeneous group, all tribes throughout the U.S. have suffered adverse effects from the high prevalence of obesity (Story et al, 2000)). Overall, studies demonstrate that obesity begins early for AI/AN children and also is a significant problem for the adult population (IHS, 2001). Many chronic diseases such as type 2 diabetes, heart disease, stroke, arthritis, and breathing problems are associated with the increasing prevalence of obesity in AIs (DHHS, 2001, Story et al, 1999).
The problem of obesity is not unique to AI/ANs. Overweight and obesity have reached epidemic proportions both nationwide and globally (Ogden et al, 2006; Washington, Post, 2006). The existence of these epidemics indicate that in addition to personal responsibility, societal factors such as convenience technology and engineering; food production and marketing patterns; and powerful social and cultural forces that have shaped our communities, our lifestyles and ultimately our bodies play an important role in this problem (McGinnis, 2004).
The purpose of this study is to provide information that will help to understand the high rates of obesity among the AI/ANs, the nature of a variety of preventive interventions and their efficacy, and directions for future research that may involve research collaborations among government agencies and other organizations.
The report is organized into four major sections: 1) a literature review that synthesizes research findings pertaining to the prevalence of obesity and examines what is known about the major determinants and consequences of obesity as well as the nature and findings of various types of clinical and community based interventions; 2) activities of selected federal agencies in the area of obesity and AI/ANs; 3) summary of a site visit to the Gila River Indian Community; and 4) directions for future research.
CONTENTS
Acknowledgements
List of Tables and Exhibits
Appendices
Executive Summary
I. Literature Review
Introduction
Prevalence
- Infants and Preschool Children
School Age Children
Adults
Contributing Factors
- Nutrition and Diet
Socioeconomic Factors
Psychosocial Factors
Genetic Factors
Physical Activity
Consequences of Obesity
- Physical Health Consequences
Psychosocial Consequences
Economic Consequences
Intervention Research
- Clinical Interventions
Community Based Interventions
Summary of Intervention Research
General Thoughts about Community-Based Research,/ul>
II. Federal Agency Activities
- IHS
NIH
CDC
USDA
III. Site Visit to Gila River Indian Community
IV. Directions for Future Research
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