Center for Alaska Native Center for Alaska Native. from the. Bulletin Bulletin

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1 Visit the CANHR web site: News Ceter News Buildig ad icreasig research capacity for Alaska to improve the health of Alaska Natives. from the Bulleti Bulleti Buildig ad icreasig research capacity to Ceter for Alaska Native help Health improve the health Research of Alaska Natives. Ceter for Alaska Native Ceter for Alaska Native Volume 4, No. 1 Health Research CANHR Studies to be Preseted at the Alaska Native Health Research Coferece Sprig 200 INSIDE THIS ISSUE CANHR Studies to be Preseted at the ANHR Coferece...1 Tobacco Use, Eculturatio, ad Risk for Metabolic Disorders...2 Obesity ad Patters of Cetralized Body Fat Amog Yup'ik Eskimos...3 Heritability Aalysis of Obesity Traits...4 Low Prevalece of Metabolic Sydrome i Yup'ik Eskimos...5 Psychosocial Stress, Eculturatio, ad Risk for Metabolic Disorders... Weak Associatio betwee Adipoecti ad Body Fat Distributio, Isuli Sesitivity, & Plasma Lipoproteis...7 Associatio of Pedometer Assessed Physical Activity ad Measures of Health..8 Metabolically Healthy, But Obese Yup'ik Eskimos...9 Istitute of Arctic Biology Irvig I Room 311 Box Uiv. of Alaska Fairbaks Fairbaks, AK (907) FAX: (907) fycahr@uaf.edu CANHR is supported by NIH's Natioal Ceter for Research Resources, uder the Ceters of Biomedical Research Excellece Program UAF is a affirmative actio/equal opportuity employer & educatioal istitutio. The icidece of obesity ad diabetes is dramatically icreasig i Alaska Natives. CANHR has bee workig with Alaska Native people from Yup'ik commuities i southwest Alaska to better uderstad the factors that cotribute to these chages. A collectio of eight studies will be preseted at the 2d Alaska Native Health Research Coferece i Achorage Alaska o March 30 ad 31, 200. The followig pages outlie these studies through brief articles. Specifically, the studies assessed: 1) the relatioships betwee tobacco use, the risk factors for chroic disease, adherece to a Yup'ik lifestyle, ad a umber of other psychosocial variables relevat to cultural idetity; 2) the prevalece of obesity by evaluatig markers of obesity such as percet body fat ad several body measuremets; 3) the heritability of the accumulatio of cetrally located body fat; 4) the prevalece of metabolic sydrome; 5) the relatioships betwee perceived stress, Yup'ik cultural orietatio, ad established risk factors for chroic disease; ) the relatioship betwee circulatig adipoecti levels ad several measuremets of body fat distributio i Yup'ik Eskimos; 7) physical activity usig pedometers to uderstad the relatioship betwee diet ad chroic diseases; ad 8) the prevalece of metabolically healthy obese (MHO) idividuals, by lookig at biological markers, body fat distributio patters, ad evirometal factors. The researchers also focused o fidig ew methods of measurig risk factors ad prevetio approaches that show some promise i reducig diabetes i Yup'ik populatios. The CANHR staff has worked closely with participatig commuities durig the coduct of these studies. Study participats were actively ivolved with data collectio ad the iterpretatio of the data. We wish to thak them for their support ad wisdom i uderstadig the meaig of the data. The CANHR team hopes that leaders i Alaska Native Tribal Health orgaizatios, providers, researchers, ad commuity members will use the results of the research to develop a better uderstadig of ways of reducig type 2 diabetes i Alaskas. A Publicatio of the Uiversity of Alaska

2 Tobacco Use, Eculturatio, ad Risk for Metabolic Disorders Gerald V. Mohatt, EdD 1 ; Christopher Wolsko, PhD 1 ; Cecile Lardo, PhD 1 ; Elizabeth Ruppert 2 ; ad Scarlett Hutchiso, MA 1 1 Ceter for Alaska Native Health Research 2 Yuko-Kuskokwim Health Corporatio, Bethel, AK Backgroud: The relatioship betwee how immersed a idigeous perso is i his/her traditioal culture has bee used to explai psychosocial problems. Research has ot adequately examied how cultural idetity relates to risk factors for chroic disease. Competig argumets dispute whether idividuals who idetify with or are strogly immersed i their local idigeous way of life are protected agaist such risks. Purpose: This study examied the relatioships betwee tobacco use, the risk factors for chroic disease, adherece to Yup'ik lifestyle, ad a umber of other psychosocial variables relevat to cultural idetity. Methods: 74 male ad o-pregat female Yup'ik Eskimos 14 years ad older were recruited from seve commuities i the Yuko Kuskokwim River Delta. The followig two aspects were studied: 1. Psychosocial characteristics, icludig: health ad welless i Yup'ik culture, idetity with Yup'ik/White culture, mastery over importat life outcomes, satisfactio with emotioal support, extet of overwhelmig ad challegig life situatios, ad level of happiess. 2. Physiological characteristics, icludig: height, weight, percet body fat, waist circumferece, blood pressure, triglycerides, HDL, LDL, ad glucose levels.! 29% smoked, 55% chewed Igmik (a idigeous tobacco mixture), ad 14% used suff tobacco.! 7% of the sample had some lifetime exposure to icotie.! Relative to o-smokers, smokers reported havig a stroger o- Native cultural idetity, a weaker Native cultural idetity, less satisfactio with their social support etwork, ad a weaker sese of commual ad persoal mastery.! Physiologically, smokers had lower HDL ad LDL, higher blood pressure, lower fastig glucose, ad lower percetage body fat.! Users of Igmik had a differet psychosocial ad physiological profile. They had a stroger Native idetity, a weaker o- Native idetity, higher HDL ad LDL, higher percetage body fat, ad lower triglycerides. Coclusio: Results suggest that cultural factors play a complex role i uderstadig both risk ad protective factors for metabolic disorders. It appears that choice of substaces is sigificatly iflueced by a combiatio of cultural idetity ad beliefs ad practices i traditioal Yup'ik cocepts of health ad welless.! Breakdow of Results Who chews iq mik more? Older people more tha youger people Wome more tha me People who idetify less with white culture People who idetify more with Yup ik culture Who smokes more? Youger people more tha older people People who idetify more with white culture Who eats more traditioal food? Older people more tha youger people People who idetify less with white culture People who idetify more with Yup ik culture Who uses drugs ad alcohol more to cope? Youger people more tha older people Me more the wome People who idetify more with white culture People who idetify less with Yup ik culture 2

3 Obesity ad Patters of Cetralized Body Fat Amog Yup'ik Eskimos i Southwester Alaska Scarlett H. Hutchiso, MA; Rosemarie Plaetke, PhD; Johaa R. Herro; Gerald V. Mohatt, EdD; ad Bert B. Boyer, PhD Backgroud: The prevalece of obesity ad type 2 diabetes mellitus is icreasig dramatically i ethic miorities. Purpose: Researchers determied the prevalece of obesity by evaluatig markers such as percet body fat ad several body measuremets. Methods: The study populatio cosisted of 341 wome ad 27 me ages 18 to 94 years of Yup'ik descet from villages ad a small tow i southwester Alaska.! Waist-to-hip ratios were sigificatly larger i me tha wome, but wome had larger hip ad thigh circumfereces.! Wome had larger skifolds ad more body fat measured by electrical bioimpedace, a machie that passes a slight electrical curret up the leg of the participat.! Average systolic ad diastolic blood pressure was sigificatly higher i me tha wome.! There were o differeces betwee me ad wome i total cholesterol or triglycerides.! High desity lipoproteis (HDL) were sigificatly higher i wome compared to me, while LDL was sigificatly higher i me tha wome.! Blood pressure icreased by age ad by BMI. Coclusios: Data suggested that high percetage of body fat ad cetralized body fat accumulatio i Yup'ik wome could become a sigificat health risk for type 2 diabetes i the future. However, the sigificatly higher blood pressure i me idicates a risk factor urelated to weight; further ivestigatio is eeded i this area. The research team feels it is a priority to examie additioal ways to reduce body fat accumulatio amog females. Efforts are curretly uderway to idetify protective factors ifluecig well-maaged blood lipids (fats), the low rates of type 2 diabetes mellitus, ad metabolic sydrome i this Yup'ik study populatio.! Measuremet Age (years) Height (cm) * Weight (kg) Body Fat BMI* (kg/m²) * Percetage Body Fat (BIA) * Percetage Body Fat (DW) * Circumfereces Waist Circumferece (cm) Hip Circumferece (cm) * Triceps Circumferece (cm) Thigh Circumferece (cm) * Skifolds Abdomial Skifold (mm) * Subscapular Skifold (mm) * Triceps Skifold (mm) * Thigh Skifold (mm) * Ratios Waist-to-Hip Ratio * Waist-to-thigh Ratio SubscapSF-to-TricepSF Ratio * Waist-to-Height Ratio * Visceral Adipose Tissue 8 Total Abdomial Area Visceral Compartmet Area * Subcutaeous Adipose Tissue * Ma-Whitey 2P=0.05 by geder withi CANHR populatio * Ma-Whitey 2P by geder withi CANHR populatio *** Ma-Whitey 2P=0.05 betwee CANHR populatio ad NHANES Table 1: Age ad Athropometric Measures by Geder Total Study Sample Females Males p value Mea SD Mea SD Mea SD ±1 349 ±1 28 ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ± ±.31.9± ± ±.10.0± ± ± ± ± ± ± ± ± ± ± ± ± ± NHANES Mea SD ±21 *** ± ±18.0 *** ±5.9 ot available ot available *** ±14. *** ±11.7 *** ±4.8 *** ± ± ±8.9 *** ±9.4 *** ±11.1 *** ± ±0.2 ot available ot available ot available ot available ot available ot available Table 2: Blood Pressure Measuremets Total Study Females Males Sample (=532) (-278) (=254) Measuremet Mea SD Mea SD Mea SD Mea Arterial Pressure * 88.1± ± ±8.85 Systolic BP * 120.5± ± ±1.8 Diastolic BP ± ± ± Ma-Whitey 2P=0.05 by geder withi CANHR populatio * Ma-Whitey 2P by geder withi CANHR populatio *** Ma-Whitey 2P=0.05 betwee CANHR populatio ad NHANES NHANES (= ) Mea SD 89± ± ±14.0 3

4 Heritability Aalysis of Obesity Related Traits i Alaska Yup'ik Eskimos Hemat K.Tiwari, PhD 1 ; Amit Patki 1 ; Yiche Wag, MS 2 ; Aa V. Goropashaya, PhD 2 ; Gabriela Atuez de Mayolo, PhD 2 ; Rosemarie Plaetke, PhD 2 ; Gerald V. Mohatt, EdD 2 ; David B. Alliso, PhD 1 ; ad Bert B. Boyer, PhD 2 1 Uiversity of Alabama at Birmigham 2 Ceter for Alaska Native Health Research Backgroud: The icidece of obesity ad diabetes is dramatically icreasig i Alaska Natives. Data collected i this study showed that the accumulatio of cetrally located body fat is especially commo amog Yup'ik Eskimos. Methods: Over 770 Yup'ik Eskimos 14 to 95 years of age residig i seve rural villages i Southwest Alaska were erolled i this study. The followig calculatios were made to estimate heritability of BMI:! Paret-Offsprig Correlatios ad correspodig stadard deviatio for each trait.! Heritability as twice the paretoffsprig correlatio.! Familial correlatios usig the FCOR program of SAGE5.0 package. Several characteristics of body type were also obtaied, ad participats provided family history iformatio which eabled the research team to costruct several extesive multigeeratioal pedigrees.! Compared to me, wome had sigificatly higher BMI (30.0±7.1 (SD) vs. 2.4±4.4), waist circumferece (94.0±15.9 vs. 91.1±12.3), ad percet body fat (3.9±8. vs..4±7.0).! I this study populatio, the heritability estimate was: 0.35 for BMI, 0.2 for waist circumferece, ad 0.2 for percet body fat. Coclusios: These results suggest that a substatial portio of the differeces see i BMI is due to geetic iflueces, ad that heritability estimates are compatible with other populatio studies. Thus, it is importat to uderstad how predisposig geetic factors ifluece the developmet of overweight ad obesity amog the populatio. This is a ovel data set to ivestigate gees of obesity related traits, ad recruitmet is still uderway to fill the gaps i the data. A ew complete data set will give more precise estimates of heritability of obesity related traits.! Descriptive Statistics with Adjustmet of Sex, Age, ad Age_square ad Usig Trasformatio Variable Trasformatio BMI log Percet body fat oe Triceps skifold oe Subscapular Skifold log Abdomial Skifold oe Thigh Skifold square root Waist Circumferece log N Mea Std Dev Skewess Kurtosis BMI Percet Body Fat Waist Circumferece Waist Circumferece Abdomial Skifold Triceps Skifold Thigh Skifold 4

5 Low Prevalece of Metabolic Sydrome i Yup'ik Eskimos Bert B. Boyer, PhD 1 ; Rosemarie Plaetke, PhD 1 ; Kimber L. Stahope, MS 2 ; Adrea Bersami, MS 2 ; Peter J. Havel, PhD 2 ; ad Gerald V. Mohatt, EdD 1 1 Ceter for Alaska Native Health Research 2 Departmet of Nutritio, Uiversity of Califoria Davis Backgroud: Historically, the prevalece of obesity ad type 2 diabetes (T2D) i Alaska Eskimos has bee low whe compared to other Alaska Native ethic groups, Native Americas, ad idividuals of Europea decet. Although T2D prevalece rates amog Alaska Eskimos is 50% of U.S. all races, the percet chage (118%) over the last 13 years is greater tha U.S. all races (75%; Alaska Native Tribal Health Cosortium Diabetes Program). It is importat to uderstad the risks associated with T2D amog Alaska Natives. Methods: Researchers assessed the prevalece of metabolic sydrome, which cosists of five risk factors for chroic disease: waist circumferece, blood pressure, HDL, Triglycerides, ad fastig blood glucose. The study group cosisted of 571 Yup ik Eskimos ages years from rural villages ad a small tow i Southwester Alaska.! The age-adjusted prevalece of metabolic sydrome was 17.7% (20.4% for females ad 11.9% for males). This is compared with 23.9% for the NHANES atioal sample.! The prevalece by geder was 15.2% (=51) i females ad.8% (=18) i males, a statistically sigificat differece.! High waist circumferece was the most prevalet risk factor for metabolic sydrome. Over 50% of female participats exceeded the 88 cm ATPIII criteria cutoff.! Blood pressure was the secod most commo risk factor, while abormal fastig glucose, HDL, ad triglycerides were much less commo.! As the umber of risk factors icreased, the plasma levels of lepti, isuli, ad C-reactive protei sigificatly icreased, ad adipoecti levels sigificatly decreased. These levels are cosistet with icreased risk for developig chroic disease. Coclusios: Prelimiary results suggest that metabolic sydrome is ot yet commo amog Yup ik Eskimos. Potetial protective factors to explai this lower prevalece are beig ivestigated ad iclude a diet rich i omega 3 polyusaturated fatty acids, which may partially explai the healthy lipid profiles observed i our study populatio. It is importat to ote that the data suggest combiig primary prevetio to maitai protective factors with secodary prevetio to reduce risk factors such as icreased visceral fat.! Figure 1: Geder Distributio of Risk Factors i Yup ik Eskimos 50 Percet Wome Me Athropometric ad Biochemical Measures by Geder CANHR NHANES III Total CANHR Females Males Measuremet Mea±SD Mea±SD Mea±SD Mea±SD Age 47±21 ±1 ±1 ±17 Height (cm) * 1.4± ± ±.2 1.4±7.1 Weight (kg) 74.7± ± ± ±13. BMI (kg/m²) * 27.0± ± ±.9 2.3±4.2 Percetage Body Fat (BIA) * ot available 30.1± ±8..2±7.1 Waist Circumferece (cm) 92.4± ± ± ±12.4 Blood Pressure Mea Arterial Pressure * 89.0± ± ± ±9.0 Systolic BP * 1.7± ± ± ±13.1 Diastolic BP 72.2± ± ± ±9.0 Biochemical Measures Cholesterol (mg/dl) 203.3± ± ± ±4.8 HDL (mg/dl) * 50.9± ± ± ±1.4 LDL (mg/dl) 127.0± ± ± ±.1 Triglyceride (mg/dl) 135.1± ± ± ±59.0 Fastig Glucose (mg/dl) 101.5± ± ± ±10.8 Isuli (µu/ml)* 11.1± ± ± ±7.2 Adipoecti (µg/ml) ot available 8.5± ± ±4.1 Lepti (g/ml)* ot available 11.9± ± ±3.2 C-Reactive Protei (mg/dl) 0.48± ± ± ±1.39 * Ma-Whitey 2P by geder withi CANHR populatio Ma-Whitey 2P=0.05 by geder withi CANHR populatio p value Percet or more Number of Risk Factors Figure 2: Metabolic Sydrome Risk Factor Distributio i Yup ik Eskimos 3 or more Risk Factors (103) 2 Risk Factors (12) 89 1 Risk Factor (193) WC TG HDL BP FG Risk Factors! Waist circumferece: me >102cm; wome >88cm.! Triglycerides: >150 mg/dl (1.7mmol/L) or meds to lower TG.! HDL: me <40 mg/dl (1.03mmol/L) or cholesterol lowerig meds; wome: <50 mg/dl (1.29mmol/L) or cholesterol lowerig meds.! Blood Pressure: >130 or >85 mm Hg or atihypertesive meds.! Fastig Glucose: >100 mg/dl (5.mmol/l), kow diabetes or curretly takig diabetes meds

6 Psychosocial Stress, Eculturatio, ad Risk for Metabolic Disorders Christopher Wolsko, PhD 1 ; Cecile Lardo, PhD 1 ; Gerald V. Mohatt, EdD 1 ; Elizabeth Ruppert 2 ; ad Scarlett Hutchiso, MA 1 1 Ceter for Alaska Native Health Research 2 Yuko-Kuskokwim Health Corporatio, Bethel, AK Backgroud: Research idicates that chroic psychosocial stress sigificatly udermies physical, metal, ad behavioral health. Life i may Alaska Native commuities is shaped by a high stress load due i part to historical trauma ad rapid cultural chage, potetially creatig serious risks for the developmet of chroic disease. Competig argumets suggest that idividuals who idetify with ad are strogly immersed i the local idigeous way of life may or may ot be protected agaist such risks. Purpose: The preset study of 74 Yup'ik Eskimos examied the relatioships betwee perceived stress, Yup'ik cultural orietatio, ad established risk factors for chroic disease. Methods: The study group icluded male ad o-pregat female Pathways from Stress to Disease Yup'ik Eskimos 14 years ad older from seve commuities i the Yuko Kuskokwim River Delta. To measure psychosocial stress, researchers looked at the extet to which participats felt emotioally overwhelmed or uable to cope with life i the past moth. They also looked at a variety of Yup'ik cultural activities ad the frequecy with which a perso egaged i those activities. Physiological risk factors were also measured for chroic disease. 1. Psychosocial stress looked at perceived stress ad Yup'ik welless:! Perceived Stress: the extet to which participats felt overwhelmed with challegig life situatios over the past moth.! Yup'ik Welless: the extet to which participats egaged i activities cosidered itegral to stayig healthy i Yup'ik culture (e.g., egagig i subsistece activities, eatig traditioal foods, usig traditioal medicie, gettig outside for fresh air, helpig others). 2. Physiological characteristics were measured to determie risk factors for chroic disease. These characteristics icluded: height, weight, percet body fat, waist circumferece, blood pressure, ad HDL ad LDL levels.! For wome, greater perceived stress was associated with greater BMI, percet body fat, waist circumferece, ad blood pressure.! For me, greater perceived stress was ot associated with ay of the risk factors. However, me who placed more importace o livig a Yup'ik lifestyle also had greater BMI, percet body fat, waist circumferece, blood pressure, HDL, ad LDL.! I cotrast, for wome, scores o the Yup'ik cultural orietatio measure were ot associated with ay of the risk factors. Coclusios: The CANHR study results suggest that psychosocial stress ad issues of cultural idetity play a complex role i the developmet of risk factors for metabolic disorders i this populatio. Additioal discussio focuses o explaatios for the observed geder differeces ad o prelimiary aalyses icorporatig measures of diet ad exercise ito the statistical models.! Table 1: Correlatios betwee Stress, Eculturatio, ad Physiological Characteristics for Male Participats ( = 20) Perceived Stress Yup ik Welless (Frequecy) Yup ik Welless (Importace) Body Mass Idex (kg/m 2 ) *.29*** Percet Body Fat.01.15*.37*** Waist Circumferece (cm).00.14*.33*** Systolic Blood Pressure *.14* Table 2: Correlatios betwee Stress, Eculturatio, ad Diastolic Blood Pressure * Physiological Characteristics for Female Participats ( = 287) HDL.10.1*.15* Perceived Yup ik Welless Yup ik Welless Stress (Frequecy) (Importace) LDL *.30*** Body Mass Idex (kg/m 2 ).15** Note: *p<.05, ***p<.001 Percet Body Fat.11*.01.0 Waist Circumferece (cm).17** Systolic Blood Pressure.14*.0.14* Diastolic Blood Pressure.19*** HDL LDL Note: *p<.05, **p<.01, ***p<.001

7 Weak Associatio betwee Adipoecti ad Body Fat Distributio, Isuli Sesitivity, & Plasma Lipoproteis i Alaska Yup'ik Eskimos Aa Goropashaya, PhD 1 ; Johaa Herro 1 ; Peter J. Havel, PhD 2 ; Kimber Stahope, MS 2 ; Rosemarie Plaetke, PhD 1 ; Gerald V. Mohatt, EdD 1 ; ad Bert B. Boyer, PhD 1 1 Ceter for Alaska Native Health Research 2 Departmet of Nutritio, Uiversity of Califoria Davis Backgroud: Adipoecti is a hormoe produced oly i fat cells that regulates the activity of fats ad glucose, ad iflueces the body's respose to isuli. Low levels of adipoecti are foud i idividuals who are obese ad who are at icreased risk for type 2 diabetes mellitus. Purpose: The aim of this study was to assess the relatioship betwee circulatig adipoecti level ad several measuremets of body fat distributio i Yup'ik Eskimos. Methods: The study group cosisted of 504 participats (210 me ad 294 wome). These idividuals raged betwee the ages of 18 ad 94 years ad resided i seve villages i Southwest Alaska.! The hormoe adipoecti was lower i those idividuals with high body mass idex (BMI), percet body fat, triglycerides, ad fat accumulatio withi the abdome.! Age ad sex iflueced the relatioship betwee adipoecti ad both BMI ad percet body fat: older idividuals had lower levels of adipoecti, ad wome had lower levels of adipoecti tha me.! A positive relatioship was observed betwee adipoecti ad total cholesterol, ad high desity lipoprotei (HDL). The research team also completed a aalysis usig the homeostasis model assessmet for isuli resistace (HOMA-IR). It is based o fastig plasma glucose ad isuli levels, ad is used to assess isuli resistace. Statistical aalysis revealed a egative relatioship betwee adipoecti ad HOMA-IR or fastig isuli. Participats were divided ito three groups: (1) low HOMA-IR <1.5; (2) itermediate HOMA-IR =1.5 ad =3.0; ad (3) high HOMA-IR > 3.0. Adipoecti cocetratios betwee the three groups differed sigificatly. Adipoecti levels were lower i the high HOMA-IR group ad higher i the low HOMA-IR group. Fidigs & Coclusios:! Idividuals with high HOMA-IR levels had elevated BMI, percet body fat, cholesterol, triglycerides, fastig plasma glucose, isuli, ad lepti levels.! Plasma adipoecti levels were sigificatly lower i idividuals with higher BMI, percet body fat, ad fat accumulatio withi the abdome; plasma adipoecti levels were sigificatly higher i idividuals with higher HDL levels. These fidigs suggest that HOMA- IR may be a added tool for researchers to assess isuli resistace. Adipoecti may also be used to measure risk for developig type 2 diabetes mellitus.! Table 1: Adipoecti Levels i Low, Itermediate, ad High HOMA-IR Groups HOMA-IR group HOMA-IR values Adipoecti (mea±s.e.m.), µg/ml Low < ±0. Itermediate =1.5 ad = ±0.3 High > ±0.2 Table 2: Physiological Characteristics of Idividuals i Low ad High HOMA-IR Groups Physiological Characteristics Low HOMA-IR, mea±s.e.m High HOMA-IR, mea±s.e.m BMI (kg/m2) 25.8± ±0.4 % body fat 28.0± ±0. Cholesterol (mg/dl) 198.5± ±2.4 Triglycerides (mg/dl) 7.± ±3.8 Glucose (mmol/l) 4.8± ±0.1 Isuli (µu/ml) 5.8± ±0. Lepti (g/ml) 9.2± ±0.7 7

8 Associatio of Pedometer Assessed Physical Activity ad Measures of Health Amog Alaska Natives Adrea Bersami, MS 1 ad Bret R. Luick, PhD 2 1 Uiversity of Califoria, Davis 2 Ceter for Alaska Native Health Research Backgroud: The prevalece of factors for metabolic sydrome, particularly obesity, is icreasig amog Alaska Natives. The World Health Orgaizatio idetified physical activity as a importat factor i uderstadig what causes obesity, yet o study to date has measured physical activity levels directly i a Alaska Native populatio. Such a assessmet is critical ad eeds to be icluded i aalyzig the effect of utritio o health outcomes. Purpose: Physical activity was measured i 17 male ad female Alaska Natives ages 14 to 74 years livig i rural commuities i southwester Alaska. Methods:! Participats wore pedometers for three days, recordig the umber of steps take each day.! Body measuremets ad percet body fat were take usig a bioimpedece machie that seds a very low wave of electricity up the legs to measure body fat, muscle, ad water.! A fastig blood sample was take to measure blood lipids, glucose, ad other hormoes of importace to uderstadig obesity ad its relatioship to chroic diseases such as diabetes ad heart disease.! The umber of average steps/day was sigificatly higher amog me tha wome.! There was a egative relatioship betwee fastig blood glucose ad average steps per day amog males ad females.! I females (cotrollig for age), the umber of average steps/day was lower the higher the Body Mass Idex, percetage body fat, waist circumferece, ad plasma triglycerides. Coclusio: Pedometer measuremets offer a simple, valid, ad cost-effective meas of assessig physical activity amog Alaska Natives. These data support usig pedometer assessed physical activity as a way of uderstadig the relatioship of diet to chroic diseases ad should be ivestigated further i this populatio. Results suggest that prevetio efforts should focus o desigig programs to icrease activity amog females i this populatio.! Table 1: Participat Characteristics by Sex Females ( = 94) Males ( = 73) Age 33.2 ± ± 1.4 BMI (kg/m 2 ) 29.5 ± 7.0* 25.5 ± 4.4 % Body Fat 3.0 ± 8.5* 20.3 ± 7.2 WC (cm) 91.3 ± ± 17.1 HDL (mg/dl) 2.4 ± ± 18.7 Triglycerides (mg/dl) 92.2 ± ± 80. Fastig glucose (mg/dl) 93.0 ± ± 11.3 Mea steps/day 5824 ± 3308* 9178± 319 Mea ± s.d WC = Waist circumferece *Sigificatly differet from Males, P <.001 (studet s t-test) Figure 2: Compariso of mea glucose, waist circumferece, ad BMI by tertile of steps/day amog wome Table 2: Partial Correlatio betwee Steps/day ad Health Outcomes, Cotrollig for Age Males Females BMI (kg/m 2 ) ** % Body fat ** WC (cm) ** HDL.07.23* Triglycerides * Glucose -.28* -.25* WC = Waist circumferece HDL, triglycerides, ad glucose (mg/dl) * P < 0.05, **P <

9 Metabolically Healthy, But Obese Yup'ik Eskimos Gabriela Atuez de Mayolo, PhD; Rosemarie Plaetke, PhD; Aa V. Goropashaya, PhD; Scarlett H. Hutchiso, MA; Gerald V. Mohatt, EdD; ad Bert B. Boyer, PhD Backgroud: Recet studies have demostrated the existece of a uique subgroup of obese idividuals who display a healthy metabolic profile, despite havig sigificat levels of body fat. Purpose: This study sought to idetify the prevalece of metabolically healthy obese (MHO) idividuals i a large sample of Alaska Native Yup'ik Eskimos, ad to examie potetial explaatory factors uderlyig MHO prevalece. The study group cosisted of 39 Yup'ik Eskimos--350 wome ad 289 meaged 18 to 94 years. Methods: The followig data were gathered for this study:! Stadig height, weight, blood pressure (sittig), ad percet body fat by bioimpedace, a machie that provided Body Mass Idex ad Percet Body Fat.! Fastig blood sample for triglycerides, total cholesterol, LDL, HDL, isuli, glucose, adipoecti, C-reactive protei, ad ghreli levels. Each of these is importat for uderstadig how to defie a metabolically healthy idividual, or for uderstadig the uderlyig mechaisms associated with the developmet of obesity.! A total of 211 idividuals were idetified as obese, ad 30 idividuals (23 females ad 7 males) met at least four out of the five MHO defiig criteria (14.2%). The remaiig 181 obese participats were classified as at risk.! MHO participats had reduced triglycerides, LDL, ad total cholesterol, as well as icreased HDL levels whe compared to at risk idividuals.! Iterestigly, HOMA values, icludig plasma levels of adipoecti, C-reactive protei, ad ghreli, were ot differet betwee MHO ad at risk participats. Coclusios: While the mechaisms uderlyig MHO are ukow at this time, we are ivestigatig additioal biological markers ad body fat distributio patters, as well as evirometal factors, icludig diet ad activity, that may help to explai why some obese idividuals are protected from a uhealthy blood lipid patter. Although obesity is a major risk factor for metabolic diseases, this aalysis further highlights the importace of ivestigatig other factors that are protective i ature.! Table 2: Physical Characteristics of All Yup ik Eskimo Participats Categorized as MHO ad At Risk Physical Characteristics/ MHO Females At Risk Females Measuremet Mea Mea Age (years) 32 ± ± 14 Height (cm)* ± ±.0 Weight (kg) 87.1 ± ± 14.2 BMI (kg/m²)* ± ± 5.34 Systolic BP (mmhg)* 110. ± ± 13.3 Diastolic BP (mmhg)** 71.9 ± ± 9.9 Physical Characteristics/ MHO Males Measuremet Mea Age (years) 32 ± 15 Height (cm)* ± 8. Weight (kg) 94.2 ±.9 BMI (kg/m²)* ± 1.75 Systolic BP (mmhg)* 1.3 ± 7. Diastolic BP (mmhg)** 71.7 ± 4.5 Table shows differeces betwee female ad male participats, Mea values + SD *Ma-Whitey 2P< by geder withi obese populatio **Ma-Whitey 2P<=0.05 by geder withi obese populatio At Risk Males Mea 44 ± ± ± ± ± ± 8.5 9

10 CANHR Cotacts CANHR Mai Office Gerald V. Mohatt, EdD Director ad PI; Michelle Dodaville Program Coordiator, Assistat to the Director; Core Leaders & PIs: Bert Boyer, PhD Project PI, Geetics of Obesity; Leader, Geetics Core; Cécile Lardo, PhD Project PI, Cultural Uderstadigs of Health; Bret Luick, PhD Project PI, Diet ad Nutritio Kowledge; Rosemarie Plaetke, PhD Leader, Epidemiology & Bioiformatics Core; Bria Saylor, PhD, MPH Leader, KAD Core; Director, Istitute for Circumpolar Health Studies; Ceter for Alaska Native Health Research Istitute of Arctic Biology Box Uiversity of Alaska Fairbaks Fairbaks, AK I cojuctio with the Uiversity of Alaska Achorage Noprofit Org U.S. Postage PAID Permit No. 107 Achorage, AK