Doctoral Dissertation Research: Intergenerational impacts of culture change-The role of traditional foods in shaping the cardiometabolic health of Alaska Native people

Human biologists have demonstrated the variable consequences of culture change on human health in a wide range of contexts. Studies conducted from Samoa to Siberia have shown that increasing market integration, migration, and globalization can drive profound transitions in diet, lifestyle, stress and other factors that impact health (Bindon & Baker 1985; Clarkin 2008; Dressler 2005; Leonard et al. 2008; McDade 2002). These findings have contributed to a general model in which chronic diseases arise from a ?mismatch? between the human genome and contemporary lifestyles shaped by recent changes in culture, diet and lifestyle, thus helping explain the rapid rise of obesity and diseases of metabolic dysregulation that were rare or absent only a few generations prior (Bindon & Baker 1985; McGarvey 1991; Snodgrass et al. 2006). Recent work highlighting the long-term biological and health impacts of the intrauterine nutritional environment (Barker et al. 1989) has led to the hypothesis that the fetus adjusts metabolic set points to match prevailing nutritional conditions in the world it will soon enter (Gluckman & Hanson 2004; Kuzawa 2005; Wells 2011). However, rising rates of maternal obesity, greater gestational weight gain, and elevated blood glucose and triglyceride levels due to shifts in diet and lifestyle may be creating an evolutionarily novel and obesogenic gestational milieu that promotes faster fetal growth, higher birth weights, obesity, and metabolic dysregulation in offspring (Catalano & De Mouzon 2010; Benyshek 2013). This emerging model based on diet-driven changes in maternal metabolism supports a new hypothesis: the deleterious health impacts of culture change do not end with the individual who directly experiences it, but may also be transmitted, via an altered gestational metabolic environment, to the next generation (Benyshek 2013). The Alaska Native population is an excellent group in which to evaluate the intergenerational impacts of diet and lifestyle change. Alaska Native mother-infant dyads will be recruited in Anchorage, AK during the infant?s 2-year wellness appointment. Consumption of traditional and non-traditional foods will be assessed via interview, and used to predict maternal pre-pregnancy body mass index (BMI), gestational weight gain, and pregnancy glucose intolerance and triglyceride levels obtained retrospectively from medical records. We will evaluate the impacts of recent shifts in diet on maternal overweight and metabolic status, and intergenerational effects of these changes on offspring fetal and postnatal growth trajectories, and body composition measured at 2 years of age. The pregnancy diets of Alaska Native mothers currently living in Anchorage will represent a wide spectrum of culture change due to variation in a) rural residence during pregnancy, with greater access to traditional foods, b) participation in subsistence practices in the surrounding area and c) rural-to-urban food sharing networks common among Alaska Native people (Fogel-Chance 1993; Lee 2002). Testing the intergenerational impacts of diet transition holds promise to illuminate the current rise of obesity-related health problems experienced by the Alaska Native population.