Risk Factors for Obesity at Age 3 in Alaskan Children, Including the Role of Beverage Consumption: Results from Alaska PRAMS 2005-2006 and Its Three-Year Follow-Up Survey, CUBS, 2008-2009

<div><p>Background</p><p>Prenatal and early life risk factors are associated with childhood obesity. Alaska Native children have one of the highest prevalences of childhood obesity of all US racial/ethnic groups.</p><p>Methods</p><p>Using the Pregnancy Risk Assessment Monitoring System (PRAMS) and the follow-up survey at 3 years of age (CUBS), we evaluated health, behavioral, lifestyle and nutritional variables in relation to obesity (95th percentile for body mass index (BMI)) at 3 years of age. Multivariate logistic regression modeling was conducted using Stata 12.0 to evaluate independent risk factors for obesity in non-Native and Alaska Native children.</p><p>Results</p><p>We found an obesity prevalence of 24.9% in all Alaskan and 42.2% in Alaska Native 3 year olds. Among Alaska Native children, obesity prevalence was highest in the Northern/Southwest part of the state (51.6%, 95%CI (42.6-60.5)). Independent predictive factors for obesity at age 3 years in Alaska non-Native children were low income (<$10,000 in the year before the child was born (OR 3.94, 95%CI 1.22--17.03) and maternal pre-pregnancy obesity (OR 2.01, 95%CI 1.01-4.01) and longer duration of breastfeeding was protective (OR 0.95, 95%CI 0.91-0.995). Among Alaska Native children, predictive factors were witnessing domestic violence/abuse as a 3 year-old (OR 2.28, 95%CI 1.17-7.60). Among obese Alaska Native children, there was an increased daily consumption of energy dense beverages in the Northern/Southwest region of the state, which may explain higher rates of obesity in this part of the state.</p><p>Conclusions</p><p>The high prevalence of obesity in Alaska Native children may be explained by differences in lifestyle patterns and food consumption in certain parts of the state, specifically the Northern/Southwest region, which have higher consumption of energy dense beverages.</p></div

Percentage of beverage consumption among obese Alaska Native 3 year-olds, by residence region.

<p>Percentage of beverage consumption among obese Alaska Native 3 year-olds, by residence region.</p

Weighted Frequencies of selected variables in PRAMS and CUBS Sample (n = 833).

<p>*Note: As determined by maternal race.</p><p>Among Alaska Native 3 year olds, the Northern/Southwest had the highest obesity prevalence (51.6%, 95%CI (42.6–60.5)) (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0118711#pone.0118711.t002" target="_blank">Table 2</a>; <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0118711#pone.0118711.s002" target="_blank">S1 Fig</a>. for visual image of different regions).</p><p>Weighted Frequencies of selected variables in PRAMS and CUBS Sample (n = 833).</p

Multivariate Logistic Regression for Obesity at Age 3 among Alaska Native^* Children (n = 226).

<p><b>*Note: As determined by maternal race.</b></p><p>Multivariate Logistic Regression for Obesity at Age 3 among Alaska Native^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0118711#t008fn001" target="_blank">*</a>} Children (n = 226).</p

Percent Obese at Age 3 (≥95^th percentile) by Maternal Prenatal/ Postnatal Health Variables and Infant Feeding/Delivery Variables.

<p>Percent Obese at Age 3 (≥95^th percentile) by Maternal Prenatal/ Postnatal Health Variables and Infant Feeding/Delivery Variables.</p

Percent Obese at Age 3 (≥95^th percentile) by Psychosocial Variables, Dietary Intake and Lifestyle Variables.

<p>Percent Obese at Age 3 (≥95^th percentile) by Psychosocial Variables, Dietary Intake and Lifestyle Variables.</p

Percent Obese at Age 3 (≥95^th percentile) by Maternal Socio-demographic Variables.

<p>Percent Obese at Age 3 (≥95^th percentile) by Maternal Socio-demographic Variables.</p

Multivariate Logistic Regression for Obesity at Age 3 among Alaska Non- Native^* Children (n = 474).

<p><b>*Note: As determined by maternal race.</b></p><p>Multivariate Logistic Regression for Obesity at Age 3 among Alaska Non- Native^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0118711#t005fn001" target="_blank">*</a>} Children (n = 474).</p

Timeline for the LaboMobil® (LM) intervention in Benin, April, 2012.

<p>Timeline for the LaboMobil® (LM) intervention in Benin, April, 2012.</p

Findings on 149 patients with suspected acute bacterial meningitis, by age group (in years) and etiology, North Benin, weeks 9 through 17, 2012.

*<p><i>Nm = Neisseria meningitidis</i>.</p