RESEARCH Current Research Diet Quality among Yup’ik Eskimos Living in Rural Communities Is Low: The Center for Alaska Native Health Research Pilot Study ANDREA BERSAMIN; BRET R. LUICK, PhD; ELIZABETH RUPPERT; JUDITH S. STERN, ScD; SHERI ZIDENBERG-CHERR, PhD ABSTRACT Objective The objectives of this pilot study were to describe the nutrient intake of Yup’ik Eskimos in comparison with national intake, identify dietary sources of key nutrients, and assess the utility of the Healthy Eating Index (HEI) to measure diet quality of Yup’ik Eskimos living in rural Alaskan Native communities. Participants and design A single 24-hour recall was collected from 48 male and 44 female Yup’ik Eskimos (aged 14 to 81 years), who resided in three villages in the Yukon Kuskokwim River Delta, AK, during September 2003. Main outcome measures HEI scores, nutrient intake, and traditional food intake. Statistical analyses performed Spearman correlations for as- sociations between variables. Results Youth scored higher than elders despite similar nutrient intakes. Overall diet quality was generally low; 63% of all participants’ diets were classified as poor. Al- though the HEI serves to identify areas of concern with respect to diet quality, it is limited in its ability to detect the positive value of traditional foods. Conclusions Traditional foods and healthful market foods, including rich sources of fiber and calcium, should be encouraged. Although traditional foods were important sources of energy and nutrients, market foods composed the preponderance of the diet, emphasizing the impor- tance of appropriately modifying a diet quality index based on a Western framework, such as the HEI. J Am Diet Assoc. 2006;106:1055-1063. U ntil recently, obesity, heart disease, and diabetes were extremely rare among Alaskan Natives. To- day, chronic disease is emerging as a major concern; during the past decade the prevalence of obesity and parameters of the metabolic syndrome have increased and may even be higher among Alaskan Natives than non-Alaskan Natives (1,2). Clearly, the occurrence of chronic disease is caused by a complex interaction be- tween environment, genetics, and lifestyle factors (3). It is hypothesized that a rapid shift away from adherence to a traditional subsistence diet toward an increasingly commercially based Western diet may contribute to an increasing prevalence of chronic disease among Alaskan Natives; similar experiences have been observed through- out the world (4). The Center for Alaska Native Health Research was established in 2001 to address increasing health dispar- ities between Alaskan Natives and the non-native US population, in the context of their unique environment. The center currently supports an interdisciplinary study investigating genetic, nutritional, and behavioral risk factors for chronic disease among Alaskan Natives. This article presents results from a pilot study conducted to examine the dietary habits of the population. Data on dietary intake among Alaskan Natives is lim- ited; much more is known about the dietary patterns of other Arctic populations from Greenland and Canada, for instance, whose experiences can be expected to be simi- lar. Many contend that the nutrient-rich traditional sub- sistence diet of Arctic populations protects these indige- nous groups against chronic diseases (5-8). Other studies further suggest that the decline of traditional food use in exchange for increased Western food consumption may be implicated in exacerbating health problems experienced, including impaired glucose tolerance (5,9,10). Although traditional food consumption has declined among Alaskan Natives (11), these foods may still be important sources of essential nutrients. Studies con- ducted among communities in the Canadian Arctic have consistently concluded that on days when traditional food was consumed, intakes of select minerals were higher, and fat, saturated fat, and sucrose intakes were lower than on days when traditional foods were not consumed (10,12). A. Bersamin is a graduate student researcher at the De- partment of Nutrition, University of California, Davis, and at the Institute of Arctic Biology, University of Alaska, Fairbanks. B. R. Luick is a cooperative exten- sion specialist with the Institute of Arctic Biology, Uni- versity of Alaska, Fairbanks. At the time of the study, E. Ruppert was a field coordinator at the Yukon-Kuskok- wim Health Corporation, Bethel, AK. J. S. Stern is a distinguished professor with the Departments of Nutri- tion and Internal Medicine, University of California, Davis. S. Zidenberg-Cherr is a Cooperative Extension specialist with the Department of Nutrition, University of California, Davis. Address correspondence to: Sheri Zidenberg-Cherr PhD, Department of Nutrition, One Shields Ave, Davis, CA 95616. E-mail: sazidenbergcherr@ucdavis.edu Copyright © 2006 by the American Dietetic Association. 0002-8223/06/10607-0004$32.00/0 doi: 10.1016/j.jada.2006.04.026 © 2006 by the American Dietetic Association Journal of the AMERICAN DIETETIC ASSOCIATION 1055