The Epidemic of Obesity in American Indians

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Abstract
The high rates of infectious diseases such as tuberculosis, trachoma, and diarrhea that plagued American Indian and Alaska Native communities as recently as 40 years ago have now been largely controlled by concerted public health programs and medical interventions.1 Predictably, however, American Indians are now experiencing increasing morbidity and mortality from chronic diseases. Rates of type II diabetes mellitus are rapidly increasing, with virtually half of all adults now affected in some tribes.2 Coincident with the epidemic of diabetes has been a more silent epidemic of increasing adiposity. The problem of obesity affects American Indians and Alaska Natives of all ages, but appears to begin early in childhood.3 Two reports about obesity in American Indian children have appeared in AJDC in recent months. In November 1991, Gallaher et al4 published a study of the determinants of obesity among children aged 1 through 5 years on the