Traditional food security and food sovereignty in the coastal region of South-Central Alaska.

A food assessment questionnaire was completed by Alutiiq and Eyak peoples of the Chugach Region of Alaska in 2016-2017. This questionnaire, conducted by the Chugach Regional Resource Commission, gathered 87 responses from adults residing in seven communities. The questions related to traditional food systems, food security, and food sovereignty and were organised into six sections: Community Food Resources, Diet and Health, Culture, Organisation and Governance, Food Resources, and Natural Resources and Environment. Nine questions directly addressed food sovereignty. Results revealed the importance of traditional food sources in the communities, foods that are not readily available or are difficult to access, resources that are useful to improve traditional food security, health problems that are perceived to be caused or exacerbated by the lack of traditional foods in the area, traditional foods commonly consumed, and barriers from accessing traditional foods. Additionally, recommendations for improving food systems and addressing barriers are provided.

Alaska Native Parents' Decision-Making About Food, Beverages, and Screen Time for Young Children: Formative Insights From the "Got Neqpiaq?" Project.

With rising childhood obesity rates, ensuring children adopt healthy habits early is imperative. Given the unique context for Alaska Native families living in rural remote communities, who are concurrently experiencing changes in traditional practices, we investigated what impacts parents' decisions as they relate to daily living before revising a preschool curriculum focused on healthy habits. The objective of this study was to explore factors influencing parents' decisions about their children's foods, beverages, and activities. In focus group discussions with AN parents of young children across 12 communities, we asked about meals, traditional foods, beverages, physical activity, and screen time. All sessions were recorded, transcribed, and analyzed using open and selective coding to allow the most important themes to emerge. As parents discussed how they make decisions, several trends emerged related to adults' and children's food and beverage preferences; the impact of adult modeling on children; and how convenience, seasonality, access, and a reluctance to engage in conflict all impact decision-making. Parents and other community members shared important perspectives on exposing children to traditional subsistence foods and activities and passing important traditional knowledge to them at an early age. These perspectives will form the basis for preschool curricula in these communities.

Development of a Nudge Program at One Alaska Food Pantry.

Food pantry clients experience many health disparities, including elevated incidence of diabetes, heart disease, and other nutrition-related conditions. Nutrition education interventions in the form of a nudge can be an effective method to increase nutrition knowledge and healthy pantry food selection. Currently there is no nutrition education program at the largest food pantry in Alaska. The goal of this project was to develop a nutrition intervention in the form of a nudge to increase the selection of nutritious foods by pantry clients. Methods included the development of nudges, or environmental cues, within the pantry as well as client education handouts and recipes for clients to take home. Implications for practice include the potential to increase staff and client knowledge and nutrition education, as well as for impacting the overall health and food security of the clients and their families. Additional implications include the availability of the program and resources for other food pantries across the state to customize for use in their facilities. After the program has been implemented, it can be evaluated across each site and its efficacy determined to implement into policy.

Impact of Assistance Programs on Indigenous Ways of Life in 12 Rural Remote Western Alaska Native Communities: Elder Perspectives Shared in Formative Work for the "Got Neqpiaq?" Project.

For more than 50 years, government programmes in the USA have been in place to help those in need have consistent access to food and education. However, questions have surfaced regarding whether or not these support impact traditional ways, such as cultural activities, food preferences, and overall health, particularly for Indigenous populations. In this paper, we share insights voiced by Alaska Native Elders in the Yukon-Kuskokwim region of Alaska and their perceptions of regulations, assistance, and the impact government assistance programmes have had on their culture. Elders raised concerns so that those administering these programmes will consider how best to meet food security and education needs without interfering with Indigenous cultural practices and traditional lifestyle.

Alaska Native Elders' perspectives on dietary patterns in rural, remote communities.

BACKGROUND: Given the increasing rates of childhood obesity in Alaska Native children and the understanding that the most effective interventions are informed by and reflect the cultural knowledge of the community in which they are implemented, this project sought to gather the wisdom of local Yup'ik and Cup'ik Elders in the Yukon-Kuskokwim region of Alaska around how to maintain a healthy diet and active lifestyle. METHODS: Perspectives were sought through the use of semi-structured focus groups, which were completed in person in twelve communities. All conversations were recorded, translated, transcribed, and analyzed using a qualitative approach, where key themes were identified. RESULTS: Elders provided a clear and consistent recollection of what their life looked like when they were young and expressed their perspectives related to maintaining a healthy and traditional lifestyle. The key themes the Elders discussed included an emphasis on the nutritional and cultural benefits of traditional foods; concerns around changing dietary patterns such as the consumption of processed foods and sugar sweetened beverages; and concerns on the time and use of screens. Elders also expressed a desire to help younger generations learn traditional subsistence practices. CONCLUSIONS: The risk of obesity in Alaska Native children is high and intervention efforts should be grounded in local knowledge and values. The perspectives from Yup'ik and Cup'ik Elders in the Yukon-Kuskokwim Delta area of Alaska provide a better understanding on local views of how to maintain a healthy diet, physical activities, and traditional values.

Storekeeper perspectives on improving dietary intake in 12 rural remote western Alaska communities: the "Got Neqpiaq?" project.

Low intake of fruits and vegetables and high intake of sugar-sweetened beverages persists as a public health concern in rural remote Alaska Native (AN) communities. Conducting key informant interviews with 22 storekeepers in 12 communities in the Yukon-Kuskokwim region of Alaska, we explored potential factors impeding or facilitating dietary change towards healthier food choices. We selected these sites as part of a multi-level intervention aimed at introducing more traditional AN subsistence foods, increasing fruit and vegetable intake, and decreasing SSB consumption among young children enrolled in Head Start (preschool) programmes (Clinicaltrials.gov #NCT03601299). Storekeepers in these communities agreed that seasonality and flight schedules were primary factors determining commercial foods' availability. Several storekeepers noted that federal food assistance programmes that specify which food items may be purchased with funds received from the programme and community policies that set limits on less healthy items promote customer purchases of healthier products. The fact that storekeepers are comfortable enforcing government assistance programme guidelines, company policies, and tribal resolutions suggests an important role storekeepers play in improving nutritional intake in their communities.

Examining Sociodemographic Factors, Food Insecurity and Obesity of Food Pantry Clients in Alaska: A Cross Sectional Study.

Food insecurity continues to be high despite the increasing use of emergency food assistance. Research shows that food insecurity among food pantry clients is over 50-70%. Despite the high rates, there remains the paradox of people who are both food insecure and obese. Limited research has examined links between obesity, food insecurity, and food pantry clients. This cross-sectional study examined the relationship between food security, weight, and sociodemographic factors of clients at the largest food pantry in Alaska. On-site surveys were completed with 148 clients between February and March of 2018. Descriptive statistics, chi-square models, and a multivariate logistic regression were used to describe participants and determine any associations. Alaska food pantry clients are primarily over 45 years old, work at least part time, and make less than $25,000 per year. A majority of participants (n = 148) were either overweight or obese (69.6%) and food insecure (88.4%). No significant associations were found between weight and food security status. Despite the lack of statistical significance, results help understand pantry clients' demographic, food security, and weight status. Providing emergency food assistance and addressing underlying causes of food insecurity or obesity, such as the ability to access healthy food, are needed first steps.

Traditional food intake is positively associated with diet quality among low-income, urban Alaska Native women.

Our objectives were to understand the links between intake of traditional foods, food security and diet quality in low-income Alaska Native women living in an urban center. Seventy-three Alaska Native women completed two 24-hour dietary recalls, a food frequency questionnaire, and the USDA Adult Food Security Survey Module. An increase in 10% calories from traditional foods (equivalent to approximately 195 kcals) was associated with a 7.3 point increase on the Healthy Eating Index , a measure of diet quality (scale is 0-100). Findings highlight the importance of policies and programs that ensure consistent access to traditional foods in urban areas.

Traditional Food Practices, Attitudes, and Beliefs in Urban Alaska Native Women Receiving WIC Assistance.

OBJECTIVE: To identify practices, attitudes, and beliefs associated with intake of traditional foods among Alaska Native women. DESIGN: Cross-sectional study that measured traditional food intake; participation in food-sharing networks; presence of a hunter or fisherman in the home; the preference, healthfulness, and economic value of traditional foods; and financial barriers to obtaining these foods. PARTICIPANTS: Purposive sample of 71 low-income Alaska Native women receiving Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) assistance in Anchorage, AK. ANALYSIS: Bivariate and multivariate regression analyses. RESULTS: Traditional foods contributed 4% of total daily calories. Given a choice, 63% of participants indicated that they would prefer half or more of the foods they ate to be traditional (ie, not store-bought). The majority of participants (64%) believed that traditional foods were healthier than store-bought foods. Of all participants, 72% relied on food-sharing networks for traditional foods; only 21% acquired traditional foods themselves. Participants who ate more traditional foods preferred traditional foods (B = .011 P = .02). IMPLICATIONS FOR RESEARCH AND PRACTICE: Traditional food intake was low and findings suggested that Alaska Native women living in an urban setting prefer to consume more but are unable to do so. Future research might examine the effect of enhancing social networks and implementing policies that support traditional food intake.

A scoping review of traditional food security in Alaska.

BACKGROUND: Food insecurity is a public health concern. The pillars of food security include food access, availability and utilisation. For some indigenous peoples, the pillars may focus on traditional foods. OBJECTIVE: To conduct a scoping review on traditional foods and food security in Alaska. DESIGN: Google Scholar and the High North Research Documents were used to search for relevant primary research using the following terms: "traditional foods", "food security", "access", "availability", "utilisation", "Alaska", "Alaska Native" and "indigenous". RESULTS: Twenty four articles from Google Scholar and four articles from the High North Research Documents met the inclusion criteria. The articles revealed three types of research approaches, those that quantified traditional food intake (n=18), those that quantified food security (n=2), and qualitative articles that addressed at least one pillar of food security (n=8). CONCLUSIONS: Studies that estimate the prevalence of traditional food insecurity in Alaska are virtually absent from the literature. Instead most studies provide a review of factors related to food security. Research investigating dietary intake of traditional foods is more prevalent. Future research should include direct measurements of traditional food intake and food security to provide a more complete picture of traditional food security in Alaska.