Which factor contributed most significantly to the rise of diabetes among Southwestern tribes such as the Pima?

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Examining the historical and epidemiological context of diabetes among Southwestern tribes, particularly the Pima, helps us evaluate the options carefully.
Option 1: 'Shift from traditional diets to Western dietary patterns on reservations' - This is the most well-supported factor. The adoption of high-calorie, high-sugar, and processed foods, combined with reduced physical activity and broader lifestyle changes, correlates strongly with rising type 2 diabetes prevalence in the Pima and other Southwestern groups. This dietary transition disrupted traditional, often lower-calorie, fiber-rich diets and contributed to obesity and insulin resistance, which are central to increased diabetes risk.
Option 2: 'Exclusive breastfeeding practices' - While early nutrition can influence long-term health, exclusive breastfeeding is not recognized as a primary driver of rising diabetes rates in this population. In fact, many public health efforts promote breastfeeding. Therefore, this option does not align with the main documented determinants of the diabetes surge among the Pima.
Option 3: 'Genetic changes in the last 20 years' - Genetic makeup in a population does not typically change rapidly over a couple of decades to explain a sudden rise in diabetes prevalence. The rapid increase is usually attributed to environmental and lifestyle factors interacting with genetic susceptibility rather than new genetic changes in such a short timeframe.
Option 4: 'Overconsumption of wild game' - While diet quality matters, the specific overconsumption of wild game is not identified in historical records as the primary contributor to the dramatic rise in diabetes among the Pima. Access to and intake of processed foods and refined carbohydrates on reservations better explain the trend observed.
In summary, the strongest and most substantiated factor among these options is the shift from traditional diets to Western dietary patterns on reservations, which aligns with observed increases in obesity and type 2 diabetes in Southwestern tribes.

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Which factor contributed most significantly to the rise of diabetes among Southwestern tribes such as the Pima?

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