This project seeks to define the link between the CPT1A arctic variant (a single nucleotide variant in the carnitine palmitoyltransferase 1A (CPT1A) gene, required for fatty acid metabolism) and childhood hearing loss, and to characterize how environmental and nutritional factors modify this effect on hearing in Alaska Native children. The study leverages a prospective cohort study in northern and western Alaska that began enrolling expectant Alaska Native mothers in early 2020 and will follow children through age two to assess overall health effects of the CPT1A arctic variant.