A total diet study and probabilistic assessment risk assessment of dietary mercury exposure among First Nations living on-reserve in Ontario, Canada

Measurement of diet quality among First Nations peoples in Canada and associations with health: a scoping review

BACKGROUND

Given the increasing number and the diversity of dietary quality indices used for research, and the differences between settings, there is a need to identify valid indices of dietary quality in different contexts and populations and to identify their associations with health-related outcomes.

OBJECTIVES

The primary objective of this scoping review is to identify the tools used in determining dietary quality among First Nations and to describe the changes in diet. The second objective is to describe the associations identified in studies that have measured the relationship between health and dietary quality among First Nations; and the third objective is to identify factors associated with diet quality.

METHODS

PubMed, Embase, CINAHL, Global Health, and Web of Science were searched from inception to June 2021 and updated in February 2022. Articles were included if the research subjects were First Nations, or if articles reported disaggregated subset data for First Nations. Eligible studies focused on nutrition and diet and were published in English or French.

RESULTS

A total of 151 articles were included in the analysis. Studies used several indicators to measure if individuals adhered to dietary guidelines. Traditional food consumption was frequently used as an indicator of diet quality (n = 96). The consumption of store-bought foods was used as an indicator in 28 studies. Some studies used other diet quality indicators such as the Healthy Eating Index (n = 5) and ultra-processed food "NOVA" classification (n = 6). A trend for decreasing traditional food intake over time was apparent, alongside an increase in store-bought food intake. This trend was accompanied with declining health status, including the increased prevalence of overweight and obesity, diabetes, metabolic diseases, and dental caries.

CONCLUSION

This scoping review showed that diet quality among First Nations is improved when traditional foods are consumed. Reduced diet quality was associated with increased risk of noncommunicable diseases.

Total mercury and fatty acids content in selected fish marketed in Quito - Ecuador. A benefit-risk assessment

Total mercury and fatty acids contents were determined in muscles of croaker, snapper, dolphinfish, blue marlin, and shark, from different markets in the Metropolitan District of Quito, Ecuador. Fifty-five samples were collected and analyzed for total mercury using cold vapor atomic fluorescence spectrometry, and the fatty acids were analyzed using gas chromatography equipped with a flame ionization detector. The lowest total mercury levels were found in snapper [0.041 µg·g^-1 wet weight (ww)] while blue marlin showed the highest (5.883 µg·g^-1 ww). EPA + DHA ranged from 1.0 mg·g^-1 in snapper to 2.4 mg·g^-1 in shark. A high omega-3/omega-6 ratio was found for all fish types; however, the HQ_EFA for the benefit-risk ratio was above 1, suggesting an evident risk to human health. Based on our results, consumption of croaker and dolphinfish is recommended up to one serving per week, considering the importance of EFAs intake and avoiding fish with elevated MeHg content. Therefore, Ecuadorian authorities could enhance public standards for seafood safety and develop consumer advice for pregnant women and young children to determine good fish choices or those to avoid.

A probabilistic hazard and risk assessment of exposure to metals and organohalogens associated with a traditional diet in the Indigenous communities of Eeyou Istchee (northern Quebec, Canada)

Hunting, trapping, and fishing are part of an Indigenous lifestyle in subarctic Canada. However, this lifestyle may be a route of exposure to contaminants and may pose a risk for the people who rely on a subsistence diet. Monte Carlo simulations for the chemical concentration of eight game species and one fish species were carried out by randomly sampling 10,000 samples from the contaminant measures for each species. We then calculated a probabilistic non-carcinogenic hazard quotient or carcinogenic risk values to estimate the human health risk of exposure to contaminants. Of the species examined, ducks were of concern for potential carcinogenic risk. There was a modeled probabilistic 95th-percentile risk associated with the consumption of ducks and polybrominated biphenyl (PBB) congener 153 in boys, women, and men (1.09 × 10-6, 1.57 × 10-6, and 2.17 × 10-6, respectively) and, to a lesser extent, with geese and polychlorinated biphenyl (PCB) congener 153 in men (1.19 × 10-6). Contaminant concentration in the intake rate (food consumption) for PBB congener 153 exposure risk was more important than that for PCB congener 153, where intake rate had greater relevance. The consumption of waterfowl may increase the exposure to organohalogens; however, there are health and wellness benefits associated with the harvesting and consumption of subsistence foods that must also be considered. We recommend follow-up species-specific studies focused on ducks to clarify and elucidate the results in the present study.

Food Security Status of Indigenous Peoples in Canada According to the 4 Pillars of Food Security: A Scoping Review

Food insecurity is a significant public health problem for Indigenous peoples in Canada. A comprehensive literature review is needed to organize the evidence according to the 4 pillars of food security (i.e., availability, access, utilization, and stability) and identify gaps in the published literature on this topic. Therefore, in this scoping review we aimed to summarize the published research discussing any of the 4 pillars of food security among Indigenous peoples in Canada. We conducted a literature search of the following databases: Ovid Medline, EMBASE, Web of Science (Web of Knowledge), and CINAHL, as well as the Indigenous Studies Portal (up to June 19, 2021). Population-based studies of any design were included, except for review-style articles. Articles published in languages other than English were also excluded. Of the 4687 studies identified by the database searches, 91 met our inclusion criteria. Evidence from these studies indicates that all dimensions of food security among Indigenous peoples in Canada have been impacted. Lack of availability of both traditional and market foods is highlighted among Inuit and First Nation communities. Economic disadvantages, high food prices, and lack of access to transportation are major factors affecting the accessibility pillar of food security. Major factors affecting the utilization pillar of food security are the loss of traditional knowledge and skills, lack of knowledge on market foods, low quality of market foods, and food safety issues. Climate change has affected all 4 pillars of food security among Indigenous peoples. These findings suggest that resolving food insecurity issues among Indigenous peoples in Canada, especially those living in remote communities, requires a culturally specific integrated approach targeting food availability, food cost, food knowledge, food safety, and food quality.

Risk assessment of mercury through dietary exposure in China

Mercury (Hg) is a widespread heavy metal causing various damages to health, while insufficient studies assessed its exposure risk across China. This study explored concentrations in food items and dietary exposure risks across China by comprehensively analyzing the researches on total Hg (THg) in eight food items and methylmercury (MeHg) in aquatic foods published between 1980 and 2021. According to the included 695 studies, the average THg concentration in all food items was 0.033 mg/kg (ranging from 0.004 to 0.185 mg/kg), with the highest concentration in edible fungi. The average daily dietary THg exposure from all foods was 12.9 μg/day. Plant-based foods accounted for 62.7% of the dietary THg exposure. Cereals and vegetables were the primary source of THg exposure. The MeHg concentration in aquatic foods was 0.08 mg/kg, and the average dietary exposure was 3.8 μg/day. Monte Carlo simulations of the dietary exposure risk assessment of THg and MeHg showed that approximately 6.4 and 7.0% of residents exceeded the health-based guidance value set by the European Food Safety Authority, with higher exposure risk in Southwest and South China. The nationwide target hazard quotient index of THg was greater than 1, suggesting that the non-carcinogenic risk of dietary exposure to THg needed further concern. In summary, this study has a comprehensive understanding of dietary Hg exposure risks across China, which provide a data basis for Hg exposure risk assessment and policy formulation.

Risk of exposure to Hg and pesticides residues in a traditional fishing community in the Amazon: a probabilistic approach based on dietary pattern

Exposure to mercury (Hg) and pesticides (o.p'DDT, p.p'DDT, o.p'DDE, and p.p'DDE) in the Amazon through eating fish is of concern due to the large participation of this food in the diet of traditional fishing communities. The aim of this study was to evaluate the estimated daily intake (EDI) and the incremental lifetime cancer risk associated with Hg and o.p'DDT, p.p'DDT, o.p'DDE, and p.p'DDE in an Amazonian community. The results showed that for Hg, the EDI from carnivorous and detritivorous fish had the highest values, while for pesticides, the EDI from detritivorous fish intake had the highest value. The incremental lifetime cancer risk was below the permitted limit. A recommendation for controlling the high risk of exposure includes the reduction of detritivorous fish ingestion and/or replacement with herbivorous fish, which had lower EDI. We highlight the importance of investigating the human dietary patterns when estimating risk of exposure to Hg and pesticides.

Exposure Assessment of methyl mercury from consumption of fish and seafood in Peninsular Malaysia

The concentration of meHg in freshwater fish and seafood was investigated, as well as the consumption patterns of fish and seafood by different demographic groups (age, ethnicity, gender). A potential alarm for human health hazards was also assessed, and the results were compared to the provisional tolerable weekly intakes (PTWIs) and the hazard quotient parameter (HQ). The results showed that meHg levels of 67 species ranged from 0.013 to 0.252 mg/kg of wet weight (WW) with significant differences between different fish and seafood groups (χ2KW = 49.09; p < 0.001). Median concentrations of meHg in fish and seafood groups in descending orders are as follows: demersal fish (0.1006 mg/kg WW) > pelagic fish (0.0686 mg/kg WW) > freshwater fish 0.045 mg/kg WW) > cephalopods (0.0405 mg/kg WW) crustaceans (0.0356 mg/kg WW). The results revealed that older population (> 40 years old) consumed significantly (p = 0.000) more fish compared to younger generations and the elderly consumed the highest amounts of fish (104.0 ± 113.0 g/day). The adolescents (10-17 years old) consumed more than double of amount for both cephalopod and crustacean compared to the older populations (p < 0.05). Malay ethnic (96.1 ± 99.6 g/day) consumed significantly (p = 0.000) higher amounts of fish and seafood compared to other ethnicities, similar to male subjects (95.2 ± 102 g/day; p = 0.026) when compared to the female (86 ± 96.3 g/day). The estimated weekly intake (EWI) values showed results below 1.6 µg/kg BW/week, the tolerable levels recommended by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) for all different demographic factors except for higher consumers at 75th percentile and above. Consumption of marine fish contributed to a higher value of PTWI to all different demographic groups (the estimated weekly intake (EWI) range: 0.2988-0.6893 µg/kg BW/week) but for the adolescents, where from the consumption of crustaceans (0.3488 µg/kg BW/week or 21.8% of PTWI) and cephalopods (0.504 µg/kg BW/week or 31.5% of PTWI). The results from this study also revealed the HQ value for overall consumption of fish and seafood by the adolescents and elderly exceeded one. This was contributed from the consumption of demersal fish and cephalopods, thus indicating the nonacceptable level of noncarcinogenic adverse health effects.

Oyster arsenic, cadmium, copper, mercury, lead and zinc levels in the northern South China Sea: long-term spatiotemporal distributions, combined effects, and risk assessment to human health

Estuarine and coastal ecosystems are often considered vulnerable due to the complex biogeochemical processes and the human disturbances through a variety of pollution. Among environmental contaminants, heavy metals in estuarine and coastal ecosystems have been of increasing concern in environmental conservation. Long-term exposure to heavy metal contamination, mainly through food and water, could be harmful to human health. It is therefore critical to understand the quantitative comparisons and combined effects of different heavy metals in common seafood species, such as oysters. This work studied the long-term spatiotemporal trends and health risk assessment of oyster arsenic (As), cadmium (Cd), copper (Cu), mercury (Hg), lead (Pb), and zinc (Zn) levels in the coastal waters of northern South China Sea. Cultured oysters (Crassostrea rivularis) from 23 estuaries and harbors in the coastal areas of northern South China Sea in 1989-2015 were analyzed for the spatiotemporal trends of the six heavy metal levels. Metal pollution index (MPI), target hazard quotient (THQ), and hazard index (HI) were used for quantifying the exposure of the six heavy metals to human health through oyster consumption. Principal component analysis (PCA) was used for assessing the relative importance of the six metals in oyster heavy metal distribution patterns in the northern South China Sea. Overall, the As, Cd, Cu, Hg, Pb, and Zn levels in oysters from the northern South China Sea generally declined from 1989 to 2015, stayed relatively high (MPI = 2.42-3.68) during 1989-2000, gradually decreased since 2000, and slightly increased after 2010. Oyster heavy metal levels were highest in the Pearl River Estuary (MPI = 1.20-5.52), followed by west Guangdong and east Guangdong, Guangxi, and Hainan coastal waters. This pattern is probably because economics and industry around the Pearl River Estuary have been growing faster than the other areas of this work in the recent two decades, and it should be taken as a hotspot for the monitoring of seafood safety in southern China. Principal component analysis indicated that Cu, Zn, and Cd were the most important metals in the long-term distributions of oyster heavy metal levels in the northern South China Sea. Health risk assessment suggested that the risk of the six heavy metals exposure through oyster consumption were relatively high during 1989-2005 (THQ = 1.01-5.82), significantly decreased since 2005 (THQ < 1), and slightly increased after 2010.

Toxic Metals in Wild Ungulates and Domestic Meat Animals Slaughtered for Food Purposes: A Systemic Review

The presence of toxic metals in harvested game meat is a cause for concern for public health and meat safety in general. Authorities and food safety agencies continue to develop guidelines and limits of the maximum allowable levels of toxic metals in food products. However, the situation is different for game meat products in developing countries, where a number of shortcomings have been identified. This includes a lack of game meat animal slaughter regulations, specific species' product limits that have not yet been established and the continued use of hunting or game meat animals' harvesting plans that could introduce the same toxic metals of concern. This review was conducted from English literature published between 2011 and 2021; it highlights the possible health effects and the shortcomings in the implementation of game meat safety production strategies for toxic metals (Arsenic, Lead, Cadmium and Mercury) in game meat animal production. Lead (Pb) remains the most significant threat for toxic metals contamination in game meat animals and the slaughter processes. In most developing countries, including in South Africa, the monitoring and control of these heavy metals in the game meat value chain has not yet been implemented.

Food frequency questionnaire assessing traditional food consumption in Dene/Métis communities, Northwest Territories, Canada

Food Frequency Questionnaires (FFQ) can be used to document food consumption and to estimate the intake of contaminants for Indigenous populations. The objective of this project was to refine and implement an FFQ to estimate the consumption of traditional locally harvested foods for Dene/Métis in the Northwest Territories, Canada. The strategy consisted of: 1) refining the FFQ through three focus groups and, 2) implementing the FFQ in Indigenous communities. Participants were asked to complete the FFQ using an iPad to document the types of traditional foods consumed over the past 12 months, as well as the consumption frequency, the portion size, and the preparation methods. Focus groups supported the refinement of the FFQ on the format, the list of foods, and the preparation methods listed in the questionnaire. The refined FFQ was then implemented with participants (n = 237). Findings indicated that the traditional foods most frequently consumed were moose, whitefish and lake trout. Participants who consumed fish and land animals reported, on average, a portion size for one serving of between 126 and 143 g, depending on age and sex. These findings increase knowledge of the current traditional food consumption of Dene/Métis communities and will support the assessment of contaminant exposure.

Nutrient adequacy and nutrient sources of adults among ninety-two First Nations communities across Canada

OBJECTIVES

To identify food sources of nutrients in First Nations adults in Canada and to establish whether these populations are meeting their nutrient requirements and whether traditional foods (TF) contribute to better nutrient intake.

METHODS

The First Nations Food, Nutrition and Environment Study is a cross-Canada participatory study of First Nations adults living south of the 60th parallel. Twenty-four-hour recalls were conducted in 92 First Nations communities from 2008 to 2016. Repeat recalls were attempted with 20% of participants to adjust for within-person variation and estimate the proportion of individuals below recommendations according to Institute of Medicine guidelines. Nutrients from days with and without TF were compared. The main food sources of select nutrients were identified, including TF.

RESULTS

Mean energy intakes among women and men ranged from 1664 to 1864 and from 1761 to 2298 kcal/day respectively. Most macronutrients were within the acceptable macronutrient diet range except for fat in most age groups and carbohydrates in men 71 years of age and older. Saturated fat was above recommendations for all ages. Only niacin was identified as above recommendations in all age and sex categories. Days where TF were eaten showed greater intakes of key nutrients.

CONCLUSION

It is imperative that we find culturally appropriate ways to improve the quality and nutritional value of First Nations Peoples food intake by improving TF access and use on the one hand and conversely providing better quality store-bought foods. For success in this, we must empower First Nations communities and health practitioners to collaboratively overcome these challenges.

Probabilistic Estimation of Dietary Intake of Methylmercury from Fish in Japan

Dietary intake of methylmercury from fish was estimated via Monte Carlo simulation using data for methylmercury concentrations in 210 fish samples and data regarding fish consumption extracted from the Japanese National Health and Nutrition Survey. The fish analyzed were classified into 5 groups according to categories used in the survey. The distribution of consumption of fish from each group was used without fitting to statistical distributions. A log-normal distribution was fitted to the distribution of methylmercury concentration in each fish group. Two random numbers that followed these distributions were generated, and a trial value was calculated by multiplying these random numbers. The trial value was divided by the body weight (50 kg) to arrive at an estimate of dietary methylmercury intake. A total of 100,000 Monte Carlo simulation iterations were performed. The estimated mean daily intake of methylmercury was 0.093 µg/kg body weight (bw)/day. This value is well below the tolerable daily intake of 0.292 µg/kg bw/day calculated from the tolerable weekly intake (2.0 µg/kg bw/week) established by the Food Safety Commission of Japan. The probability that the daily intake of methylmercury exceeds the tolerable daily intake was 7.6%. As there are no data regarding fish consumption for consecutive days, estimation of the weekly intake of methylmercury is a subject for future studies.

Using a geographic information system to assess local scale methylmercury exposure from fish in nine communities of the Eeyou Istchee territory (James Bay, Quebec, Canada)

Exposure to methylmercury is a concern for those who rely on fish as a traditional food in the Eeyou Istchee territory of James Bay, Quebec, Canada, because industrial land uses overlap with community water bodies where fish are harvested. Consequently, this study assessed if traditional practices, particularly fishing, increased the risk of exposure to methylmercury from the consumption of locally harvested fish. We designed a geographic information system (GIS) that included land use and fish methylmercury tissue concentrations to assess clustering of potential hot spots. We also used generalized linear models to assess the association of fish consumption to blood organic-mercury concentrations, and logistic regression models to assess the probability of fish exceeding the safety threshold for methylmercury tissue concentrations in areas of high intensity land use. The GIS demonstrated significant clustered hot spots around regions of hydroelectric and mining land use. Our results also revealed that adult consumption of pike, lake trout and/or walleye, and child consumption of pike or walleye were significantly associated with blood organic-mercury concentrations. Further, large fish harvested in a community with high intensity land use yielded a 77% probability that the fish exceeded the safety threshold. From a human exposure perspective, our study highlights the need for further research on children who consume fish from this region.

Subsistence fishing in the Eeyou Istchee (James Bay, Quebec, Canada): A regional investigation of fish consumption as a route of exposure to methylmercury

Fishing is part of the traditional activities of Indigenous people in Canada. However, it is also a route of exposure to methylmercury, a known neurotoxicant, and this is a concern for those who rely on fish as part of their diet. The probable weekly intake (PWI) of methylmercury from six species of fish was calculated for Indigenous community members (N = 1406), grouped by age and sex, and compared to Canadian and international provisional reference doses to assess exposure. Mixed-effects regression models were also used to estimate the input of methylmercury into the blood, and Hazard Quotients (HQ) were used to assess potential effects. Of the species of fish in our study, walleye and lake trout contributed the most to methylmercury intake. There was a positive association between the consumption of walleye and the total blood mercury concentrations of mercury in women and men (R²_A = 0.40 and 0.47, respectively), and to a lesser extent, children. Similar results were observed for the consumption of lake trout. The 95th-percentile HQ for girls (3.16) and boys (3.18) from the consumption of lake trout was relatively high, and to a lesser extent, so was the HQ for walleye and pike. The consumption of some species of fish increases the exposure to methylmercury, however, taking a balanced approach, there are health benefits associated with the consumption of fish that must be considered. To mitigate future exposure to methylmercury, we recommend follow-up blood monitoring and local-geospatial-based assessments.

Evaluating the concentrations of total mercury, methylmercury, selenium, and selenium:mercury molar ratios in traditional foods of the Bigstone Cree in Alberta, Canada

Traditional foods provide nutritional, social, and economic benefits for Indigenous communities; however, anthropogenic activities have raised concerns about mercury (Hg), especially methylmercury (MeHg), in these foods. This issue may be of particular concern for communities near large industrial activities, including the Bigstone Cree Nation adjacent to the Athabasca oil sands region, Canada. This community-led study sought to assess variation in THg and MeHg concentrations among traditional food types (plants or animals), species, and tissues (muscles, organs), and variation in concentrations of the micronutrient selenium (Se)- thought to protect against Hg toxicity-and Se:THg ratios. Thirteen plant and animal species were collected in 2015 by Bigstone Cree community members. We quantified THg, Se, and Se:THg ratios in 65 plant and 111 animal samples and MeHg in 106 animal samples. For plants, the lichen, old man's beard (Usnea spp.), showed the highest concentrations of THg and Se (0.11 ± 0.02 and 0.08 ± 0.01 μg g^-1 w. w., respectively) and also had a low Se:THg molar ratio. Concentrations of THg, MeHg, and Se differed among animal samples (P < 0.010), showing variation among species and among tissues/organs. Generally, concentrations of THg and MeHg were highest in aquatic animals, which also had relatively low Se:THg molar ratios. Overall results revealed substantial variation in the patterns of THg, MeHg, Se and Se:THg ratios across this comprehensive basket of traditional foods. Thus, measuring concentrations of THg alone, without considering MeHg and potential associations with Se, may not adequately convey the exposure to Hg in traditional foods.

Mercury exposure and premature mortality in the Grassy Narrows First Nation community: a retrospective longitudinal study

BACKGROUND

Little is known about the influence of toxic exposures on reduced life expectancy in First Nations people in Canada. The Grassy Narrows First Nation community have lived with the consequences of one of the worst environmental disasters in Canadian history. In the early 1960s, 10 000 kg of mercury (Hg) was released into their aquatic ecosystem. Although Hg concentration in fish, their dietary staple, decreased over time, it remains high. We aimed to examine whether elevated Hg exposure over time contributes to premature mortality (younger than 60 years) in this community.

METHODS

We did longitudinal and case-control analyses with data for individuals of the Grassy Narrows First Nation community. In 2019, the community obtained their historical Hg biomarker data from a government surveillance programme, which was then shared with the authors. A matched-pair approach allowed us to compare longitudinal hair Hg concentration between cases (individuals who died aged younger than 60 years) and controls (individuals who lived beyond 60 years). Matching criteria included year of birth (allowing 2 years either side), sex, and a minimum of four hair Hg concentration measures, of which at least two were in the same year. Analyses included change-point detection, interrupted time series, mixed models, and Cox survival models.

FINDINGS

We analysed data collected between Jan 1, 1970, and Jan 31, 1997, for 657 individuals (319 women and 338 men, born between 1884 and 1991) for whom we assembled a retrospective database of yearly measures of hair Hg concentration (n=3603). Hair Hg concentration decreased over time. A subgroup of 222 individuals (107 women and 115 men) reached or could have reached 60 years old by August, 2019. There was an increased risk of dying at a younger age among those with at least one hair Hg measure of 15 μg/g or more (adjusted hazard ratio 1·55, 95% CI 1·11-2·16; p=0·0088). Among the deceased individuals (n=154), longevity decreased by 1 year with every 6·25 μg/g (4·35-14·29) increase in hair Hg concentration. Analyses of 36 matched pairs showed that hair Hg concentration of those who died aged younger than 60 years was 4·7 times higher (3·4-5·9) than controls.

INTERPRETATION

The consistent findings between our different analyses support an association between long-term Hg exposure from freshwater fish consumption and premature mortality in this First Nation community. There is a need to do risk-benefit analyses of freshwater fish consumption in environmentally contaminated regions.

FUNDING

Canadian Institutes of Health Research.

Blood and hair mercury concentrations among Cree First Nations of Eeyou Istchee (Quebec, Canada): time trends, prenatal exposure and links to local fish consumption

To describe exposure to methylmercury among Cree, focusing on women of childbearing age, we used data from 2 studies. Multiple regression was employed to examine associations between blood and hair mercury concentrations and consumption of locally harvested fish. Approximately 9.9% of non-pregnant women aged 15-44 y and 3.9% of pregnant women required follow-up according to Health Canada's blood mercury guidance value of 40 nmol/L. 8% of hair mercury observations in the non-pregnant women and 2.5% among pregnant women exceeded the equivalent threshold of 10 nmol/g. The geometric mean blood mercury concentration was 12.7 nmol/L in 1,429 persons aged 8 and over, and 17.7 nmol/L in adults aged 18 and older. The proportion of hair mercury concentrations greater than 12.5 nmol/g decreased in all age-sex groups when comparing the 2002-2009 data to published values for 1993-1994. Among women of childbearing age, local fish consumption was associated with increased blood and hair mercury concentrations. While over 90% of women of childbearing age in this population have acceptable levels of mercury, ongoing intake of mercury suggests that their consumption of fish with known high mercury content be minimised. Reducing consumption of fish known to be high in mercury content needs to be balanced with promoting ongoing connection to Cree culture and land-based activities that are also important determinants of health.

Modelling optimal diets for quality and cost: examples from Inuit and First Nations communities in Canada 1

This review summarizes aspects of the 2017 Canadian Nutrition Society symposium, "Modelling diets for quality and cost: examples from Inuit and First Nations in Canada". Indigenous peoples in Canada experience a high prevalence of nutrition-related chronic disease because of the poor quality and high cost of their food supply. Since European colonization, they have transitioned from a diet of minimally processed traditional foods (game, fish, and plants) procured using pursuits such as hunting, fishing, gathering, and horticulture to a diet comprised mostly of processed market foods. This nutrition transition is the result of factors such as colonial policies and practices; climate change; environmental degradation; contaminants in traditional foods; and limited availability of, or access to, economical and healthful market foods. Presenters Malek Batal and Laurie Chan characterized the contemporary diets of First Nations and Inuit populations and demonstrated novel methods for modelling more optimal diets using 2 datasets: the First Nations Food, Nutrition, and Environment Study and the Inuit Health Survey. It was demonstrated how the NOVA classification characterized the portion of the diet consisting of processed foods. Dietary components were then manipulated to reduce ultra-processed food and drink intake to increase the Healthy Eating Index score. Linear programming was explained as a way to mathematically design theoretical diets that aim to optimize food cost, nutrition quality, and contaminant level of traditional foods. While diet-modelling methodologies have limitations, they provide a basis for engaging Indigenous peoples and governments to develop nutrition goals and policies anchored in contemporary food realities.

Factors associated with the intake of traditional foods in the Eeyou Istchee (Cree) of northern Quebec include age, speaking the Cree language and food sovereignty indicators

The Eeyouch are a First Nations (Cree) population that live above 49.6°N latitude in Eeyou Istchee in northern Quebec. Eeyouch rely on traditional foods (TF) hunted, fished or gathered from the land. The overarching aim of this study was to achieve an understanding of the factors associated with TF intake among Eeyouch. Data were from 465 women and 330 men who participated in the Nituuchischaayihtitaau Aschii Multi-Community Environment-and-Health (E&H) study. The relationship between TF consumption and dietary, health, sociodemographic and food sovereignty (i.e. being a hunter or receiving Income Security to hunt, trap or fish) variables was examined using linear and logistic regression. Analyses were stratified by sex because of the male/female discrepancy in being a hunter. Among respondents, almost all (99.7%) consumed TF, 51% were hunters and 10% received Income Security. Higher intake of TF was associated with lower consumption of less nutritious ultra-processed products (UPP). In women, TF intake increased with age, hunting and receiving Income Security, but decreased with high school education. In men, TF intake increased with age and speaking only Cree at home. The findings suggest that increased food sovereignty would result in improved diet quality among Eeyouch through increased TF intake and decreased UPP intake.

Mercury and omega-3 fatty acid profiles in freshwater fish of the Dehcho Region, Northwest Territories: Informing risk benefit assessments

Traditional foods have significant nutritional, sociocultural and economic value in subarctic First Nations communities of the Northwest Territories, and play a crucial role in promoting cultural continuity and sovereignty. Omega-3 polyunsaturated fatty acids (N-3 PUFAs), including eicosapentaenoic (EPA) and docosahexaenoic acid (DHA), carry significant benefits for neurocognitive development and cardiovascular health. However, the health risks posed by methylmercury may serve to undermine the benefits of fish consumption in Northern Indigenous communities. The objective of this study was to characterize profiles for mercury (Hg) and fatty acids in fish species harvested across lakes of the Dehcho Region, in the Mackenzie Valley of the Northwest Territories, to better understand the risks and benefits associated with traditional foods. Hg levels increased with trophic position, with the highest levels found in Burbot, Lake Trout, Walleye, and Northern Pike. Lake Trout, along with planktivorous species including Lake Whitefish, Cisco, and Sucker, demonstrated higher N-3 PUFAs than other species. Negative associations were observed between Hg and N-3 PUFAs in Lake Trout, Northern Pike, Walleye and Burbot. Further stratifying these relationships revealed significant interactions by lake. Significant differences observed in fatty acid and Hg profiles across lakes underscore the importance of considering both species- and lake-specific findings. This growing dataset of freshwater fish of the Dehcho will inform future efforts to characterize human Hg exposure profiles using probabilistic dose reconstruction models.

Spatial and length-dependent variation of the risks and benefits of consuming Walleye (Sander vitreus)

Restricted fish consumption due to elevated contaminant levels may limit the intake of essential omega-3 fatty acids, such as eicosapentaenoic (EPA; 20:5n-3) and docosahexaenoic (DHA; 22:6n-3) acids. We analyzed lake- and length-specific mercury and EPA+DHA contents in Walleye (Sander vitreus; Mitchell 1818) from 20 waterbodies in Ontario, Canada, and used this information to calculate the theoretical intake of EPA+DHA when the consumption advisories are followed. The stringent consumption advisory resulted in decreased EPA+DHA intake regardless of the EPA+DHA content in Walleye. Walleye length had a strong impact on the EPA+DHA intake mainly because it was positively correlated with the mercury content and thereby consumption advisories. The highest EPA+DHA intake was achieved when smaller Walleye (30-40cm) were consumed. The strong relationship between the consumption advisory and EPA+DHA intake enabled us to develop a more generic regression equation to estimate EPA+DHA intake from the consumption advisories, which we then applied to an additional 1322 waterbodies across Ontario, and 28 lakes from northern USA for which Walleye contaminant data are available but fatty acid data are missing. We estimate that adequate EPA+DHA intake (>250mgday^-1) is achieved in 23% of the studied Ontario lakes, for the general population, when small (30-40cm) Walleye are eaten. Consumption of medium- (41-55cm), and large-sized (60-70cm) Walleye would provide adequate EPA+DHA intake from only 3% and 1% of the lakes, respectively. Our study highlights that mercury contamination, which triggers consumption advisories, strongly limits the suitability of Walleye as the sole dietary source of EPA+DHA to humans.