Indigenous peoples' food systems for health: finding interventions that work

Exploring Healthy Eating Perceptions, Barriers, and Facilitators among Urban Indigenous Peoples in Saskatchewan

Urban Indigenous populations encounter distinctive challenges in maintaining traditional dietary practices, compounded by the complexities of socio-economic and environmental factors and the modern urban lifestyle. This qualitative study explores the perceptions of healthy eating, along with the facilitators and barriers to such practices, among urban Indigenous peoples in Saskatoon, Regina, and Prince Albert. Through virtual interviews, we engage 14 participants from these cities. Utilizing NVivo for thematic coding, we apply inductive thematic analysis to reveal relevant themes. The study highlights a preference for nutrient-rich, natural, and minimally processed foods, with a significant emphasis on incorporating traditional Indigenous foods into diets. These preferences are deeply entwined with cultural identity and underscore the importance of traditional foods in maintaining cultural heritage and promoting well-being. Despite the intrinsic value of these traditional foods, participants face several barriers to healthy eating, including economic constraints, limited access to traditional foods, and the psychological impacts of historical trauma. Nevertheless, facilitators such as community and family support, engagement in traditional food practices, and a growing awareness of nutritional knowledge are identified as being crucial in supporting healthy dietary choices. This research underscores the complex interplay of cultural, economic, and environmental factors in shaping the dietary practices of urban Indigenous peoples.

Indigenous Peoples: Traditional knowledges, climate change, and health

Indigenous Peoples around the globe make up approximately six percent of the global population, yet they sustainably care for around eighty percent of the world's remaining biodiversity. Despite continued political, economic, and racial marginalization, as well as some of the worst health inequities on the planet, Indigenous Peoples have worked hard to maintain their cultures and languages against all odds. Indigenous Peoples' close connections to land, water, and ecosystems, however, have placed them at increasing vulnerability from the effects of climate change. With this, the health risks from climate change have unique considerations within Indigenous Nations for both mitigation and adaptation responses that are largely unappreciated. This Indigenous narrative review will synthesis the current climate and health landscape of Indigenous Peoples at a global, high-level scale, including relevant international mechanisms and considerations for Indigenous Peoples' health. This Indigenous narrative review will also explore and reflect on the strengths of Indigenous traditional knowledges as it pertains to climate change and health.

Loss of ancestral food practices and perception of its effect on children's health among Inga indigenous grandmothers, Nariño, Colombia

OBJECTIVE

Novel foods and dietary practices, a lack of available land, and displacement by armed conflict have affected the ancestral food traditions practiced by the Inga community in Aponte, in Nariño, Colombia. These factors have led to problems with food security and malnutrition, which have impacted the growth and development of children. Therefore, this study is aimed at identifying the changes in ancestral food practices reported by Inga grandmothers, and the possibility of recuperating them in order to improve children's health.

METHOD

A qualitative study was conducted that included 24 mothers with children under five years old and 25 grandmothers in nine Inga communities. Participants were recruited using snowball sampling. Free listing was used to identify changes in food patterns, and semi-structured interviews were conducted with 20 grandmothers to delve deeper into the subject. A translator of the Inga language facilitated communication, and the Inga researcher validated the translation using audio recordings. Each interview was transcribed and categorized for the purpose of analysis, using the NVivo 12 software.

RESULTS

Free lists showed changes from a corn-based to a rice-based diet and a wide variety of non-ancestral food products. According to the grandmothers, "tiendas" have replaced traditional foods with those that are easy to prepare, which are attractive to mothers as well as to the children because of their flavor. Ancestral practices such as grinding, peeling, and log cooking are being abandoned. Government programs and daycare have incorporated new food that compete with traditional ones, with no clear evidence of an intercultural approach. Added to this is the dismissal by young mothers of the knowledge held by their grandmothers, which hinders the continuation of traditions.

CONCLUSIONS

The findings suggest that it is necessary to prevent the loss of the Inga food culture, and policies need to be created that promote and protect ancestral knowledge and that help to regain the value of the "chagra" farming system, with the support of elders, authorities who are recognized by the community, and government technicians, as recommended by the grandmothers who participated in this study.

Transforming food systems with trees and forests

The global food system is failing to deliver sufficient and nutritious food to all, while damaging the earth and unsustainably drawing down its resources. We argue that trees and forests are essential to solving these challenges. We outline the current contributions of trees and forests to the global food system and present recommendations to leverage these contributions as part of the efforts to reshape food systems to better support healthy diets and environmental sustainability. Trees and forests provide nutrient-rich foods, incomes for food security, ecosystem services for food production, and add resilience to food systems. At the same time, trees and forests protect biodiversity and mitigate climate change through carbon sequestration. We recommend four approaches to realise the full potential of trees and forests to contribute to healthy and sustainable food systems: scaling up current tree-based food production, reorientating some agricultural investments towards nutrient-dense food production, repurposing production incentives from support of calorie-rich but nutrient-poor foods to support nutrient-dense foods, and integrate nutrition objectives into forest conservation and restoration programmes. Trees and forests have important roles to play in the transformation of our food systems, but more needs to be done to ensure that these roles are realised.

Investigating the Intersections of Racial Identity and Perceived Income Adequacy in Relation to Dietary Quality Among Adults in Canada

BACKGROUND

Structural racism and economic marginalization shape dietary patterns in complex ways. Most research examining race and income inequities discount their interactions in shaping dietary intakes. An intersectional approach is needed to identify interconnected sources of social inequities and to more precisely locate dietary inequities.

OBJECTIVES

We examined whether racial identity and perceived income adequacy independently and jointly shape dietary quality, defined using the Healthy Eating Index (HEI) 2015, among a large sample of adults in Canada.

METHODS

Cross-sectional data from 2540 adults (≥18 years of age) in Canada who participated in the 2019 International Food Policy Study were analyzed. Multivariable linear regression models were executed to test the independent associations and interactions between racial identity and perceived income adequacy with HEI-2015 scores. Models were constructed to examine HEI-2015 total and component scores, adjusting for age, gender, and education.

RESULTS

Perceived income adequacy, but not racial identity, was independently associated with HEI-2015 total scores. The interaction between racial identity and perceived income adequacy was significantly associated with HEI-2015 scores. Compared to the reference group (individuals identifying as White and reporting income adequacy), those identifying as Black and reporting income adequacy were associated with lower HEI-2015 scores (β, -7.30; 95% CI, -13.07 to -1.54) and those identifying as Black and reporting income inadequacy were associated with lower HEI-2015 scores (β, -6.37; 95% CI, -12.13 to -0.60). Individuals who identified as indigenous and reported neither income adequacy nor inadequacy had lower HEI-2015 scores (β, -8.50; 95% CI, -13.82 to -3.18) compared to the reference group.

CONCLUSIONS

Findings suggest that racial identity and perceived income adequacy jointly shape dietary quality. Inequities in dietary quality may be missed when intersecting racial identities and socioeconomic positions are not explicitly investigated. To support healthier dietary patterns, strategies must reduce socioeconomic barriers that impose dietary constraints on some racialized groups.

[Comparison of a community-based nutritional intervention and a conventional nutritional intervention in Mayan communities in Mexico]

Poor nutritional conditions persist in many Mayan communities in Yucatán, Mexico, even though various programs have been implemented. The study aimed to compare the effects of a community-based nutritional intervention with an intercultural focus versus a conventional nutritional intervention on body mass index (BMI) and diet in women in Mayan communities in Yucatán. The sample included adult women with BMI ≥ 25kg/m2 from neighboring rural Mayan villages. Both interventions lasted three months with 11 sessions and followed the prevailing guidelines. The community-based intervention used an intercultural tool called Good Mayan Food [Plato del Bien Comer Maya], besides strategies designed according to information obtained from a prior qualitative study phase using interviews. The group that received the community-based intervention (n = 7), compared to the conventional intervention group (n = 9), showed larger decreases in BMI (-0.58 ± 0.70 kg/m2 and +0.27 ± 0.64kg/m2; p = 0.042), waist circumference (-2.15 ± 2.60 cm and -0.50 ± 0.75 cm; p = 0.042), and consumption of fats (-53.23 ± 21.92 grams and -7.34 ± 25.77 grams; p = 0.004), as well as higher increases in weekly consumption of some local foods such as nance fruit (p = 0.012), tamarind (p = 0.001), and chili peppers (p = 0.004). The community-based intervention was the only one to show a significant decrease in daily calorie intake (baseline: 2,067 ± 91 kcal/day, at three months: 1,474 ± 31 kcal/day; p = 0.018), and both groups showed decreases in the consumption of ultra-processed foods, but without significant differences between the two groups. The community-based intervention group showed better results than the conventional intervention group.

Food Sovereignty and Rights-Based Approaches Strengthen Food Security and Nutrition Across the Globe: A Systematic Review

This systematic review assembles evidence for rights-based approaches–the right to food and food sovereignty–for achieving food security and adequate nutrition (FSN). We evaluated peer-reviewed and gray literature produced between 1992 and 2018 that documents empirical relationships between the right to food or food sovereignty and FSN. We classified studies by literature type, study region, policy approach (food sovereignty or right to food) and impact (positive, negative, neutral, and reverse-positive) on FSN. To operationalize the concepts of food sovereignty and the right to food and connect them to the tangible interventions and practices observed in each reviewed study, we also classified studies according to 11 action types theorized to have an impact on FSN; these included “Addressing inequities in land access and confronting the process of land concentration” and “Promoting gender equity,” among others. We found strong evidence from across the globe indicating that food sovereignty and the right to food positively influence FSN outcomes. A small number of documented cases suggest that narrow rights-based policies or interventions are insufficient to overcome larger structural barriers to realizing FSN, such as inequitable land policy or discrimination based on race, gender or class.

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.

Mainstreaming Local Food Species for Nutritional and Livelihood Security: Insights From Traditional Food Systems of Adi Community of Arunachal Pradesh, India

This study brings out the critical role of lesser-known local plant species in the food, nutrition and livelihood security of Adi community in Arunachal Pradesh, India. Considering women as a major custodian in knowledge and practices on foods, a total of 90 Adi women and 60 key knowledgeable community members (thus a total of 150 participants) were selected from East Siang and Upper Siang districts of Arunachal Pradesh. Data were collected using combination of methods including recipe contest, focus group discussion, personal interviews and laboratory analyses. The results indicated that Adi women were able to identify 39 bioculturally important species from a range of locally available plant species. Used alone or with other foods, these plants remain central to the Adi people's cultural identity and livelihood security. In addition to improving food and nutritional security, these species accessed from different land use systems, are also sold on the local markets to generate decent incomes. Of the species identified by Adi women, 28 were culturally shared and used frequently in food and ethnomedicine. Laboratory analyses of the selected 22 species revealed exceptionally high levels of minerals and other nutrients, such as proteins and anti-oxidants, supporting their traditional use for health benefits. Our study results provide valuable insights to the researchers to explore the vast hidden potential of these and other similar species for improving nutritional well-being of local communities in marginal areas. Adequate policy support is needed to enable Adi and other such marginalized communities to cope with challenges being posed to traditional food systems.

Implications of Zoonoses From Hunting and Use of Wildlife in North American Arctic and Boreal Biomes: Pandemic Potential, Monitoring, and Mitigation

The COVID-19 pandemic has re-focused attention on mechanisms that lead to zoonotic disease spillover and spread. Commercial wildlife trade, and associated markets, are recognized mechanisms for zoonotic disease emergence, resulting in a growing global conversation around reducing human disease risks from spillover associated with hunting, trade, and consumption of wild animals. These discussions are especially relevant to people who rely on harvesting wildlife to meet nutritional, and cultural needs, including those in Arctic and boreal regions. Global policies around wildlife use and trade can impact food sovereignty and security, especially of Indigenous Peoples. We reviewed known zoonotic pathogens and current risks of transmission from wildlife (including fish) to humans in North American Arctic and boreal biomes, and evaluated the epidemic and pandemic potential of these zoonoses. We discuss future concerns, and consider monitoring and mitigation measures in these changing socio-ecological systems. While multiple zoonotic pathogens circulate in these systems, risks to humans are mostly limited to individual illness or local community outbreaks. These regions are relatively remote, subject to very cold temperatures, have relatively low wildlife, domestic animal, and pathogen diversity, and in many cases low density, including of humans. Hence, favorable conditions for emergence of novel diseases or major amplification of a spillover event are currently not present. The greatest risk to northern communities from pathogens of pandemic potential is via introduction with humans visiting from other areas. However, Arctic and boreal ecosystems are undergoing rapid changes through climate warming, habitat encroachment, and development; all of which can change host and pathogen relationships, thereby affecting the probability of the emergence of new (and re-emergence of old) zoonoses. Indigenous leadership and engagement in disease monitoring, prevention and response, is vital from the outset, and would increase the success of such efforts, as well as ensure the protection of Indigenous rights as outlined in the United Nations Declaration on the Rights of Indigenous Peoples. Partnering with northern communities and including Indigenous Knowledge Systems would improve the timeliness, and likelihood, of detecting emerging zoonotic risks, and contextualize risk assessments to the unique human-wildlife relationships present in northern biomes.

The "Double Burden of Malnutrition" in the Amazon: dietary change and drastic increases in obesity and anemia over 40 years among the Awajún

Undernutrition and overnutrition are interconnected. Yet few studies have examined the "double burden of malnutrition" (DBM) over time in indigenous communities. We investigated changes in the food systems and nutritional health of Awajún communities in the Peruvian Amazon in the 1970s and in 2013. Methods included ethnography, 24 hr food recalls, and biological measures. In 2013, the number of traditional foods consumed decreased to 10% of levels in the 1970s and the number of market foods consumed increased 40-fold. Rates of anemia and obesity were also substantially higher in 2013 compared to the 1970s (23% vs 6% for anemia and 30% vs. 0% for obesity) indicating a DBM has emerged. Examining the predictors of hemoglobin levels and body mass indices in the 2013 sample reveals that this DBM is differentially impacting women and that risk for obesity among the Awajún is associated with multiple proxies of market integration beyond just the consumption of market foods. These findings highlight the complex pathways by which rapid lifestyle changes are creating gendered health inequalities within indigenous communities over time.

Indigenous Community Perspectives of Food Security, Sustainable Food Systems and Strategies to Enhance Access to Local and Traditional Healthy Food for Partnering Williams Treaties First Nations (Ontario, Canada)

In partnership with communities of the Williams Treaties First Nations in southern Ontario (Canada), we describe an approach to work with communities, and highlight perspectives of food security and sustainability, including priorities and opportunities to revitalize local food systems as a pathway to food security and food sovereignty. The objectives of our project were: (1) to build a shared understanding of food security and sustainability; and (2) to document community priorities, challenges and opportunities to enhance local food access. Utilizing an Indigenous methodology, the conversational method, within the framework of community-based participatory research, formative work undertaken helped to conceptualize food security and sustainability from a community perspective and solidify interests within the four participating communities to inform community-led action planning. Knowledge generated from our project will inform development of initiatives, programs or projects that promote sustainable food systems. The community-based actions identified support a path towards holistic wellbeing and, ultimately, Indigenous peoples' right to food security and food sovereignty.

The Retail Food Sector and Indigenous Peoples in High-Income Countries: A Systematic Scoping Review

Indigenous Peoples in high-income countries experience higher burdens of food insecurity, obesity, and diet-related health conditions compared to national averages. The objective of this systematic scoping review is to synthesize information from the published literature on the methods/approaches, findings, and scope for research and interventions on the retail food sector servicing Indigenous Peoples in high-income countries. A structured literature search in two major international databases yielded 139 relevant peer-reviewed articles from nine countries. Most research was conducted in Oceania and North America, and in rural and remote regions. Several convergent issues were identified across global regions including limited grocery store availability/access, heightened exposure to unhealthy food environments, inadequate market food supplies (i.e., high prices, limited availability, and poor quality), and common underlying structural factors including socio-economic inequality and colonialism. A list of actions that can modify the nature and structure of retailing systems to enhance the availability, accessibility, and quality of healthful foods is identified. While continuing to (re)align research with community priorities, international collaboration may foster enhanced opportunities to strengthen the evidence base for policy and practice and contribute to the amelioration of diet quality and health at the population level.

Effects of food policy actions on Indigenous Peoples' nutrition-related outcomes: a systematic review

INTRODUCTION

Indigenous Peoples worldwide endure unacceptable health disparities with undernutrition and food insecurity often coexisting with obesity and chronic diseases. Policy-level actions are required to eliminate malnutrition in all its forms. However, there has been no systematic synthesis of the evidence of effectiveness of food and nutrition policies for Indigenous Peoples around the world. This review fills that gap.

METHODS

Eight databases were searched for peer-reviewed literature, published between 2000 and 2019. Relevant websites were searched for grey literature. Articles were included if they were original studies, published in English and included data from Indigenous Peoples from Western colonised countries, evaluated a food or nutrition policy (or intervention), and provided quantitative impact/outcome data. Study screening, data extraction and quality assessment were undertaken independently by two authors, at least one of whom was Indigenous. A narrative synthesis was undertaken with studies grouped according to the NOURISHING food policy framework.

RESULTS

We identified 78 studies from Canada, Australia, Aotearoa/New Zealand and the USA. Most studies evaluated targeted interventions, focused on rural or remote Indigenous communities. The most effective interventions combined educational strategies with policies targeting food price, composition and/or availability, particularly in retail and school environments. Interventions to reduce exposure to unhealthy food advertising was the only area of the NOURISHING framework not represented in the literature. Few studies examined the impact of universal food policies on Indigenous Peoples' diets, health or well-being.

CONCLUSION

Both targeted and universal policy action can be effective for Indigenous Peoples. Actions that modify the structures and systems governing food supply through improved availability, access and affordability of healthy foods should be prioritised. More high-quality evidence on the impact of universal food and nutrition policy actions for Indigenous Peoples is required, particularly in urban areas and in the area of food marketing.

Examining the Influence of Cultural Immersion on Willingness to Try Fruits and Vegetables among Children in Guam: The Traditions Pilot Study

This pilot study examined the influence of cultural immersion on willingness to try fruits and vegetables (FV) among children 3-12 years old in three summer camps in Guam with different cultural exposure levels: cultural immersion camp (CIC), high exposure; university day camp (UDC), moderate exposure; and recreational sports camp (RSC), zero exposure. Children, ages 3-12 years old for CIC and UDC and 5-12 years old for RSC, participated: CIC (n = 47), UDC (n = 23), and RSC (n = 33). Children's willingness to try FV was assessed with the Adapted WillTry tool before and after each program. Whole FV intakes were assessed concurrently using the mobile food record in CIC and UDC. Using multivariate regression, WillTry post-assessment outcomes were modeled adjusting for pre-assessment, child characteristics, exposure, and parent cultural affiliation. Unique to the Adapted WillTry tool are three FV scales, local novel, local common, and imported, which are classified by source (local or imported) and/or familiarity (novel or common). WillTry adjusted mean FV post-scores by highest exposure camp to lowest were 2.2, 2.3, and 2.2 for local novel and 2.6, 2.6, and 2.6 for local common. No differences among camps were significant; however, there was an increase in the willingness to try scores for all FV score types and camps. The Traditions pilot study demonstrated: (1) feasibility of a multi-arm parallel design using existing community programs in limited-resource environments and (2) further examination of nutrition education components and contexts are needed to understand diet behaviors of indigenous populations.

Healthy and Sustainable Diets and Food Systems: the Key to Achieving Sustainable Development Goal 2?

The Sustainable Development Goals (SDGs) are considered a unifying global goal setting agenda that every country is meant to achieve. One of those goals, SDG2, promises to ensure food security and nutrition within sustainable food systems. However, achieving that goal is riddled with uncertainty because of the way in which the world currently produces and consumes foods. The global trends of diets and the food systems that produce those diets suggest that they are neither healthy nor sustainable, which has implications for achieving SDG2. This paper characterizes the current state of global diets and food systems, the concept of “healthy and sustainable diets,” and the ethical considerations to achieving healthy and sustainable diets for sustainable development.

Strengthening Aboriginal and Torres Strait Islander health policy: lessons from a case study of food and nutrition

OBJECTIVE

To examine key factors influencing the prioritisation of food and nutrition in Aboriginal and Torres Strait Islander health policy during 1996-2015.

DESIGN

A qualitative policy analysis case study was undertaken, combining document analysis with thematic analysis of key informant interviews.

SETTING

Australia.

PARTICIPANTS

Key actors involved in Aboriginal and Torres Strait Islander health policy between 1996 and 2015 (n 38).

RESULTS

Prioritisation of food and nutrition in policy reduced over time. Several factors which may have impeded the prioritisation of nutrition were identified. These included lack of cohesion among the community of nutritionists, Aboriginal and Torres Strait Islander leaders and civil society actors advocating for nutrition; the absence of an institutional home for nutrition policy; and lack of consensus and a compelling policy narrative about how priority nutrition issues should be addressed. Political factors including ideology, dismantling of public health nutrition governance structures and missing the opportunities presented by 'policy windows' were also viewed as barriers to nutrition policy change. Finally, the complexity and multifaceted nature of nutrition as a policy problem and perceived lack of evidence-based solutions may also have constrained its prioritisation in Aboriginal and Torres Strait Islander health policy.

CONCLUSIONS

Future advocacy should focus on embedding nutrition within holistic approaches to health and building a collective voice through advocacy coalitions with Aboriginal and Torres Strait Islander leadership. Strategic communication and seizing political opportunities may be as important as evidence for raising the priority of Aboriginal and Torres Strait Islander health issues.

Food in rural northern Norway in relation to Sami ethnicity: the SAMINOR 2 Clinical Survey

OBJECTIVE

To estimate current food intake in the population of northern Norway and to investigate the impact of self-perceived Sami ethnicity and region of residence on food intake.

DESIGN

The data are part of the second cross-sectional survey of the Population-based Study on Health and Living Conditions in Regions with Sami and Norwegian Populations (the SAMINOR 2 Clinical Survey, 2012-2014). Food intake was assessed by an FFQ. Ethnic and regional differences in food intake were studied by sex-specific, multivariable-adjusted quantile regression models.

SETTING

Ten municipalities (rural northern Norway).

SUBJECTS

Males (n 2054) and females (n 2450) aged 40-69 years (2743 non-Sami, 622 multi-ethnic Sami, 1139 Sami).

RESULTS

The diet of Sami participants contained more reindeer meat, moose meat, food made with animal blood and freshwater fish; and contained less lean fish and vegetables. In the inland region, the consumption of reindeer meat was greatest in Sami participants, followed by multi-ethnic Sami participants and non-Sami participants, who had the lowest consumption (median 25, 12 and 8 g/d, respectively). Compared with the inland region, fish roe/liver intake was higher in the coastal region and lean fish intake was twice as high (41 and 32 g/d in males and females, respectively).

CONCLUSIONS

When compared with non-Sami participants, those with solely self-perceived Sami ethnicity reported a significantly different intake of several foods, especially reindeer meat in the inland region. Multi-ethnic Sami tended to have similar diets to non-Sami. Residence in the coastal region predicted higher fish and roe/liver intake.

Contribution of forest foods to dietary intake and their association with household food insecurity: a cross-sectional study in women from rural Cameroon

OBJECTIVE

To determine the contribution of forest foods to dietary intake and estimate their association with household food insecurity.

DESIGN

Cross-sectional survey conducted among 279 households. Using a 7 d recall questionnaire, information on household food consumption was collected from women and used to determine the household dietary diversity score, food variety score and forest food consumption score (FFCS). Household Food Insecurity Access Scale (HFIAS) score was determined and Spearman rank correlation was used to establish the relationship between consumption of forest foods and HFIAS score. Women's dietary intake was estimated from two 24 h recalls. The contribution of forest foods to women's nutrient intakes was calculated and women's nutrient intakes were compared with estimated average nutrient requirements.

SETTING

Rural forest-dependent households in twelve villages in eastern and southern Cameroon.

SUBJECTS

Household heads and their non-pregnant, non-lactating spouses.

RESULTS

Forty-seven unique forest foods were identified; of these, seventeen were consumed by 98 % of respondents over the course of one week and by 17 % of women during the two 24 h recall periods. Although forest foods contributed approximately half of women's total daily energy intake, considerably greater contributions were made to vitamin A (93 %), Na (100 %), Fe (85 %), Zn (88 %) and Ca (89 %) intakes. Despite a highly biodiverse pool of foods, most households (83 %) suffered from high food insecurity based on the HFIAS. A significant inverse correlation was observed between the HFIAS score and the FFCS (r 2=-0·169, P=0·0006), demonstrating that forest foods play an important role in ensuring food security in these forest-dependent communities.

CONCLUSIONS

Forest foods are widely consumed by forest-dependent communities. Given their rich nutrient content, they have potential to contribute to food and nutrition security.

Factors influencing consumption of nutrient rich forest foods in rural Cameroon

Studies show that a number of forest foods consumed in Cameroon are highly nutritious and rich in health boosting bioactive compounds. This study assessed the knowledge and perceptions towards the nutritional and health promoting properties of forest foods among forest dependent communities. The relationship between knowledge, perceptions and socio-demographic attributes on consumption of forest foods was also determined. A total of 279 females in charge of decision making with respect to food preparation were randomly selected from 12 villages in southern and eastern Cameroon and interviewed using researcher administered questionnaires. Multivariate logistic regression analysis was used to identify the factors affecting consumption of forest foods. Baillonella toxisperma (98%) and Irvingia gabonesis (81%) were the most known nutrient rich forest foods by the respondents. About 31% of the respondents were aware of the nutritional value and health benefits of forest foods. About 10%-61% of the respondents expressed positive attitudes to questions related with health benefits of specific forest foods. Consumption of forest foods was found to be higher among polygamous families and also positively related to length of stay in the forest area and age of respondent with consumption of forest foods. Education had an inverse relationship with use of forest foods. Knowledge and positive attitude towards the nutritional value of forest foods were also found to positively influence consumption of forest foods. Since knowledge was found to influence attitude and consumption, there is need to invest in awareness campaigns to strengthen the current knowledge levels among the study population. This should positively influence the attitudes and perceptions towards increased consumption of forest foods.

Socioeconomic and Cultural Correlates of Diet Quality in the Canadian Arctic: Results from the 2007–2008 Inuit Health Survey

Purpose: We examined the impact of socioeconomic and cultural factors on dietary quality in adult Inuit living in the Canadian Arctic.

Methods: Interviews and a 24-h dietary recall were administered to 805 men and 1292 women from Inuit regions in the Canadian Arctic. We examined the effect of age, sex, education, income, employment, and cultural variables on respondents' energy, macronutrient intake, sodium/potassium ratio, and healthy eating index. Logistic regression was used to assess the impact of socioeconomic status (SES) on diet quality indicators.

Results: Age was positively associated with traditional food (TF) consumption and greater energy from protein but negatively associated with total energy and fibre intake. Associations between SES and diet quality differed considerably between men and women and there was considerable regional variability in diet quality measures. Age and cultural variables were significant predictors of diet quality in logistic regression. Increased age and use of the Inuit language in the home were the most significant predictors of TF consumption.

Conclusions: Our findings are consistent with studies reporting a nutrition transition in circumpolar Inuit. We found considerable variability in diet quality and complex interaction between SES and cultural variables producing mixed effects that differ by age and gender.

Food system sustainability for health and well-being of Indigenous Peoples

OBJECTIVE

To describe how Indigenous Peoples understand how to enhance use of their food systems to promote sustainability, as demonstrated in several food-based interventions.

DESIGN

Comments contributed by partners from case studies of Indigenous Peoples and their food systems attending an international meeting were implemented with public health interventions at the community level in nine countries.

SETTING

The Rockefeller Foundation Bellagio Conference Center in Bellagio, Italy, where experiences from case studies of Indigenous Peoples were considered and then conducted in their home communities in rural areas.

SUBJECTS

Leaders of the Indigenous Peoples' case studies, their communities and their academic partners.

RESULTS

Reported strategies on how to improve use of local food systems in case study communities of Indigenous Peoples.

CONCLUSIONS

Indigenous Peoples' reflections on their local food systems should be encouraged and acted upon to protect and promote sustainability of the cultures and ecosystems that derive their food systems. Promoting use of local traditional food biodiversity is an essential driver of food system sustainability for Indigenous Peoples, and contributes to global consciousness for protecting food biodiversity and food system sustainability more broadly. Key lessons learned, key messages and good practices for nutrition and public health practitioners and policy makers are given.

Determinants of Diet for Urban Aboriginal Youth

Overweight and obesity are associated with several life-threating comorbidities, including type 2 diabetes and cardiovascular disease. Obesity is a growing health concern in North America, with some groups experiencing higher levels of obesity than others. One group of particular interest is urban Aboriginal youth because they are a quickly growing population who experience high rates of obesity. Obesity is a complex condition with many contributing factors, diet being one of the primary contributors. In this article, we discuss the findings from an ethnographic study that examined determinants of diet for urban Aboriginal youth. Results revealed two themes: (a) Traditions and Sharing, and (b) The Struggle. The findings with Traditions and Sharing showed that food-sharing networks are often used to acquire traditional food. Traditional foods were believed to be healthy and desired by the participants. The theme The Struggle provides insight into the daily challenges the participants faced with food insecurity. Health promotion professionals need to consider the multiplicity of determinants of diet for urban Aboriginal youth in order to plan and implement culturally appropriate health promotion programs.

Rebuilding northern foodsheds, sustainable food systems, community well-being, and food security

Background

Multiple climatic, environmental and socio-economic pressures have accumulated to the point where they interfere with the ability of remote rural Alaska Native communities to achieve food security with locally harvestable food resources. The harvest of wild foods has been the historical norm, but most Alaska Native villages are transitioning to a cash economy, with increasing reliance on industrially produced, store-bought foods, and with less reliable access to and reliance on wild, country foods. While commercially available market foods provide one measure of food security, the availability and quality of market foods are subject to the vagaries and vulnerabilities of the global food system; access is dependent on one's ability to pay, is limited to what is available on the shelves of small rural stores, and, store-bought foods do not fulfill the important roles that traditional country foods play in rural communities and cultures. Country food access is also constrained by rising prices of fuel and equipment, a federal and state regulatory framework that sometimes hinders rather than helps rural subsistence users who need to access traditional food resources, a regulatory framework that is often not responsive to changes in climate, weather and seasonality, and a shifting knowledge base in younger generations about how to effectively harvest, process and store wild foods.

Objective

The general objective is to provide a framework for understanding the social, cultural, ecological and political dimensions of rural Alaska Native food security, and to provide information on the current trends in rural Alaska Native food systems.

Design

This research is based on our long-term ethnographic, subsistence and food systems work in coastal and interior Alaska. This includes research about the land mammal harvest, the Yukon River and coastal fisheries, community and village gardens, small livestock production and red meat systems that are scaled appropriately to village size and capacity, and food-system intervention strategies designed to rebuild local and rural foodsheds and to restore individual and community health.

Results

The contemporary cultural, economic and nutrition transition has severe consequences for the health of people and for the viability of rural communities, and in ways that are not well tracked by the conventional food security methodologies and frameworks. This article expands the discussion of food security and is premised on a holistic model that integrates the social, cultural, ecological, psychological and biomedical aspects of individual and community health.

Conclusion

We propose a new direction for food-system design that prioritizes the management of place-based food portfolios above the more conventional management of individual resources, one with a commitment to as much local and regional food production and/or harvest for local and regional consumption as is possible, and to community self-reliance and health for rural Alaska Natives.

Traditional food consumption behaviour and concern with environmental contaminants among Cree schoolchildren of the Mushkegowuk territory

Objectives

To investigate factors influencing consumption of traditional foods (e.g. wild game, fish) and concerns about environmental contaminants among schoolchildren of the Mushkegowuk Territory First Nations (Moose Factory, Fort Albany, Kashechewan, Attawapiskat, and Peawanuck).

Study design

Cross-sectional data collection from a Web-based Eating Behaviour Questionnaire (WEB-Q).

Methods

Schoolchildren in grades 6–12 (n =262) responded to 4 of the WEB-Q questions: (a) Do you eat game? (b) How often do you eat game? (c) How concerned are you about the environmental contaminants in the wild game and fish that you eat? (d) I would eat more game if… [6 response options]. Data were collected in 2004 (Fort Albany), 2005 (Peawanuck), 2006 (Attawapiskat), 2007 (Moose Factory) and 2009 (Kashechewan). Hierarchical log-linear modelling (LLM) was used for analyses of multi-way frequency data.

Results

Of the schoolchildren answering the specific questions: 174 consumed game; 95 reported concerns about contaminants in game; and 84 would increase their game consumption if it were more available in their homes. LLM revealed significant differences between communities; schoolchildren in Moose Factory consumed game “rarely or never” at greater than expected frequency, and fewer than expected consumed game “at least once a day”. Schoolchildren in Kashechewan had greater frequency of daily game consumption and few were concerned about contaminants in game. Using LLM, we found that sex was an insignificant variable and did not affect game consumption frequency or environmental contaminant concern.

Conclusion

The consumption of traditional foods differed between communities and appears to be related to contamination concerns. In addition, latitudinal variation appears to influence the frequency of traditional food consumption in children; children in the most southerly location consumed traditional food less frequently.

Nutrition and indigenous health in New Zealand

Within New Zealand, Maori experience a greater burden than non-Maori from childhood communicable diseases and from adult non-communicable diseases, for which malnutrition is recognised to have an important role in causality. The nutritional status of Maori is poorer than non-Maori. A larger proportion of Maori newborns are small for gestational age. Weight gain during the first 2 years of life is then more rapid than for non-Maori, and the proportion of Maori that are obese is higher than non-Maori through childhood and into adulthood. Across the age range from infancy to women of childbearing age, iron deficiency is more prevalent, and vitamin D status is poorer in Maori than non-Maori. Over the past two decades, the nutritional status of Maori has improved at birth and during childhood. The proportion of Maori infants small for gestational age and the mean body mass of Maori children aged 2-14 years have decreased. These improvements have been larger than in non-Maori. Further reduction in disparities in nutritional status between Maori and non-Maori must be a priority if the health status of New Zealand's population is to improve. The interventions must address the role that poverty plays in malnutrition, need to be rooted in local food systems and be community driven. If population health status is to improve, New Zealand must secure access to nutritious food for pregnant women, infants and children living in low-income families.

Traditional knowledge of wild edible plants used in the northwest of the Iberian Peninsula (Spain and Portugal): a comparative study

BACKGROUND

We compare traditional knowledge and use of wild edible plants in six rural regions of the northwest of the Iberian Peninsula as follows: Campoo, Picos de Europa, Piloña, Sanabria and Caurel in Spain and Parque Natural de Montesinho in Portugal.

METHODS

Data on the use of 97 species were collected through informed consent semi-structured interviews with local informants. A semi-quantitative approach was used to document the relative importance of each species and to indicate differences in selection criteria for consuming wild food species in the regions studied.

RESULTS AND DISCUSSION

The most significant species include many wild berries and nuts (e.g. Castanea sativa, Rubus ulmifolius, Fragaria vesca) and the most popular species in each food-category (e.g. fruits or herbs used to prepare liqueurs such as Prunus spinosa, vegetables such as Rumex acetosa, condiments such as Origanum vulgare, or plants used to prepare herbal teas such as Chamaemelum nobile). The most important species in the study area as a whole are consumed at five or all six of the survey sites.

CONCLUSION

Social, economic and cultural factors, such as poor communications, fads and direct contact with nature in everyday life should be taken into account in determining why some wild foods and traditional vegetables have been consumed, but others not. They may be even more important than biological factors such as richness and abundance of wild edible flora. Although most are no longer consumed, demand is growing for those regarded as local specialties that reflect regional identity.