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Lee MJ, Henderson SB, Clermont H, Turna NS, McIntyre L. The health risks of marine biotoxins associated with high seafood consumption: Looking beyond the single dose, single outcome paradigm with a view towards addressing the needs of coastal Indigenous populations in British Columbia. Heliyon 2024; 10:e27146. [PMID: 38463841 PMCID: PMC10923677 DOI: 10.1016/j.heliyon.2024.e27146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 02/16/2024] [Accepted: 02/25/2024] [Indexed: 03/12/2024] Open
Abstract
People who consume high quantities of seafood are at a heightened risk for marine biotoxin exposure. Coastal Indigenous peoples may experience higher levels of risk than the general population due to their reliance on traditional marine foods. Most evidence on the health risks associated with biotoxins focus on a single exposure at one point in time. There is limited research on other types of exposures that may occur among those who regularly consume large quantities of seafood. The objective of this review is to assess what is known about the unique biotoxin exposure risks associated with the consumption patterns of many coastal Indigenous populations. These risks include [1]: repeated exposure to low doses of a single or multiple biotoxins [2]; repeated exposures to high doses of a single or multiple biotoxins; and [3] exposure to multiple biotoxins at a single point in time. We performed a literature search and collected 23 recent review articles on the human health effects of different biotoxins. Using a narrative framework synthesis approach, we collated what is known about the health effects of the exposure risks associated with the putative consumption patterns of coastal Indigenous populations. We found that the health effects of repeated low- or high-dose exposures and the chronic health effects of marine biotoxins are rarely studied or documented. There are gaps in our understanding of how risks differ by seafood species and preparation, cooking, and consumption practices. Together, these gaps contribute to a relatively poor understanding of how biotoxins impact the health of those who regularly consume large quantities of seafood. In the context of this uncertainty, we explore how known and potential risks associated with biotoxins can be mitigated, with special attention to coastal Indigenous populations routinely consuming seafood. Overall, we conclude that there is a need to move beyond the single-dose single-outcome model of exposure to better serve Indigenous communities and others who consume high quantities of seafood.
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Affiliation(s)
- Michael Joseph Lee
- Environmental Health Services, British Columbia Centre for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada
| | - Sarah B. Henderson
- Environmental Health Services, British Columbia Centre for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada
| | - Holly Clermont
- Environmental Public Health Services, First Nations Health Authority, Snaw-naw-as Territory, Nanoose Bay, Canada
| | - Nikita Saha Turna
- Environmental Health Services, British Columbia Centre for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada
| | - Lorraine McIntyre
- Environmental Health Services, British Columbia Centre for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada
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Stotz SA, Moore KR, McNulty M, Begay K, Scarton L, Jiang L, Adedoyin I, Brega AG. Evaluation of a Synchronous, Online Diabetes Nutrition Education Program for American Indians and Alaska Natives With Type 2 Diabetes: Facilitators and Participants' Experiences. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:114-124. [PMID: 36764793 DOI: 10.1016/j.jneb.2022.10.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 10/03/2022] [Accepted: 10/31/2022] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To explore the overall experiences of key players involved in a culturally adapted, online, synchronous diabetes nutrition education program across 5 reservation tribal and intertribal urban Indian clinics. METHODS A multimethods design, including postclass surveys with Likert-scale and short-answer questions, was completed after each of the 5 classes. Participants (n = 54) and class facilitators/coordinators (n = 10) completed postclass surveys (n = 189 and 58, respectively). A subset of participants (n = 24) and all class facilitators/coordinators (n = 10) engaged in online focus groups after the conclusion of program implementation. Qualitative thematic methods and frequency distributions were used to analyze the data. RESULTS Most participants reported that the classes were enjoyable (94%), culturally respectful (77%), and easily accessed online (68%). Qualitative themes included (1) class satisfaction, (2) class improvements, (3) preference for class facilitator, and (4) recommendations to improve recruitment and retention. CONCLUSIONS AND IMPLICATIONS These findings will guide program modifications to provide improved diabetes nutrition education for American Indians and Alaska Natives adults with type 2 diabetes.
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Affiliation(s)
- Sarah A Stotz
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO.
| | - Kelly R Moore
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Monica McNulty
- University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Kelli Begay
- Maven Collective Consulting, Albuquerque, NM
| | - Lisa Scarton
- College of Nursing, University of Florida, Gainesville, FL
| | - Luohua Jiang
- Department of Epidemiology and Biostatistics, Susan and Henry Samueli College of Health Sciences, University of California Irvine, Irvine, CA
| | | | - Angela G Brega
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
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Slater M, Bruser G, Sutherland R, Andrew MK, Warry W, Jacklin KM, Walker JD. Wellness in the Face of Frailty Among Older Adults in First Nations Communities. J Aging Health 2022; 34:996-1004. [PMID: 35426332 PMCID: PMC9483700 DOI: 10.1177/08982643221085107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives First Nations people report high levels of wellness despite high rates of chronic illness. Our goal was to understand the factors associated with wellness among First Nations adults in Ontario who were considered frail. Methods Using the First Nations Regional Health Survey, we created a profile of First Nations adults (aged 45+) who were categorized as “frail” (weighted sample size = 8121). We used multivariate logistic regression to determine associations between wellness (as measured by self-reported physical, emotional, mental, and spiritual balance) and determinants of health. Results Rates of reported wellness were high among those who were frail, ranging from 56.7% reporting physical balance to 71.6% reporting mental balance. Three key elements were associated with wellness: the availability of resources, individual lifestyle factors, and cultural connection and identity. Discussion Our findings provide a profile of strength and wellness among older First Nations adults living with frailty.
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Affiliation(s)
- Morgan Slater
- Health Services and Policy Research Institute, Queen’s University, Kingston, ON, Canada
| | - Gabrielle Bruser
- School of Rural and Northern Health, Laurentian University, Sudbury, ON, Canada
| | | | - Melissa K. Andrew
- Department of Medicine (Geriatrics), Dalhousie University, Halifax, NS, Canada
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Wayne Warry
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, USA
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School, Duluth, MN, USA
| | - Kristen M Jacklin
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN, USA
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School, Duluth, MN, USA
| | - Jennifer D. Walker
- School of Rural and Northern Health, Laurentian University, Sudbury, ON, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
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Kai J, Chen JJ, Braun KL, Kaholokula JK, Novotny R, Boushey CJ, Fialkowski MK. Associations between Cultural Identity, Household Membership and Diet Quality among Native Hawaiian, Pacific Islander, and Filipino Infants in Hawai'i. CHILDREN (BASEL, SWITZERLAND) 2022; 9:48. [PMID: 35053673 PMCID: PMC8774442 DOI: 10.3390/children9010048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/18/2021] [Accepted: 12/27/2021] [Indexed: 11/17/2022]
Abstract
Public health efforts to reduce diet-related health disparities experienced by indigenous peoples could be enhanced by efforts to improve complementary infant feeding practices. The latter is possible through interventions informed by cultural determinants. This cross-sectional secondary analysis explored possible determinants of the complementary feeding practices of Native Hawaiian, Pacific Islander, and/or Filipino infants (NHPIF) in Hawai'i, ages 3-12 months. The objective was to determine the association between caregiver cultural identity and infant household membership with indicators of infant diet healthfulness. The cultural identities, infant household memberships, early infant feeding practices and additional demographic information (infant age and sex, household income) were assessed via an online questionnaire. Surrogate reporting of the infants' diets over four days was evaluated using an image-based mobile food record (mFR). Data collected by the mFR were evaluated to derive the World Health Organization's minimum dietary diversity (MDD) indicator and food group consumption. Data were summarized by descriptive statistics and analyzed using multivariate linear and logistic regressions. Seventy infant participants, ages 3-12 months, and their primary caregivers completed the study. Of these, there were 56 infant participants between the age of 6-12 months. Approximately 10% of infants, ages 6-12 months, met MDD for all four days. Meeting MDD and the number of food groups consumed were significantly associated with age. Caregiver cultural identity, infant household membership and infant sex had non-significant associations with indicators of infant diet quality. Findings inform the influences shaping dietary patterns of Native Hawaiian, Pacific Islander and Filipino infants in Hawai'i.
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Affiliation(s)
- Jessie Kai
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaiʻi at Mānoa, 1955 East West Road, AgSci 216, Honolulu, HI 96822, USA; (J.K.); (R.N.)
| | - John J. Chen
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaiʻi at Mānoa, 651 Ilalo Street, MEB Suite 411, Honolulu, HI 96813, USA;
| | - Kathryn L. Braun
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawaiʻi at Mānoa, 1960 East-West Road, Honolulu, HI 96822, USA;
| | - Joseph Keaweʻaimoku Kaholokula
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaiʻi at Mānoa, 677 Ala Moana Blvd., 1016, Honolulu, HI 96813, USA;
| | - Rachel Novotny
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaiʻi at Mānoa, 1955 East West Road, AgSci 216, Honolulu, HI 96822, USA; (J.K.); (R.N.)
| | - Carol J. Boushey
- Nutrition Support Shared Resource, University of Hawaiʻi Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA;
| | - Marie K. Fialkowski
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaiʻi at Mānoa, 1955 East West Road, AgSci 216, Honolulu, HI 96822, USA; (J.K.); (R.N.)
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Batal M, Chan HM, Fediuk K, Ing A, Berti P, Sadik T, Johnson-Down L. Importance of the traditional food systems for First Nations adults living on reserves in Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2021; 112:20-28. [PMID: 34181221 PMCID: PMC8239073 DOI: 10.17269/s41997-020-00353-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 05/04/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To describe the traditional food (TF) systems of First Nations in Canada, including intake, barriers and promoters. METHODS The First Nations Food, Nutrition and Environment Study is a cross-Canada participatory study of First Nations adults below the 60th parallel that obtained data for communities excluded from other national studies. A food frequency questionnaire was used to establish frequency of TF intake (number of days in a year) to allow comparisons across ecozones/regions in Canada. Grams of TF intake were also calculated using frequency multiplied by average portions from 24-h recalls. Closed- and open-ended questions attempted to identify some of the key barriers and concerns regarding TF access and use. Multivariable analyses were run to determine what factors are associated with increased TF consumption. RESULTS Across communities, there is a strong preference by adults to have TF in the diet more often. Consumption of land animals was most frequently reported in most ecozones except for the Pacific Maritime and Mixedwood Plains, where fish and plants, respectively, were more frequently consumed. First Nations identified structural and environmental challenges such as development, government regulations and climate change, along with household barriers such as insufficient capital for equipment and transportation, lack of time and absence of a hunter in the household. Multivariable analyses revealed that the highest intake of TF occurred in the Taiga Plains ecozone, and for older individuals and men. CONCLUSION Identifying solutions that empower First Nations at all levels is required to overcome the multiple challenges to the inclusion of TF in the diet.
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Affiliation(s)
- Malek Batal
- Département de nutrition, Faculté de Médecine, Université de Montréal, Pavillon Liliane de Stewart, CP 6128 succ. Centre-Ville, Montréal, QC, H3T 1A8, Canada.
- Centre de recherche en santé publique de l'Université de Montréal et du CIUSS du Centre-sud-de-l'Île-de-Montréal (CReSP), 7101 Avenue du Parc, Montréal, QC, H3N 1X7, Canada.
| | - Hing Man Chan
- Department of Biology, University of Ottawa, 30 Marie Curie, Ottawa, ON, K1N 6N5, Canada
| | - Karen Fediuk
- First Nations Food, Nutrition and Environment Study, University of Ottawa, 30 Marie Curie, Ottawa, ON, K1N 6N5, Canada
| | - Amy Ing
- Département de nutrition, Faculté de Médecine, Université de Montréal, Pavillon Liliane de Stewart, CP 6128 succ. Centre-Ville, Montréal, QC, H3T 1A8, Canada
| | - Peter Berti
- HealthBridge Foundation of Canada, 1 Nicholas Street, Suite 1004, Ottawa, ON, K1N 7B7, Canada
| | - Tonio Sadik
- Assembly of First Nations, 55 Metcalfe Street, Suite 1600, Ottawa, ON, K1P 6L5, Canada
| | - Louise Johnson-Down
- Département de nutrition, Faculté de Médecine, Université de Montréal, Pavillon Liliane de Stewart, CP 6128 succ. Centre-Ville, Montréal, QC, H3T 1A8, Canada
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Domingo A, Spiegel J, Guhn M, Wittman H, Ing A, Sadik T, Fediuk K, Tikhonov C, Schwartz H, Chan HM, Batal M. Predictors of household food insecurity and relationship with obesity in First Nations communities in British Columbia, Manitoba, Alberta and Ontario. Public Health Nutr 2021; 24:1021-1033. [PMID: 32366338 PMCID: PMC8025097 DOI: 10.1017/s1368980019004889] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 10/20/2019] [Accepted: 11/21/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To further understandings of household food insecurity in First Nations communities in Canada and its relationship with obesity. DESIGN Analysis of a cross-sectional dataset from the First Nations Food, Nutrition and Environment Study representative of First Nations communities south of the 60th parallel. Multivariate logistic regression was used to assess associations between food insecurity and sociodemographic factors, as well as the odds of obesity among food-insecure households adjusting for sociodemographic characteristics. SETTING Western and Central Canada. PARTICIPANTS First Nations peoples aged ≥19 years. RESULTS Forty-six percent of First Nations households experienced food insecurity. Food insecurity was highest for respondents who received social assistance; had ≤10 years of education; were female; had children in the household; were 19-30 years old; resided in Alberta; and had no year-round road access into the community. Rates of obesity were highest for respondents residing in marginally food-insecure households (female 56·6 %; male 54·6 %). In gender-specific analyses, the odds of obesity were highest among marginally food-insecure households in comparison with food-secure households, for both female (OR 1·57) and male (OR 1·57) respondents, adjusting for sociodemographic variables. For males only, those in severely food-insecure (compared with food-secure) households had lower odds of obesity after adjusting for confounding (OR 0·56). CONCLUSIONS The interrelated challenges of food insecurity and obesity in First Nations communities emphasise the need for Indigenous-led, culturally appropriate and food sovereign approaches to food security and nutrition in support of holistic wellness and prevention of chronic disease.
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Affiliation(s)
- Ashleigh Domingo
- Faculty of Applied Health Sciences, School of Public Health and Health Systems, University of Waterloo, Waterloo, ONN2L 3G1, Canada
- Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BCV6T 1Z3, Canada
| | - Jerry Spiegel
- Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BCV6T 1Z3, Canada
| | - Martin Guhn
- Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BCV6T 1Z3, Canada
| | - Hannah Wittman
- Faculty of Land and Food Systems, Centre for Sustainable Food Systems, University of British Columbia, Vancouver, BCV6T 1Z4, Canada
| | - Amy Ing
- Département de Nutrition, Faculté de Médecine, Université de Montréal, Montréal, QCH3T 1A8, Canada
| | - Tonio Sadik
- Environment, Assembly of First Nations, Ottawa, ONK1P 6L5, Canada
- School of Sociological and Anthropological Studies, University of Ottawa, Ottawa, ONK1N 6N5, Canada
| | - Karen Fediuk
- First Nations Food, Nutrition and Environment Study, University of Ottawa, Ottawa, ON, Canada
| | - Constantine Tikhonov
- Environmental Public Health Division, First Nations and Inuit Health Branch, Indigenous Services Canada, Ottawa, ON, Canada
| | - Harold Schwartz
- Environmental Public Health Division, First Nations and Inuit Health Branch, Indigenous Services Canada, Ottawa, ON, Canada
| | - Hing Man Chan
- Department of Biology, University of Ottawa, Ottawa, ONK1N 6N5, Canada
| | - Malek Batal
- Département de Nutrition, Faculté de Médecine, Université de Montréal, Montréal, QCH3T 1A8, Canada
- Centre de recherche en santé publique (CReSP), 7101 Avenue du Parc, Montreal, QCH3N 1X7, Canada
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Rosella LC, Kornas K, Green ME, Shah BR, Walker JD, Frymire E, Jones C. Characterizing risk of type 2 diabetes in First Nations people living in First Nations communities in Ontario: a population-based analysis using cross-sectional survey data. CMAJ Open 2020; 8:E178-E183. [PMID: 32184281 PMCID: PMC7082110 DOI: 10.9778/cmajo.20190210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Population-based planning tools are important for informing diabetes-prevention efforts in First Nations communities. We used the Diabetes Population Risk Tool (DPoRT) to predict 10-year diabetes risk and describe the factors that contribute to diabetes risk in First Nations adults living in Ontario First Nations communities. METHODS We examined population data from adult (≥ 20 yr) respondents to the First Nations Regional Health Survey (RHS) phase 3, a representative cohort of First Nations people living in Ontario First Nations communities. We applied the DPoRT to risk factor information in the survey to predict the distribution of 10-year type 2 diabetes incidence and number of new diabetes cases from 2015/16 to 2025/26. RESULTS There were 993 respondents to the RHS phase 3 adult survey, of whom 936 (708 without diabetes and 228 with a diagnosis of type 2 diabetes) were eligible for inclusion. The DPoRT predicted a type 2 diabetes risk of 9.6% (confidence interval [CI] 8.3-10.8) between 2015/16 and 2025/26, corresponding to 3501 (95% CI 2653-4348) new diabetes cases. Diabetes cases were predicted to occur disproportionately among those experiencing food insecurity, low income, overweight, obesity and physical inactivity. Reduced diabetes risk was predicted among those who reported connections to Indigenous culture, as measured by eating traditional vegetative foods a few times or often in the previous 12 months. INTERPRETATION Socioeconomic conditions and known risk factors for type 2 diabetes are important determinants of diabetes risk in First Nations communities. Culturally appropriate policies, programming and services that address socioeconomic disadvantage and other diabetes risk factors in First Nations communities likely have an important role for diabetes prevention in First Nations adults.
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Affiliation(s)
- Laura C Rosella
- Dalla Lana School of Public Health (Rosella, Kornas), University of Toronto; ICES Central (Rosella, Shah, Walker), Toronto, Ont.; ICES Queen's (Green, Frymire), Department of Family Medicine (Green) and Faculty of Health Sciences (Frymire), Queen's University, Kingston, Ont.; Sunnybrook Research Institute (Shah), Toronto, Ont.; Centre for Rural and Health Research (Walker), Laurentian University, Sudbury, Ont.; Chiefs of Ontario (Jones), Toronto, Ont.
| | - Kathy Kornas
- Dalla Lana School of Public Health (Rosella, Kornas), University of Toronto; ICES Central (Rosella, Shah, Walker), Toronto, Ont.; ICES Queen's (Green, Frymire), Department of Family Medicine (Green) and Faculty of Health Sciences (Frymire), Queen's University, Kingston, Ont.; Sunnybrook Research Institute (Shah), Toronto, Ont.; Centre for Rural and Health Research (Walker), Laurentian University, Sudbury, Ont.; Chiefs of Ontario (Jones), Toronto, Ont
| | - Michael E Green
- Dalla Lana School of Public Health (Rosella, Kornas), University of Toronto; ICES Central (Rosella, Shah, Walker), Toronto, Ont.; ICES Queen's (Green, Frymire), Department of Family Medicine (Green) and Faculty of Health Sciences (Frymire), Queen's University, Kingston, Ont.; Sunnybrook Research Institute (Shah), Toronto, Ont.; Centre for Rural and Health Research (Walker), Laurentian University, Sudbury, Ont.; Chiefs of Ontario (Jones), Toronto, Ont
| | - Baiju R Shah
- Dalla Lana School of Public Health (Rosella, Kornas), University of Toronto; ICES Central (Rosella, Shah, Walker), Toronto, Ont.; ICES Queen's (Green, Frymire), Department of Family Medicine (Green) and Faculty of Health Sciences (Frymire), Queen's University, Kingston, Ont.; Sunnybrook Research Institute (Shah), Toronto, Ont.; Centre for Rural and Health Research (Walker), Laurentian University, Sudbury, Ont.; Chiefs of Ontario (Jones), Toronto, Ont
| | - Jennifer D Walker
- Dalla Lana School of Public Health (Rosella, Kornas), University of Toronto; ICES Central (Rosella, Shah, Walker), Toronto, Ont.; ICES Queen's (Green, Frymire), Department of Family Medicine (Green) and Faculty of Health Sciences (Frymire), Queen's University, Kingston, Ont.; Sunnybrook Research Institute (Shah), Toronto, Ont.; Centre for Rural and Health Research (Walker), Laurentian University, Sudbury, Ont.; Chiefs of Ontario (Jones), Toronto, Ont
| | - Eliot Frymire
- Dalla Lana School of Public Health (Rosella, Kornas), University of Toronto; ICES Central (Rosella, Shah, Walker), Toronto, Ont.; ICES Queen's (Green, Frymire), Department of Family Medicine (Green) and Faculty of Health Sciences (Frymire), Queen's University, Kingston, Ont.; Sunnybrook Research Institute (Shah), Toronto, Ont.; Centre for Rural and Health Research (Walker), Laurentian University, Sudbury, Ont.; Chiefs of Ontario (Jones), Toronto, Ont
| | - Carmen Jones
- Dalla Lana School of Public Health (Rosella, Kornas), University of Toronto; ICES Central (Rosella, Shah, Walker), Toronto, Ont.; ICES Queen's (Green, Frymire), Department of Family Medicine (Green) and Faculty of Health Sciences (Frymire), Queen's University, Kingston, Ont.; Sunnybrook Research Institute (Shah), Toronto, Ont.; Centre for Rural and Health Research (Walker), Laurentian University, Sudbury, Ont.; Chiefs of Ontario (Jones), Toronto, Ont
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Leibovitch Randazzo M, Robidoux MA. The costs of local food procurement in a Northern Canadian First Nation community: an affordable strategy to food security? JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2018. [DOI: 10.1080/19320248.2018.1464998] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
| | - Michael A. Robidoux
- Indigenous Health Research Group, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Kulhawy-Wibe S, King-Shier KM, Barnabe C, Manns BJ, Hemmelgarn BR, Campbell DJT. Exploring structural barriers to diabetes self-management in Alberta First Nations communities. Diabetol Metab Syndr 2018; 10:87. [PMID: 30524507 PMCID: PMC6276258 DOI: 10.1186/s13098-018-0385-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 11/09/2018] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Type 2 diabetes is highly prevalent in Canadian First Nations (FN) communities. FN individuals with diabetes are less likely to receive guideline recommended care and access specialist care. They are also less likely to be able to engage in optimal self-management behaviours. While the systemic and racial contributors to this problem have been well described, individuals' experiences with structural barriers to care and self-management remain under-characterized. METHODS We utilized qualitative methods to gain insight into the structural barriers to self-management experienced by FN individuals with diabetes. We conducted a qualitative descriptive analysis of a subcohort of patients with diabetes from FN communities (n = 5) from a larger qualitative study. Using detailed semi-structured telephone interviews, we inquired about participants' diabetes and barriers to diabetes self-management. Inductive thematic analysis was performed in duplicate using NVivo 10. RESULTS The structural barriers faced by this population were substantial yet distinct from those described by non-FN individuals with diabetes. For example, medication costs, which are usually cited as a barrier to care, are covered for FN persons with status. The barriers to diabetes self-management that were commonly experienced in this cohort included transportation-related difficulties, financial barriers to uninsured health services, and lack of accessible diabetes education and resultant knowledge gaps. CONCLUSIONS FN Albertans with diabetes face a myriad of barriers to self-management, which are distinct from the Non-FN population. In addition to the barriers introduced by colonialism and historical injustices, finances, geographic isolation, and lack of diabetes education each impede optimal management of diabetes. Programs targeted at addressing FN-specific barriers may improve aspects of diabetes self-management in this population.
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Affiliation(s)
- Stephanie Kulhawy-Wibe
- Department of Medicine, Cumming School of Medicine, University of Calgary, North Tower, 9th Floor, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
| | - Kathryn M. King-Shier
- Department of Community Health Sciences, Cumming School of Medicine, O’Brien Institute for Public Health, Libin Cardiovascular Institute of Alberta, Faculty of Nursing, University of Calgary, TRW 3rd Floor, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
| | - Cheryl Barnabe
- Departments of Medicine and Community Health Sciences, Cumming School of Medicine, O’Brien Institute for Public Health, Libin Cardiovascular Institute of Alberta, University of Calgary, North Tower, 9th Floor, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
| | - Braden J. Manns
- Departments of Medicine and Community Health Sciences, Cumming School of Medicine, O’Brien Institute for Public Health, Libin Cardiovascular Institute of Alberta, University of Calgary, North Tower, 9th Floor, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
| | - Brenda R. Hemmelgarn
- Departments of Medicine and Community Health Sciences, Cumming School of Medicine, O’Brien Institute for Public Health, Libin Cardiovascular Institute of Alberta, University of Calgary, North Tower, 9th Floor, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
| | - David J. T. Campbell
- Department of Medicine, Cumming School of Medicine, University of Calgary, 1820 Richmond Road SW, Calgary, AB T2N 4N1 Canada
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Moffitt P, Dickinson R. Creating exclusive breastfeeding knowledge translation tools with First Nations mothers in Northwest Territories, Canada. Int J Circumpolar Health 2016; 75:32989. [PMID: 27938644 PMCID: PMC5149661 DOI: 10.3402/ijch.v75.32989] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 07/27/2016] [Accepted: 09/29/2016] [Indexed: 12/03/2022] Open
Abstract
Background Breastfeeding is an ideal method of infant feeding affecting lifelong health, and yet the uptake of breastfeeding in some Indigenous communities in Canada's north is low. Objective The aims of this project were to determine the rate and determinants of exclusive breastfeeding in a remote community in the Northwest Territories and to create knowledge translation tools to enhance breastfeeding locally. Methods The study methodology followed three steps. Firstly, a series of retrospective chart audits were conducted from hospital birth records of Tłı̨chǫ women (n=198) who gave birth during the period of 1 January 2010 to 31 December 2012. A second follow-up chart audit determined the rate of exclusive breastfeeding and was conducted in the local Community Health Centre. Chart audit data included the following factors related to breastfeeding: age of mother, parity, birthweight and Apgar scores. Secondly, semi-structured interviews with a purposive sample of Tłı̨chǫ mothers (n=8) and one Elder were conducted to identify breastfeeding practices, beliefs and the most appropriate medium to use to deliver health messages in Tłı̨chǫ. Third, based on the information obtained in Step 2, two knowledge translation tools were developed in collaboration with a local community Advisory Committee. Results The rate of exclusive breastfeeding initiation in the Tłı̨chǫ region is less than 30%. Physiological and demographic factors related to breastfeeding were identified. Thematic analysis revealed two overarching themes from the data, namely, “the pull to formula” (lifestyle preferences, drug and alcohol use, supplementation practices and limited role models) and “the pull to breast feeding” (traditional feeding method, spiritual practice and increased bonding with infant). Conclusion There are a myriad of influences on breastfeeding for women living in remote locations. Ultimately, society informs the choice of infant feeding for the new mother, since mothers’ feeding choices are based on contextual realities and circumstances in their lives that are out of their control. As health care providers, it is imperative that we recognize the realities of women's lives and the overlapping social determinants of health that may limit a mother's ability or choice to breastfeed. Further health promotion efforts, grounded in community-based research and a social determinants framework, are needed to improve prenatal and postnatal care of Indigenous women and children in Canada.
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Affiliation(s)
- Pertice Moffitt
- Health Research Programs, Aurora Research Institute, Aurora College, Yellowknife, NWT, Canada;
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Bordeleau S, Asselin H, Mazerolle MJ, Imbeau L. "Is it still safe to eat traditional food?" Addressing traditional food safety concerns in aboriginal communities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 565:529-538. [PMID: 27196990 DOI: 10.1016/j.scitotenv.2016.04.189] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 04/26/2016] [Accepted: 04/28/2016] [Indexed: 06/05/2023]
Abstract
Food insecurity is a growing concern for indigenous communities worldwide. While the risk of heavy metal contamination associated to wild food consumption has been extensively studied in the Arctic, data are scarce for the Boreal zone. This study addressed the concerns over possible heavy metal exposure through consumption of traditional food in four Anishnaabeg communities living in the Eastern North American boreal forest. Liver and meat samples were obtained from 196 snowshoe hares (Lepus americanus) trapped during winter 2012 across the traditional lands of the participating communities and within 56-156km of a copper smelter. Interviews were conducted with 78 household heads to assess traditional food habits, focusing on snowshoe hare consumption. Concentrations in most meat and liver samples were below the detection limit for As, Co, Cr, Ni and Pb. Very few meat samples had detectable Cd and Hg concentrations, but liver samples had mean dry weight concentrations of 3.79mg/kg and 0.15mg/kg respectively. Distance and orientation from the smelter did not explain the variability between samples, but percent deciduous and mixed forest cover had a marginal negative effect on liver Cd, Cu and Zn concentrations. The estimated exposition risk from snowshoe hare consumption was low, although heavy consumers could slightly exceed recommended Hg doses. In accordance with the holistic perspective commonly adopted by indigenous people, the nutritional and sociocultural importance of traditional food must be considered in risk assessment. Traditional food plays a significant role in reducing and preventing serious health issues disproportionately affecting First Nations, such as obesity, diabetes, and cardiovascular diseases.
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Affiliation(s)
- Serge Bordeleau
- Chaire de Recherche du Canada en Foresterie Autochtone, Université du Québec en Abitibi-Témiscamingue, 445 boul. de l'Université, Rouyn-Noranda, Québec J9X 5E4, Canada; Chaire Industrielle CRSNG-UQAT-UQÀM en Aménagement Forestier Durable, Université du Québec en Abitibi-Témiscamingue, 445 boul. de l'Université, Rouyn-Noranda, Québec J9X 5E4, Canada.
| | - Hugo Asselin
- Chaire de Recherche du Canada en Foresterie Autochtone, Université du Québec en Abitibi-Témiscamingue, 445 boul. de l'Université, Rouyn-Noranda, Québec J9X 5E4, Canada; Chaire Industrielle CRSNG-UQAT-UQÀM en Aménagement Forestier Durable, Université du Québec en Abitibi-Témiscamingue, 445 boul. de l'Université, Rouyn-Noranda, Québec J9X 5E4, Canada.
| | - Marc J Mazerolle
- Chaire Industrielle CRSNG-UQAT-UQÀM en Aménagement Forestier Durable, Université du Québec en Abitibi-Témiscamingue, 445 boul. de l'Université, Rouyn-Noranda, Québec J9X 5E4, Canada.
| | - Louis Imbeau
- Chaire Industrielle CRSNG-UQAT-UQÀM en Aménagement Forestier Durable, Université du Québec en Abitibi-Témiscamingue, 445 boul. de l'Université, Rouyn-Noranda, Québec J9X 5E4, Canada.
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Gates A, Hanning RM, Gates M, Tsuji LJS. The Food and Nutrient Intakes of First Nations Youth Living in Northern Ontario, Canada: Evaluation of a Harvest Sharing Program. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2016. [DOI: 10.1080/19320248.2016.1157552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Eating in the City: A Review of the Literature on Food Insecurity and Indigenous People Living in Urban Spaces. SOCIETIES 2016. [DOI: 10.3390/soc6020007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bhawra J, Cooke MJ, Hanning R, Wilk P, Gonneville SLH. Community perspectives on food insecurity and obesity: Focus groups with caregivers of metis and Off-reserve first nations children. Int J Equity Health 2015; 14:96. [PMID: 26475264 PMCID: PMC4609156 DOI: 10.1186/s12939-015-0232-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 10/05/2015] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Aboriginal children in Canada are at a higher risk for overweight and obesity than other Canadian children. In Northern and remote areas, this has been linked to a lack of affordable nutritious food. However, the majority of Aboriginal children live in urban areas where food choices are more plentiful. This study aimed to explore the experiences of food insecurity among Métis and First Nations parents living in urban areas, including the predictors and perceived connections between food insecurity and obesity among Aboriginal children. METHODS Factors influencing children's diets, families' experiences with food insecurity, and coping strategies were explored using focus group discussions with 32 parents and caregivers of Métis and off-reserve First Nations children from Midland-Penetanguishene and London, Ontario. Four focus groups were conducted and transcribed verbatim between July 2011 and March 2013. A thematic analysis was conducted using NVivo software, and second coders ensured reliability of the results. RESULTS Caregivers identified low income as an underlying cause of food insecurity within their communities and as contributing to poor nutrition among their children. Families reported a reliance on energy-dense, nutrient-poor foods, as these tended to be more affordable and lasted longer than more nutritious, fresh food options. A lack of transportation also compromised families' ability to purchase healthful food. Aboriginal caregivers also mentioned a lack of access to traditional foods. Coping strategies such as food banks and community programming were not always seen as effective. In fact, some were reported as potentially exacerbating the problem of overweight and obesity among First Nations and Métis children. CONCLUSION Food insecurity manifested itself in different ways, and coping strategies were often insufficient for addressing the lack of fruit and vegetable consumption in Aboriginal children's diets. Results suggest that obesity prevention strategies should take a family-targeted approach that considers the unique barriers facing urban Aboriginal populations. This study also reinforces the importance of low income as an important risk factor for obesity among Aboriginal peoples.
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Affiliation(s)
- Jasmin Bhawra
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
| | - Martin J Cooke
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada. .,Department of Sociology and Legal Studies, University of Waterloo, Waterloo, ON, Canada.
| | - Rhona Hanning
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
| | - Piotr Wilk
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
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Heidelberger LA, Smith C. A Child’s Viewpoint: Determinants of Food Choice and Definition of Health in Low-Income 8- to 13-Year-Old Children in Urban Minnesota Communities. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2014. [DOI: 10.1080/19320248.2014.929547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Association of red blood cell n-3 polyunsaturated fatty acids with plasma inflammatory biomarkers among the Quebec Cree population. Eur J Clin Nutr 2014; 68:1042-7. [PMID: 25028086 DOI: 10.1038/ejcn.2014.125] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 05/13/2014] [Accepted: 05/26/2014] [Indexed: 01/20/2023]
Abstract
BACKGROUND/OBJECTIVES We examined the prevalence of elevated plasma high-sensitivity C-reactive protein (hs-CRP) concentrations and associations with red blood cell (RBC) long-chain n-3 polyunsaturated fatty acids (LCn-3PUFA) in the James Bay Cree population from the province of Quebec (Canada). SUBJECTS/METHODS A total of 744 Cree adults (18-91 years) from seven communities of Eastern James Bay were included in these cross-sectional analyses. Associations between RBC LCn-3PUFA and proinflammatory markers (hs-CRP, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α)) were assessed by using multivariate general linear models with adjustment for sex, age and waist circumference. An arbitrary inflammation score was defined based on the sum of the quartiles of hs-CRP, IL-6 and TNF-α concentrations (range=3-12). RESULTS Elevated hs-CRP concentrations (>3 mg/l) were present in 46.9% (95% confidence interval (CI) 43.3-50.5) of the James Bay Cree population. RBC docosapentaenoic acid (DPAn-3; C22:5n-3) was inversely associated with hs-CRP, TNF-α and the inflammation score (all P trend<0.02), whereas eicosapentaenoic acid (C20:5n-3) and docosahexaenoic acid (C22:6n-3) in RBC were not associated with inflammation (all P trend>0.18). Among participants with RBC DPAn-3 levels above the median of the population, odds ratio of having an elevated inflammation score (≥9) was 0.67 (95% CI, 0.48-0.93) compared with participants below the median. CONCLUSIONS RESULTS indicate that low-grade systemic inflammation is highly prevalent and that higher RBC DPAn-3 levels are associated with a lower risk of systemic inflammation in the James Bay Cree population.
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Is hunting still healthy? Understanding the interrelationships between indigenous participation in land-based practices and human-environmental health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:5751-82. [PMID: 24879487 PMCID: PMC4078546 DOI: 10.3390/ijerph110605751] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 05/05/2014] [Accepted: 05/13/2014] [Indexed: 11/16/2022]
Abstract
Indigenous participation in land-based practices such as hunting, fishing, ceremony, and land care has a long history. In recent years, researchers and policy makers have advocated the benefits of these practices for both Indigenous people and the places they live. However, there have also been documented risks associated with participation in these activities. Environmental change brought about by shifts in land use, climate changes, and the accumulation of contaminants in the food chain sit alongside equally rapid shifts in social, economic and cultural circumstances, preferences and practices. To date, the literature has not offered a wide-ranging review of the available cross-disciplinary or cross-ecozone evidence for these intersecting benefits and risks, for both human and environmental health and wellbeing. By utilising hunting as a case study, this paper seeks to fill part of that gap through a transdisciplinary meta-analysis of the international literature exploring the ways in which Indigenous participation in land-based practices and human-environmental health have been studied, where the current gaps are, and how these findings could be used to inform research and policy. The result is an intriguing summary of disparate research that highlights the patchwork of contradictory understandings, and uneven regional emphasis, that have been documented. A new model was subsequently developed that facilitates a more in-depth consideration of these complex issues within local-global scale considerations. These findings challenge the bounded disciplinary and geographic spaces in which much of this work has occurred to date, and opens a dialogue to consider the importance of approaching these issues holistically.
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Gates A, Skinner K, Gates M. The diets of school-aged Aboriginal youths in Canada: a systematic review of the literature. J Hum Nutr Diet 2014; 28:246-61. [DOI: 10.1111/jhn.12246] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- A. Gates
- School of Public Health & Health Systems; University of Waterloo; Waterloo ON Canada
| | - K. Skinner
- Faculty of Health & Behavioural Sciences; Lakehead University; Thunder Bay ON Canada
| | - M. Gates
- School of Public Health & Health Systems; University of Waterloo; Waterloo ON Canada
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Seabert TA, Pal S, Pinet BM, Haman F, Robidoux MA, Imbeault P, Krümmel EM, Kimpe LE, Blais JM. Elevated contaminants contrasted with potential benefits of ω-3 fatty acids in wild food consumers of two remote first nations communities in northern Ontario, Canada. PLoS One 2014; 9:e90351. [PMID: 24598815 PMCID: PMC3943865 DOI: 10.1371/journal.pone.0090351] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 01/29/2014] [Indexed: 11/18/2022] Open
Abstract
Indigenous communities in Boreal environments rely on locally-harvested wild foods for sustenance. These foods provide many nutritional benefits including higher levels of polyunsaturated fatty acids (PUFAs; such as ω-3) than what is commonly found in store-bought foods. However, wild foods can be a route of exposure to dietary mercury and persistent organic pollutants (POPs) such as polychlorinated biphenyls (PCBs). Here, we show a strong association between the frequency of wild food consumption in adults (N = 72) from two remote First Nations communities of Northern Ontario and environmental contaminants in blood (POPs) and hair (mercury). We observed that POPs and mercury were on average 3.5 times higher among those consuming wild foods more often, with many frequent wild food consumers exceeding Canadian and international health guidelines for PCB and mercury exposures. Contaminants in locally-harvested fish and game from these communities were sufficiently high that many participants exceeded the monthly consumption limits for methylmercury and PCBs. Those consuming more wild foods also had higher proportions of potentially beneficial ω-3 fatty acids including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). These results show that the benefits of traditional dietary choices in Boreal regions of Canada must be weighed against the inherent risks of contaminant exposure from these foods.
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Affiliation(s)
| | - Shinjini Pal
- Department of Biology, University of Ottawa, Ontario, Canada
| | - Bernard M. Pinet
- Indigenous Health Research Group, University of Ottawa, Ottawa, Ontario, Canada
| | - Francois Haman
- Indigenous Health Research Group, University of Ottawa, Ottawa, Ontario, Canada
| | - Michael A. Robidoux
- Indigenous Health Research Group, University of Ottawa, Ottawa, Ontario, Canada
| | - Pascal Imbeault
- Behavioural and Metabolic Research Unit, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Eva M. Krümmel
- Department of Biology, University of Ottawa, Ontario, Canada
| | - Linda E. Kimpe
- Department of Biology, University of Ottawa, Ontario, Canada
| | - Jules M. Blais
- Department of Biology, University of Ottawa, Ontario, Canada
- * E-mail:
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Myre M, Imbeault P. Persistent organic pollutants meet adipose tissue hypoxia: does cross-talk contribute to inflammation during obesity? Obes Rev 2014; 15:19-28. [PMID: 23998203 DOI: 10.1111/obr.12086] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 07/08/2013] [Accepted: 08/04/2013] [Indexed: 01/15/2023]
Abstract
Lipophilic persistent organic pollutants (POPs) accumulate in lipid-rich tissues such as human adipose tissue. This is particularly problematic in individuals with excess adiposity, a physiological state that may be additionally characterized by local adipose tissue hypoxia. Hypoxic patches occur when oxygen diffusion is insufficient to reach all hypertrophic adipocytes. POPs and hypoxia independently contribute to the development of adipose tissue-specific and systemic inflammation often associated with obesity. Inflammation is induced by increased proinflammatory mediators such as tumour necrosis factor-alpha, interleukin-6, and monocyte chemotactic protein-1, as well as reduced adiponectin release, an anti-inflammatory and insulin-sensitizing adipokine. The aryl hydrocarbon receptor (AhR) mediates the cellular response to some pollutants, while hypoxia responses occur through the oxygen-sensitive transcription factor hypoxia-inducible factor (HIF)-1. There is some overlap between the two signalling pathways since both require a common subunit called the AhR nuclear translocator. As such, it is unclear how adipocytes respond to simultaneous POP and hypoxia exposure. This brief review explores the independent contribution of POPs and adipose tissue hypoxia as factors underlying the inflammatory response from adipocytes during obesity. It also highlights that the combined effect of POPs and hypoxia through the AhR and HIF-1 signalling pathways remains to be tested.
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Affiliation(s)
- M Myre
- Behavioral and Metabolic Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Dietary practices in isolated First Nations communities of northern Canada: combined isotopic and lipid markers provide a good qualitative assessment of store-bought vs locally harvested foods consumption. Nutr Diabetes 2013; 3:e92. [PMID: 24145576 PMCID: PMC3817348 DOI: 10.1038/nutd.2013.34] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 07/26/2013] [Accepted: 09/08/2013] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE: In First Nations communities of northwestern Ontario, where rates of type 2 diabetes mellitus are some of the highest in the world, ascertaining wild food dietary practices is extremely challenging owing to seasonal availability, environmental factors, life circumstances and language/cultural barriers. The purpose of this study was to determine whether analysis of isotopic and fatty acid (FA) profiles could provide more comprehensive information to discriminate between three categories of wild food consumption (that is, plants and animals) in two isolated First Nations communities of northwestern Ontario. In addition, this analysis also highlights whether wild food consumption as practiced in these two communities can increase circulating levels of polyunsaturated FAs (PUFAs), which provide a number of important metabolic benefits that could impact the prevention/treatment of T2DM. RESULTS: 13C enrichment (in expired CO2, plasma and hair), 15N enrichment (in hair) and FA profiles in plasma phospholipids (phospholipid fatty acid (PL-FA)) were quantified in men and in women consuming various amounts of wild food. 13C/12C ratios were lower and 15N/14N ratios were higher in participants consuming wild food at least once a week. In addition, FA results indicated that the relative contributions of 20:4 Ω-6 and 22:6 Ω-3 to total PL-FAs were higher and 18:2 Ω-6 lower in wild food consumers. CONCLUSION: Together, these findings confirm that isotopic and lipid markers discriminate between the different wild food categories in these two First Nations communities. Knowing the close relationship between dietary intake and the potential role of PUFA in the prevention/treatment of obesity and obesity-related diseases, it is critical to accurately measure the composition of diet for individuals in their specific environments.
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The association of type 2 diabetes and insulin resistance/secretion with persistent organic pollutants in two First Nations communities in northern Ontario. DIABETES & METABOLISM 2013; 39:497-504. [PMID: 23639570 DOI: 10.1016/j.diabet.2013.01.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 01/11/2013] [Accepted: 01/11/2013] [Indexed: 01/04/2023]
Abstract
AIMS Recent evidence suggests an association between persistent organic pollutants (POPs) and type 2 diabetes. In two First Nations communities where wild food is consumed by a large portion of the population, we compared pollutants in plasma between diabetic and non-diabetic individuals, and investigated the strength of association between pollutants and insulin resistance/secretion in non-diabetic individuals. METHODS The study population consisted of 72 participants. Oral Glucose Tolerance Tests were used to assess diabetes status. Plasma was used to determine POP concentrations and mercury concentrations were determined from hair samples. RESULTS Age-adjusted plasma concentrations of some pollutants were significantly higher in diabetic than in non-diabetic individuals. When taking into account age, adiposity levels, and smoking status, POP levels were not associated with insulin resistance nor with insulin secretion in non-diabetic individuals. CONCLUSIONS These findings confirm that POP concentrations in plasma may be higher in diabetic than in non-diabetic individuals. No association was however seen between POP concentrations and markers of insulin resistance/secretion in non-diabetic individuals.
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Pal S, Haman F, Robidoux MA. The Costs of Local Food Procurement in Two Northern Indigenous Communities in Canada. FOOD AND FOODWAYS 2013. [DOI: 10.1080/07409710.2013.792193] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Using exploratory factor analysis of FFQ data to identify dietary patterns among Yup'ik people. Public Health Nutr 2013; 17:510-8. [PMID: 23290469 DOI: 10.1017/s1368980012005411] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE An FFQ developed by the Center for Alaska Native Health Research for studies in Yup'ik people includes market foods and subsistence foods such as moose, seal, waterfowl and salmon that may be related to disease risk. Because the FFQ contains >100 food items, we sought to characterize dietary patterns more simply for use in ongoing pharmacogenomics studies. DESIGN Exploratory factor analysis was used to derive a small number of 'factors' that explain a substantial amount of the variation in the Yup'ik diet. We estimated factor scores and measured associations with demographic characteristics and biomarkers. SETTING South-west Alaska, USA. SUBJECTS Yup'ik people (n 358) aged ≥18 years. RESULTS We identified three factors that each accounted for ≥10 % of the common variance: the first characterized by 'processed foods' (e.g. salty snacks, sweetened cereals); the second by 'fruits and vegetables' (e.g. fresh citrus, potato salad); and the third by 'subsistence foods' (seal or walrus soup, non-oily fish). Participants from coastal communities had higher values for the 'subsistence' factor, whereas participants from inland communities had higher values for the 'fruits and vegetables' factor. A biomarker of marine intake, δ 15N, was correlated with the 'subsistence' factor, whereas a biomarker of corn- and sugarcane-based market food intake, δ 13C, was correlated with 'processed foods'. CONCLUSIONS The exploratory factor analysis identified three factors that appeared to reflect dietary patterns among Yup'ik based on associations with participant characteristics and biomarkers. These factors will be useful for chronic disease studies in this population.
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Imbeault P, Findlay CS, Robidoux MA, Haman F, Blais JM, Tremblay A, Springthorpe S, Pal S, Seabert T, Krümmel EM, Maal-Bared R, Tetro JA, Pandey S, Sattar SA, Filion LG. Dysregulation of cytokine response in Canadian First Nations communities: is there an association with persistent organic pollutant levels? PLoS One 2012; 7:e39931. [PMID: 22768323 PMCID: PMC3388062 DOI: 10.1371/journal.pone.0039931] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Accepted: 05/29/2012] [Indexed: 12/21/2022] Open
Abstract
In vitro and animal studies report that some persistent organic pollutants (POPs) trigger the secretion of proinflammatory cytokines. Whether POP exposure is associated with a dysregulation of cytokine response remains to be investigated in humans. We studied the strength of association between plasma POP levels and circulating cytokines as immune activation markers. Plasma levels of fourteen POPs and thirteen cytokines were measured in 39 Caucasians from a comparator sample in Québec City (Canada) and 72 First Nations individuals from two northern communities of Ontario (Canada). Caucasians showed significantly higher levels of organochlorine insecticides (β-HCH, p,p'-DDE and HCB) compared to First Nations. Conversely, First Nations showed higher levels of Mirex, Aroclor 1260, PCB 153, PCB 170, PCB 180 and PCB 187 compared to Caucasians. While there was no difference in cytokine levels of IL-4, IL-6, IL-10 and IL-22 between groups, First Nations had significantly greater average levels of IFNγ, IL-1β, IL-2, IL-5, IL-8, IL-12p70, IL-17A, TNFα and TNFβ levels compared to Caucasians. Among candidate predictor variables (age, body mass index, insulin resistance and POP levels), high levels of PCBs were the only predictor accounting for a small but significant effect of observed variance (∼7%) in cytokine levels. Overall, a weak but significant association is detected between persistent organochlorine pollutant exposure and elevated cytokine levels. This finding augments the already existing information that environmental pollution is related to inflammation, a common feature of several metabolic disorders that are known to be especially prevalent in Canada's remote First Nations communities.
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Affiliation(s)
- Pascal Imbeault
- Behavioral and Metabolic Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
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Schell LM, Gallo MV. Overweight and obesity among North American Indian infants, children, and youth. Am J Hum Biol 2012; 24:302-13. [PMID: 22378356 PMCID: PMC3514018 DOI: 10.1002/ajhb.22257] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 01/18/2012] [Accepted: 01/22/2012] [Indexed: 11/12/2022] Open
Abstract
The frequency of overweight and obesity among North American Indian children and youth exceeds that of other ethnic groups in the United States. This observation is based on studies using body mass index as the primary measure of overweight and obesity. In the mid-20th century, there were regional differences among North American Indian groups in sub-adults' size and shape and only a few Southwestern groups were characterized by high rates of overweight and obesity. In most populations, the high prevalence of overweight and obesity developed in the last decades of the 20th century. Childhood obesity may begin early in life as many studies report higher birth weights and greater weight-for-height in the preschool years. Contributing factors include higher maternal weights, a nutritional transition from locally caught or raised foods to store bought items, psychosocial stress associated with threats to cultural identity and national sovereignty, and exposure to obesogenic pollutants, all associated to some degree with poverty. Obesity is part of the profile of poor health among Native Americans in the US and Canada, and contributes to woefully high rates of diabetes, cardiovascular disease, and early mortality. Interventions that are culturally appropriate are needed to reduce weights at all points in the lifespan.
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Affiliation(s)
- Lawrence M Schell
- Center for the Elimination of Minority Health Disparities, University at Albany, New York, USA.
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Nash SH, Bersamin A, Kristal AR, Hopkins SE, Church RS, Pasker RL, Luick BR, Mohatt GV, Boyer BB, O’Brien DM. Stable nitrogen and carbon isotope ratios indicate traditional and market food intake in an indigenous circumpolar population. J Nutr 2012; 142:84-90. [PMID: 22157543 PMCID: PMC3237231 DOI: 10.3945/jn.111.147595] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The transition of a society from traditional to market-based diets (termed the nutrition transition) has been associated with profound changes in culture and health. We are developing biomarkers to track the nutrition transition in the Yup'ik Eskimo population of Southwest Alaska based on naturally occurring variations in the relative abundances of carbon and nitrogen stable isotopes (δ(15)N and δ(13)C values). Here, we provide three pieces of evidence toward the validation of these biomarkers. First, we analyzed the δ(15)N and δ(13)C values of a comprehensive sample of Yup'ik foods. We found that δ(15)N values were elevated in fish and marine mammals and that δ(13)C values were elevated in market foods containing corn or sugar cane carbon. Second, we evaluated the associations between RBC δ(15)N and δ(13)C values and self-reported measures of traditional and market food intake (n = 230). RBC δ(15)N values were correlated with intake of fish and marine mammals (r = 0.52; P < 0.0001). RBC δ(13)C values were correlated with intake of market foods made from corn and sugar cane (r = 0.46; P < 0.0001) and total market food intake (r = 0.46; P < 0.0001). Finally, we assessed whether stable isotope ratios captured population-level patterns of traditional and market intake (n = 1003). Isotopic biomarkers of traditional and market intake were associated with age, community location, sex, and cultural identity. Self-report methods showed variations by age and cultural identity only. Thus, stable isotopes show potential as biomarkers for monitoring dietary change in indigenous circumpolar populations.
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Affiliation(s)
- Sarah H. Nash
- Center for Alaska Native Health Research, Institute of Arctic Biology,Department of Biology and Wildlife,To whom correspondence should be addressed. E-mail:
| | - Andrea Bersamin
- Center for Alaska Native Health Research, Institute of Arctic Biology,Department of Biology and Wildlife
| | - Alan R. Kristal
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Rebecca S. Church
- Center for Alaska Native Health Research, Institute of Arctic Biology
| | - Renee L. Pasker
- Center for Alaska Native Health Research, Institute of Arctic Biology,Department of Biology and Wildlife
| | | | - Gerald V. Mohatt
- Center for Alaska Native Health Research, Institute of Arctic Biology,Department of Psychology, University of Alaska, Fairbanks, AK; and
| | - Bert B. Boyer
- Center for Alaska Native Health Research, Institute of Arctic Biology,Department of Biology and Wildlife
| | - Diane M. O’Brien
- Center for Alaska Native Health Research, Institute of Arctic Biology,Department of Biology and Wildlife
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Martens PJ, Bartlett JG, Prior HJ, Sanguins J, Burchill CA, Burland EMJ, Carter S. What is the comparative health status and associated risk factors for the Métis? A population-based study in Manitoba, Canada. BMC Public Health 2011; 11:814. [PMID: 22011510 PMCID: PMC3257314 DOI: 10.1186/1471-2458-11-814] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Accepted: 10/19/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Métis are descendants of early 17th century relationships between North American Indians and Europeans. This study's objectives were: (1) to compare the health status of the Métis people to all other residents of Manitoba, Canada; and (2) to analyze factors in predicting the likelihood of diabetes and related lower limb amputation. METHODS Using de-identified administrative databases plus the Métis Population Database housed at the Manitoba Centre for Health Policy, age/sex-adjusted rates of mortality and disease were calculated for Métis (n = 73,016) and all other Manitobans (n = 1,104,672). Diseases included: hypertension, arthritis, diabetes, ischemic heart disease (age 19+); osteoporosis (age 50+); acute myocardial infarction (AMI) and stroke (age 40+); total respiratory morbidity (TRM, all ages). Using logistic regression, predictors of diabetes (2004/05-2006/07) and diabetes-related lower-limb amputations (2002/03-2006/07) were analyzed. RESULTS Disease rates were higher for Métis compared to all others: premature mortality before age 75 (4.0 vs. 3.3 per 1000, p < .001); total mortality (9.7 vs. 8.4 per 1000, p < .001); injury mortality (0.58 vs. 0.51 per 1000, p < .03); Potential Years of Life Lost (64.6 vs. 54.6 per 1000, p < .001); all-cause 5-year mortality for people with diabetes (20.8% vs. 18.6%, p < .02); hypertension (27.9% vs. 24.8%, p < .001); arthritis (24.2% vs. 19.9%, p < .001), TRM (13.6% vs. 10.6%, p < .001); diabetes (11.8% vs. 8.8%, p < .001); diabetes-related lower limb amputation (24.1 vs. 16.2 per 1000, p < .001); ischemic heart disease (12.2% vs. 8.7%, p < .001); osteoporosis (12.2% vs. 12.3%, NS), dialysis initiation (0.46% vs. 0.34%, p < .001); AMI (5.4 vs. 4.3 per 1000, p < .001); stroke (3.6 vs. 2.9 per 1000, p < .001). Controlling for geography, age, sex, income, continuity of care and comorbidities, Métis were more likely to have diabetes (aOR = 1.29, 95% CI 1.25-1.34), but not diabetes-related lower limb amputation (aOR = 1.13, 95% CI 0.90-1.40, NS). Continuity of care was associated with decreased risk of amputation both provincially (aOR = 0.71, 95% CI 0.62-0.81) and for Métis alone (aOR = 0.62, 95% CI 0.40-0.96). CONCLUSION Despite universal healthcare, Métis' illness and mortality rates are mostly higher. Although elevated diabetes risk persists for the Métis even after adjusting for sociodemographic, healthcare and comorbidity variables, the risk of amputation for Métis appears more related to healthcare access rather than ethnicity.
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Affiliation(s)
- Patricia J Martens
- Manitoba Centre for Health Policy, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, 408 - 727 McDermot Avenue, Winnipeg, Manitoba, R3E 3P5, Canada.
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Current world literature. Curr Opin Endocrinol Diabetes Obes 2011; 18:336-8. [PMID: 21878756 DOI: 10.1097/med.0b013e32834ba6ec] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Imbeault P, Haman F, Blais JM, Pal S, Seabert T, Krümmel EM, Robidoux MA. Obesity and type 2 diabetes prevalence in adults from two remote first nations communities in northwestern ontario, Canada. J Obes 2011; 2011:267509. [PMID: 21603265 PMCID: PMC3092563 DOI: 10.1155/2011/267509] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Revised: 01/21/2011] [Accepted: 02/15/2011] [Indexed: 01/14/2023] Open
Abstract
Objective. To assess the prevalence rates of obesity and type 2 diabetes in adults from two First Nations communities in northwestern Ontario, Canada. Methods. Body weight, height, and waist circumference as well as fasting and postprandial glucose levels following an oral glucose tolerance test were measured in 31 men and 41 women. Results. The mean age of the sample was 43 ± 13 y. The prevalence of obesity was 65.3% and was comparable between men and women. 90.3% of the individuals presented waist circumference levels greater than the thresholds associated with an increased risk of developing health problems. 26 of the 72 individuals (36.1%) were found to be type 2 diabetic. The prevalence of diabetes was not different between men and women. Conclusion. Using objective measurements, this study confirms that First Nations adults from remote communities of Canada continue to experience a disproportionately higher prevalence of obesity and type 2 diabetes than nonaboriginal Canadians.
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Affiliation(s)
- Pascal Imbeault
- Behavioral and Metabolic Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 125, University Street (room 350), Ottawa, ON, Canada K1N 6N5
- *Pascal Imbeault:
| | - François Haman
- Indigenous Health Group, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada K1N 6N5
| | - Jules M. Blais
- Department of Biology, University of Ottawa, Ottawa, ON, Canada K1N 6N5
| | - Shinjini Pal
- Indigenous Health Group, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada K1N 6N5
| | - Tim Seabert
- Department of Biology, University of Ottawa, Ottawa, ON, Canada K1N 6N5
| | - Eva M. Krümmel
- Department of Biology, University of Ottawa, Ottawa, ON, Canada K1N 6N5
| | - Michael A. Robidoux
- Indigenous Health Group, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada K1N 6N5
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