Food Profiles of Indigenous Households in Brazil: Results of the First National Survey of Indigenous Peoples' Health and Nutrition

Body composition versus anthropometric results of the Khisêdjê Indigenous of Xingu - MT/Brazil

This study aimed to evaluate the body composition of the Khisêdjê, an Indigenous people residing in the Xingu Indigenous Territory, and compare it to the results obtained by anthropometry. One hundred seventy-nine individuals aged above 20 of both genders were included. The nutritional status was classified per the cutoff proposed by the WHO (1995). The body composition was identified using measures derived directly from a bioelectrical impedance device (resistance - R, reactance - Xc, and phase angle - PA). Data were analyzed using the Student t-test, chi-square, Pearson correlation, and analysis of variance, and 57% of the sample was male. The mean age of the population was 37.5 years, and 48% of subjects had some overweight level (BMI ≥ 25,0 kg/m2). We identified a positive correlation between BMI with waist (WC) and arm (AC) circumference, and PA measurements, and an inverse correlation between BMI and R and Xc measurements. R and Xc mean values decreased with increasing BMI. In contrast, mean PA increased with greater weight. The results suggest that being overweight among the Khisêdjê Indigenous people was associated with higher muscle mass amounts.

Xingu Indigenous Territory: nutritional and metabolic profile of indigenous people evaluated between 2017 and 2019

The study evaluates the nutritional and metabolic profile of the adult population of the Xingu Indigenous Territory by gender and base hub. It was developed in 18 villages from 2017 to 2019. Anthropometry and clinical, physical examinations were conducted in loco in individuals over 18. A total of 1,598 Indigenous people were evaluated, with a mean age of 36.7 years. Of these, 50.6% were male, 53.2% lived in the Leonardo Base hub, 22.7% in Diauarum, 12.3% in Pavuru and 11.8% in Wawi. Women had a higher prevalence (p < 0.05) than men, respectively, of underweight (2.0% vs. 0.1%), normal weight (46.1% vs. 37.4%), central obesity (63.4% vs. 21 .8%), low HDL cholesterol (77.7% vs. 72.9%) and Metabolic Syndrome (29.0% vs. 23.5%). In comparison, men had a higher prevalence (p < 0.05) than women, respectively, of overweight (46.3% vs. 37.5%), high triglycerides (34.5% vs. 28.2%) and high blood pressure levels (13.1% vs. 8.6%). The Leonardo and Wawi base hubs had the worst nutritional and cardiometabolic results. Overall, subjects had a high frequency of noncommunicable diseases and cardiometabolic risk. Urgent measures need to be taken to control this situation.

The GSTP1 rs1695 Polymorphism Is Associated with Mercury Levels and Neurodevelopmental Delay in Indigenous Munduruku Children from the Brazilian Amazon

Genetic polymorphisms may influence mercury (Hg) toxicity. The aims of this study were to evaluate individual factors, such as the presence of the GSTP1 rs1695 polymorphism, associated with internal Hg dose and child neurodevelopment in indigenous people from the Brazilian Amazon chronically exposed to Hg. Eighty-two indigenous children were clinically evaluated, hair Hg was measured, and the GSTP1 rs1695 polymorphism was genotyped. The mean age was 4.8 years, the median Hg was 5.5 µg/g, and 93.8% of children exceeded the safe limit (2.0 µg/g). Fish consumption was associated with Hg levels (p = 0.03). The GSTP1 rs1695 A>G polymorphism was in the Hardy-Weinberg equilibrium and the highest prevalence of the GSTP1 AA genotype (80%) was found in Sawré Aboy, which had the highest Hg levels (10 µg/g) among the studied villages. The Hg levels tended to increase over the years in males and in carriers of the GSTP1 AA genotype (0.69 µg/g and 0.86 µg/g, respectively). Nine children failed the neurodevelopmental test, all of whom had Hg > 2.0 µg/g, and 88.9% carried the GSTP1 AA or AG genotypes, previously associated with the highest internal Hg doses and neurocognitive disorders. The genetic counseling of this population is important to identify the individuals at greater risk for neurodevelopmental disorders resulting from chronic Hg exposure.

Fourteen-year trends in overweight, general obesity, and abdominal obesity in Amazonian indigenous peoples

BACKGROUND

Available data show that the epidemiological profile of most indigenous Brazilian populations is characterized by the coexistence of long-standing health problems (high prevalence of infectious and parasitic diseases, malnutrition, and deficiency diseases, such as anemia in children and women of reproductive age), associated with new health problems, especially those related to obesity (hypertension, type 2 diabetes mellitus and dyslipidemia). Based on this scenario, this study analyzed the nutritional profile of the adult population of seven indigenous peoples from the Brazilian Amazon in the years 2007 and 2021.

METHODS

A total of 598 adults individuals were analyzed in 2007 (319 women and 279 men) and 924 in 2021 (483 women and 441 men), from seven indigenous peoples located in the state of Pará, who were assisted during health actions carried out in 2007 and in 2021. Body mass index classification used the World Health Organization criteria for adults: low weight, < 18.5 kg/m2; normal weight, ≥ 18.5 and < 25 kg/m2); overweight, ≥ 25 and < 30 kg/m2, and obesity, ≥ 30 kg/m2. A waist circumference (WC) < 90 cm in men and < 80 cm in women was considered normal.

RESULTS

The data revealed heterogeneous anthropometric profiles, with a low prevalence of nutritional changes in the Araweté, Arara and Parakanã peoples, and high proportions of excess weight and abdominal obesity in the Kararaô, Xikrin do Bacajá, Asurini do Xingu and Gavião peoples, similar to or even higher than the national averages.

CONCLUSION

Different stages of nutritional transition were identified in the indigenous peoples analyzed, despite apparently having been subjected to the same environmental pressures that shaped their nutritional profile in recent decades, which may indicate different genetic susceptibilities to nutritional changes. The evidence shown in this study strongly suggests the need to investigate in greater depth the genetic and environmental factors associated with the nutritional profile of Brazilian indigenous peoples, with assessment of diet, physical activity and sociodemographic and socioeconomic variables that enable the development of appropriate prevention and monitoring measures.

Healthy food, unhealthy food: Indigenous perspectives on the nutrition transition

Amazonian Indigenous Peoples are undergoing drastic changes in their ways of life including the quality and availability of food and its impact on their health and well-being. Indigenous populations have their own perspectives and interpretations of dietary changes unfolding in their communities. Based on in-depth interviews, observations and validation workshops we explored the way Awajún describe and problematise the concept of healthy and unhealthy food in the context of the nutrition transition. We learn that the characteristics of 'good food' are informed by their capacity to give strength, protect health and enable them to be hardworking people. On the contrary, food that comes from the city weakens the body and may result in health problems. For the Awajún, chicken with hormones, fish preserved in cans, and powdered milk negatively affect their health. We argue that the dichotomy 'healthy' and 'unhealthy' used to classify food provides information not only about Indigenous conceptualisations of health and die, but is also a critique of broader structural processes affecting their well-being. The terms, explanations and idioms used by the Awajún to talk about food, provide an insight into Indigenous perspectives and knowledge key to informing global health interventions in culturally appropriate ways.

Diet change and sustainability in Indigenous areas: characteristics, drivers, and impacts of diet change in Gunayala, Panama

Many Indigenous communities around the world have been experiencing rapid and profound diet changes. This case report uses a Sustainability Science lens to understand the characteristics of diet change in Indigenous Gunas communities of Panama, as well as its drivers and sustainability impacts. We use primary information collected through interviews with 30 experts and 232 household surveys in three Gunas islands  characterised by different levels of development, western influence, and cultural erosion. We observe a rapid westernization of diets that has been mainly driven by closer interaction with tourists and the Panamanian society, as well as broader development processes. However, this diet change has a series of intersecting sustainability impacts related to food security, health, and socio-cultural and environmental change. It is necessary to understand the intersection of these phenomena when designing programs and interventions that seek to prevent or mitigate negative diet changes in Gunayala, and other  Indigenous contexts more broadly.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11625-023-01325-0.

Food profile of Yanomami indigenous children aged 6 to 59 months from the Brazilian Amazon, according to the degree of food processing: a cross-sectional study

OBJECTIVE

The current study aimed to characterise the food profile of Yanomami indigenous children according to the degree of food processing and its associated factors.

DESIGN

This is a cross-sectional study with Yanomami indigenous children aged 6 to 59 months. Socio-demographic, maternal and infant data were collected through a standardised questionnaire. The food profile was obtained by using a list of thirty-four foods to verify the child's consumption of these foods on the day preceding the interview. Foods were classified according to the degree of processing based on the NOVA system (in natura or minimally processed, processed culinary ingredients, processed and ultra-processed). In natura and minimally processed foods were subdivided into 'regional' and 'urban' foods. Poisson regression analysis was applied to estimate the associated factors according to the 90 % CI.

SETTING

Three villages (Auaris, Maturacá and Ariabú) in the Yanomami indigenous territory, in the Brazilian Amazon.

PARTICIPANTS

In total, 251 Yanomami children aged 6 to 59 months were evaluated.

RESULTS

The prevalence of consumption of 'regional' and 'urban' in natura or minimally processed foods was 93 % and 56 %, respectively, and consumption of ultra-processed foods was 32 %. Ultra-processed food consumption was 11·6 times higher in children of Maturacá and 9·2 times higher in Ariabú when compared with the children of Auaris and 31 % lower in children who had mothers with shorter stature.

CONCLUSION

Despite the high frequency of consumption of in natura and minimally processed foods, the consumption of ultra-processed foods was substantial and was associated with demographic and maternal factors in Yanomani indigenous children under 5 years of age.

COVID-19 and Indigenous health in the Brazilian Amazon

We test whether the COVID-19 pandemic has an ethnicity-differentiated (Indigenous vs non-Indigenous) effect on infant health in the Brazilian Amazon. Using vital statistics data we find that Indigenous infants born during the pandemic are 0.5% more likely to have very low birth weights. Access to health care contributes to health gaps. Thirteen percent of mothers travel to deliver their babies. For traveling mothers, having an Indigenous baby during the pandemic increases the probability of very low birth weight by 3%. Indigenous mothers are 7.5% less likely to receive adequate prenatal care. Mothers that travel long distances to deliver their babies and give birth during the pandemic are 35% less likely to receive proper prenatal care. We also find evidence that the pandemic shifts medical resources from rural to urban areas, which disproportionately benefits non-Indigenous mothers. These results highlight the need for policies to reduce health inequalities in the Amazon.

Consumption and Preferences for Wild and Domestic Meat in Indigenous Communities in the Brazilian Atlantic Forest

Wild animals have traditionally been the main sources of protein available, if not the only, to numerous indigenous populations worldwide. However, greater access to markets, reduced availability or access to wildlife, and policies in support of agricultural development, have shifted food habits toward domestic and industrial sources of protein. In this study, we evaluated consumption patterns and preferences/avoidances for wild animals (wildmeat, crustaceans, and fish) in comparison to domestic sources of protein among the Potiguara living on the Brazilian coast. Using data from 843 semi-structured interviews applied to students from 28 indigenous villages, we found that domestic meats were more consumed and preferred as compared to wild animals (aquatic and game animals), despite the high abundance of fish and crustacean resources in the surveyed area. Consumption and preference for game were higher among male students while avoidance was higher among female students. The avoidance of domestic meats and fish was low for both genders. The occupation of the fathers affected students’ food habits, in those nature-related occupations (farmer, fisherman/woman, sugarcane worker) conditioned greater consumption of wildmeat and fish, while non-nature related occupations lead to greater consumption of protein from domestic sources. The consumption of protein from all sources increased with the distance between villages and a protected area. Our results indicate that the younger generation of Potiguaras does not regularly consume wildmeat and fish and their preference for domestic sources of protein is shaped by the socio-environmental context, access to different types of meat, and taste preferences.

Contextual Factors and Motor Skills in Indigenous Amazon Forest and Urban Indigenous Children

This study investigated the contextual factors, motor performance, and body mass index across indigenous land children, indigenous urban children, and non-indigenous urban children. A number of 153 children, both sexes (71 girls, 46.4%), from 8 to 10 years were assessed. The Test of Motor Gross Development-3 was utilized. Indigenous land children showed higher motor performance ( η 2 ρ = 0.37 and η 2 ρ = 0.19 locomotor and object control, respectively) than indigenous urban children (p < 0.03) and non-indigenous urban children (p < 0.01); Indigenous urban children showed higher motor performance than non-indigenous urban children (p < 0.01). Body mass index was similar across groups ( η 2 ρ = 0,02; p = 0.15). Motor performance of indigenous land children was explained by the contextual factors that lead to a more active lifestyle, unsupervised free time, and play outside. In urban areas, behavior was similar, and although indigenous urban children kept some play tradition, it was not strong enough to be a protective factor for the motor performance.

A’uwẽ (Xavante) views of food security in a context of monetarization of an indigenous economy in Central Brazil

Following boom-and-bust economic cycles provoked by Brazilian governmental attempts to integrate Indigenous peoples into national society, it is approximately since the beginning of the 2000s that Brazilian Indigenous peoples came to be viewed officially as “poor” and victims of “hunger.” Consequently, the national indigenist agency and other State entities started to conceive and implement diverse initiatives that ultimately injected money and resources into Indigenous communities. In 2019 we undertook an ethnographic study in three A’uwẽ (Xavante) communities in the Pimentel Barbosa Indigenous Reserve, Central Brazil, with the objective of analyzing how people understand and pursue food security. We propose that in the studied communities the complex network of A’uwẽ food reciprocity is a fundamental strategy for mitigating hunger and acute lack of food. We show that among the A’uwẽ, the hybrid economy that developed since the 1970s has proved resilient to dramatic transformations and uncertainty in the availability and characteristics of external government inputs.

Coping with Hypertension among Indigenous Peoples in Brazil and the Role of the Primary Care Nurse: A Critical Review from a Transcultural Perspective

Our objective is to critically review the literature addressing the strategic role of nurses in the daily primary care of arterial hypertension in Indigenous communities in Brazil. We selected studies based on an initial keyword search of major bibliographic indexing databases for the years 2000 to 2020 and manual search. Further selection was based on topical, methodological, and thematic relevance, as well as evaluation of scholarship quality and pertinence to our chosen narrative. The literature demonstrates Indigenous peoples do not receive health services that measure up to national standards in large part due to a marked lack of academic and employer preparation for nurses operating in transcultural settings. Inequities were apparent in recurrent reports of victim-blaming, deficient clinical communication with patients, clinical malpractice, devaluation of hypertension as a problem for Indigenous peoples, insufficient intercultural training for nurses, and discrimination against Indigenous students in nursing education programs. This systemic problem needs to be addressed by universities and the Indigenous Health Care Subsystem in Brazil.