Traditional food consumption is associated with better diet quality and adequacy among Inuit adults in Nunavut, Canada

"The needle is already ready to go": communities' and health care professionals' perceptions of routine vaccination in Nunavik, Canada

Inuit living in the northern region of Nunavik continue to experience significant health inequalities, which are rooted in colonialism that still have repercussions on their health-related perceptions and practices, including vaccination. This study aimed to explore the perceptions and determinants of routine vaccination among the Inuit of Nunavik by describing factors influencing vaccination decisions from the perspective of community members and health professionals. Semi-structured interviews focusing on the perception of vaccination and experience with vaccination and health services were conducted with 18 Inuit and 11 non-Inuit health professionals. Using the socio-ecological model, factors acting at the community and public policy (e.g. rumours and misinformation about vaccination, language barrier), organisational (e.g. complexity of the vaccination process, staff turnover, lack of specialised vaccination workers and interpreters), and intrapersonal and interpersonal (e.g. past experiences with vaccination, vaccine attitudes, social norms) levels were identified as having an impact on vaccination decisions. Improving vaccination coverage in Nunavik requires a more global reflection on how to improve and culturally adapt the health care and services offered to the Inuit population.

Contaminated sites and Indigenous peoples in Canada and the United States: A scoping review

Indigenous communities are disproportionately exposed to contaminated sites, and this poses unique challenges as many Indigenous peoples consider land as an integral part of their culture and economy. This scoping review aimed to identify and map information on contaminated sites and Indigenous peoples in Canada and the United States, namely (1) the relationship between contaminated sites and Indigenous peoples and their land and food systems; (2) strategies, challenges, and successes for contaminated sites assessment and management on Indigenous land; and (3) Indigenous leadership and inclusion in contaminated site assessment and management. We followed a PRISMA-ScR (Transparent Reporting of Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews) checklist to collect data that could be categorized into these three objectives. Between October 2021 and July 2023, information from three data streams was retrieved: a systematic literature search; a grey literature search; and federal site data retrieval (Canada's Federal Contaminated Sites Inventory, USEPA's contaminated sites databases, including Superfund). This search yielded 51 peer-reviewed articles, 21 grey literature articles, and 11 404 federal site records, evidencing the contamination of the lands of 875 Indigenous communities and the presence of 440 different contaminants or contaminant groups. The body of information was categorized into three themes within the above objectives: Objective 1: Indigenous communities and geographic patterns; Contaminated sites, sources, and media; Contaminated sites and Indigenous lands; Contaminated sites and Indigenous food systems; Contaminated sites and the health of Indigenous peoples; Objective 2: Site management and classification processes; Health risk assessment; Risk management; Long-term management; and Objective 3: Collaborative research, Collaborative site management; Traditional knowledge and contaminated sites. Results highlighted a need to prioritize holism, efficiency, and Indigenous leadership in site assessment, management, and research, including a focus on community-specific approaches to site assessment and management; a reconceptualization of risks that privileges Indigenous epistemologies; and greater collaboration between stakeholder networks. Integr Environ Assess Manag 2024;20:1306-1329. © 2023 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Indigenous food production in a carbon economy

Indigenous communities in the North American Arctic are characterized by mixed economies that feature hunting, fishing, gathering, and trapping activities-and associated sharing practices-alongside the formal wage economy. The region is also undergoing rapid social, economic, and climate changes, including, in Canada, carbon taxation, which is impacting the cost of fuel used in local food harvesting. Because of the importance of local foods to nutrition, health, and well-being in Arctic Indigenous communities, there is an urgent need to better understand the sensitivity of Arctic food systems to social, economic, and climate changes and to develop plans for mitigating potential adverse effects. Here, we develop a Bayesian model to calculate the substitution value and carbon emissions of market replacements for local food harvests in the Inuvialuit Settlement Region, Canada. Our estimates suggest that under plausible scenarios, replacing locally harvested foods with imported market substitutes would cost over 3.1 million Canadian dollars per year and emit over 1,000 tons of CO2-equivalent emissions per year, regardless of the shipping scenario. In contrast, we estimate that gasoline inputs to harvesting cost approximately $295,000 and result in 315 to 497 tons of emissions. These results indicate that climate change policies that fail to account for local food production may undermine emissions targets and adversely impact food security and health in Arctic Indigenous communities, who already experience a high cost of living and high rates of food insecurity.

"I Haven't Had Moose Meat in a Long Time": Exploring Urban Indigenous Perspectives on Traditional Foods in Saskatchewan

This qualitative study investigates the perspectives of urban Indigenous individuals in Saskatchewan, Canada, regarding their consumption of traditional foods. Through in-depth, semi-structured interviews with 14 participants across Saskatoon, Regina, and Prince Albert, the research aimed to uncover the benefits, risks, and barriers associated with acquiring and consuming traditional foods. Participants emphasized the nutritional advantages of traditional foods, such as higher nutrient density and absence of industrial additives, which they linked to improved health outcomes and alignment with Indigenous biology. The study also highlighted the vital role of traditional foods in maintaining cultural identity and fostering community connections through practices of food sharing and intergenerational knowledge transfer. However, significant challenges were identified, including economic and physical barriers to access, environmental degradation, and regulatory issues that restrict the availability of traditional foods in urban settings. The findings suggest a complex landscape where cultural practices are both preserved and challenged within the urban environment. This study contributes to the broader understanding of how Indigenous populations navigate the preservation of their culinary heritage in the face of modern economic and environmental pressures, providing insights for policy and community-based interventions aimed at supporting Indigenous food sovereignty.

Wild fish consumption and latitude as drivers of vitamin D status among Inuit living in Nunavik, northern Québec

OBJECTIVE

To measure vitamin D status and estimate factors associated with serum 25-hydroxyvitamin D (25(OH)D) in Nunavimmiut (Inuit living in Nunavik) adults in 2017.

DESIGN

Data were from Qanuilirpitaa? 2017 Nunavik Inuit Health Survey, a cross-sectional study conducted in August-October 2017. Participants underwent a questionnaire, including an FFQ, and blood samples were analysed for total serum 25(OH)D.

SETTING

Nunavik, northern Québec, Canada.

PARTICIPANTS

A stratified proportional model was used to select respondents, including 1,155 who identified as Inuit and had complete data.

RESULTS

Geometric mean serum vitamin D levels were 65·2 nmol/l (95 % CI 62·9-67·6 nmol/l) among women and 65·4 nmol/l (95 % CI 62·3-68·7 nmol/l) among men. The weighted prevalence of serum 25(OH)D < 75 nmol/l, <50 nmol/l <30 nmol/l was 61·2 %, 30·3 % and 7·0 %, respectively. Individuals who were older, female, lived in smaller and/or more southerly communities and/or consumed more country (traditional) foods were at a reduced risk of low vitamin D status. Higher consumption of wild fish was specifically associated with increased serum 25(OH)D concentration.

CONCLUSION

It is important that national, regional and local policies and programs are in place to secure harvest, sharing and consumption of nutritious and culturally important country foods like Arctic char and other wild fish species, particularly considering ongoing climate change in the Arctic which impacts the availability, access and quality of fish as food.

Traditional Food Consumption in Andean Ecuador and Associated Consumer Characteristics, Shopping and Eating Habits

Traditional foods (TFs) hold increasing global relevance due to their potential to address health and dietary challenges. This study explores TF consumption and patterns in a middle-income country's general population. Using 2017 Ecuadorian highlands survey data, we identified four consumption clusters with distinct TF preferences. Chi-square tests identified variations in independent variables across clusters. Poisson regression models highlighted city, age, education, and food habits as independent predictors of TF-based clusters. Our findings broaden TF importance to nutrition beyond specific populations. Understanding consumption patterns and socioeconomic links supports nuanced public health strategies to tackle contemporary health, social equity, and sustainability issues.

Framing an Indigenous Food Sovereignty Research Agenda

Access to healthy and appealing food is essential for individuals to be able to live a healthy and quality life. For decades, food security has been a priority issue for public health professionals. Food sovereignty expands upon the concept of food insecurity (i.e., having access to nutritious and culturally relevant food) by incorporating people's rights to define their own food system. The expanded focus of food sovereignty on food systems prioritizes public health professionals' role in supporting environmental- and systems-level initiatives and evaluating their implications for health, economics, and the natural environment. Food sovereignty is of particular importance for Indigenous peoples (i.e., American Indian, Alaska Native, Native Hawaiian, and Pacific Islander communities). Colonization had demonstrable consequences, with many Indigenous communities being forcibly relocated from traditional lands, alongside the destruction of traditional food sources. Indigenous food sovereignty aligns with the sovereign nation status that American Indian tribes and Alaska Native communities have with the United States. Furthermore, the worldviews that incorporate Indigenous communities' relational responsibilities to care for their food systems, according to their traditional practices and beliefs (Coté, 2016; Morrison, 2011), uniquely positions Indigenous peoples to lead food sovereignty initiatives. In this article, we explore what is currently known regarding food sovereignty and health. We then discuss opportunities to expand the evidence on Indigenous food sovereignty's relationships with (1) health and well being, (2) economics, (3) the natural environment, and (4) programming facilitators and barriers.

Dietary Patterns of Off-Reserve Indigenous Peoples in Canada and Their Association with Chronic Conditions

Nationally representative nutrition surveys (Canadian Community Health Survey (CCHS) Cycle 2.2, Nutrition 2004 and 2015) were used to examine dietary patterns and their association with socioeconomic/sociodemographic factors and chronic conditions in off-reserve Indigenous population in Canada. A cluster analysis was used to identify dietary patterns (DPs), and the Nutrient Rich Food Index (NRF 9.3) was used as the diet quality score and stratified by age/gender groups. In 2004 (n = 1528), the dominant DPs among Indigenous adults (age = 41 ± 2.3) were "Mixed" (mean NRF = 450 ± 12) and "Unhealthy" among men (mean NRF = 426 ± 18), "Fruits" among women (mean NRF = 526 ± 29), and "High-Fat/High-Sugar" among children (age = 10.2 ± 0.5) (mean NRF = 457 ± 12). In 2015 (n = 950), the dominant DPs were "Unhealthy" (mean NRF = 466 ± 6), "Mixed" (mean NRF = 485 ± 21), Healthy-Like (mean NRF = 568 ± 37), and "Mixed" (mean NRF = 510 ± 9) among adults (age = 45.6 ± 2.2), men, women, and children (age = 10.9 ± 0.3) respectively. The majority of Indigenous peoples had the "Unhealthy" DP with a low diet quality, which may contribute to a high prevalence of obesity and chronic diseases. The income level and smoking status among adults and physical inactivity among children were recognized as important factors that may be associated with the dietary intake of off-reserve Indigenous population.

Exploring the environmental determinants of food choice among Haudenosaunee female youth

Background

Research on Indigenous food literacy within Canada has been focused on northern and remote communities despite the fact there are considerable and unique barriers to food access, availability, and utilization in southern Indigenous communities. Food insecurity is also a prevalent issue among Indigenous Peoples living in these more populous regions. Study objectives included investigating the determinants of food choice among youth, along with perceived opportunities that would improve food environments individually and at the community level.

Methods

This community-based study used Photovoice to explore the perceptions and experiences of traditional foods and the determinants of food choice among youth in the community of Six Nations of the Grand River. Participants took photos of their local food environments, including where foods were acquired, consumed, prepared, or shared, and participated in semi-structured interviews to share the stories behind these images. Thematic analysis was used to identify patterns in participants’ photos and interview content.

Results

Environmental factors were found to influence participants’ traditional and everyday food choices. Built, social, economic and ecological environments were described by the youth as distinct yet inter-related determinants that converge to influence individual food choice. Built environments had a notable impact on food choice, most notably at home and in school settings. Home and family were found to be facilitators of meal consistency and healthy food choices across participants. The social environment including participants’ relationships with their peers and community friends was often a barrier to healthy food choices. Eating at fast food outlets was a common social activity. The economic environment included cost deterrents associated with food choices and regular meals. The ecological environment was less of an influence and impacted the seasonal consumption of traditional and other locally harvested foods.

Conclusions

Overall, the study findings have generated important knowledge regarding food environments and literacy and serves as a unique example of how to explore the traditional and everyday food experiences of Indigenous youth. Recommendations will inform the development of new as well as existing initiatives and resources to enhance the holistic wellbeing of youth and the broader community.

Gains and Losses of Agricultural Food Production: Implications for the Twenty-First Century

The world food supply depends on a diminishing list of plant crops and animal livestock to not only feed the ever-growing human population but also improve its nutritional state and lower the disease burden. Over the past century or so, technological advances in agricultural and food processing have helped reduce hunger and poverty but have not adequately addressed sustainability targets. This has led to an erosion of agricultural biodiversity and balanced diets and contributed to climate change and rising rates of chronic metabolic diseases. Modern food supply chains have progressively lost dietary fiber, complex carbohydrates, micronutrients, and several classes of phytochemicals with high bioactivity and nutritional relevance. This review introduces the concept of agricultural food systems losses and focuses on improved sources of agricultural diversity, proteins with enhanced resilience, and novel monitoring, processing, and distribution technologies that are poised to improve food security, reduce food loss and waste, and improve health profiles in the near future. Expected final online publication date for the Annual Review of Food Science and Technology, Volume 13 is March 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Traditional Food Energy Intake among Indigenous Populations in Select High-Income Settler-Colonized Countries: A Systematic Literature Review

The traditional diets of Indigenous Peoples globally have undergone a major transition due to settler colonialism. This systematic review aims to provide a perspective of traditional food intake of Indigenous populations in high-income settler-colonized countries. For inclusion, studies reported the primary outcome of interest-traditional food contribution to total energy intake (% of energy)-and occurred in Canada, the United States (including Hawaii and Alaska), New Zealand, Australia, and/or Scandinavian countries. Primary outcome data were reported and organized by date of data collection by country. Forty-nine articles published between 1987 and 2019 were identified. Wide variation in contribution of traditional food to energy was reported. A trend for decreasing traditional food energy intake over time was apparent; however, heterogeneity in study populations and dietary assessment methods limited conclusive evaluation of this. This review may inform cross-sectoral policy to protect the sustainable utilization of traditional food for Indigenous Peoples.

Changing food preferences among a former hunter-gatherer group in Namibia

The purpose of this study was to identify, describe and conceptualize the present drivers of food choices and preferences of the Khwe San indigenous peoples by considering influences of their historical and cultural contexts. Data were collected in Eastern Bwabwata National Park in Namibia using a range of qualitative methods: semi-structured and structured interviews and free listing. The various drivers of food choices have been clustered into four levels of the ecological conceptual framework. Key factors, found to be driving participants' food choices, were the following: taste, hunger, health, familiarity and body satisfaction at the individual level; culture and food taboos at the social level; access to food and food storage at the physical level, and; cost and seasonality at the macro level. Many of these factors are directly related to food insecurity and previous experiences of hunger. Current preferences towards traditional foods existed but were not prevailing among all the participants. Interviews with the elderly revealed the historical context of the increasing exposure to modern foods and a contested access to traditional foods and traditional knowledge transmission. Our findings exposed some substantial gaps in the nutritional knowledge of the Khwe that need consideration by future health promotion strategies along with the current perceptions of local food choices. Ensuring access and promoting sustainable management of traditional foods would not only contribute to the health of the Khwe people but also help to maintain a nutritional safety net in their current situation of extreme poverty.

Exploring the Perceptions of and Experiences with Traditional Foods among First Nations Female Youth: A Participatory Photovoice Study

Traditional foods contribute to the health and well-being of Indigenous Peoples. Many Indigenous Peoples within Canada have expressed a desire to consume more traditional foods; however, there are a number of barriers to doing so. Southern and urban communities face unique challenges associated with traditional food consumption. To address these concerns and build on community interests in a Haudenosaunee community in Southern Ontario, a participatory research project was initiated. This community-based study utilized Photovoice methodology to explore the perceptions of and experiences with traditional foods among local youth. Participants ranging in age from 15-22 (n = 5) took photos of their local food environments, including locations where foods were acquired, consumed, prepared, or shared during two seasons of the year. Semi-structured interviews were conducted to collect participants' stories behind 8-10 self-selected images. A thematic analysis was subsequently utilized to identify patterns and themes illustrated by the photos and interview content. The youth conveyed contextual understandings of traditional foods and a preference for these items, despite their limited consumption, preparation or harvesting of these foods. The youth also identified the important influence of families and communities on their individual perceptions and experiences with traditional foods. Recommendations to reduce barriers to traditional food choices among youth are made.

Capturing a Complexity of Nutritional, Environmental, and Economic Impacts on Selected Health Parameters in the Russian High North

The rapid pace of economic exploration of the Arctic against the backdrop of progressing environmental change put a high priority on improving understanding of health impacts in the northern communities. Deficiencies in the capability to capture the complexity of health-influencing parameters along with a lack of observations in circumpolar territories present major challenges to establishing credible projections of disease incidence across varying northern environments. It is thus crucial to reveal the relative contributions of coacting factors to provide a basis for sustainable solutions in the sphere of public health. In order to better understand the adverse effects associated with public health, this study employed six-stage multiple regression analysis of incidence rates of fourteen diseases (International Classification of Diseases (ICD-11) codes most widespread in the Russian Arctic) against a set of environmental, nutritional, and economic variables. Variance inflationary factor and best-subsets regression methods were used to eliminate collinearity between the parameters of regression models. To address the diversity of health impacts across northern environments, territories of the Arctic zone of Russia were categorized as (1) industrial sites, (2) urban agglomerations, (3) rural inland, and (4) coastline territories. It was suggested that, in Type 1 territories, public health parameters were most negatively affected by air and water pollution, in Type 2 territories—by low-nutrient diets, in Type 3 and Type 4 territories—by economic factors. It was found that in the Western parts of the Russian Arctic, poor quality of running water along with low access to the quality-assured sources of water might increase the exposure to infectious and parasitic diseases and diseases of the circulatory, respiratory, and genitourinary systems. Low living standards across the Russian Arctic challenged the economic accessibility of adequate diets. In the cities, the nutritional transition to low-quality cheap market food correlated with a higher incidence of digestive system disorders, immune diseases, and neoplasms. In indigenous communities, the prevalence of low diversified diets based on traditional food correlated with the increase in the incidence rates of nutritional and metabolic diseases.

Risk tradeoffs associated with traditional food advisories for Labrador Inuit

The traditional Inuit diet includes wild birds, fish and marine mammals, which can contain high concentrations of the neurotoxicant methylmercury (MeHg). Hydroelectric development may increase MeHg concentrations in traditional foods. Consumption advisories are often used to mitigate such risks and can result in reduced intake of traditional foods. Data from a dietary survey, MeHg exposure assessment and risk analysis for individuals in three Inuit communities in Labrador, Canada (n = 1145) in 2014 indicate reducing traditional food intake is likely to exacerbate deficiencies in n-3 polyunsaturated fatty acids and vitamins B12 and B2. Traditional foods accounted for < 5% of per-capita calories but up to 70% of nutrients consumed. Although consumption advisories could lower neurodevelopmental risks associated with an increase in MeHg exposure (90th-percentile ∆IQ = - 0.12 vs. - 0.34), they may lead to greater risks of cardiovascular mortality (90th-percentile increase: + 58% to + 116% vs. + 25%) and cancer mortality (90th-percentile increase + 2% to + 4% vs. no increase). Conversely, greater consumption of locally caught salmon mostly unaffected by hydroelectric flooding would lower all these risks (90th-percentile ∆IQ = + 0.4; cardiovascular risk: - 45%; cancer risk: - 1.4%). We thus conclude that continued consumption of traditional foods is essential for Inuit health in these communities.