Highly unsaturated n-3 fatty acids status of Canadian Inuit: International Polar Year Inuit Health Survey, 2007–2008

Age‐related features of the content of substrates of energy metabolism and body mass index in women residing in the S ubarctic and A rctic regions of R ussia

OBJECTIVES

Age is associated with a number of health risks linked to obesity caused by an imbalance in the main energy substrates-fatty acids (FA) and glucose (Glu). Therefore, the objective of this study was to identify age-related features of the metabolism of fatty acids and Glu, their correlations and the relation with the body mass index (BMI) in women of the local Caucasoid population from two northern regions of Russia with different nature, climate, and geography.

METHODS

We examined women aged 21-60 years born and permanently residing in the Subarctic region (SR) and the Arctic region (AR). The participants were divided into three age groups: 21-35, 36-45, and 46-60 years. The levels of FAs, Glu, and triglycerides (TG) in the blood serum were determined by spectrophotometric and gas chromatographic methods; the values of BMI and TyG (triglyceride glucose) index were calculated. To analyze data, we used the descriptive and correlation analyses by nonparametric methods, as well as multiple linear regression analysis.

RESULTS

With age, the surveyed women demonstrated elevated levels of triglyceride, the majority of the studied fatty acids, BMI and TyG index. For three fatty acids, age-related changes were noted in one of the regions only: stearic and linoleic acids in the SR, and docosahexaenoic acid in the AR; no significant changes were observed for dihomo-γ-linolenic and arachidonic acids. We found elevated Glu levels in women aged 46-60 years residing in the SR. Regional differences were due to higher concentrations of FAs and Glu in the AR. All identified correlations were positive. BMI values were associated with FAs and TG, and in women aged 46-60 years, they were additionally associated with Glu. The latter also correlated with some FAs and TG in this group. TyG index associations with saturated FAs (SFAs) became stronger with age.

CONCLUSIONS

Age has a significant impact on the homeostasis of key energy substrates (Glu, TG, SFAs, monounsaturated FAs), on BMI and TyG index, which are indicators of obesity and insulin resistance. Depending on the region of residence (Subarctic or Arctic), we found changes in the FA profile undersaturation (especially long-chain polyunsaturated FAs) and some specific features of Glu homeostasis (for the age groups of 21-35 and 46-60 years) in women of Caucasoid race in the Russian North. Multiple regression analysis showed that BMI, as well as the region of residence and age, are significant predictors for almost all biochemical parameters, especially for TG and TyG index.

Drivers and health implications of the dietary transition among Inuit in the Canadian Arctic: a scoping review

OBJECTIVE

The current study undertook a systematic scoping review on the drivers and implications of dietary changes among Inuit in the Canadian Arctic.

DESIGN

A keyword search of peer-reviewed articles was performed using PubMed, Web of Science, CINAHL, Academic Search Premier, Circumpolar Health Bibliographic Database and High North Research Documents. Eligibility criteria included all full-text articles of any design reporting on research on food consumption, nutrient intake, dietary adequacy, dietary change, food security, nutrition-related chronic diseases or traditional food harvesting and consumption among Inuit populations residing in Canada. Articles reporting on in vivo and in vitro experiments or on health impacts of environmental contaminants were excluded.

RESULTS

A total of 162 studies were included. Studies indicated declining country food (CF) consumption in favour of market food (MF). Drivers of this transition include colonial processes, poverty and socio-economic factors, changing food preferences and knowledge, and climate change. Health implications of the dietary transition are complex. Micro-nutrient deficiencies and dietary inadequacy are serious concerns and likely exacerbated by increased consumption of non-nutrient dense MF. Food insecurity, overweight, obesity and related cardiometabolic health outcomes are growing public health concerns. Meanwhile, declining CF consumption is entangled with shifting culture and traditional knowledge, with potential implications for psychological, spiritual, social and cultural health and well-being.

CONCLUSIONS

By exploring and synthesising published literature, this review provides insight into the complex factors influencing Inuit diet and health. Findings may be informative for future research, decision-making and intersectoral actions around risk assessment, food policy and innovative community programmes.

Oceans and human health—navigating changes on Canada’s coasts

Ocean conditions can affect human health in a variety of ways that are often overlooked and unappreciated. Oceans adjacent to Canada are affected by many anthropogenic stressors, with implications for human health and well-being. Climate change further escalates these pressures and can expose coastal populations to unique health hazards and distressing conditions. However, current research efforts, education or training curriculums, and policies in Canada critically lack explicit consideration of these ocean–public health linkages. The objective of this paper is to present multiple disciplinary perspectives from academics and health practitioners to inform the development of future directions for research, capacity development, and policy and practice at the interface of oceans and human health in Canada. We synthesize major ocean and human health linkages in Canada, and identify climate-sensitive drivers of change, drawing attention to unique considerations in Canada. To support effective, sustained, and equitable collaborations at the nexus of oceans and human health, we recommend the need for progress in three critical areas: ( i) holistic worldviews and perspectives, ( ii) capacity development, and ( iii) structural supports. Canada can play a key role in supporting the global community in addressing the health challenges of climate and ocean changes.

Forearm bone density is not elevated in Inuit women with impaired fasting glucose or type 2 diabetes mellitus

Bone mineral density (BMD) and fracture risk are elevated in adults with impaired fasting glucose (IFG) or type 2 diabetes mellitus (T2D). This study aimed to compare bone health among Inuit women with IFG, T2D and normoglycemia. The study included Inuit women (≥40 y) with IFG (n = 57), T2D (n = 72) or normoglycemia (n = 340) from the International Polar Year Inuit Health Survey 2007-2008 in Canada. Distal one-third forearm BMD (FaBMD) was measured using a peripheral instantaneous x-ray imager. Anthropometry, fasting plasma glucose (FPG), serum adiponectin, leptin and 25-hydroxyvitamin D (25(OH)D) were measured. Traditional food intakes were surveyed. Data were analysed using mixed model ANOVA and regression models. The median age was 53 (IFG: IQR 48, 67) y and 56 (T2D: IQR 49, 63) y. Compared to normoglycemic women, FaBMD and T-scores were significantly lower in women with T2D, but not with IFG. Frequency of marine mammal intakes (ß = 0.145; 95%CI: 0.018, 0.053, p = 0.0001) positively related to FaBMD. The odds ratio of having a T-score consistent with osteoporosis was lower among women with T2D and higher BMI, while aging increased the risk. Although T2D associates with lower BMD among Inuit women, risk of osteoporosis is tempered, possibly by maintenance of a traditional lifestyle.

Adulthood transitions in health and welfare; a literature review

AIM

The aim of the literature review was to describe how adulthood transition is used in health and welfare.

DESIGN

A qualitative design with a deductive approach were used.

METHODS

As material, 283 articles published in scientific journals, between 2011-August 2013, were selected. The search was conducted August 2013. The data were analysed and sorted in a categorization matrix.

RESULTS

Transition was identified as a process mainly related to the four types previously identified; developmental, situational, health-illness and organizational transitions. Another one transition was also identified, lifestyle transition.

Inuit Country Food Diet Pattern Is Associated with Lower Risk of Coronary Heart Disease

BACKGROUND

Inuit have experienced a rapid transition in diet and lifestyle over the past several decades, paralleled by the emergence of chronic diseases such as obesity, diabetes, and hypertension.

OBJECTIVE

To identify contemporary dietary patterns among Inuit and investigate their association with cardiovascular disease outcomes.

DESIGN

This was an association study in a cross-sectional population health and nutrition survey.

PARTICIPANTS

The participants included 1,570 adults (aged ≥18 years) from Nunavut in the International Polar Year Inuit Health Survey 2007-2008 who completed diet/health questionnaires and provided blood samples.

MAIN OUTCOME MEASURES

Outcomes measured included the prevalence of coronary heart disease, myocardial infarction, stroke, hyperlipidemia, and hypertension.

STATISTICAL ANALYSES PERFORMED

Principal component analysis was used to derive dietary patterns based on the consumption of nine market food groups and four country food groups reported in 24-hour dietary recalls. The associations between cardiovascular outcomes and identified dietary patterns were examined with logistic regression.

RESULTS

Three dietary patterns were identified: market food, country food-fat, and country food-fish. The market food diet, characterized by high consumption of market-bought meat, cereals, vegetables, and added oil, was associated with elevated prevalence of coronary heart disease, myocardial infarction, and hypertension (odds ratio [OR] 1.44, 95% CI 0.82 to 2.51; OR 2.27, 95% CI 0.88 to 5.83; and OR 1.36, 95% CI 0.88 to 2.09). The country food-fish diet, characterized by high fish consumption and low sugar and sweets intake, was inversely associated with the prevalence of coronary heart disease, myocardial infarction, stroke, and hyperlipidemia (OR 0.78, 95% CI 0.43 to 1.37; OR 0.46, 95% CI 0.18 to 1.20; OR 0.34, 95% CI 0.07 to 2.13; and OR 0.69, 95% CI 0.39 to 1.22). The country food-fat diet, characterized by high marine mammal and added fat intake, was positively associated with the prevalence of coronary heart disease.

CONCLUSIONS

A diet featuring high food variety, high fish intake, and low sugar intake was negatively associated with the prevalence of cardiovascular outcomes among Inuit.

Dietary sources of energy and nutrients in the contemporary diet of Inuit adults: results from the 2007–08 Inuit Health Survey

Objective

To characterize the major components of the contemporary Inuit diet and identify the primary sources of energy and essential nutrients.

Design

Dietary data were derived from the 24 h recall collected by the Inuit Health Survey (IHS) from 2007 to 2008. The population proportion method was used to determine the percentage contribution of each group. Unique food items/preparations (ninety-three country foods and 1591 market foods) were classified into eight country food groups and forty-one market food groups. Nutrient composition of each food item was obtained from the Canadian Nutrient File.

Setting

Thirty-six communities across three Inuit regions of northern Canada.

Subjects

A representative sample (n2095) of non-pregnant Inuit adults (≥18 years), selected through stratified random sampling.

Results

Despite their modest contribution to total energy intake (6·4–19·6 %, by region) country foods represented a major source of protein (23–52 %), Fe (28–54 %), niacin (24–52 %) and vitamins D (up to 73 %), B6(18–55 %) and B12(50–82 %). By contrast, the three most popular energy-yielding market foods (i.e. sweetened beverages, added sugar and bread) collectively contributed approximately 20 % of total energy, while contributing minimally to most micronutrients. A notable exception was the contribution of these foods to Ca (13–21 %) and vitamins E (17–35 %) and C (as much as 50 %). Solid fruits were consumed by less than 25 % of participants while vegetables were reported by 38–59 % of respondents.

Conclusions

Country foods remain a critical dimension of the contemporary Inuit diet.

Dietary and blood selenium are inversely associated with the prevalence of stroke among Inuit in Canada

Inuit in Canada have high selenium intake from the consumption of country food such as fish and marine mammals. The health consequence is not known. This study examines the association between blood selenium concentration and prevalence of stroke among Canadian Inuit. The International Polar Year Inuit Health Survey was conducted in 2007-2008. Among the 2077 adults participants (≥18years old) who completed a questionnaire and gave blood samples, 49 stroke cases were reported, 31 of which were from women. The crude prevalence of stroke was 2.4% in the participants. Participants with stroke had lower blood selenium (geometric mean: 260μg/L vs. 319μg/L) and dietary selenium (144μg/day vs. 190μg/day) compared to individuals without stroke. Participants with high blood/dietary selenium exposure (quartiles 3 and 4) had a lower prevalence of stroke compared to those with low selenium exposure (quartile 1). The adjusted odds ratio ranged from 0.09 to 0.25 among subgroups (e.g. age, sex, and blood mercury). An L-shaped relationship between prevalence of stroke with blood and dietary selenium was observed, based on the cubic restricted spline and segmented regression analyses. The estimated turning points of the L-shaped curve for blood selenium and dietary selenium were 450μg/L and 350μg/day, respectively. Below the turning points, it was estimated that each 50-μg/L increase in blood selenium was associated with a 38% reduction in the prevalence of stroke, and each 50-μg/day increase in dietary selenium was associated with a 30% reduction in the prevalence of stroke. In conclusion, blood and dietary selenium are reversely associated with the prevalence of stroke in Inuit, which follows an L-shaped relationship. Whether this relationship applies to other population needs further investigation.

Associations between omega-3 fatty acids and 25(OH)D and psychological distress among Inuit in Canada

Background: Inuit in Canada have experienced dietary changes over recent generations, but how this relates to psychological distress has not been investigated.

Objective: To evaluate how nutritional biomarkers are related to psychological distress.

Design: A total of 36 communities in northern Canada participated in the International Polar Year Inuit Health Survey (2007–2008). Of 2796 households, 1901 (68%) participated; 1699 Inuit adults gave blood samples for biomarker analysis and answered the Kessler 6-item psychological distress questionnaire (K6). Biomarkers included n-3 fatty acids and 25-hydroxyvitamin D (25(OH)D). The K6 screens for psychological distress over the last 30 days with six items scored on a 4-point scale. A total score of 13 or more indicates serious psychological distress (SPD). Logistic regression models were used to investigate any associations between SPD and biomarkers while controlling for age, gender, marital status, days spent out on the land, feeling of being alone, income and smoking.

Results: The 30-day SPD prevalence was 11.2%, with women below 30 years having the highest and men 50 years and more having the lowest SPD prevalence at 16.1% and 2.6%, respectively. SPD was associated with being female, younger age, not being married or with a common-law partner, spending few days out on the land, feelings of being alone, smoking and low income. Low levels of both 25(OH)D and long-chain n-3 FAs were associated with higher odds for SPD in both unadjusted and adjusted logistic regression models.

Conclusion: In this cross-sectional analysis, low levels of 25(OH)D and long-chain n-3 FAs were associated with higher odds ratios for SPD, which highlights the potential impact of traditional foods on mental health and wellbeing. Cultural practices are also important for mental health and it may be that the biomarkers serve as proxies for cultural activities related to food collection, sharing and consumption that increase both biomarker levels and psychological well-being.

Abbreviations: n-3 FAs: omega-3 fatty acids; PUFAs: polyunsaturated fatty acids; 25(OH)D: 25-hydroxyvitamin D; IPY: International Polar Year; IHS : Inuit Health Survey; RBC: red blood cell; OR: odds ratio; K6: Kessler 6-item screening scale; SPD: serious psychological distress; EPA: eicosapentaenoic acid (20:5 n-3); DHA: docosahexaenoic acid (22:6 n-3); DPA n-3: docosapentaenoic acid (22:5 n-3); n-3 LC-PUFAs: EPA (20:5 n-3) + DHA (22:6 n-3) + DPA (22:5 n-3); BMI: body mass index (kg m^–2)

Effects of preparation on nutrient and environmental contaminant levels in Arctic beluga whale (Delphinapterus leucas) traditional foods

For Canadian Arctic indigenous populations, marine mammal (MM) traditional foods (TFs) represent sources of both important nutrients and hazardous environmental contaminants. Food preparation is known to impact the nutrient and environmental contaminant content of processed items, yet the impacts of preparation on indigenous Arctic MM TFs remain poorly characterized. In order to determine how the various processes involved in preparing beluga blubber TFs affect their levels of nutrients and environmental contaminants, we collected blubber samples from 2 male beluga whales, aged 24 and 37 years, captured during the 2014 summer hunting season in Tuktoyaktuk, Northwest Territories, and processed them according to local TF preparation methods. We measured the levels of select nutrients [selenium (Se), polyunsaturated fatty acids (PUFAs)] and contaminants [organochlorine pesticides, perfluoroalkyl and polyfluoroalkyl substances (PFASs), polybrominated diphenyl ethers, polychlorinated biphenyls, polycyclic aromatic hydrocarbons (PAHs), mercury (Hg)] in raw and prepared (boiled, roasted, aged) beluga blubber TFs. The impacts of beluga blubber TF preparation methods on nutrient and environmental contaminant levels were inconsistent, as the majority of processes either did not appear to influence concentrations or affected the two belugas differently. However, roasting and ageing beluga blubber consistently impacted certain compounds: roasting blubber increased concentrations of hydrophilic substances (Se and certain PFASs) through solvent depletion and deposited PAHs from cookfire smoke. The solid-liquid phase separation involved in ageing blubber depleted hydrophilic elements (Se, Hg) and some ionogenic PFASs from the lipid-rich liquid oil phase, while PUFA levels appeared to increase, and hydrophobic persistent organic pollutants were retained. Ageing blubber adjacent to in-use smokehouses also resulted in considerable PAH deposition to processed samples. Our findings demonstrated that contaminant concentration differences were greater between the two sets of whale samples, based on age differences, than they were within each set of whale samples, due to variable preparation methods. When considering means to minimize human contaminant exposure while maximizing nutrient intake, consumption of aged liquid from younger male whales would be preferred, based on possible PUFA enhancement and selective depletion of hydrophilic environmental contaminants in this food item.

Mercury diminishes the cardiovascular protective effect of omega-3 polyunsaturated fatty acids in the modern diet of Inuit in Canada

BACKGROUND

Inuit in Canada have low reported incidence of myocardial infarction (MI) because of their traditional rich n-3 fatty acids marine diet. They are experiencing rapid nutrition transition and ischemic heart disease is now becoming a health concern.

OBJECTIVES

Our goal was to describe the modern Inuit diet, the eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and methyl mercury (MeHg) intake and estimate their contributions to the risk of MI. We also estimated the effect of promoting the consumption of more traditional food on Inuit's MI risk.

METHODS

We estimated the effect of Inuit diet on MI risk with modelling. Model formulas and assumptions were extracted from various epidemiology studies and literatures. International Polar Year Inuit Health Survey (IHS) was a comprehensive health and nutrition survey conducted in 2007-8 with 2072 participants (aged 18-79) in Canada. Traditional food intake, blood biomarkers values from the IHS served as the baseline parameters of model input.

RESULTS

Inuit traditional diet contained both high level of EPA, DHA and MeHg and their combined net effect was estimated to reduce the relative risk of MI by 1% for men and 2% for women. Arctic char meat provided the largest amount of EPA and DHA. Ringed seal liver was the main source for MeHg. Increase intake of selected fish, like salmon, herring and Arctic char by 75g per day can reduce the relative risk of MI (RR 0.70, 0.78 and 0.90 respectively).

CONCLUSIONS

In the Inuit diet, the beneficial effect on MI of EPA and DHA is diminished by the adverse effect of MeHg. Promoting the increase consumption of fish species with high EPA+DHA and low MeHg may help to prevent MI among Inuit.

Global survey of the omega-3 fatty acids, docosahexaenoic acid and eicosapentaenoic acid in the blood stream of healthy adults

Studies reporting blood levels of the omega-3 polyunsaturated fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), were systematically identified in order to create a global map identifying countries and regions with different blood levels. Included studies were those of healthy adults, published in 1980 or later. A total of 298 studies met all inclusion criteria. Studies reported fatty acids in various blood fractions including plasma total lipids (33%), plasma phospholipid (32%), erythrocytes (32%) and whole blood (3.0%). Fatty acid data from each blood fraction were converted to relative weight percentages (wt.%) and then assigned to one of four discrete ranges (high, moderate, low, very low) corresponding to wt.% EPA+DHA in erythrocyte equivalents. Regions with high EPA+DHA blood levels (>8%) included the Sea of Japan, Scandinavia, and areas with indigenous populations or populations not fully adapted to Westernized food habits. Very low blood levels (≤4%) were observed in North America, Central and South America, Europe, the Middle East, Southeast Asia, and Africa. The present review reveals considerable variability in blood levels of EPA+DHA and the very low to low range of blood EPA+DHA for most of the world may increase global risk for chronic disease.

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

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

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

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

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

Relationship between the esterase paraoxonase-1 (PON1) and metal concentrations in the whole blood of Inuit in Canada

The esterase paraoxonase (PON1), a major component of high-density lipoprotein (HDL), protects against the development of atherosclerosis in humans. Although variation in PON1 activity is primarily governed by PON1 genotype, there is growing evidence that environmental chemicals may also modulate its activity. This cross-sectional study aimed to determine whether environmental exposure to various metals is associated with PON1 activity in Inuit people routinely exposed to mercury (Hg), cadmium (Cd), lead (Pb), and (Se) selenium. PON1 activity and metal concentrations were measured in blood collected from 2172 healthy participants. Sociodemographic, anthropometric and lifestyle variables were also assessed. The associations between PON1 activity and blood metal concentrations, HDL, omega-3 fatty acid blood levels, age, sex, body mass index (BMI), and lifestyle habits (e.g. smoking and alcohol consumption) were explored via multiple linear regression. PON1 activity was positively associated with Se blood concentration (β=0.056, P=0.001) but was negatively associated with Cd blood concentration (β=-0.025, P<0.001). No association was observed between PON1 activity and Hg or Pb blood concentrations. Our results suggest that: PON1 activity is modulated by metal exposure, and Inuit traditional foods may confer health benefit by increasing PON1 activity via higher Se intakes. These findings underline that current environmental metal exposures among Inuit living in the Canadian Arctic are associated with paraoxonase activity, a toxicologically-relevant biochemical parameter.

Usual dietary fatty acid intakes and red-blood-cell membrane fatty acid composition in Inuit children attending child-care centres in Nunavik, northern Québec, Canada

OBJECTIVES

To assess dietary fatty acid intakes and to examine the relationship between dietary sources of n-3 and n-6 PUFA and red-blood-cell (RBC) n-3 and n-6 PUFA composition.

DESIGN

A cross-sectional study. Dietary intakes were assessed with a 24 h dietary recall. A second recall was performed for 44 % of the children. Usual dietary intakes were estimated with the Software for Intake Distribution Estimation (SIDE). The fatty acid composition was measured in RBC membranes. Multivariate linear regression analyses were performed to explain RBC n-3 and n-6 PUFA concentrations.

SETTING

Child-care centres in Nunavik, northern Québec, Canada.

SUBJECTS

One hundred and sixty-seven Inuit children aged 11-53 months.

RESULTS

A high proportion of the participants had inadequate n-3 and n-6 PUFA intakes (47·9 % and 93·5 %, respectively). Breast-feeding status and consumption of traditional food during the first 24 h dietary recall were significantly associated with RBC n-3 PUFA levels. Older children also tended to have higher RBC n-3 PUFA levels (P = 0·0528), whereas sex, infant formula status and n-3 PUFA dietary intakes were not associated with RBC n-3 PUFA concentrations. RBC n-6 PUFA concentrations were positively associated with breast-feeding status and n-6 PUFA dietary intakes, whereas age, sex and infant formula status were not.

CONCLUSIONS

The present findings highlight the fact that Inuit pre-school children are not consuming enough n-3 and n-6 PUFA for optimum health. These observations call for actions to increase traditional food intake among Inuit children and to help them and their parents make healthier store-bought food choices.

Dietary advice on Inuit traditional food use needs to balance benefits and risks of mercury, selenium, and n3 fatty acids

Elevated concentrations of mercury (Hg) are commonly found in the traditional foods, including fish and marine mammals, of Inuit living in Canada's Arctic. As a result, Inuit often have higher dietary Hg intake and elevated Hg blood concentrations. However, these same traditional foods are excellent sources of essential nutrients. The goals of this study were 1) to identify the traditional food sources of Hg exposure for Inuit, 2) to estimate the percentage of Inuit who meet specific nutrient Dietary Reference Intakes and/or exceed the Toxicological Reference Values (TRVs), and 3) to evaluate options that maximize nutrient intake while minimizing contaminant exposure. A participatory cross-sectional survey was designed in consultation with Inuit in 3 Canadian Arctic jurisdictions (Nunatsiavut, Nunavut, and the Inuvialuit Settlement Region). Estimated intakes for EPA (20:5n3) and DHA (22:6n3) met suggested dietary targets, and estimated selenium (Se) intake fell within the Acceptable Range of Oral Intake. Estimated intakes of Hg (rs = 0.41, P < 0.001), Se (rs = 0.44, P < 0.001), EPA (rs = 0.32, P < 0.001), and DHA (rs = 0.28, P < 0.001) were correlated with their respective blood concentrations. Mean estimated Hg intake (7.9 μg · kg(-1) · wk(-1)) exceeded the TRV of 5.0 μg · kg(-1) · wk(-1), with 35% of the population above this guideline. Because the estimated intakes of each of the nutrients were strongly correlated (Se: rs = 0.92, P < 0.001; EPA: rs = 0.82, P < 0.001; DHA: rs = 0.81, P < 0.001) with estimated Hg intake, efforts to decrease Hg exposure must emphasize the overall healthfulness of traditional foods and be designed to prevent concomitant harm to the nutrient intakes of Inuit.

Hunger among Inuit children in Canada

Background and objectives

Inuit populations may be at increased risk for experiencing poor nutrition or hunger due to limited access and availability to food. The prevalence and correlates of parental perceptions of hunger among a nationally representative sample of Inuit children in Canada have not yet been reported.

Design

Data are from the 2006 Aboriginal Children's Survey (ACS). Sociodemographic information, dietary behaviours and hunger status were parent-reported via a household interview for Inuit children aged 2–5 years (n=1,234). Prevalence of hunger was calculated among Inuit children by sociodemographic factors and by dietary behaviours. In addition, a multivariate logistic regression model was conducted to determine factors associated with parental perception of ever experiencing hunger.

Results

The prevalence of Inuit children in Canada aged 2–5 years ever experiencing hunger was 24.4%. Children who were reported to have experienced hunger consumed milk and milk products (p<0.001); fish, eggs and meat (p<0.05); fruits (p<0.001); and vegetables (p<0.001) significantly less often than never-hungry children. Fast food and processed foods, soft drinks and juice, and salty snacks, sweets and desserts were consumed as often as never-hungry children (all p>0.05). The majority (81%) of Inuit parents/guardians of ever-hungry children sought help from family or friends. Factors associated with an increased likelihood of experiencing hunger include sociodemographic characteristics (such as income and household size), living in an Inuit region and living in a community with cultural activities.

Conclusion

About 1 in 4 Inuit children were reported by their parents to have experienced hunger, and hunger was associated with region, sociodemographic and community factors. Future research could further examine the impact of ever experiencing hunger on the health status of Inuit children and their families in Canada.

Higher n3-fatty acid status is associated with lower risk of iron depletion among food insecure Canadian Inuit women

BACKGROUND

High rates of iron deficiency and anemia are common among Inuit and Arctic women despite a traditional diet based on animal source foods. However, representative data on iron status and relevant determinants for this population are lacking. The objectives were to determine the prevalence of anemia and depletion of iron stores, then to identify correlates of iron status in non-pregnant Canadian Inuit women.

METHODS

In a cross-sectional survey of 1550 women in the International Polar Year Inuit Health Survey, 2007-2008, hemoglobin, serum ferritin, soluble transferrin receptor (on a subset), C-reactive protein (CRP), RBC fatty acid composition, and H pylori serology were analyzed on fasting venous blood. Sociodemographic, food security status, anthropometric, dietary, and health data were collected. Correlates of iron status were assessed with multivariate linear and logistic models.

RESULTS

Anemia was observed in 21.7% and iron deficient erythropoiesis in 3.3% of women. For women with CRP ≤ 10 mg/L (n = 1260) 29.4% had depleted iron stores. Inadequate iron intakes were observed in 16% of premenopausal and <1% of postmenopausal women. Among food insecure women, higher long-chain (n-3) polyunsaturated fatty acid (LC-PUFA) status, which reflects a more traditional food pattern, was associated with reduced risk of iron depletion.

CONCLUSIONS

Iron depletion and anemia are a concern for Inuit women despite adequate total dietary iron intake primarily from heme sources. The high prevalence of H. pylori exposure, together with dietary iron adequacy, suggests an inflammation-driven iron deficiency and mild anemia. The anti-inflammatory properties of LC-PUFA may be important for iron status in this population.

Design and methods of the Adult Inuit Health Survey 2007-2008

Background

The Canadian International Polar Year (IPY) program made it possible to undertake much needed health research in 3 jurisdictions within the Canadian Inuit Nunangat (homeland) over a 2-year period: Inuvialuit Settlement Region (ISR), Nunavut Territory, and Nunatsiavut.

Design

The Adult Inuit Health Survey (IHS) was a cross-sectional survey and provides baseline data upon which future comparisons can be made for prospectively assessing factors leading to the progression of chronic diseases among Canadian Inuit. With the help of the Canadian Coast Guard Ship Amundsen, which was equipped with research and laboratory facilities, 33 coastal communities were visited; land survey teams visited 3 inland communities.

Results

The Adult IHS succeeded in obtaining important baseline information concerning the health status and living conditions of 2,595 adults living in ISR, Nunavut and Nunatsiavut.

Conclusion

Information from this survey will be useful for future comparisons and the opportunity to link with the International Inuit Cohort, a follow-up evaluation, and for the development of future health policies and public health interventions.

How is nutrition transition affecting dietary adequacy in Eeyouch (Cree) adults of Northern Quebec, Canada?

Rapid development, including the building of hydroelectric projects and roads in remote areas of Northern Quebec, Canada, has led to concerns about the contamination of traditional foods (TF) and a transition to a diet characterized by increased commercial food intake. A cross-sectional study of 850 Cree adults, aged ≥19 years, from 7 of the 9 Eeyouch communities was conducted during the spring and summer seasons of 2005-2008. Anthropometric measures were collected. TF and dietary intake were assessed using food-frequency questionnaires (FFQs) and 24-h recalls. Obesity was high, with 77% of the women and 64% of the men classified as obese. Past-year TF consumption was 100%, and 41% of participants reported eating TF on the 24-h recall. TF intake as reported on both the FFQs and the 24-h recalls was higher in individuals aged >50 years of age and in men, relative to younger adults and women, respectively. TF consumption increased protein, vitamin D, iron, and magnesium in all individuals, and energy, cholesterol, magnesium, sodium, and zinc in men aged 19-50 years; it decreased vitamin C in men and women aged ≥51 years. Participants reported drinking a mean daily 0.78 ± 1.34 cans of soft drinks or other high-sugar beverages per day or 5.28% ± 8.92% of total energy. It is important to identify behaviours that are contributing to obesity and its health consequences in this population and to find culturally appropriate ways to promote the consumption of TF and to reduce the consumption of energy-dense and nutrient-poor beverages and food items.

Isoprostanes and isofurans as non-traditional risk factors for cardiovascular disease among Canadian Inuit

OBJECTIVES

The aim of the present study was to investigate the potential importance of oxidative stress, measured by isoprostanes-related compounds, as non-traditional risk factor for cardiovascular disease. We planned to examine the relationship between concentrations of plasma F₂-isoprostanes (F₂-IsoPs), isofurans (IsoFs), measures of obesity and various cardiometabolic risk factors.

MATERIALS AND METHODS

Cross-sectional study using a sub-sample from the population of a survey conducted in the summer and fall 2007 and 2008 by Canadian Coastguard Ship Amundsen in 36 Canadian Arctic Inuit communities. Subjects included a subset (n = 233) of a total study population (n = 2595) with a mean age 42.56 ± 15.39 years and body mass index 27.78 ± 5.65 kg/m². Plasma levels of F₂-IsoPs and IsoFs was determined by gas chromatography/negative ion chemical ionization/mass spectrometry (GC/NICI/MS) method; and their relationships to waist circumference (WC), blood pressure C reactive proteins (CRP), blood lipids and fasting glucose were assessed by multivariate analyses.

RESULTS

Plasma F₂-IsoPs correlated positively with CRP (r =.132, P =.048) and systolic blood pressure (SBP) (r =.157, P =.024) after adjustment for age, sex and body mass index. IsoFs correlated with WC (r =.190, P =.005) and SBP (r =.137, P =.048). F2-IsoPs were not found elevated in smokers (P =.034), whereas IsoFs were decreased in smokers (P =.001). WC, SBP and sex were found to be major correlates of oxidative stress in Canadian Inuit.

CONCLUSIONS

Plasma measures of F₂-IsoPs and IsoFs increase with increased obesity and associated cardiometabolic risk factors, including CRP and blood pressure. Simultaneous measurement of IsoFs provides an advantageous mechanistic insight into oxidative stress not captured by F₂-IsoPs alone.