Olivier Receveur

Environmental contaminants and human health in the Canadian Arctic.

The third Canadian Arctic Human Health Assessment conducted under the Canadian Northern Contaminants Program (NCP), in association with the circumpolar Arctic Monitoring and Assessment Programme (AMAP), addresses concerns about possible adverse health effects in individuals exposed to environmental contaminants through a diet containing country foods. The objectives here are to: 1) provide data on changes in human contaminant concentrations and exposure among Canadian Arctic peoples; 2) identify new contaminants of concern; 3) discuss possible health effects; 4) outline risk communication about contaminants in country food; and 5) identify knowledge gaps for future contaminant research and monitoring. The nutritional and cultural benefits of country foods are substantial; however, some dietary studies suggest declines in the amount of country foods being consumed. Significant declines were found for most contaminants in maternal blood over the last 10 years within all three Arctic regions studied. Inuit continue to have the highest levels of almost all persistent organic pollutants (POPs) and metals among the ethnic groups studied. A greater proportion of people in the East exceed Health Canadas guidelines for PCBs and mercury, although the proportion of mothers exceeding these guidelines has decreased since the previous assessment. Further monitoring and research are required to assess trends and health effects of emerging contaminants. Infant development studies have shown possible subtle effects of prenatal exposure to heavy metals and some POPs on immune system function and neurodevelopment. New data suggest important beneficial effects on brain development for Inuit infants from some country food nutrients. The most successful risk communication processes balance the risks and benefits of a diet of country food through input from a variety of regional experts and the community, to incorporate the many socio-cultural and economic factors to arrive at a risk management decision that will be the most beneficial in Arctic communities.

Could the Quality of Dietary Fat, and Not Just Its Quantity, Be Related to Risk of Obesity?

This review focuses on the possible association between types of fatty acids and weight change. It examines the biological plausibility underlining these associations and the evidence obtained to date from clinical trials and epidemiological studies. Animal studies have shown that dietary short‐ and medium‐chain fatty acids compared to long‐chain fatty acids appear to promote weight loss. Similarly, monounsaturated fatty acids (MUFAs) appear to favor weight loss compared to saturated fatty acids (SFAs) in human studies. The structure of fatty acids seems to affect their degree of oxidation and deposition. Although results are conflicting, human studies follow the general trend reported in animal studies. These trials suggest that some fatty acids are prone to oxidation and some others lead to fat storage when comparing isocaloric diets. For instance, n‐3 polyunsaturated fatty acids (PUFAs), eicosapentaenoic and docosahexaenoic acids are preferentially oxidizied to other PUFA but results remain inconsistent. Epidemiological studies concerning this issue reported that total dietary fat, which includes MUFA, PUFA, and SFA could increase the risk of obesity, but results are few and conflicting. The rising biological plausibility linking dietary fat quality and risk of obesity, together with the rather recent addition of fatty acids content in food composition tables, support the need for major epidemiological studies in that area.

Traditional and market food access in Arctic Canada is affected by economic factors

Abstract Objectives. This study aimed to evaluate the access that Indigenous women have to traditional and market foods in 44 communities across Arctic Canada. Study design. This secondary data analysis used a cross-sectional survey of 1771 Yukon First Nations, Dene/Métis and Inuit women stratified by age. Methods. Socio-cultural questionnaires were used to investigate food access and chi-square testing was used to ascertain the distribution of subject responses by age and region. Results. There was considerable regional variation in the ability to afford adequate food, with between 40% and 70% saying they could afford enough food. Similarly, regional variation was reflected in the percentage of the population who could afford, or had access to, hunting or fishing equipment. Up to 50% of the responses indicated inadequate access to fishing and hunting equipment, and up to 46% of participants said they could not afford to go hunting or fishing. Conclusions. Affordability of market food and accessibility to hunting and fishing in Arctic Canada were major barriers to Indigenous women’s food security. (Int J Circumpolar Health 2006: 65(4): 331–340.)

Unique patterns of dietary adequacy in three cultures of Canadian Arctic indigenous peoples

BACKGROUND Information is needed on dietary adequacy of Arctic indigenous populations in Canada. Extensive work has been completed on composition of Arctic food and food use, and dietary reference intakes are available. OBJECTIVE To complete the first comprehensive dietary adequacy assessment of three populations of adult Arctic indigenous people. SETTING AND SUBJECTS Dietary assessment interviews were conducted with randomly selected indigenous adults during two seasons in 44 representative communities of Yukon First Nations (n = 797), Dene/Métis, (n = 1007) and Inuit (n = 1525). METHODS Twenty-four-hour recalls were used to derive adjusted distributions of usual nutrient intakes in four age/gender groups for assessment of dietary adequacy for carbohydrate, dietary fibre, protein, n-3 fatty acids, n-6 fatty acids, calcium, copper, iron, magnesium, manganese, phosphorus, selenium, zinc, vitamin A, riboflavin, folate, vitamin B6, vitamin C, vitamin D and vitamin E. RESULTS Nutrients with high prevalence of adequacy for most age/gender groups in all three cultures were protein, carbohydrate, n-3 fatty acids, iron, copper, zinc, manganese, selenium, riboflavin and vitamin B6; some individuals exceeded the upper intake level for iron, zinc, selenium, vitamin A and vitamin D. Estimated average requirement nutrients of concern for adequacy were magnesium, folate, vitamin A, vitamin C and vitamin E; however, a few age/gender groups were exceptions. Prevalence of inadequacy for AI nutrients which may be undesirably high were fibre, n-6 fatty acids and calcium. Vitamin D was more adequate in Inuit women and men than for Yukon First Nations or Dene/Métis. CONCLUSIONS Unique patterns of dietary adequacy exist among Arctic indigenous peoples. Local wildlife food sources and market food sources should be maximised for their nutrient contributions to Arctic diets.

Traditional food attributes must be included in studies of food security in the Canadian Arctic

Objectives. The objective was to explore some typically understudied characteristics of food security in Arctic Canada: observed changes to traditional food systems, perceived advantages and health benefits of traditional food and traditional food preferences. Study Design. Data analysis used a cross-sectional survey of Yukon First Nations, Dene/Metis and Inuit women in 44 Arctic communities. Methods. Open-ended responses to 4 questions were used to qualitatively investigate roles traditional foods play in Arctic food security. Chi-square tests were applied to responses to ascertain differences by age and region. A fifth question explored agreement with cultural responses to harvesting and using traditional food. Results. Traditional food was regarded as natural and fresh, tasty, healthy and nutritious, inexpensive, and socially and culturally beneficial. Between 10% and 38% of participants noticed recent changes in the quality or health of traditional food species, with physical changes and decreasing availability being reported most often. Caribou, moose and seal were among the foods considered particularly healthy and held special values in these populations. The opinion that all traditional food was healthy was also popular. More than 85%, of participants agreed with most cultural attributes of traditional food. Conclusions. This study confirms that traditional food remains important to Arctic indigenous women and that food security in the Arctic is contingent upon access to these foods.

Poor nutritional status of schoolchildren in urban and peri-urban areas of Ouagadougou (Burkina Faso)

BackgroundMalnutrition is still highly prevalent in developing countries. Schoolchildren may also be at high nutritional risk, not only under-five children. However, their nutritional status is poorly documented, particularly in urban areas. The paucity of information hinders the development of relevant nutrition programs for schoolchildren. The aim of this study carried out in Ouagadougou was to assess the nutritional status of schoolchildren attending public and private schools.MethodsThe study was carried out to provide baseline data for the implementation and evaluation of the Nutrition Friendly School Initiative of WHO. Six intervention schools and six matched control schools were selected and a sample of 649 schoolchildren (48% boys) aged 7-14 years old from 8 public and 4 private schools were studied. Anthropometric and haemoglobin measurements, along with thyroid palpation, were performed. Serum retinol was measured in a random sub-sample of children (N = 173). WHO criteria were used to assess nutritional status. Chi square and independent t-test were used for proportions and mean comparisons between groups.ResultsMean age of the children (48% boys) was 11.5 ± 1.2 years. Micronutrient malnutrition was highly prevalent, with 38.7% low serum retinol and 40.4% anaemia. The prevalence of stunting was 8.8% and that of thinness, 13.7%. The prevalence of anaemia (p = 0.001) and vitamin A deficiency (p < 0.001) was significantly higher in public than private schools. Goitre was not detected. Overweight/obesity was low (2.3%) and affected significantly more children in private schools (p = 0.009) and younger children (7-9 y) (p < 0.05). Thinness and stunting were significantly higher in peri-urban compared to urban schools (p < 0.05 and p = 0.004 respectively). Almost 15% of the children presented at least two nutritional deficiencies.ConclusionThis study shows that malnutrition and micronutrient deficiencies are also widely prevalent in schoolchildren in cities, and it underlines the need for nutrition interventions to target them.

Risk Factors for Moderate to Severe Anemia among Children in Benin and Mali: Insights from a Multilevel Analysis

Background Anemia currently affects 2 billion people throughout the world. Although the immediate causes of anemia among children are known (including malnutrition and infections), the importance of contextual determinants and their relationships with individual effects have rarely been explored. Objective To identify anemia risk factors at the individual, household, and community levels among Beninese and Malian children, using simple and multilevel regression methods. Methods An analysis was undertaken of nationally representative data collected in 2001 in Benin (n = 2,284) and Mali (n = 2,826) by the Demographic and Health Surveys. Sixteen potential risk factors for anemia were considered at the individual, household, and community levels. Comparative analyses were carried out using simple and multilevel logistic regression models. Results Simple and multilevel logistic regression analyses yielded broadly similar results. Risk factors for moderate to severe anemia included incomplete immunization, stunted growth, recent infection, absence of bednet, low household living standard, rural residency (Mali), low maternal education, and low community development index (Benin). In addition, multilevel analysis indicated a clustering level of anemia in communities (intraclass correlation) of 14% and 19% in Benin and Mali, respectively. Conclusions Risk factors for child anemia appeared at all three levels (individual, household and community). Community-level clustering seemed to be low. Therefore, interventions to address anemia need not be village- or region-specific. Identifying a successful and replicable program is now a priority in child survival endeavors. It is likely that such a program would include a focus on improving immunization coverage, increased bednet usage, and reduced protein–energy malnutrition.

Mercury in the traditional diet of indigenous peoples in Canada

Traditional food of indigenous people in Canada, particularly fish and marine mammal meat, has mercury (Hg) concentrations exceeding the Canadian consumption guideline level of 0.5 microg/g. Health effects of Hg in traditional food are, therefore, a concern. We conducted contaminant exposure assessments in 28 indigenous communities in Canada. Hg exposure was greatest among communities with high use of marine mammals as food. Exposure among other communities was variable. Recent adoption of a lower intake guideline for women of reproductive age and by Health Canada may decrease the use of traditional food, and could result in other health problems, such as increased risk of diabetes and cardiovascular disease.

Dietary Intake and Body Mass Index of Adults in 2 Ojibwe Communities

OBJECTIVE To describe and compare dietary intake and prevalence of overweight in a sample of adults in 2 Ojibwe communities in Mille Lacs, Minn, and Lac Courte Oreilles, Wis. DESIGN Cross-sectional survey based on interviews that included a 24-hour recall, food frequency questionnaire, and a sociocultural questionnaire. SUBJECTS/SETTING One hundred four adult Band (tribe) members were selected randomly from current housing lists; pregnant and lactating women were excluded. STATISTICAL ANALYSES PERFORMED Nonparametric Wilcoxon rank sum tests were used to determine differences in absolute nutrient intakes where normality could not be assumed. Two-tailed t tests were conducted to test for differences between nutrient densities. A significance level of alpha = .05 was used; procedurewise adjustments were made using the Bonferroni method when adjusting for multiple comparisons. RESULTS The importance of the traditional food system was evident: at least 50% of respondents engaged in hunting and fishing practices. Prevalence of overweight was 47%. Mean nutrient intakes were below the Recommended Dietary Allowance for women for vitamin A, folate, calcium, iron, and zinc and for men for vitamin A and calcium, despite energy intakes that met the Recommended Dietary Allowance. Nutrient densities were lower than those in the third National Health and Nutrition Examination Survey for women for carbohydrate, vitamin C, folate, calcium, and dietary fiber and for men for folate and dietary fiber. Fat contributed 37% (for men) and 40% (for women) of energy intake. APPLICATIONS/CONCLUSIONS Areas of focus for culturally relevant education programs (eg, promotion of traditional foods that provide nutrients of low intake status and low-fat traditional food preparation methods) and research needs are suggested to reduce risks for nutrition-related chronic disease among Native Americans.

Estimation of traditional food intake in indigenous communities in Denendeh and the Yukon

Abstract Objectives. Chronic non-communicable diseases related to excessive or unbalanced dietary intakes are on the rise among some Indigenous populations in Canada. Nutritional problems of Indigenous peoples arise in the transition from a traditional diet to a market diet characterized by highly processed foods with reduced nutrient density. This study aimed at assessing traditional food intake of Indigenous people in 18 communities. Study design. This study was cross-sectional with a sample size of 1,356. Methods. This study used food frequency and 24-hour recall questionnaires to quantify traditional food intake in 18 communities in the McKenzie basin of the Northwest Territories (Denendeh and the Yukon). Results. Typical daily intakes of groups of traditional food items were generated and intake of an extensive list of traditional food detailed for adult men and women. Per capita intake of traditional food items was also calculated. Conclusion. Reliance on traditional food intake is still high in Denendeh, as well as in the Yukon. The detailed description of the traditional food system presented here allows an accurate identification of the contribution of traditional food items to nutrient and contaminant intake by Indigenous people for future studies. (Int J Circumpolar Health 2005; 64(1):46–54)