Measurement of diet quality among First Nations peoples in Canada and associations with health: a scoping review.

BACKGROUND: Given the increasing number and the diversity of dietary quality indices used for research, and the differences between settings, there is a need to identify valid indices of dietary quality in different contexts and populations and to identify their associations with health-related outcomes. OBJECTIVES: The primary objective of this scoping review is to identify the tools used in determining dietary quality among First Nations and to describe the changes in diet. The second objective is to describe the associations identified in studies that have measured the relationship between health and dietary quality among First Nations; and the third objective is to identify factors associated with diet quality. METHODS: PubMed, Embase, CINAHL, Global Health, and Web of Science were searched from inception to June 2021 and updated in February 2022. Articles were included if the research subjects were First Nations, or if articles reported disaggregated subset data for First Nations. Eligible studies focused on nutrition and diet and were published in English or French. RESULTS: A total of 151 articles were included in the analysis. Studies used several indicators to measure if individuals adhered to dietary guidelines. Traditional food consumption was frequently used as an indicator of diet quality (n = 96). The consumption of store-bought foods was used as an indicator in 28 studies. Some studies used other diet quality indicators such as the Healthy Eating Index (n = 5) and ultra-processed food "NOVA" classification (n = 6). A trend for decreasing traditional food intake over time was apparent, alongside an increase in store-bought food intake. This trend was accompanied with declining health status, including the increased prevalence of overweight and obesity, diabetes, metabolic diseases, and dental caries. CONCLUSION: This scoping review showed that diet quality among First Nations is improved when traditional foods are consumed. Reduced diet quality was associated with increased risk of noncommunicable diseases.

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.

Promoting traditional foods for human and environmental health: lessons from agroecology and Indigenous communities in Ecuador.

BACKGROUND: The displacement of traditional dietary practices is associated with negative nutritional consequences for rural Indigenous people, who already face the brunt of both nutritional inadequacies and excesses. Traditional food (TF) consumption and production practices can improve nutritional security by mitigating disruptive dietary transitions, providing nutrients and improving agricultural resilience. Meanwhile, traditional agricultural practices regenerate biodiversity to support healthy ecosystems. In Ecuador, Indigenous people have inserted TF agricultural and dietary practices as central elements of the country's agroecological farming movement. This study assesses factors that may promote TF practices in rural populations and explores the role of agroecology in strengthening such factors. METHODS: Mixed methods include a cross-sectional comparative survey of dietary, food acquisition, production and socioeconomic characteristics of agroecological farmers (n = 61) and neighboring reference farmers (n = 30) in Ecuador's Imbabura province. Instruments include 24-h dietary recall and a food frequency questionnaire of indicator traditional foods. We triangulate results using eight focus group discussions with farmers' associations. RESULTS: Compared to their neighbors, agroecological farmers produce and consume more TFs, and particularly underutilized TFs. Farm production diversity, reliance on non-market foods and agroecology participation act on a pathway in which TF production diversity predicts higher TF consumption diversity and ultimately TF consumption frequency. Age, income, market distance and education are not consistently associated with TF practices. Focus group discussions corroborate survey results and also identify affective (e.g. emotional) and commercial relationships in agroecological spaces as likely drivers of stronger TF practices. CONCLUSIONS: Traditional food practices in the Ecuadorian highlands are not relics of old, poor and isolated populations but rather an established part of life for diverse rural people. However, many TFs are underutilized. Sustainable agriculture initiatives may improve TF practices by integrating TFs into production diversity increases and into consumption of own production. Agroecology may be particularly effective because it is a self-expanding global movement that not only promotes the agricultural practices that are associated with TF production, but also appears to intensify affective sentiments toward TFs and inserts TFs in commercial spaces. Understanding how to promote TFs is necessary in order to scale up their potential to strengthen nutritional health.

The Agroecological Farmer's Pathways from Agriculture to Nutrition: A Practice-Based Case from Ecuador's Highlands.

Agroecology is increasingly recognized as a sustainable production strategy that is appropriate for the rural poor. Meanwhile, agricultural initiatives have received much attention for their role in improving farmer nutrition, and three key pathways between agriculture and nutrition include consumption of own production, income and women's empowerment. In this study based in Ecuador's Imbabura province, we used qualitative methods to explore the practices of agroecological farmers with respect to these three key pathways. Results demonstrate the heterogeneity of lived experiences through which agroecology increases agricultural diversity and builds social and human capital to improve nutrition. We further identify barter as an under-explored means to nutrition outcomes, and we discuss the role of the complex rationales that mediate farmers' performance on agriculture-for-nutrition pathways. Finally, our results illustrate agroecology's potential to spread nutrition-promoting practices through endogenous farmers' networks.