Assessment of dietary intake among Inuvialuit in Arctic Canada using a locally developed quantitative food frequency questionnaire.

OBJECTIVE: Inuvialuit in Arctic Canada are experiencing a nutritional and lifestyle transition, characterized by a declining consumption of traditional foods, increased consumption of non-nutrient-dense store-bought foods (NNDF), and reduced levels of physical activity with a concurrent rise in chronic diseases. The aim of the present study was to determine dietary intake of Inuvialuit adults in the Northwest Territories, Canada, using a culturally specific, validated quantitative food frequency questionnaire (QFFQ). METHODS: A cross-sectional dietary survey of 213 randomly selected adults (≥19 years) was conducted in 3 remote communities in the Northwest Territories. Nonparametric analysis was used to compare mean nutrient intake, dietary inadequacy, and differences in nutrient density among men and women. Data were also analyzed to determine the top food groups contributing to energy and selected nutrients. RESULTS: With response rates of 65% to 85%, 43 men (mean age 43.2 ± 12.8) and 170 women (mean age 44.7 ± 13.9) completed the QFFQ. Mean daily energy intakes for men were 3478 ± 1474 kcal and for women they were 3299 ± 1653 kcal. For both sexes, protein, carbohydrates, and fat provided approximately 16%, 47%, and 28% of energy intake, respectively. NNDFs were the top contributors to energy (39%), fat (40%), carbohydrate (54%), sugar (74%), and sodium (23%) intake. Total traditional foods from the land, sea, and sky such as polar bear and wild birds contributed 11% of energy and 41% of protein intake. Most participants' daily intakes were below recommended levels for dietary fiber; vitamins A, E, and D; potassium; and magnesium. Mean daily energy, saturated fat, and sodium intakes exceeded recommendations. CONCLUSIONS: We identified nutrient inadequacies and characterized food consumption among Inuvialuit. These data support nutritional interventions that encourage consumption of traditional foods. The cultural and ethnic differences in Canadian Arctic populations require specific tailoring of public health interventions and policy using population specific tools to meet local needs.

Healthy Foods North improves diet among Inuit and Inuvialuit women of childbearing age in Arctic Canada.

BACKGROUND: Healthy Foods North (HFN) is a community-based intervention designed to promote a healthy diet and lifestyle of Inuit and Inuvialuit populations in Arctic Canada. The objective of the present study was to determine the effects of HFN on the nutrient intake of women of childbearing age. METHODS: Six communities in Nunavut (n = 3) and the Northwest Territories (n = 3) were selected for programme implementation; four received a 12-month intervention and two served as controls. Quantitative food frequency questionnaires were used to assess dietary intake at baseline and 1 year post-intervention. Among women participants aged 19-44 years (n = 136), 79 were exposed to the intervention and 57 were not. Mean daily energy and nutrient intake and density were determined. Dietary adequacy was assessed by comparing the women's daily nutrient intakes with dietary reference intakes (DRI). RESULTS: Main outcomes were the pre- to post-intervention changes between intervention and control groups for energy and selected nutrient intakes, nutrient density and dietary adequacy. Among the participants, the intervention had a beneficial effect on vitamin A and D intake. The percentage of individuals with nutrient intakes below the DRI increased from pre- to post-intervention for vitamin A and D in the control group but only for vitamin A in the intervention group. The programme did not have a significant impact on calorie, sugar, or fat consumption. CONCLUSIONS: The HFN programme is effective in mitigating some of the negative impacts of the nutrition transition on dietary adequacy among Inuit and Inuvialuit women of childbearing age.

Dietary adequacy and alcohol consumption of Inuvialuit women of child-bearing age in the Northwest Territories, Canada.

BACKGROUND: Previous studies highlight a possible association between alcohol-drinking patterns and dietary inadequacies, which may have negative implications, particularly for women of child-bearing age. The present study aimed to compare dietary adequacy among alcohol drinkers versus nondrinkers in Inuvialuit women of child-bearing age. METHODS: A cross-sectional survey of 92 randomly selected women of childbearing age (19-44 years) was conducted in three communities in the Northwest Territories of Arctic Canada, using a validated quantitative food frequency questionnaire. Data were analysed to compare mean daily energy and nutrient intakes, dietary adequacy and nutrient densities (per 4184 kJ) between alcohol drinkers and nondrinkers, as well as heavy drinkers and nonheavy drinkers, using the nonparametric Wilcoxen rank sum test. RESULTS: The response rate was between 65% and 85% depending on the community sampled. Of the study participants, 54% (n = 49) were drinkers and 46% (n = 42) were nondrinkers. Of the drinkers, 45% (n = 22) were heavy drinkers. Mean energy intakes were high among all women, although they were significantly higher among drinkers [17,179 kJ (4106 kcal)] compared to nondrinkers [13,317 kJ (3183 kcal)]. There were no significant differences in nutrient intake between the two groups; however, drinkers had a lower nutrient density for most nutrients. Heavy drinkers had a significantly lower nutrient density for all nutrients, except protein, iron, and vitamins B6 , C and D, compared to nonheavy drinkers. CONCLUSIONS: The findings of the present study provide evidence of inadequate dietary intake among Inuvialuit of child-bearing age, regardless of alcohol-drinking behaviour.

The adaptation of the beyond cold water bootcamp course for Inuvialuit communities in Northwest Territories, Canada.

Boating-related fatalities in the Northwest Territories (NWT) are well above the national average. These fatalities are exacerbated by very cold water, and water and boating safety resources that lack relevance to residents of northern communities. We utilised an iterative, participatory approach to create a plain language, culturally and geographically adapted version of a cold water survival course, "Beyond Cold Water Bootcamp". The purpose of this research was to determine what adaptations are necessary to create appealing and pertinent boating safety interventions for Inuvialuit communities in the NWT and to demonstrate the value of generating such interventions. First, we conducted a focus group with boating safety experts to gain feedback on the first draft of the adapted course. We then subsequently completed a pilot of the course with community members in Tuktoyaktuk, NWT, and we obtained their feedback and suggestions. We then trained a local community member to deliver the course and conducted another focus group with residents. Using reflexive thematic analysis, our results demonstrated the value of culturally and geographically adapted boating safety interventions for Inuvialuit communities and the importance of relinquishing colonial power structures and enabling community members to independently adapt and disseminate knowledge.

Development of a strategic plan for food security and safety in the Inuvialuit Settlement Region, Canada.

BACKGROUND: Current social and environmental changes in the Arctic challenge the health and well-being of its residents. Developing evidence-informed adaptive measures in response to these changes is a priority for communities, governments and researchers. OBJECTIVES: To develop strategic planning to promote food security and food safety in the Inuvialuit Settlement Region (ISR), Northwest Territories (NWT), Canada. DESIGN: A qualitative study using group discussions during a workshop. METHODS: A regional workshop gathered Inuit organizations and community representatives, university-based researchers from the Inuit Health Survey (IHS) and NWT governmental organizations. Discussions were structured around the findings from the IHS. For each key area, programs and activities were identified and prioritized by group discussion and voting. RESULTS: The working group developed a vision for future research and intervention, which is to empower communities to promote health, well-being and environmental sustainability in the ISR. The group elaborated missions for the region that address the following issues: (a) capacity building within communities; (b) promotion of the use of traditional foods to address food security; (c) research to better understand the linkages between diseases and contaminants in traditional foods, market foods and lifestyle choices; (d) and promotion of affordable housing. Five programs to address each key area were developed as follows: harvest support and traditional food sharing; education and promotion; governance and policy; research; and housing. Concrete activities were identified to guide future research and intervention projects. CONCLUSIONS: The results of the planning workshop provide a blueprint for future research and intervention projects.

Body burden of metals and persistent organic pollutants among Inuit in the Canadian Arctic.

Inuit living in the Arctic are exposed to elevated levels of environmental contaminants primarily due to long-range atmospheric transport. Blood sampling and contaminant biomonitoring was conducted as part of the International Polar Year Inuit Health Survey in 2007-2008. The body burden of metals (e.g. Cd, Pb) and persistent organic pollutants (e.g. PCBs, DDT & DDE, toxaphene, chlordane, PBDEs) were measured for Inuit participants (n=2172) from 36 communities in Nunavut, Nunatsiavut, and the Inuvialuit Settlement Region, in Canada. The geometric mean of blood concentrations for Cd, Pb, PCBs, DDE & DDT, toxaphene, and chlordane were higher than those in the Canadian general population. A total of 9% of study participants exceeded the intervention guideline of 100µgL(-1) for Pb, 11% of participants exceeded the trigger guideline of 5µgL(-1) for Cd, and 1% exceeded the intervention guideline of 100µgL(-1) for PCBs. Also, 3% of women of child-bearing age exceeded blood Pb of 100µgL(-1) while 28% of women of child-bearing age exceeded 5µgL(-1) of PCBs. This work showed that most Inuit Health Survey participants were below blood contaminant guidelines set by Health Canada but that metal and POP body burdens commonly exceed exposures observed in the general population of Canada.