Assessment of dietary adequacy in a remote Inuvialuit population.

BACKGROUND: Traditional foods are rich sources of essential nutrients, but Inuvialuit in the Northwest Territories (NWT), Canada, have been undergoing a nutrition transition, characterised by an increased consumption of non-nutrient-dense foods. The present study aimed to characterise energy, nutrient and food intakes amongst adult Inuvialuit. METHODS: The study collected up to three 24-h dietary recalls on nonconsecutive days for each participant in spring/summer of 2008 in one remote community in the NWT. Recall data were analysed for energy and nutrient intake, dietary adequacy, most commonly reported foods, and food contributors to energy and nutrients. RESULTS: Participants included 14 men and 50 women (response rate 79%). Median daily energy intake was 9.4 (interquartile range=5.7) MJ for men and 8.3 (3.6) MJ for women. The majority of adult Inuvialuit did not meet the recommendation for vitamins A [median intake=344.7 (246.3) µg-RAE in men, 248.9 (213.8) µg-RAE in women], B(6) [0.9 (0.8) mg in men, 1.0 (0.5) mg in women] and E [2.4 (2.1) mg in men, 1.8 (1.0) mg in women], dietary fibre [7.7 (5.7) g in men, 8.7 (4.4) g in women], calcium [779.6 (842.0) mg in men, 610.4 (431.5) mg in women] and total folate [222.6 (57.7) µg in men, 264.6 (127.5) µg in women]. Vitamin D intake was below the recommendation for most women [median intake=100.0 (119.2) IU]. Traditional foods contributed substantially to protein and iron intake. Juices were the main contributors to energy, carbohydrate and calcium. CONCLUSIONS: The present study revealed an inadequate consumption of essential nutrients in an Inuvialuit population. If these nutrient deficiencies continue, this population will face an increased burden of chronic diseases and malnutrition.

Prevalence and risk factors for self-reported chronic disease amongst Inuvialuit populations.

BACKGROUND: Chronic disease prevalence amongst Canadian Arctic populations is increasing, but the literature amongst Inuvialuit is limited. The present study aimed to provide baseline data that could be used to monitor changes in chronic disease risk factors and long-term health in the Arctic by determining prevalence and risk factors of self-reported chronic disease amongst adult Inuvialuit in remote communities. METHODS: Self-reported demographics and history of chronic disease (hypertension, heart disease, diabetes and cancer) were collected in three communities between July 2007 and July 2008 in the Northwest Territories. Food frequency questionnaires recorded dietary intake, International Physical Activity Questionnaires recorded physical activity and anthropometric measures of height and weight were obtained. RESULTS: Response rates ranged from 65-85%. More than 20% of the 228 participants aged 19-84 years reported having a chronic disease. Age-adjusted prevalence was 28, 9, 9 and 6 per 100 for hypertension, heart disease, diabetes and cancer, respectively. Compared with non-cases, participants reporting hypertension were more likely to have a higher body mass index and a lower level of education. Hypertension was more common amongst participants reporting heart disease and diabetes than Inuvialuit not reporting these morbidities. CONCLUSIONS: Inuvialuit participants in this study were most affected by hypertension and diabetes compared with heart disease or any cancer. Female participants had a higher prevalence of heart disease compared with the Canadian average. Primary preventive strategies are necessary to mitigate the increasing rates of chronic disease risk factors in this population. Further studies with a larger sample size and measured chronic disease are necessary to confirm the findings obtained in the present study.

Food patterns and socioeconomic indicators of food consumption amongst Inuvialuit in the Canadian Arctic.

BACKGROUND: Inuvialuit in the Canadian Arctic have been experiencing a nutrition transition resulting in a decrease in nutrient-dense food consumption, which may, in part, explain this population's increasing chronic disease rates. Because the available literature is limited, the present study aimed to document the extent of this transition by examining current dietary patterns and socioeconomic factors affecting food group consumption. METHODS: This cross-sectional study was conducted in three Inuvialuit communities in the Northwest Territories between 2007 and 2008. A validated food frequency questionnaire determined intake frequency of fruit and vegetables (FV), traditional foods (TF) and non-nutrient-dense foods (NNDF). Socioeconomic status (SES) was assessed by questions on education, ownership of items in working condition used to create a Material Style of Life (MSL) scale and residents in household employed/on income support. Daily intake frequencies were compared by gender and age group using Wilcoxon rank sum test. SES association with food group intake was determined using logistic regression. RESULTS: The response rate was 65-85%. One hundred and seventy-five participants were female and 55 were male, aged 19-84 years [mean (SD) 44 (14)]. Mean frequencies of FV and TF consumption were 1.6 (1.5) and 1.6 (1.7) times per day, respectively. NNDF were reported 9.2 (3.0) times per day. The highest MSL score (>12) was significantly associated with higher fruit (≥0.7 times per day) and higher TF intake (≥1.1 times per day) compared with the lowest score (≤7). An intermediate MSL score (8-12) was related to higher vegetable consumption (≥0.4 times per day). CONCLUSIONS: NNDF were consumed approximately seven times more frequently than TF in the present study, indicating that the dietary transition is well underway amongst Inuvialuit. Participants with higher SES were more likely to consume nutrient-dense foods, suggesting possible cost barriers.

Important psychosocial factors to target in nutrition interventions to improve diet in Inuvialuit communities in the Canadian Arctic.

BACKGROUND: With increasing chronic disease amongst Inuvialuit in the Canadian Arctic, research on dietary behaviours and their determinants in this population is needed to develop nutritional behaviour change intervention strategies. The present study aimed to assess the knowledge, self-efficacy and intentions towards healthy eating and healthy eating behaviours of Inuvialuit adults in the Northwest Territories (NWT), Canada. METHODS: The Adult Impact Questionnaire was developed from behavioural theories and workshops held in the communities. It was conducted with adult Inuvialuit (≥19 years) from randomly selected households in three NWT communities to collect data on the psychosocial constructs of healthy food knowledge, self-efficacy and intentions, and the dietary behaviours of healthy and unhealthy food acquisition and preparation. Associations between demographic, socioeconomic, psychosocial constructs and behaviours were analysed using multivariate linear regression. RESULTS: The 228 participants [mean (SD) age 43.4 (13.6) years; response rates 65-85%] acquired non-nutrient-dense foods a mean (SD) of 2.7 (3.0) times more frequently than nutrient-dense, low sugar and low fat foods. Increased intention was associated with a greater frequency of acquiring healthy foods (ß=0.17, P=0.012) and a lower frequency of acquiring unhealthy foods (ß=-0.18, P=0.008). Overall, participants reported using food preparation methods that reduce fat content slightly more than methods that add fat [mean (SD) score 0.3 (1.9)]. Use of healthier food preparation methods was associated with higher levels of healthy food knowledge (ß=0.26, P<0.001), self-efficacy (ß=0.29, P<0.001) and intentions (ß=0.22, P=0.001). CONCLUSIONS: Healthy food intention was the construct most significantly associated with all three healthier dietary behaviours. Interventions that target intentions to change food choice and preparation may be effective strategies to improve dietary intake in Inuvialuit populations.

Inuvialuit adults in the Canadian Arctic have a high body mass index and self-reported physical activity.

BACKGROUND: Inuvialuit in Arctic Canada are undergoing nutrition and lifestyle transitions that encourage decreased physical activity (PA) and increased body mass index (BMI), although data specific to PA and BMI within this unique population are not currently available. The present study aimed to characterise current PA and BMI levels in a sample of Inuvialuit adults. METHODS: Inuvialuit adults randomly selected from a cross-sectional survey of three communities in the Northwest Territories, Canada, completed an adapted International Physical Activity Questionnaire (IPAQ) and an anthropometric questionnaire to obtain height and weight. Data were analysed using the standardised IPAQ protocol, and the results are presented by gender and age group (≤50 and >50 years). RESULTS: One hundred and ninety-six Inuvialuit adults [148 women, 48 men; mean (standard deviation (SD)) ages 45 (14) and 41 (14) years, respectively; age range 19-84 years] completed the IPAQ (response rates 65-85%). Seventy-one percent of men and 74% of women allowed height measurements, whilst 81% and 84% allowed weight measurements, respectively; the remainder provided self-reported anthropometrics. Mean (SD) BMIs were 28.6 (7.7) kg/m(2) for males and 30.5 (8.8) kg/m(2) for females. The greatest percentage of participants in both gender and age groups fell into the obese BMI category. Self-reported PA was high, with means for men and participants ≤50 years in the high category of PA and means for women and participants >50 years in the medium category. Almost two-thirds (65%) of participants were classified as being overweight or obese, although 89% reported medium or high levels of PA. CONCLUSIONS: The results obtained in the present study indicate widespread overweight/obesity accompanying high levels of self-reported PA.