Quality of diet is associated with insulin resistance in the Cree (Eeyouch) indigenous population of northern Québec.

BACKGROUND AND AIMS: Indigenous people worldwide have a greater disease burden than their non-aboriginal counterparts with health challenges that include increased obesity and higher prevalence of diabetes. We investigate the relationships of dietary patterns with nutritional biomarkers, selected environmental contaminants and measures of insulin resistance in the Cree (Eeyouch) of northern Québec Canada. METHODS AND RESULTS: The cross-sectional 'Nituuchischaayihitaau Aschii: A Multi-Community Environment-and-Health Study in Eeyou Istchee' recruited 835 adult participants (≥18 y) from 7 communities in the James Bay region of northern Québec. The three dietary patterns identified by principal component analysis (PCA) were: inland and coastal patterns with loadings on traditional foods, and a junk food pattern with high-fat and high-sugar foods. We investigated dietary patterns scores (in quantiles) in relation with nutritional biomarkers, environmental contaminants, anthropometry, blood pressure, fasting plasma glucose and insulin, and insulin resistance. Homeostatic model assessment (HOMA-IR) was used as surrogate markers of insulin resistance. ANCOVA ascertained relationships between dietary patterns relationship and outcomes. Greater scores for the traditional patterns were associated with higher levels of n-3 fatty acids, mercury and polychlorinated biphenyls (PCBs) (P trend <0.001). Higher scores for the junk food pattern were associated with lower levels of PCBs and Vitamin D, but higher fasting plasma insulin and HOMA-IR. CONCLUSION: Our results suggest that poor diet quality accompanied greater insulin resistance. Impacts of diet quality on insulin resistance, as a sign of metabolism perturbation, deserve more attention in this indigenous population with high rates of obesity and diabetes.

Implementation of a community greenhouse in a remote, sub-Arctic First Nations community in Ontario, Canada: a descriptive case study.

INTRODUCTION: Food insecurity is prevalent in northern communities in Canada and there is a movement to improve food security through both the re-vitalization of traditional harvesting practices as well as through sustainable agriculture initiatives. Gardening in northern communities can be difficult and may be aided by a community greenhouse. The objective of this project was to conduct a descriptive case study of the context and process surrounding the implementation of a community greenhouse in a remote, sub-Arctic First Nations community in Ontario, Canada. METHOD: Data sources included semi-directed interviews with a purposive and snowball sample of key informants (n=14), direct observations (n=32 days), written documentation (n=107), and photo-documentation (n=621 total). Digital photographs were taken by both a university investigator during community visits and a community investigator throughout the entire project. The case study was carried out over 33 months; from early 2009 until October of 2011. Thematic data analyses were conducted and followed a categorical aggregation approach. RESULTS: Categories emerging from the data were appointed gardening-related themes: seasons, fertile ground, sustainability, gardeners, ownership, participant growth, and sunshine. Local champions were critical to project success. Uncertainty was expressed by several participants regarding ownership of the greenhouse; the local community members who championed the project had to emphasize, repeatedly, that it was community owned. Positive outcomes included the involvement of many community members, a host of related activities, and that the greenhouse has been a learning opportunity to gain knowledge about growing plants in a northern greenhouse setting. A strength of the project was that many children participated in greenhouse activities. CONCLUSIONS: Community and school greenhouse projects require local champions to be successful. It is important to establish guidelines around ownership of a greenhouse and suitable procedures for making the building accessible to everyone without compromising security. Implementing a greenhouse project can engage community members, including children, and provide a great learning opportunity for gardeners in a remote, northern community.

Body Mass Index of First Nations youth in Ontario, Canada: influence of sleep and screen time.

INTRODUCTION: Prevalence rates of overweight and obesity in Canada have risen rapidly in the past 20 years. Concurrent with the obesity epidemic, sleep time and physical activity levels have decreased among youth. Aboriginal youth experience disproportionately high obesity prevalence but there is inadequate knowledge of contributing factors. This research aimed to examine sleep and screen time behavior and their relationship to Body Mass Index (BMI) in on-reserve First Nations youth from Ontario, Canada. METHODS: This was an observational population-based study of cross-sectional design. Self-reported physical activity, screen time, and lifestyle information was collected from 348 youth aged 10-18 years residing in five northern, remote First Nations communities and one southern First Nations community in Ontario, Canada, from October 2004 to June 2010. Data were collected in the school setting using the Waterloo Web-based Eating Behaviour Questionnaire. Based on self-reported height and weight, youth were classified normal (including underweight), overweight and obese according to BMI. Descriptive cross-tabulations and Pearson's χ² tests were used to compare screen time, sleep habits, and physical activity across BMI categories. RESULTS: Participants demonstrated low levels of after-school physical activity, and screen time in excess of national guidelines. Overall, 75.5% reported being active in the evening three or less times per week. Approximately one-quarter of the surveyed youth watched more than 2 hours of television daily and 33.9% spent more than 2 hours on the internet or playing video games. For boys, time using the internet/video games (p=0.022) was positively associated with BMI category, with a greater than expected proportion of obese boys spending more than 2 hours using the internet or video games daily (56.7%). Also for boys, time spent outside after school (p=0.033) was negatively associated with BMI category, with a lesser than expected proportion spending 'most of the time' outside (presumably being active) after school. These relationships were not observed in girls. Adjusted standardized residuals suggest a greater than expected proportion of obese individuals had a television in their bedroom (66.7%) as compared with the rest of the population. CONCLUSIONS: The current study adds to the limited information about contributors to overweight and obesity in First Nations youth living on-reserve in Canada. Concerns about inadequate sleep, excess screen time, and inadequate physical activity mirror those of the general population. Further investigation is warranted to improve the understanding of how various lifestyle behaviors influence overweight, obesity, and the development of chronic disease among First Nations youth. Initiatives to reduce screen time, increase physical activity, and encourage adequate sleep among on-reserve First Nations youth are recommended.

Government bodies and their influence on the 2009 H1N1 health sector pandemic response in remote and isolated First Nation communities of sub-Arctic Ontario, Canada.

INTRODUCTION: First Nation communities were highly impacted by the 2009 H1N1 influenza pandemic. Multiple government bodies (ie federal, provincial, and First Nations) in Canada share responsibility for the health sector pandemic response in remote and isolated First Nation communities and this may have resulted in a fragmented pandemic response. This study aimed to discover if and how the dichotomy (or trichotomy) of involved government bodies led to barriers faced and opportunities for improvement during the health sector response to the 2009 H1N1 pandemic in three remote and isolated sub-arctic First Nation communities of northern Ontario, Canada. METHODS: A qualitative community-based participatory approach was employed. Semi-directed interviews were conducted with adult key informants (n=13) using purposive sampling of participants representing the two (or three) government bodies of each study community. Data were manually transcribed and coded using deductive and inductive thematic analysis to reveal positive aspects, barriers faced, and opportunities for improvement along with the similarities and differences regarding the pandemic responses of each government body. RESULTS: Primary barriers faced by participants included receiving contradicting governmental guidelines and direction from many sources. In addition, there was a lack of human resources, information sharing, and specific details included in community-level pandemic plans. Recommended areas of improvement include developing a complementary communication plan, increasing human resources, and updating community-level pandemic plans. CONCLUSIONS: Participants reported many issues that may be attributable to the dichotomy (or trichotomy) of government bodies responsible for healthcare delivery during a pandemic. Increasing formal communication and collaboration between responsible government bodies will assist in clarifying roles and responsibilities and improve the pandemic response in Canada's remote and isolated First Nation communities.

Determining tissue-lead levels in large game mammals harvested with lead bullets: human health concerns.

Recently, the use of lead isotope ratios has definitively identified lead ammunition as a source of lead exposure for First Nations people, but the isotope ratios for lead pellets and bullets were indistinguishable. Thus, lead-contaminated meat from game harvested with lead bullets may also be contributing to the lead body burden; however, few studies have determined if lead bullet fragments are present in big game carcasses. We found elevated tissue-lead concentrations (up to 5,726.0 microg/g ww) in liver (5/9) and muscle (6/7) samples of big game harvested with lead bullets and radiographic evidence of lead fragments. Thus, we would advise that the tissue surrounding the wound channel be removed and discarded, as this tissue may be contaminated by lead bullet fragments.

The use of leeches to monitor aquatic PCB contamination at Mid-Canada Radar Line site 050: four years post-remediation.

The Mid-Canada Radar Line (MCRL) was built by the Canadian government during the 1950s and closed in the 1960s. MCRL Site 050 located in close proximity to Fort Albany First Nation was a source of polychlorinated biphenyls (PCBs); thus, this site was remediated in 2001. There has been concern in Fort Albany that the Albany River by MCRL Site 050 is still contaminated. We examined whether the aquatic environment surrounding MCRL Site 050 has returned to background levels four years post-remediation using leeches (Haemopis spp.) as bioindicators. Leech data for 2005 indicates that PCB levels remain higher near Site 050 than at the control site upstream; however, there has been a decrease in difference between Site 050 and the control site for leech body burden between years. Thus, the removal of the terrestrial source of PCB contamination at Site 050 appears to have removed the main source of aquatic PCBs.

Elevated blood-lead levels in first nation people of Northern Ontario Canada: policy implications.

We evaluated the preliminary impact of the Canadian "non-toxic" shotshell policy, for the hunting of migratory game birds, by examining blood-lead levels of First Nations people living in sub-arctic Canada. If the use of lead shotshell was the major source of lead exposure as has been postulated and the ban on the use of lead shotshell for hunting migratory birds was immediately effective, we would expect that blood-lead levels would be typical of a geographic area remote from industrialization. Our findings present some concern in that approximately 18% of the 196 First Nations people examined had blood-lead levels > or =100 microg/L.

The use of leeches and logit log-linear contingency models to assess and monitor aquatic PCB contamination originating from mid-Canada radar line site 050.

Abandoned military sites in northern North America are relics of the Cold War and sources of polychlorinated biphenyls (PCBs). In the late 1990s, the Canadian federal and provincial governments began the cleanup of the mid-Canada radar line in Ontario, Canada. The first site to be remediated was Site 050 (Fort Albany First Nation) in 2001; however, the community remains concerned that contaminants may have moved prior to, during, and after remediation into the Albany River directly adjacent to Site 050. Thus, the Albany River was monitored (1999, 2001, 2002) during the remediation process to determine if the cleanup itself further contaminated the aquatic compartment, using leeches (Haemopis spp.) as bioindicators. Few organochlorines were found in leeches at levels higher than the detection limit, aside from PCBs. Leech data from the present study indicated that PCB levels were significantly higher near Site 050 than the control site upstream, indicating point source contamination from Site 050. The temporal trend in leech contaminant data indicated an increase in PCB contaminant load from 1999 (pre-remediation) to 2001 (immediately post-remediation), but this difference was not statistically significant due to high variances. Nevertheless, logit log-linear contingency modeling did reveal that immediately after cleanup (2001), contaminants (CBs 99, 118, 128, 156, 170, 183) in leeches were detected significantly more frequent than expected. When taken together, leech body burden and frequency of detection data suggest that the remediation process itself further contaminated the aquatic environment, if only temporarily. Lastly, the removal of the terrestrial source of PCBs during remediation did remove the source of aquatic contaminants in that body burden of contaminants in leeches were significantly lower a year after cleanup.

Lead pellet ingestion and liver-lead concentrations in upland game birds from southern Ontario, Canada.

One-hundred twenty-three gizzards from upland game birds (chukar, Alectoris chukar; and common pheasant, Phasianus colchicus) harvested by hunters in southern Ontario, Canada, were examined for lead pellet ingestion by manual examination of gizzard contents and by radiography. Lead pellets were found to be ingested by chukars (6/76; 8%) and the common pheasant (16/47; 34%). Further, 13% (17/129) of the bird (wild turkey, Meleagris gallopavo; Hungarian partridge, Perdix perdix; chukar; and common pheasant) livers analyzed had elevated lead concentrations (> or =6 microg/g wet weight [ww]). Liver-lead concentrations above Health Canada's guideline for human consumption of fish protein (<0.5 microg/g ww) were found in 40% (51/129) of livers analyzed. Data indicate that the ingestion of lead pellets in upland game birds and the potential consumption of lead-contaminated meat by humans are concerns related to the continued use of lead shotshell for hunting.

Determining the background levels of bismuth in tissues of wild game birds: a first step in addressing the environmental consequences of using bismuth shotshells.

Bismuth shotshells have been approved as a "nontoxic" alternative to lead in North America. Approval was based on a limited number of studies; even background levels of bismuth in wildfowl were unknown. We report on the concentration of bismuth (and lead) in muscle and liver tissues of wildfowl (Anas platyrhynchos, Anas acuta, Anas crecca, Branta canadensis, Chen caerulescens) harvested with lead shotshell. Average liver-bismuth levels detected in the present study (e.g., teal, 0.05 microg/g dw; mallard, 0.09 microg/g dw) suggest analytical error in other studies examining the effects of bismuth in birds. Significant positive relationships between bismuth- and lead-tissue levels for muscle when all species were combined (and for B. canadensis and C. caerulescens separately) can be explained by noting that bismuth is a contaminant of lead. Thus, more research is recommended to confirm the appropriateness of bismuth as a "nontoxic" shot alternative.