Prevalence and determinants of insufficient vitamin D status in young Canadian Inuit children from Nunavik.

Background: Vitamin D deficiency has reached pandemic levels affecting over one billion people worldwide. However, limited data is available on the prevalence and determinants of vitamin D status of Canadian Indigenous children and no study has been reported in Inuit children from Nunavik. Aim: Therefore, using data collected between 2006 and 2010, we aimed to investigate the prevalence and main determinants of insufficient serum 25-hydroxyvitamin D (s25(OH)D) concentrations in Inuit children attending childcare centres in Nunavik. Methods: This study included 245 Inuit children aged 11 to 54 months. s25(OH)D concentrations were measured by radioimmunoassay. Dietary intakes were assessed using 24-hour recalls. Usual dietary intakes were estimated using the National Cancer Institute method. We used a multiple imputation technique to replace missing values when performing regression analysis. Results: Our findings revealed that 64.5% of children had a s25(OH)D concentration < 75 nmol/L, while 78.1% did not meet the estimated average requirement (EAR) for vitamin D. Vitamin D intake and fluid milk consumption were positively associated with s25(OH)D concentrations, while negative associations were observed with children' energy intake, non-alcoholic beverage consumption, body weight, breastfeeding duration and, biological/adoptive/foster parents' educational level. Conclusion: Vitamin D inadequacy was highly prevalent and closely aligned with levels observed over the years in non-Indigenous children. Breastfed children who do not receive vitamin D supplementation, overweight and obese children, and children with inadequate milk consumption were at high risk of vitamin D insufficiency. Eating vitamin D rich foods such as fluid milk and seafood along with vitamin D supplementation when needed are recommended.

Temporal trends of legacy and emerging persistent organic pollutants in inuit preschoolers from Northern Quebec (Canada).

In this study, we report the temporal trends of persistent organic pollutants (POPs) in 181 preschool Inuit children from Nunavik and the influence of confounding factors on blood contaminant levels. From 2006 to 2010, no significant trends were detected in Σpolychlorinated biphenyls (ΣPCBs), Σorganochlorine pesticides (ΣOPs), Σtoxaphene, and Σper- and polyfluoroalkyl substances (ΣPFASs). On the contrary, significant downward trends ranging from 9.3% to 14.3% per year were found for polybrominated diphenyl ethers (PBDEs). Breastfeeding was significantly associated with increased levels of POPs. Age was positively and significantly related to ΣPCBs, ΣOPs and Σtoxaphene. Compared with girls, boys had significantly higher concentrations of ΣPBDEs, but lower concentrations of ΣPFASs. Weight-for-height or body mass index z-scores were negatively and significantly related to ΣPCBs and ΣOPs. Passive smoking was positively and significantly associated with ΣOPs and Σtoxaphene. In conclusion, continued efforts to reduce contaminant exposure are needed to protect children's health and development.

Using Soluble Transferrin Receptor and Taking Inflammation into Account When Defining Serum Ferritin Cutoffs Improved the Diagnosis of Iron Deficiency in a Group of Canadian Preschool Inuit Children from Nunavik.

The prevalence of iron depletion, iron deficient erythropoiesis (IDE), and iron deficiency anemia (IDA) was assessed in preschool Inuit children using soluble transferrin receptor (sTfR) and traditional indicators of iron status while disregarding or taking inflammation into account when defining SF cutoffs. Iron depletion was defined as follows: (1) SF < 15 µg/L regardless of the C-reactive protein (CRP) level and (2) SF < 15 or <50 µg/L with CRP ≤ 5 or >5 mg/L, respectively. IDE corresponded to iron depletion combined with total iron binding capacity > 72 µmol/L and/or transferrin saturation < 16%. Iron depletion and IDE affected almost half of the children when accounting for inflammation, compared to one-third when the SF cutoff was defined regardless of CRP level (P < 0.0001). The prevalence of IDE adjusted for inflammation (45.1%) was very similar to the prevalence observed when sTfR was used as a sole marker of IDE (47.4%). The prevalence of anemia was 15%. The prevalence of IDA (IDE + hemoglobin < 110 g/L) was higher when accounting for than when disregarding inflammation (8.0% versus 6.2%, P = 0.083). Using sTfR and different SF cutoffs for children with versus without inflammation improved the diagnosis of iron depletion and IDE. Our results confirm that Inuit children are at particularly high risk for iron deficiency.

Effect of dietary calcium intake on lead exposure in Inuit children attending childcare centres in Nunavik.

High blood lead levels (BLLs) can be found in Inuit from Nunavik. At the same time, various nutrients such as calcium could lower lead absorption and toxicity. We examined the effect of dietary calcium intakes on BLLs in 245 preschool Inuit children attending childcare centres in Nunavik. Calcium intake was assessed with one 24-h dietary recall and BLLs were determined by inductively coupled plasma mass spectrometry in whole blood samples. Multiple imputation was performed to deal with missing data. Median blood lead concentration was 0.08 µmol/L. A high proportion of children did not meet the Estimated Average Requirement for vitamin D intake (73 %) and, to a lower extent, for calcium (20 %). Calcium intake was negatively associated with BLLs (p = 0.0001) while child's age and energy intake were positively associated with BLLs (p = 0.015 and p = 0.024, respectively). Consuming traditional foods rich in calcium as well as milk and alternatives may protect against lead exposure.

Consumption of tomato products is associated with lower blood mercury levels in Inuit preschool children.

Some evidence suggests that various diet components and nutrients, including vegetables, fruit and food-derived antioxidants, could mitigate contaminant exposure and/or adverse health effects of contaminants. To examine the effect of the consumption of tomato products on blood mercury levels in Inuit preschool children, 155 Inuit children (25.0±9.1months) were recruited from 2006-2008 in Nunavik childcare centers (northern Québec, Canada). Food frequency questionnaires were completed at home and at the childcare center, and total blood mercury concentration was measured by inductively coupled plasma-mass spectrometry. Multivariate regression analysis was performed after multiple imputation. The median blood concentration of mercury was 9.5nmol/L. Age, duration of breastfeeding, annual consumption frequency of seal meat, and monthly consumption frequency of tomato products were significant predictors of blood mercury levels, whereas annual consumption frequencies of beluga muktuk, walrus, Arctic char, and caribou meat were not. Each time a participant consumed tomato products during the month before the interview was associated with a 4.6% lower blood mercury level (p=0.0005). All other significant predictors in the model were positively associated with blood mercury levels. Further studies should explore interactions between consumption of healthy store-bought foods available in Arctic regions and contaminant exposure.

Traditional food consumption is associated with higher nutrient intakes in Inuit children attending childcare centres in Nunavik.

OBJECTIVES: To describe traditional food (TF) consumption and to evaluate its impact on nutrient intakes of preschool Inuit children from Nunavik. DESIGN: A cross-sectional study. METHODS: Dietary intakes of children were assessed with a single 24-hour recall (n=217). TF consumption at home and at the childcare centres was compared. Differences in children's nutrient intakes when consuming or not consuming at least 1 TF item were examined using ANCOVA. RESULTS: A total of 245 children attending childcare centres in 10 communities of Nunavik were recruited between 2006 and 2010. The children's mean age was 25.0±9.6 months (11-54 months). Thirty-six percent of children had consumed at least 1 TF item on the day of the recall. TF contributed to 2.6% of total energy intake. Caribou and Arctic char were the most reported TF species. Land animals and fish/shellfish were the main contributors to energy intake from TF (38 and 33%, respectively). In spite of a low TF intake, children who consumed TF had significantly (p<0.05) higher intakes of protein, omega-3 fatty acids, iron, phosphorus, zinc, copper, selenium, niacin, pantothenic acid, riboflavin, and vitamin B12, and lower intakes of energy and carbohydrate compared with non-consumers. There was no significant difference in any of the socio-economic variables between children who consumed TF and those who did not. CONCLUSION: Although TF was not eaten much, it contributed significantly to the nutrient intakes of children. Consumption of TF should be encouraged as it provides many nutritional, economic, and sociocultural benefits.

Exposure to toxic metals and persistent organic pollutants in Inuit children attending childcare centers in Nunavik, Canada.

Arctic populations are exposed to substantial levels of environmental contaminants that can negatively affect children's health and development. Moreover, emerging contaminants have never been assessed in Inuit children. In this study, we document the biological exposure to toxic metals and legacy and emerging persistent organic pollutants (POPs) of 155 Inuit children (mean age 25.2 months) attending childcare centers in Nunavik. Blood samples were analyzed to determine concentrations of mercury, lead, polychlorinated biphenyls (PCBs), pesticides, brominated flame retardants [e.g., polybrominated diphenyl ethers (PBDEs)] and perfluoroalkyl and polyfluoroalkyl substances [PFASs; e.g. perfluorooctanesulfonate (PFOS) and perfluorooctane (PFOA)]. Lead [geometric mean (GM) 0.08 µmol/L], PCB-153 (GM 22.2 ng/g of lipid), BDE-47 (GM 184 ng/g of lipid), PFOS (GM 3369 ng/L), and PFOA (GM 1617 ng/L) were detected in all samples. Mercury (GM 9.8 nmol/L) was detected in nearly all blood samples (97%). Levels of metals and legacy POPs are consistent with the decreasing trend observed in Nunavik and in the Arctic. PBDE levels were higher than those observed in many children and adolescents around the world but lower than those reported in some U.S. cities. PFOS were present in lower concentrations than in Nunavimmiut adults. There is a clear need for continued biomonitoring of blood contaminant levels in this population, particularly for PBDEs and PFASs.

Nutrition intervention and adequate hygiene practices to improve iron status of vulnerable preschool Burkinabe children.

OBJECTIVE: To determine the impact of an intervention that combined an increase in dietary and bioavailable iron intakes and an improvement in hygiene behaviors on the iron status of preschool children from Burkina Faso. METHODS: Thirty-three orphans and vulnerable children from 11 families who were 1-6 y old, were non-anemic, or had mild to moderate anemia were enrolled in an 18-wk trial. Using the probability approach for planning diets in an assisted-living facility, bioavailable iron intake was increased from 0.4 to 0.9 mg/d by increasing the amounts of meat and citrus fruits and by adding iron-rich condiments to the diet, for an estimated cost of U.S. $0.59/mo. Hygiene behaviors were modified by implementing hand-washing before meals and by the use of individual plates for meals. Iron status indicators were measured twice and means at enrollment and after intervention were compared. RESULTS: After intervention, hemoglobin concentration increased from 98.7 to 103.8 g/L (P=0.006). There was a decrease in total iron binding capacity (107 to 91 micromol/L, P=0.05) and a marginal increase in transferrin saturation (13% to 17%, P=0.06). Significant improvement was not observed for serum ferritin concentration or prevalence of depleted iron stores, likely due to the confounding effect of infection. Anemia and iron-deficiency anemia were decreased from 64% to 30% and from 61% to 30%, respectively. CONCLUSION: Dietary modification associated with adequate hygiene behaviors could be a relevant strategy to control iron deficiency and anemia in areas where infection is a major health problem.

Maternal iron deficiency alters essential fatty acid and eicosanoid metabolism and increases locomotion in adult guinea pig offspring.

Iron deficiency (ID) is the most prevalent worldwide nutritional deficiency. Groups at risk of developing ID anemia are infants and pregnant women, even in industrialized countries. Our goal in this study was to evaluate the long-term consequences of maternal ID on the offspring's fatty acid and eicosanoid metabolism, behavior, and spatial memory. Female guinea pigs consumed iron-sufficient (IS) and -deficient (ID) diets for 14 d before mating and throughout pregnancy and lactation. Dietary iron restriction resulted in ID in pregnant females. On postnatal d 9, all offspring (ID and IS) were weaned to the IS diet and at 42 d, all offspring were iron replete. Locomotion was tested in pups on postnatal d 24 and 40 and spatial memory from d 25 to 40. Pups from the ID group were significantly more active in the open field at both times of testing, whereas spatial memory, tested in a Morris water maze, was comparable in both groups. On postnatal d 42, liver, RBC, and brain fatty acid composition were measured. Dihomogammalinolenic [20:3(n-6)], docosapentaenoic [22:5(n-3)], and docosahexaenoic [22:6(n-3)] acid contents were significantly higher in brain phospholipids of offspring born to ID dams. Prostaglandin E(2) and F(2alpha) concentrations were also significantly higher in brains of offspring born to ID dams. This demonstrates that moderate ID during gestation and lactation results in alterations of brain fatty acid and eicosanoid metabolism and perturbation in behavior in adult offspring.

Iron status of adolescent girls from two boarding schools in southern Benin.

Iron deficiency (ID) is the most prevalent micronutrient deficiency in the world, particularly in developing countries. Blood samples and a qualitative FFQ on Fe- and vitamin C-rich foods were obtained in 180 adolescent girls aged 12 to 17 years living in two boarding schools from south Benin. ID, defined as serum ferritin either 73 micromol/l or transferrin saturation<20%, was found in 32% of subjects. Anaemia (Hb<120 g/l) was found in 51% of adolescents, while 24% suffered from iron-deficiency anaemia (IDA) (ID and Hb<20 g/l). After adjusting for confounding factors (age, mother's and father's occupation, household size) in a logistic regression equation, subjects having a low meat consumption (beef, mutton, pork) (<4 times/week) were more than twice as likely to suffer from ID (OR=2.43; 95% CI 1.72, 3.35; P=0.04). Adolescents consuming less fruits (<4 times/week) also had a higher likelihood of suffering from ID (OR=1.53; 95% CI 1.31, 2.80; P=0.03). Finally, subjects whose meat consumption was low were twice as likely to suffer from IDA (OR=2.24; 95% CI 1.01, 4.96; P=0.04). The prevalence of ID represents an important health problem in these Beninese adolescent girls. A higher consumption of Fe-rich foods and of promoters of Fe absorption (meat factor and vitamin C) is recommended to prevent ID deficiency in these subjects.

The Association of Low and High Ferritin Levels and Anemia with Pregnancy Outcome.

There are few data about the influence of iron stores and anemia on pregnancy outcome. Results that are available are controversial. This study used the medical records of 202 pregnant women aged 29.5 + 4.8 years to examine the association of low and high ferritin levels and anemia with pregnancy outcome. Iron depletion (serum ferritin <20 µg/L) evaluated at 16 +/-4 weeks of gestation was present in 35% of subjects. Anemia affected 6.2%, 3.2%, and 24.2% of subjects during the first, second, and third trimesters. Average hemoglobin (Hb) measurements among anemic women were less than 110 g/L, less than 105 g/L, and less than 110 g/L in the first, second, and third trimesters, respectively. When hematocrit (Ht) values were used to diagnose anemia, the percentages of anemic women were 14.6% (Ht <0.33) in the first trimester, 22.6% (Ht <0.32) in the second trimester, and 39.8% (Ht <0.33) in the third tri-mester. Shorter gestation was found in women with a serum ferritin level below 20 µg/L (279 +/-1 d) or >50 µg/L (278 +/-2 d) than in women with intermediate levels (20 ug/L to 50 ug/L) (283 +/-1 d). When multiple regression analysis was used, an inverse relationship was also observed between first trimester anemia (low Ht levels) and birth weight and fetal growth ratio. No such association was observed during the second and third trimesters. The strength of this inverse relationship between first trimester Ht levels and birth weight and fetal growth ratio was similar to that between first trimester Ht levels and newborn sex and smoking, but much less than parity. This finding indicates the importance of evaluating iron status early in pregnancy.