Improving vitamin A and D intake among Inuit and Inuvialuit in Arctic Canada: evidence from the Healthy Foods North study.

BACKGROUND: People in Arctic Canada are undergoing a nutritional transition and increased prevalence of chronic disease. The Healthy Foods North diet and physical activity intervention was developed in 2007-2008 while working with populations in six communities in Nunavut and the Northwest Territories, Canada. METHODS: Four communities received the 1-year intervention (eg, conducting workshops, cooking classes and walking clubs) and two communities served as controls. Among the 263 adult evaluation participants, food frequency questionnaires were used to assess dietary intake at baseline and postintervention. Changes in mean nutrient intakes, nutrient density and dietary adequacy from baseline to postintervention were determined. The intervention impact on nutrient intakes was assessed through multivariate linear regression analysis. RESULTS: Post-intervention assessment showed a reductions in total fat, saturated, monounsaturated and polyunsaturated fatty acids, and increases in iron intake, only in the intervention group. More than a 4%-increase in the percentage of adherence to vitamins A and D recommendations was observed in the intervention group. After adjusting the regression models, respondents in the intervention communities significantly reduced their energy intake and increased their vitamins A and D intake. CONCLUSIONS: The Healthy Foods North is an effective programme to improve dietary quality among populations of the Canadian Arctic. Long-term interventions are expected to be important factors in the prevention of diet-related chronic diseases in these communities.

Tunngajuq: stress and resilience among Inuit youth in Nunavut, Canada.

As part of a cross-national collaborative study of resilience among circumpolar youth, we examined the life experiences, stressors, and coping or resilience strategies of Inuit youth in the community of Igloolik, Nunavut, Canada. An Inuit steering committee was formed with youth, adults, and one elder. The steering committee led this project in the community, informing community members of progress and helping direct all aspects of the study from research questions to methods to data collection to dissemination. A structured interview used across sites allowed youth to describe what matters to them, that is, what is at stake for them in terms of challenges and successes. Developing stable and secure relationships with one's friends and family members enabled Inuit youth to become more resilient in the face of stresses related to social change in the Canadian Arctic.

Does sitting height ratio affect estimates of obesity prevalence among Canadian Inuit? Results from the 2007-2008 Inuit Health Survey.

OBJECTIVES: High sitting height ratio (SHR) is a characteristic commonly associated with Inuit morphology. Inuit are described as having short leg lengths and high trunk-to-stature proportions such that cutoffs for obesity derived from European populations may not adequately describe thresholds of disease risk. Further, high SHR may help explain the reduced impact of BMI on metabolic risk factors among Inuit relative to comparison populations. This study investigates the relationship between SHR and body mass index (BMI) in Inuit. METHODS: Subjects are 2,168 individuals (837 males and 1,331 females) from 36 Inuit communities in the Canadian Arctic. Mean age is 42.63 ± 14.86 years in males and 41.71 ± 14.83 years in females. We use linear regression to examine the association between age, sex, height, sitting height, SHR, waist circumference (WC), and BMI. We then evaluate the efficacy of the relative sitting height adjustment as a method of correcting observed BMI to a population-standardized SHR. RESULTS: Mean BMI is significantly higher than among non-Inuit Canadians. Obesity prevalence is high, particularly among Inuit women. In the regression, only age and WC are significant predictors of BMI. While SHR is significantly greater than that of the US population, there is substantial agreement between overweight and obesity prevalence using observed and corrected BMI. CONCLUSIONS: We find no consistent relationship between SHR and BMI and suggest the unique anthropometric and metabolic profile observed in Inuit arise from factors not yet delineated. More complex anthropometric and imaging studies in Inuit are needed.

Feeding the family during times of stress: experience and determinants of food insecurity in an Inuit community.

This paper uses a mixed methods approach to characterise the experience of food insecurity among Inuit community members in Igloolik, Nunavut, and examine the conditions and processes that constrain access, availability, and quality of food. We conducted semi-structured interviews (n= 66) and focus groups (n= 10) with community members, and key informant interviews with local and territorial health professionals and policymakers (n= 19). The study indicates widespread experience of food insecurity. Even individuals and households who were food secure at the time of the research had experienced food insecurity in the recent past, with food insecurity largely transitory in nature. Multiple determinants of food insecurity operating over different spatial-temporal scales are identified, including food affordability and budgeting, food knowledge and preferences, food quality and availability, environmental stress, declining hunting activity, and the cost of harvesting. These determinants are operating in the context of changing livelihoods and climate change, which in many cases are exacerbating food insecurity, although high-order manifestations of food insecurity (that is, starvation) are no longer experienced.

Food insecurity among Inuit women exacerbated by socioeconomic stresses and climate change.

OBJECTIVES: To identify and characterize the determinants of food insecurity among Inuit women. METHODS: A community-based study in Igloolik, Nunavut, using semi-structured interviews (n = 36) and focus groups (n = 5) with Inuit women, and key informants interviews with health professionals (n = 13). RESULTS: There is a high prevalence of food insecurity among Inuit females in Igloolik, with women in the study reporting skipping meals and reducing food intake on a regular basis. Food insecurity is largely transitory in nature and influenced by food affordability and budgeting; food knowledge; education and preferences; food quality and availability; absence of a full-time hunter in the household; cost of harvesting; poverty; and addiction. These determinants are operating in the context of changing livelihoods and climate-related stresses. CONCLUSION: Inuit women's food insecurity in Igloolik is the outcome of multiple determinants operating at different spatial-temporal scales. Climate change and external socio-economic stresses are exacerbating difficulties in obtaining sufficient food. Coping strategies currently utilized to manage food insecurity are largely reactive and short-term in nature, and could increase food system vulnerability to future stresses. Intervention by local, territorial and federal governments is required to implement, coordinate and monitor strategies to enhance women's food security, strengthen the food system, and reduce vulnerability to future stressors.

The value of a polar bear: evaluating the role of a multiple-use resource in the Nunavut mixed economy.

The polar bear (Ursus maritimus) is a common pool resource that contributes to both the subsistence and monetary aspects of the Nunavut mixed economy through its use as food, the sale of hides in the fur trade, and sport hunt outfitting. Sport hunting is more financially profitable than subsistence hunting; however, the proportion of the polar bear quota devoted to the sport hunt has become relatively stable at approximately 20% across Nunavut. This ratio suggests local Inuit organizations are not using a neoclassical economic model based on profit maximization. This paper examines local-level hunting organizations and their institutions (as sets of rules) governing the sport and Inuit subsistence hunts from both formalist and substantivist economic perspectives. It concludes that profit maximization is used within the sport hunting sphere, which fits a neoclassical model of economic rationality. A second and parallel system, better viewed through the substantivist perspective, demonstrates that the communities focus on longer-term goals to maintain and reproduce the socio-economic system of the subsistence economy, which is predicated on maintaining social, human-environment, and human-polar bear relations.

Emerging obesity among preschool-aged Canadian Inuit children: results from the Nunavut Inuit Child Health Survey.

OBJECTIVES: The study goal was to evaluate the growth status of preschool-age Canadian Inuit children. STUDY DESIGN: As part of a larger study of population health across the Canadian High Arctic, the International Polar Year Inuit Health Survey collected growth and nutrition data on 388 children aged 3 to 5 years. METHODS: Data collection included anthropometric measures, health history, food frequency and 24-hour recall. Height and BMI were compared with the 2000 Centers for Disease Control and Prevention (CDC) growth reference (1); 24-hour recall and FFQ results were tabulated to produce daily and monthly frequencies of consumption of market and country foods. RESULTS: Mean height-for-age z-scores were comparable, but body mass index z-scores were significantly greater than the U.S. standard reference population for all age and sex categories. The overall prevalence of overweight was 50.8%. There were significantly more boys (57.1%) than girls (45.2%) in the overweight category. An examination of biological, socio-economic and dietary factors, including birth weight, breastfeeding, day care attendance, traditional and market food consumption and sweetened beverage consumption revealed no significant associations that could explain the development of obesity risk in this population. CONCLUSIONS: Stature in preschool-age Inuit children is comparable to the U.S. reference, indicating that the previously reported secular trend toward increasing height has continued. Overweight prevalence is higher than that previously reported in Inuit children and may be occurring at an earlier age. The gender difference in child overweight prevalence runs counter to that reported in adults, leading to concern that contemporary growth atterns may result in significant increases in obesity-related illness for young Inuit men.

Healing the body and the soul through visualization: a technique used by the Community Healing Team of Cape Dorset, Nunavut.

As Alice Kimiksana indicated, the Healing Circle or Healing Teams evolved to help First Nations people who attended residential schools deal with the aftermath of the abuse many of them suffered there. They use a variety of interventions, some traditional and some more Western in origin, for an innovative approach to a very serious problem. One technique developed by Western psychology, but very useful and adaptable in other cultural settings, is guided imagery or visualization. Often used for performance enhancement in sports, it is also applicable to other situations from medical settings to mental health treatment. In this presentation, Novaliinga Kingwatsiaq of Kingnait (Cape Dorset) led the audience through a modified version of a visualization used by her Community Healing Team. (During visualization one assumes a relaxed state with one's eyes closed and imagines oneself in the context of a story told by the person guiding the imagery.) The imagery she chose is both symbolically and culturally appropriate. Most audience members were unfamiliar with the process of visualization, and several indicated that they were intrigued by the experience. Kumaarjuk Pii introduced Novaliinga Kingwatsiaq and translated for her.