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.

Combining data sets of organochlorines (OCs) in human plasma for the Russian Arctic.

As part of AMAP's human circumpolar study of POPs, an international effort was initiated to extend coverage to communities across the Russian Arctic. Two additional laboratories were invited to join the analytical component of this effort, resulting in four participating analytical centres. Although quality assurance measures were put in place, and the level of performance of the laboratories was generally acceptable, deficiencies in the analytical protocols used were recognized subsequent to the collection and analyses of the plasma specimens. The current paper describes the criteria employed to critically appraise the four data bases and guide their integration into a single data set. Summary statistics are presented for plasma concentrations of major PCBs, p,p'-DDE, p,p'-DDT, beta-HCH, and HCB for communities/regions across the arctic/subarctic Russian continent, and for one community located in the Aral Sea area of Uzbekistan (a control group). Highly exposed people were identified in the coastal communities of Chukotka, which appears mainly related to marine mammal intake, but recent pesticide use is also suspected. Other communities with intermediate levels of PCBs had relatively elevated beta-HCH, p,p'-DDT and HCB concentrations and low DDE/DDT ratios (<10), suggesting recent pesticide use.

10th anniversary review: when healthy food becomes polluted-implications for public health and dietary advice.

Divergent scientific and regulatory agency perspectives about contaminants in fish have lead to contradictory advice and confusing public messages about its consumption. The evidence for the protective effect of eating fish on cardiovascular outcomes is considered to be convincing. It has long been attributed to n-3 unsaturated long-chain fatty acids. Persistent organic pollutants (POPs) are compounds that are lipid soluble and accumulate in the aquatic food chain. Despite a considerable decrease in their levels in fish during the last two decades, there is still significant concern about potential negative health effects and an ongoing debate exists about what type of fish consumption advisories are most suitable. In this review our aim is twofold, namely to explore: (1) the underlying causes for the conflicting recommendations by discussing the strengths and limitations of risk assessment and epidemiological evidence; and (2), the role of risk management in formulating public dietary advisories. It is our view that the latter advice is most appropriately formulated in the context of risk management, of which both epidemiologic evidence and risk assessment are essential components.

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.

Effects of acute exposure to aluminum on cognition in humans.

There is epidemiological evidence suggesting an association between aluminum in drinking water and Alzheimer's disease (AD), and between aluminum in dialysate and dialysis dementia. The exact role of aluminum in the pathogenesis of these and other dementias is not clear. This study examined the acute effects of aluminum on cognitive function in patients with AD and related dementias and in age-matched and younger volunteers with normal cognitive function. Whether individuals with AD and/or the APOE epsilon4 genotype had enhanced gastrointestinal absorption of aluminum was tested, and whether individuals with elevated blood aluminum concentrations exhibited acute cognitive effects was determined. Subjects were randomized to receive a single dose of aluminum orally (Amphojel plus citrate) for 3 d followed by a 3-wk washout, and then 3 d of matched placebo administration, or vice versa. Serum aluminum levels were measured and the daily dose of Amphojel was adjusted to a target aluminum level between 50 and 150 microg/L. Neuropsychological tests were administered at baseline and 90 min after the third dose of Amphojel or placebo. There was a large interindividual variation in aluminum serum levels in all study groups after the same initial dose of Amphojel. There were no significant differences in neuropsychological test scores after aluminum ingestion in normal volunteers or in patients with cognitive impairment. There was no association between APOE epsilon4 genotype and aluminum absorption. The results did not support the hypothesis that aluminum ingested at these doses produces acute effects on cognition or adverse effects, nor did they reveal that AD patients are more vulnerable to such outcomes. Further inquiry is required to explore any possible association between aluminum and cognition, but controlled trials may be limited by safety concerns.

Intra- and intercompartmental associations between levels of organochlorines in maternal plasma, cord plasma and breast milk, and lead and cadmium in whole blood, for indigenous peoples of Chukotka, Russia.

Long-range transport of pollutants towards circumpolar regions emphasizes the need for up-to-date and reliable biological monitoring data. This paper explores the use, reliability and availability of maternal blood (MB) and plasma (MP), cord blood (CB) and plasma (CP) and mother's milk (MM) in terms of assessing exposure to persistent toxic substances (PTSs). It is concluded that MP has the best combination of availability, sensitivity in terms of number of PTSs, their detection frequency and concentrations, and physiological relevance. The study group consisted of 48 pregnant women of indigenous origin from the Chuchki district in the eastern Russian arctic. Blood, CB and MM specimens were collected from all women and MP, CP and MM were analyzed for the Arctic Monitoring and Assessment Programme (AMAP) suite of organochlorines (OCs) and metals (Pb and Cd in MB and CB). Generally speaking, the levels of PTSs coincided with those indicated in several AMAP publications from Chukotka and other areas of northern Russia. The correlations of PTS concentrations between the three body fluid compartments exceeded the minimum statistical requirements of alpha = 0.05 and beta = 0.20 for most of the compounds, with r > 0.46 except for Cd (r = 0.05); lipid adjustments for the OCs did not affect the r-values to any significant extent. The majority of the inter-OC correlations within compartments also fulfilled the indicated statistical condition. Careful consideration is given to the replacement of concentrations below the detection limit, OC detection frequency, the criteria for log-transformation of the data, analytical uncertainty, and biological variability. Practical implications of the findings are explored.

[Kolsky register of births as an instrument of epidemiologic studies of female reproductive health].

The authors evaluate possible use of Monchegorsk retrospective birth database for demographic and epidemiologic studies of various female reproductive health parameters, newborn health parameters, as well as their connections with occupational and other environmental factors.

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.

Intercommunity and temporal variation of eleven essential and five toxic elements in human placentas from deliveries in thirteen arctic and sub-arctic areas of Russia and Norway.

Research is described that constitutes an extension of an earlier paper (J. Environ. Monit., 2001, 3, 177-184), in which concentrations were measured in 263 human placentas of 11 essential elements (P, Ca, Mg, Cu, S, Na, Fe, Zn, K, Se, Mn) and 5 toxic elements (Ba, Sr, Pb, Ni, Cd). The additional data considered derive from earlier visits to 4 of the original 6 communities and 3 others, all but one of which are located in northern Norway and neighbouring areas of Russia. This more than doubled the number of placental samples available (263 to 571). Unfortunately, the personal, life-style and morphometric information obtained for the first study group was not available for the additional mothers. Country differences were evident for all elements except Ba, Fe and Zn; Cd, Cu, Mn, Na, Se, Ni, Pb, Sr and S were higher and K, P, Ca and Mg were lower in Russia (p < 0.03). Not unexpectedly, the highest median lead concentration was observed for the largest city in the western arctic region of Russia, namely Murmansk. Similarly, the higher median nickel level observed for Russia reflects the established observation that urinary nickel concentrations are higher in the Russian than in the Norwegian communities. Even though sampling was performed at different times of the year and before and after a 3-year interval in four centres, inter-collection differences were of relatively small magnitude and appear not to be linked to seasonal or temporal changes. Principal component analysis (PCA) confirmed the prominence of Factor 1, which grouped those metals that are known to form insoluble phosphate complexes and whose concentrations showed a dependence on gestational age and maternal smoking in the earlier study. It is concluded that PCA is a powerful statistical tool for exploring and identifying fundamental pathways and processes involved in governing the inorganic elemental composition of placental tissue. It also has the potential of identifying study limitations and quality assurance shortfalls. Further our findings show promise that placental concentrations of toxic elements may serve as an index of exposure and of nutritional intake for selected essential micro-elements.

Factor analysis of essential and toxic elements in human placentas from deliveries in arctic and subarctic areas of Russia and Norway.

Concentrations in human placenta of 11 essential elements (P, Ca, Mg, Cu, S, Na, Fe, Zn, K, Se, Mn) and 5 toxic elements (Ba, Sr, Pb, Ni, Cd) are compared for each of two arctic communities in eastern Norway and western Russia, and for another in each country located at more southerly latitudes. All but Mg, Fe, P and K were present in higher concentrations in the Russian study group. The observed inter-element correlations are reflected by the four major factors identified in a principal component analysis. The total variation explained was 67.3%, of which more than half (35.3%) was contributed by Factor 1. P, Ca, Mg, Ba, Sr, Pb, and Ni were major contributors to this factor. The placental concentrations of these elements depended strongly on gestational age, increasing from about week 35 and peaking near weeks 39 and 40, and exhibited skewed frequency distributions and a dependence on maternal smoking. The gestational-dependent mineralization of the placenta is interpreted to reflect the deposition of metal phosphates coinciding with smoking-induced tissue damage. The loadings of the remaining three factors are reviewed in the context of common uptake mechanisms, similar biochemistries and unique transport pathways. The inter-element relationships and grouping of the elements observed should constitute a scientific base for the use of placenta composition in environmental monitoring and epidemiological studies.

Elevated dentine-lead levels in deciduous teeth collected from remote first nation communities located in the western James Bay region of northern Ontario, Canada.

Teeth were collected from First Nation schoolchildren inhabiting the remote western James Bay region of northern Ontario, Canada. Lead levels in dentine chips were determined by graphite furnace atomic absorption spectrometry, for naturally exfoliated deciduous teeth. Within exfoliated teeth (one tooth supplied per person), no significant differences in lead concentrations between tooth type were found (P = 0.36). The mean lead concentration of exfoliated teeth of 9.2 microg g(-1) dry weight (N = 61) from this remote region was comparable to levels reported by others for children inhabiting urban centers or residing near smelters. Further, 24.6% (N = 15) had elevated dentine-lead levels ( > 10 microg g(-1)). Lead levels in soil, water, and air have been reported as being low and unimportant sources of exposure for people of the western James Bay area. Evidence is reviewed suggesting that lead contaminated game meat was one source of environmental lead exposure. Consumption data indicate that wildlife is still an important food source for First Nation people of the western James Bay region; 98% (46/47) of the children surveyed consumed some type of wild meat.

Chemical composition of individual aerosol particles from working areas in a nickel refinery.

Individual aerosol particles (n = 1170) collected at work stations in a nickel refinery were analyzed by wavelength-dispersive electron-probe microanalysis. By placing arbitrary restrictions on the contents of sulfur and silicon, the particles could be divided into four main groups. Scanning electron images indicated that most of the particles examined were relatively small (< or = 2 microm, equivalent projected area diameter), and that their morphology suggested formation from a melt. There was an absence of well-defined phases and simple stoichiometries, indicating that exposures to pure substances such as nickel subsulfide or specific oxides appeared not to occur. Although the elemental composition of particles varied greatly, a rough association was evident with the known elemental content of the refinery intermediates. The implications of the findings for aerosol speciation measurements, toxicological studies and interpretation of adverse health effects are explored.

Blood lead and cadmium and birth weight among sub-arctic and arctic populations of Norway and Russia.

BACKGROUND: Delivering women and their newborns in the Kola Peninsula of Russia and the neighboring arctic area of Norway were studied to explore relationships between maternal cadmium and lead status and birth weight as a pregnancy outcome. METHODS: Life-style information, maternal blood and cord blood specimens were collected from 50 consecutive mother-infant pairs from hospital delivery departments in three Russian and three Norwegian communities. Pregnancy outcomes were verified by consulting medical records. Lead and cadmium were determined in the blood samples by electrothermal atomic absorption spectrometry. RESULTS: The median blood-cadmium concentration for the Russian mothers was 2.2 nmol/L (n = 148) versus 1.8 nmol/L in the Norwegian group (n = 114, p = 0.55). A weak association was observed between maternal cadmium and amount smoked (r = 0.30, p<0.001); no correlation was found between maternal blood cadmium and birth weight. The corresponding maternal lead values were 0.14 (Russia) and 0.06 micromol/L (Norway), p<0.001. The latter lead concentration constitutes one of the lowest adult population values reported to date. Maternal and cord blood lead levels were strongly correlated (r = 0.88, p<0.001). In a multivariate linear regression model, maternal blood lead was recognized as a negative explanatory variable (p<0.05) for birth weight and child's body mass index (BMIC), with or without adjustment for gestational age. A similar association was suggested by ANOVA-analysis of maternal blood lead by quartiles. CONCLUSION: Maternal blood-lead level as an environmental factor is an apparent predictor of low birth weight and BMIC. It reduced substantially the contribution of a country factor in explaining the observed differences in birth weight.

Critical evaluation of medical, statistical, and occupational data sources in the Kola Peninsula of Russia pertinent to reproductive health studies.

BACKGROUND: The feasibility study described herein was prompted by a report in 1992 of possible reproductive and developmental health concerns among female workers in a Russian nickel refinery. OBJECTIVE: The primary goal was to ascertain whether medical, statistical, and occupational data bases could be accessed for information about the pregnancy histories, occupational histories, and life-style factors of the women affected. METHODS: The project was facilitated by construction of a registry of all births in three towns with a nickel refinery and verification of its contents against patients' records obtained from hospital delivery and gynecology departments and community polyclinics. Municipal Registration Board, Regional Health Statistics Board, and nickel company records were also reviewed. RESULTS: Reproductive/developmental outcome information and workplace histories were acceptable. Sample-size calculations indicated that a cohort or cross-sectional study would be amenable and suitable for the detection of an excess risk for spontaneous abortion with adequate statistical significance and power. Such investigations would need to be supplemented by workplace environmental/biological monitoring assessments for evaluation of exposure to occupational hazardous factors and a worker's questionnaire to obtain information about life-style factors. A case-control design is recommended for the study of congenital defects. CONCLUSIONS: A well-designed, comprehensive epidemiology study is technically feasible because of the availability of a favorable pool of study subjects, reproductive/developmental outcome data, information to control for major confounders, and suitable occupational records.