Abstract
Background
Inuit have experienced a rapid transition in diet and lifestyle over the past several
decades, paralleled by the emergence of chronic diseases such as obesity, diabetes,
and hypertension.
Objective
To identify contemporary dietary patterns among Inuit and investigate their association
with cardiovascular disease outcomes.
Design
This was an association study in a cross-sectional population health and nutrition
survey.
Participants
The participants included 1,570 adults (aged ≥18 years) from Nunavut in the International Polar Year Inuit Health Survey 2007-2008
who completed diet/health questionnaires and provided blood samples.
Main outcome measures
Outcomes measured included the prevalence of coronary heart disease, myocardial infarction,
stroke, hyperlipidemia, and hypertension.
Statistical analyses performed
Principal component analysis was used to derive dietary patterns based on the consumption
of nine market food groups and four country food groups reported in 24-hour dietary
recalls. The associations between cardiovascular outcomes and identified dietary patterns
were examined with logistic regression.
Results
Three dietary patterns were identified: market food, country food–fat, and country
food–fish. The market food diet, characterized by high consumption of market-bought
meat, cereals, vegetables, and added oil, was associated with elevated prevalence
of coronary heart disease, myocardial infarction, and hypertension (odds ratio [OR]
1.44, 95% CI 0.82 to 2.51; OR 2.27, 95% CI 0.88 to 5.83; and OR 1.36, 95% CI 0.88
to 2.09). The country food–fish diet, characterized by high fish consumption and low
sugar and sweets intake, was inversely associated with the prevalence of coronary
heart disease, myocardial infarction, stroke, and hyperlipidemia (OR 0.78, 95% CI
0.43 to 1.37; OR 0.46, 95% CI 0.18 to 1.20; OR 0.34, 95% CI 0.07 to 2.13; and OR 0.69,
95% CI 0.39 to 1.22). The country food–fat diet, characterized by high marine mammal
and added fat intake, was positively associated with the prevalence of coronary heart
disease.
Conclusions
A diet featuring high food variety, high fish intake, and low sugar intake was negatively
associated with the prevalence of cardiovascular outcomes among Inuit.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Academy of Nutrition and DieteticsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Assessing dietary intake in a population undergoing a rapid transition in diet and lifestyle: The Arctic Inuit in Nunavut, Canada.Br J Nutr. 2010; 103: 749-759
- Arctic indigenous peoples experience the nutrition transition with changing dietary patterns and obesity.J Nutr. 2004; 134: 1447-1453
- Dietary patterns are linked to cardiovascular risk factors but not to inflammatory markers in Alaska Eskimos.J Nutr. 2009; 139: 2322-2328
- Changing dietary patterns and body mass index over time in Canadian Inuit communities.Int J Circumpolar Health. 2012; 70: 511-519
- Dietary correlates of an at-risk BMI among Inuit adults in the Canadian high arctic: Cross-sectional international polar year Inuit health survey, 2007-2008.Nutr J. 2012; 11: 73
- Indigenous health in the Arctic: An overview of the circumpolar Inuit population.Scand J Public Health. 2004; 32: 390-395
- Obesity risks: Towards an emerging Inuit pattern.Int J Circumpolar Health. 2011; 70: 166-177
- High prevalence of markers of coronary heart disease among Greenland Inuit.Atherosclerosis. 2008; 196: 772-778
- Cardiovascular burden and related risk factors among Nunavik (Quebec) Inuit: Insights from baseline findings in the circumpolar Inuit health in transition cohort study.Can J Cardiol. 2010; 26: 190-196
- Eicosapentaenoic acid and prevention of thrombosis and atherosclerosis?.Lancet. 1978; 2: 117-119
- Prevalence of affirmative responses to questions of food insecurity: International Polar Year Inuit Health Survey, 2007-2008.Int J Circumpolar Health. 2011; 70: 488-497
- The associations of a marine diet with plasma lipids, blood glucose, blood pressure and obesity among the inuit in Greenland.Eur J Clin Nutr. 2000; 54: 732-737
- n-3 Fatty acids and cardiovascular disease risk factors among the Inuit of Nunavik.Am J Clin Nutr. 2001; 74: 464-473
- The association of n-3 fatty acids with serum high density cholesterol (HDL) is modulated by sex but not by Inuit ancestry.Atherosclerosis. 2013; 226: 281-285
- Highly unsaturated n-3 fatty acids status of Canadian Inuit: International Polar Year Inuit Health Survey, 2007-2008.Int J Circumpolar Health. 2011; 70: 498-510
- Mercury diminishes the cardiovascular protective effect of omega-3 polyunsaturated fatty acids in the modern diet of Inuit in Canada.Environ Res. 2016; : 1-8
- Association between environmental contaminants and health outcomes in indigenous populations of the Circumpolar North.Int J Circumpolar Health. 2014; 73: 25808
- Dietary pattern analysis: A new direction in nutritional epidemiology.Curr Opin Lipidol. 2002; 13: 3-9
- Inuit dietary patterns in modern Greenland.Int J Circumpolar Health. 2010; 69: 13-24
- Mediterranean diet pattern with low consumption of liquid sweets and refined cereals is negatively associated with adiposity in adults from rural Lebanon.Int J Obes (Lond). 2011; 35: 251-258
- Traditional dietary pattern is associated with elevated cholesterol among the Inuit of Nunavik.J Acad Nutr Diet. 2014; 114: 1208-1215
- Dietary patterns in Greenland and their relationship with type 2 diabetes mellitus and glucose intolerance.Public Health Nutr. 2013; 17: 1-9
- Design and methods of the Adult Inuit Health Survey 2007-2008.Int J Circumpolar Health. 2012; 71: 1-9
- Dietary nutrient profiles of Canadian Baffin Island Inuit differ by food source, season, and age.J Am Diet Assoc. 1996; 96: 155-162
- Food insecurity among inuit women exacerbated by socioeconomic stresses and climate change.Can J Public Heal. 2010; 101: 196-201
Direction de Santé Québec I de la S du Q. Food Models. Montreal, Canada; 2013.
- Dietary sources of energy and nutrients in the contemporary diet of Inuit adults: Results from the Inuit Health Survey.Public Health Nutr. 2018;January; 14: 1-13
CANDAT. London, Ontario, Canada: Godin London Incorporated; 2015.
- Traditional food intake is correlated with iron stores in Canadian Inuit men.J Nutr. 2012; 142: 3-5
- The prevalence of food insecurity is high and the diet quality poor in Inuit communities.J Nutr. 2012; 142: 541-547
Kuhnlein H V, Receveur O, Chan HM, Soueida R. Arctic indigenous women consume greater than acceptable levels of organochlorines. 1995;November 1994:2501-2510.
- Body burden of metals and persistent organic pollutants among Inuit in the Canadian Arctic.Environ Int. 2013; 59: 33-40
- Hypertension Canada’s 2017 guidelines for diagnosis, risk assessment, prevention, and treatment of hypertension in adults.Can J Cardiol. 2017; 33: 557-576
- Definition, classification and diagnosis of diabetes, prediabetes and metabolic syndrome.Can J Diabetes. 2013; 37: S8-S11
World Health Organization. Waist circumference and waist-hip ratio. report of a WHO Expert Consultation. http://www.who.int/nutrition/publications/obesity/WHO_report_waistcircumference_and_waisthip_ratio/en/. Accessed February 21, 2018.
Health Canada. Canadian guidelines for weight classification in adults. 2003. https://www.canada.ca/en/health-canada/services/food-nutrition/healthy-eating/healthy-weights/canadian-guidelines-body-weight-classification-adults.html. Accessed February 21, 2018.
The Canadian Society for Exercise Physiology. Canadian Physical Activity Guidelines. 2012. http://www.csep.ca/cmfiles/guidelines/canadianphysicalactivityguidelinesstatements_e_2012.pdf. Accessed March 23, 2018.
SAS [computer program]. Version 9.2. Cary, NC: SAS Institute Inc; 2013.
Stata [computer program]. Version 13.1. College Station, TX: StataCorp LP; 2013.
- Dietary adequacy of Inuit in the Canadian Arctic.J Hum Nutr Diet. 2010; 23: 27-34
- Lipid Components of traditional Inuit foods and diets of Baffin Island.J Food Compos Anal. 1991; 4: 227-236
- Dietary patterns and their association with cardiovascular risk factors in a population undergoing lifestyle changes: The Strong Heart Study.Nutr Metab Cardiovasc Dis. 2013; 23: 528-535
- Food security in Nunavut, Canada: Barriers and recommendations.Int J Circumpolar Health. 2006; 65: 416-431
- Fruit and vegetable intake and risk of cardiovascular disease in US adults: The first National Health and Nutrition Examination Survey Epidemiologic Follow-up Study.Am J Clin Nutr. 2002; 76: 93-99
- Fruit and vegetables, and cardiovascular disease: A review.Int J Epidemiol. 1997; 26: 1-13
- Food consumption patterns and socioeconomic factors among the inuit of Nunavik.Ecol Food Nutr. 2002; 41: 91-118
- Age differences in vitamin A intake among Canadian Inuit.Can J Public Healt. 2004; 95: 465-469
- Traditional and modern Greenlandic food—dietary composition, nutrients and contaminants.Sci Total Environ. 2007; 384: 106-119
- IPY Inuit Health Survey speaks to need to address inadequate housing, food insecurity and nutrition transition.Int J Circumpolar Health. 2011; 70: 444-446
- Food coding in nutritional surveys.in: Vichi M. Opitz O. Classification and Data Analysis: Theory and Application Proceedings of the Biannual Meeting of the Classification Group of Societ{à} Italiana Di Statistica (SIS) Pescara, July 3-4, 1997. Springer Berlin Heidelberg, Heidelberg, Germany1999: 361-366
- Database requirements to meet food grouping needs.J Food Compos Anal. 2001; 14: 279-285
- Food consumption trends of US women: Patterns and determinants between 1977 and 1985.Am J Clin Nutr. 1989; 49: 1307-1319
- Dietary advice on Inuit traditional food use needs to balance benefits and risks of mercury, selenium, and n3 fatty acids 1–3.J Nutr. 2013; 143: 923-930
Biography
X. F. Hu is a postdoctoral fellow, Department of Biology, University of Ottawa, Ottawa, Ontario, Canada.
Biography
T.-A. Kenny is a postdoctoral fellow, Department of Biology, University of Ottawa, Ottawa, Ontario, Canada.
Biography
H. M. Chan is a professor and Canada Research Chair, Department of Biology, University of Ottawa, Ottawa, Ontario, Canada.
Article info
Publication history
Published online: April 21, 2018
Accepted:
February 2,
2018
Received:
July 26,
2017
Footnotes
Supplementary materials: Figure 1 and Table 2 are available at www.jandonline.org
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This study was supported by the Northern Contaminant Program of the Government of Canada and the Canada Research Chair Program.
Identification
Copyright
© 2018 by the Academy of Nutrition and Dietetics.
