Background:  Food intake amongst Canadian Inuit is currently in transition with a concurrent increase in diet‐related chronic disease. There is a lack of current data on nutrient intake and dietary adequacy in this population. The present study aimed to assess dietary intake and adequacy amongst Inuit adults in a community in Nunavut, Canada. Methods:  Random sampling of 130 households in a remote Inuit community in the Kitikmeot region of Nunavut, Canada, was used for this cross‐sectional study. Up to three 24‐h dietary recalls were collected on nonconsecutive days, capturing weekday and weekend consumption. Data were analysed to estimate energy and nutrient intake, to determine dietary adequacy, and to summarise the most commonly reported foods and the top food contributors to selected nutrients. Results:  The response rate was 69%, with 75 Inuit adults participating (mean (standard deviation (SD)) age 44 (SD = 17) years). Mean (SD) daily energy intake was 9.3 (4.4) MJ and 8.7 (3.5) MJ for men and women, respectively. Intakes of dietary fibre, calcium, total folate and vitamins A, D and E were below the Dietary Reference Intakes (Estimated Average Requirements where available) for 60–100% of all men and women. Traditional foods contributed substantially to protein and iron intake, whilst shop‐bought foods were primary contributors to total fat, carbohydrate and sugar intake. Conclusions:  The present study reports an in‐depth assessment of total dietary quality amongst Inuit adults in Nunavut, Canada. The results obtained indicate inadequate intakes of several essential nutrients, as well as a reliance on a nontraditional diet. A nutrition intervention is needed to prevent a continued rise in diet‐related chronic disease incidence.

A 21-year-old female reports an 18-month history of light-headedness on standing. This is often associated with palpitations and a feeling of intense anxiety. She has had two black-outs in the past 12 months. She is not taking any regular medications. Her supine blood pressure was 126/84 mmHg with a heart rate of 76 bpm, and her upright blood pressure was 122/80 mmHg with a heart rate of 114 bpm. A full system examination was otherwise normal. She had a 12-lead electrocardiogram performed which was unremarkable. She was referred for head-up tilt testing. She was symptomatic during the test and lost consciousness at 16 min. Figure 1 summarizes her blood pressure and heart rate response to tilting. A diagnosis of postural orthostatic tachycardia syndrome with overlapping vasovagal syncope was made.

Maintenance of water balance is essential to normal physiologic function and vigorous aging. Older adults, however, frequently experience alterations in fluid homeostasis, which result in dehydration. This article describes the physiology of water balance, age-related changes that influence fluid regulation, and associated risk factors for dehydration in older adults. Fluid hygiene is an important health promotion activity for this age group, but when efforts to prevent imbalance are unsuccessful, early identification and intervention to correct problems should be done to minimize adverse consequences. Although much is known about fluid homeostasis, dehydration, and contributory factors in the aging process, water disorders remain prevalent in this group. A great deal of work is still needed to determine "best practices" and creative clinical interventions to support adequate fluid intake behaviors. Both quality management programs and research studies provide avenues for systematic evaluation.

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