Nutrient intakes are associated with adherence to a traditional diet among Yup`ik Eskimos living in remote Alaska Native communities: the CANHR Study

Abstract

Objectives. To determine whether dietary westernization is associated with intake of select nutrients among Alaska Natives living in remote communities. To investigate participant characteristics associated with adherence to the traditional Alaska Native diet. Study Design. Cross-sectional survey. Methods. A 24-hour recall was collected from 241 men and 307 women aged 14-94 years living in seven remote communities of Western Alaska. Bivariate analyses and ANOVA were used to examine the relationship between energy from traditional foods (the primary variable of interest), participant characteristics and intake of select nutrients. Results. Traditional foods accounted for % of energy intake overall. This estimate varied by age, educational attainment, and geographic location. Participants in the highest quintile of traditional food intake consumed significantly more vitamin A, vitamin D, Vitamin E, Iron, and n-3 fatty acids than participants in the lowest quintile (p<0.00). Intake of vitamin C, calcium, and total dietary fiber decreased with increased consumption of traditional foods (p<0.001). Conclusions. The degree of dietary westernization contributes to nutrient intake, both positively and negatively, in a dose response manner. Participant characteristics, particularly age, must be addressed in the development of a nutrition education program since they are associated with distinct dietary intakes. (Int J Circumpolar Health 2007; 66(1):62-70)

A scoping review of traditional food security in Alaska

“…How?Food security measured? How?Food security pillarQuantitative traditional food intake articlesBallew et al [3]The Alaska Traditional Diet Survey13 Remote villages statewideAlaska Native women (n=401) and men (n=253) aged 13–88 yearsYes – interviewer administered FFQ with portion sizes over the past 12 monthsNoFood access and food utilisationBartell et al [22]What People Eat: atka, Alaska, 1998–19991 Remote community in the Aleutians34 of the 80 residents in Atka of unknown agesYes – FFQ and a 24-h recallNoFood utilisationBersamin et al [23]The Center for Alaska Native Health Research Pilot Study3 Remote communities in SW AlaskaAlaska Native women (n=44) and men (n=48), aged 14–81 yearsYes – single 24-h recallNoFood utilisationBersamin et al [4]The Center for Alaska Native Health Research Study7 Remote communities in SW AlaskaAlaska Native women (n=307) and men (n=241), aged 14–94 yearsYes – single 24-h recallNoFood utilisationBersamin et al [43]The Center for Alaska Native Health Research Study7 Remote communities in SW AlaskaAlaska Native women (n=301) and men (n=230), aged 14–94 yearsYes – 24-h recall and a 3-day food from 54% of the participantsNoFood utilisationEliat-Adar et al [44]Genetics of Coronary Artery Disease in Alaska Natives (GOCADAN) Stud7 Remote villages in the Norton Sound regionAlaska Native women (n=677) and men (n=537), aged 18 years and olderYes – FFQ from previous year; 97 food items classified into 28 food groupsNoFood utilisationHeller and Scott [20]The Alaska Dietary Survey: 1956–196111 Rural villages in AlaskaAlaska Native women and men, children and adultsYes – diet records of 3–7 day duration; collected on a seasonal basisNoFood utilisationJohnson et al […”

“…A majority (n=13) of the research that estimated traditional food intake found that people who consumed traditional foods had higher intakes of several important nutrients, including protein, omega-3 fatty acids and iron [3,4,20,21]. Other articles compared the dietary intake of people who consumed traditional foods against a national sample or national recommendations [20,22–25] and in many situations concluded that traditional foods help to meet these recommendations, especially for energy, protein and fat intake (n=9) [21,25–27].…”

“…Individuals who consume traditional foods have high levels of many nutrients in their diet, including protein, vitamin A, most B vitamins, vitamin C, vitamin D, vitamin E, phosphorus, iron, niacin, selenium and omega-3 fatty acids [3,4,6,20,21,25,27,30,41]. The amount of traditional foods consumed varied by age, education and geographic location in the study populations [4,6,42]. Several articles concluded that traditional foods promote cardiovascular health [6,24,43,44] and a lower prevalence of glucose intolerance [21].…”

“…Of the 28 studies, only 2 quantify food security. Many Alaska Native peoples continue to consume a wide variety of traditional foods and these foods make up 15–22% of the diet in some rural communities [3,4,6]. It is unknown to what extent traditional foods contribute to the food security status of Alaska Native people since the role of traditional foods is still so poorly understood in relationship with food security.…”

“…These include Fazzino and Loring [35] who focus specifically on the experiences of food bank users who have recently moved to urban areas from rural communities, and Harrison and Loring [47] who interviewed harvesters of salmon and clams in Cook Inlet. This research gap could be significant for understanding the health status of urban indigenous peoples, because as noted, the increased consumption of store-bought foods has been shown to decrease nutrient and diet quality and increase the potential for chronic diseases such as obesity, diabetes and heart disease in both Alaska and the Circumpolar North [4,48–50]. Conversely, an increased intake of traditional foods has been associated with better health outcomes such as improved glucose tolerance and lipid profiles [51], lower risk of cardiovascular disease [28] and higher diet quality [13,52].…”