Nutritional transition – where do we go from here?

The size of the Inuit population in Canada, Alaska and Greenland is growing. Unfortunately, this statement does not refer to the number of individuals but to their body mass. The obesity epidemic is caused by unhealthy dietary habits and too little physical exercise to counterbalance the energy intake, perhaps facilitated by a 'feast or famine' genotype. Along with the increasing prevalence of obesity, the risk for chronic diseases is also becoming higher and diseases such as type 2 diabetes, unknown amongst the Inuit in the 1950s, are now as, if not even more, common amongst the Inuit as amongst people of European descent. The articles in the present special issue of the Journal of Human Nutrition and Dietetics aim to throw light on the problems related to the nutritional transition amongst two Inuit populations: the Inuit of the Kitikmeot region in Nunavut and the Inuvialuit of the Beaufort Delta in the Northwest Territories. The Inuit across the Arctic share a number of similar characteristics and have been through similar societal transitions after contact with the majority societies in Europe and North America. However, there are also differences. Their ancestors are the same people but some areas were colonised more than 300 years ago, others much more recently. In some communities, the ATV (all terrain vehicle) is the natural choice if you want to visit the local store, whereas, in others, both the young and the old think nothing of walking. Some eat bannock (fried bread) as a staple, others coarse, dark rye bread. The traditional food differs substantially, with marine mammals as the mainstay here and caribou and geese there. In short, there are sufficient local differences to require health promotion to be tailored to the local situation, yet there are sufficient similarities that communities can be inspired by each other. The research published in the supplement issue of the journal looks at problems, barriers and solutions related to food and nutrition in the selected communities. Many of these have a wider significance for all Inuit population groups and across the circumpolar north. Nutrient-poor food takes a prominent place in the current diet, and consumption of vitamins A, B6, E and D, as well as dietary fibre, calcium and folate, is inadequate (Erber et al., 2010a,b; Hopping et al., 2010a,b) This is not novel information, and knowledge about the local situation is required prior to the design of an intervention programme. With our present knowledge, the dietary inadequacies probably describe the situation for all Inuit populations, although a comparison amongst Inuit in Alaska, Canada and Greenland would be welcome. Two articles demonstrate the co-existence of high body mass index (BMI) and high reported physical activity (Hopping et al., 2010c,d). This should not be a surprise because the use of BMI as a measure of obesity amongst the Inuit has some limitations and because the International Physical Activity Questionnaire for self-reporting of physical activity is not too precise and has not been validated against objective measures of physical activity in Inuit populations. The observation, however, raises some questions that should be examined also in other northern populations. Higher socioeconomic status and knowledge about healthy food are associated with consumption and acquisition of healthy food (Erber et al., 2010b; Hopping et al., 2010b; Mead et al., 2010a,b) but is it knowledge that creates behaviour or does high socioeconomic status allow people to buy healthier and more expensive food? In Greenland, healthy food is expensive, and the latter explanation is certainly one that needs to be taken into consideration. The Healthy Foods North nutrition and lifestyle intervention programme aims basically to improving people's knowledge and awareness about healthy food and changing the food environment to make healthier options more available (Sharma, 2010). This will be successful if lack of knowledge and availability are the major determinants for poor dietary habits but, if lack of money is a key factor, the chance of success is much less. From Greenland, we look forward to a follow-up study of the programme because there are many tools in Healthy Foods North that we can use.

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.