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Background To describe the sources of meat and their contributions to vitamin B12, iron and zinc in five ethnic groups in the USA. Methods Dietary data for the Multiethnic Cohort, established in Hawaii and Los Angeles, were collected using a quantitative food frequency questionnaire from more than 215 000 subjects, aged 45-75 years at baseline (1993-1996). Participants included African American, Latino, Japanese American, Native Hawaiian and Caucasian men and women. Servings of meat items were calculated based on the US Department of Agriculture recommendations and their contributions to intakes of total meat, red meat, vitamin B12, iron and zinc were determined. Results Of all types of meat, poultry contributed the most to meat consumption, followed by red meat and fish among all ethnicities, except for Latino (born in Mexico and Central/ South America) men who consumed more beef. Lean beef was the most commonly consumed red meat for all ethnic-sex groups (9.3-14.3%), except for Native Hawaiian and Japanese American men, and Japanese American women whose top contributor was stew/curry with beef/lamb and stir-fried beef/pork with vegetables, respectively. The contribution of meat was most substantial for zinc (11.1-29.3%) and vitamin B12 (19.7-40%) and, to a lesser extent, for iron (4.3-14.2%). Conclusions This is the first large multiethnic cohort study to describe meat sources and their contributions to selected nutrients among ethnic minorities in the USA. These findings may be used to develop ethnic-specific recommendations for meat consumption aiming to improve dietary quality among these groups. [ABSTRACT FROM AUTHOR]

Background: Validation of a quantitative food frequency questionnaire (QFFQ) developed specifically for Inuit is necessary to determine its usefulness in assessing dietary intake and adequacy and in identifying dietary risk factors for chronic disease in this population. Methods: Seventy-five randomly selected Inuit adults in Nunavut, Canada, were recruited. Mean daily intake of nutrients from one to three 24-h recalls was used as the reference to measure QFFQ validity. Crude and energy-adjusted Spearman rank correlations (ρ), cross classification and weighted kappa were computed as measures of concordance. Bland–Altman plotting was used for additional assessment. Results: Excluding four participants with daily energy intake of >25.1 MJ, 71 participants were included in the analysis. For all nutrients, mean daily intake from the QFFQ was higher than the recall. ρ’s for macronutrients were in the range 0.71 for carbohydrate to 0.25 for protein. The best ρ amongst micronutrients was observed for vitamin C (0.66). Overall correlation between the two dietary tools improved after correction for within-person variance (from 0.46 to 0.49), although adjusting for energy did not improve the overall coefficient. When nutrient intakes were categorised into quartiles, the QFFQ and 24-h recalls indicated relative agreement proportion (same or adjacent quartiles) of 83% for energy, 94% for total sugar, 83% for macronutrients and 77% for micronutrients. Bland–Altman plots showed a tendency for increased scatter of the differences in nutrients at higher intakes. Conclusions: The QFFQ developed is valid and can be used to assess usual dietary intake and dietary adequacy, determine the contribution of foods to specific nutrient intakes, and identify dietary risk factors for chronic disease amongst this population. [ABSTRACT FROM AUTHOR]

Background: The estimation of dietary intake in population-based studies is often assessed by a food frequency questionnaire (FFQ). This present study aimed to establish the validity of a 142-item quantitative FFQ (QFFQ) developed to assess dietary intake in a population living in the Northwest Territories, Canada, and undergoing rapid nutrition transition. Methods: Sixty-four randomly selected Inuvialuit adults were recruited. The mean of one to three 24-h recalls was used as the reference to measure the validity of the QFFQ. Spearman rank correlations (ρ), cross-classification and weighted kappa were computed as measures of concordance, adjusting for the daily dietary intake variations in the recalls. Bland – Altman plots were used for additional assessment. Results: Four participants with daily energy intake of >25.1 MJ were not included in the analysis. For all nutrients, mean daily intake estimations were higher from the QFFQ than from the recalls. De-attenuated ρ’s for macronutrients ranged from 0.33 (protein) to 0.45 (carbohydrate). The best de-attenuated ρ amongst micronutrients was observed for vitamin C (0.53). Overall correlation between the two dietary tools improved after correction for within-person variance (from 0.32 to 0.35). When nutrient intakes were categorised into quartiles, the QFFQ and 24-h recalls indicated relative agreement (same or adjacent quartiles) for 77% for energy and macronutrients, 86% for total sugar and 72% for micronutrients. Bland–Altman plots showed a tendency for increased scatter of the differences at higher intakes. Conclusions: The QFFQ developed is valid and can be used to assess usual dietary intake and dietary adequacy, determine the contribution of foods to specific nutrient intakes, and identify dietary risk factors for chronic disease amongst Inuvialuit. [ABSTRACT FROM AUTHOR]

Background: Chronic disease prevalence amongst Canadian Arctic populations is increasing, but the literature amongst Inuvialuit is limited. The present study aimed to provide baseline data that could be used to monitor changes in chronic disease risk factors and long-term health in the Arctic by determining prevalence and risk factors of self-reported chronic disease amongst adult Inuvialuit in remote communities. Methods: Self-reported demographics and history of chronic disease (hypertension, heart disease, diabetes and cancer) were collected in three communities between July 2007 and July 2008 in the Northwest Territories. Food frequency questionnaires recorded dietary intake, International Physical Activity Questionnaires recorded physical activity and anthropometric measures of height and weight were obtained. Results: Response rates ranged from 65–85%. More than 20% of the 228 participants aged 19–84 years reported having a chronic disease. Age-adjusted prevalence was 28, 9, 9 and 6 per 100 for hypertension, heart disease, diabetes and cancer, respectively. Compared with non-cases, participants reporting hypertension were more likely to have a higher body mass index and a lower level of education. Hypertension was more common amongst participants reporting heart disease and diabetes than Inuvialuit not reporting these morbidities. Conclusions: Inuvialuit participants in this study were most affected by hypertension and diabetes compared with heart disease or any cancer. Female participants had a higher prevalence of heart disease compared with the Canadian average. Primary preventive strategies are necessary to mitigate the increasing rates of chronic disease risk factors in this population. Further studies with a larger sample size and measured chronic disease are necessary to confirm the findings obtained in the present study. [ABSTRACT FROM AUTHOR]

Background: With increasing chronic disease amongst Inuvialuit in the Canadian Arctic, research on dietary behaviours and their determinants in this population is needed to develop nutritional behaviour change intervention strategies. The present study aimed to assess the knowledge, self-efficacy and intentions towards healthy eating and healthy eating behaviours of Inuvialuit adults in the Northwest Territories (NWT), Canada. Methods: The Adult Impact Questionnaire was developed from behavioural theories and workshops held in the communities. It was conducted with adult Inuvialuit (≥19 years) from randomly selected households in three NWT communities to collect data on the psychosocial constructs of healthy food knowledge, self-efficacy and intentions, and the dietary behaviours of healthy and unhealthy food acquisition and preparation. Associations between demographic, socioeconomic, psychosocial constructs and behaviours were analysed using multivariate linear regression. Results: The 228 participants [mean (SD) age 43.4 (13.6) years; response rates 65–85%] acquired non-nutrient-dense foods a mean (SD) of 2.7 (3.0) times more frequently than nutrient-dense, low sugar and low fat foods. Increased intention was associated with a greater frequency of acquiring healthy foods (β = 0.17, P = 0.012) and a lower frequency of acquiring unhealthy foods (β = −0.18, P = 0.008). Overall, participants reported using food preparation methods that reduce fat content slightly more than methods that add fat [mean (SD) score 0.3 (1.9)]. Use of healthier food preparation methods was associated with higher levels of healthy food knowledge (β = 0.26, P < 0.001), self-efficacy (β = 0.29, P < 0.001) and intentions (β = 0.22, P = 0.001). Conclusions: Healthy food intention was the construct most significantly associated with all three healthier dietary behaviours. Interventions that target intentions to change food choice and preparation may be effective strategies to improve dietary intake in Inuvialuit populations. [ABSTRACT FROM AUTHOR]

Background: Changing food behaviours amongst Canadian Inuit may contribute to rising chronic disease prevalence, and research is needed to develop nutritional behaviour change programmes. The present study examined patterns of food acquisition and preparation behaviours amongst Inuit adults in Nunavut and associations with psychosocial and socioeconomic factors. Methods: Developed from behavioural theories and community workshops, Adult Impact Questionnaires were conducted with adult Inuit (≥19 years) from randomly selected households in three remote communities in Nunavut, Canada, to determine patterns of healthy food knowledge, self-efficacy and intentions, frequencies of healthy and unhealthy food acquisition and healthiness of preparation methods. Associations between these constructs with demographic and socioeconomic factors were analysed using multivariate linear regressions. Results: Amongst 266 participants [mean (SD) age 41.2 (13.6) years; response rates 69–93%], non-nutrient-dense foods were acquired a mean (SD) of 2.9 (2.3) times more frequently than nutrient-dense, and/or low sugar/fat foods. Participants tended to use preparation methods that add fat. Intentions to perform healthy dietary behaviours was inversely correlated with unhealthy food acquisition (β = −0.25, P < 0.001), and positively associated with healthy food acquisition (β = 0.22, P < 0.001) and healthiness of preparation methods (β = 0.15, P = 0.012). Greater healthy food knowledge and self-efficacy were associated with intentions (β = 0.21, P = 0.003 and β = 0.55, P < 0.001, respectively). Self-efficacy was associated with healthier preparation (β = 0.14, P = 0.025) and less unhealthy food acquisition (β = −0.27, P < 0.001), whilst knowledge was associated with acquiring healthy foods (β = 0.13, P = 0.035). Socioeconomic status was positively associated with healthy preparation and food acquisition behaviours. Conclusions: Interventions to improve diet in Nunavut Inuit should target healthy food intentions, knowledge and self-efficacy. Behaviour change strategies emphasising economic benefits of a healthy diet should be employed to target individuals of low socioeconomic status. [ABSTRACT FROM AUTHOR]

Background: Existing evidence indicates that Inuit in Arctic Canada are undergoing a lifestyle transition leading to decreased physical activity (PA) and increased body mass index (BMI). Data specific to PA and BMI amongst Inuit in Nunavut, Canada, are currently limited. The present study aimed to characterise current PA and BMI levels in a sample of Inuit adults. Methods: Inuit adults randomly selected from a cross-sectional survey of three communities in Nunavut, Canada, completed an adapted International Physical Activity Questionnaire (IPAQ) and an anthropometric survey. Data were analysed by gender and age group using standardised IPAQ protocol. Results: Response rates ranged from 69–93%. Two hundred and eighteen Inuit adults [180 women, 38 men; mean (standard deviation (SD)) ages 42.3 (13.0) and 42.4 (14.8) years respectively; age range 19–89 years] completed the IPAQ. All men and 97% of women allowed height and weight measurements; the remainder were self-reported. Mean (SD) BMI was 27.7 (6.3) kg/m2 for males and 30.3 (8.0) kg/m2 for females. The largest proportion of women and participants in both age groups had a BMI in the obese category; males were evenly split between the normal and obese categories. Self-reported PA was high, with most men, women and participants ≤50 years in the high category of PA. Participants >50 years were evenly split across the medium and high categories. Most participants (72%) were classified as being overweight or obese, yet reported medium or high levels of PA (89%). Conclusions: The findings obtained in the present study indicate the co-existence of high BMI and high self-reported PA amongst Inuit adults. [ABSTRACT FROM AUTHOR]

Background: Inuvialuit in the Canadian Arctic have been experiencing a nutrition transition resulting in a decrease in nutrient-dense food consumption, which may, in part, explain this population’s increasing chronic disease rates. Because the available literature is limited, the present study aimed to document the extent of this transition by examining current dietary patterns and socioeconomic factors affecting food group consumption. Methods: This cross-sectional study was conducted in three Inuvialuit communities in the Northwest Territories between 2007 and 2008. A validated food frequency questionnaire determined intake frequency of fruit and vegetables (FV), traditional foods (TF) and non-nutrient-dense foods (NNDF). Socioeconomic status (SES) was assessed by questions on education, ownership of items in working condition used to create a Material Style of Life (MSL) scale and residents in household employed/on income support. Daily intake frequencies were compared by gender and age group using Wilcoxon rank sum test. SES association with food group intake was determined using logistic regression. Results: The response rate was 65–85%. One hundred and seventy-five participants were female and 55 were male, aged 19–84 years [mean (SD) 44 (14)]. Mean frequencies of FV and TF consumption were 1.6 (1.5) and 1.6 (1.7) times per day, respectively. NNDF were reported 9.2 (3.0) times per day. The highest MSL score (>12) was significantly associated with higher fruit (≥0.7 times per day) and higher TF intake (≥1.1 times per day) compared with the lowest score (≤7). An intermediate MSL score (8–12) was related to higher vegetable consumption (≥0.4 times per day). Conclusions: NNDF were consumed approximately seven times more frequently than TF in the present study, indicating that the dietary transition is well underway amongst Inuvialuit. Participants with higher SES were more likely to consume nutrient-dense foods, suggesting possible cost barriers. [ABSTRACT FROM AUTHOR]

Background: Traditional foods are rich sources of essential nutrients, but Inuvialuit in the Northwest Territories (NWT), Canada, have been undergoing a nutrition transition, characterised by an increased consumption of non-nutrient-dense foods. The present study aimed to characterise energy, nutrient and food intakes amongst adult Inuvialuit. Methods: The study collected up to three 24-h dietary recalls on nonconsecutive days for each participant in spring/summer of 2008 in one remote community in the NWT. Recall data were analysed for energy and nutrient intake, dietary adequacy, most commonly reported foods, and food contributors to energy and nutrients. Results: Participants included 14 men and 50 women (response rate 79%). Median daily energy intake was 9.4 (interquartile range = 5.7) MJ for men and 8.3 (3.6) MJ for women. The majority of adult Inuvialuit did not meet the recommendation for vitamins A [median intake = 344.7 (246.3) μg-RAE in men, 248.9 (213.8) μg-RAE in women], B6 [0.9 (0.8) mg in men, 1.0 (0.5) mg in women] and E [2.4 (2.1) mg in men, 1.8 (1.0) mg in women], dietary fibre [7.7 (5.7) g in men, 8.7 (4.4) g in women], calcium [779.6 (842.0) mg in men, 610.4 (431.5) mg in women] and total folate [222.6 (57.7) μg in men, 264.6 (127.5) μg in women]. Vitamin D intake was below the recommendation for most women [median intake = 100.0 (119.2) IU]. Traditional foods contributed substantially to protein and iron intake. Juices were the main contributors to energy, carbohydrate and calcium. Conclusions: The present study revealed an inadequate consumption of essential nutrients in an Inuvialuit population. If these nutrient deficiencies continue, this population will face an increased burden of chronic diseases and malnutrition. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Increasing consumption of non-nutrient-dense foods (NNDF), decreasing consumption of traditional foods (TF) and low consumption of fruit and vegetables (FV) may contribute to increasing chronic disease rates amongst Inuit. The present study aimed to assess the daily frequency and socioeconomic and demographic factors influencing consumption of TF, FV and NNDF amongst Inuit adults in Nunavut, Canada. Methods: Using a cross-sectional study design and random household sampling in three communities in Nunavut, a food frequency questionnaire developed for the population was used to assess frequency of NNDF, TF and FV consumption amongst Inuit adults. Socioeconomic status (SES) was assessed by education level, ownership of items in working condition, and whether or not people in the household were employed or on income support. Mean frequencies of daily consumption were compared across gender and age groups, and associations with socioeconomic indicators were analysed using logistic regression. Results: Two hundred and eleven participants (36 men, 175 women; mean (standard deviation) ages 42.1 (15.0) and 42.2 (13.2) years, respectively; response rate 69–93%) completed the study. Mean frequencies of consumption for NNDF, TF and FV were 6.3, 1.9 and 1.6 times per day, respectively. On average, participants ≤50 years consumed NNDF ( P = 0.003) and FV ( P = 0.01) more frequently and TF ( P = 0.01) less frequently than participants >50 years. Education was positively associated with FV consumption and negatively associated with TF consumption. Households on income support were more likely to consume TF and NNDF. Conclusions: These results support the hypothesis that the nutrition transition taking place amongst Inuit in Nunavut results in elevated consumption of NNDF compared with TF and FV. [ABSTRACT FROM AUTHOR]

Background: Nutritional inadequacies and increasing chronic disease prevalence amongst Inuit in the Canadian Arctic highlight the need to address dietary practices. Research is needed to investigate the individual and environmental factors impacting diet to guide interventions. The present study aimed to explore multiple community perspectives of key factors affecting food choice and availability in Inuit communities in Nunavut, Canada. Methods: Semi-structured in-depth interviews were conducted with Inuit adults ( n = 43) in two communities in Nunavut, Canada, and included community members, community leaders, elders, health staff and food shop staff. The interviewer transcribed the audio-taped interviews. Data were analysed using codes and the constant comparative method to determine categories and emergent themes. Results: Thirty-three Inuit (27 females and six males) and 10 non-Inuit (four females and six males) adults participated. Traditional foods procured through hunting and gathering were considered the healthiest by community members, although multiple factors inhibited their procurement, including high petrol cost and decrease in traditional knowledge about hunting and gathering practices. Cost and quality were the main barriers to purchasing healthy foods at the shops. Community leaders and health staff identified multiple barriers to healthy eating in the community, such as skills to prepare some shop-bought foods. Shop managers identified several challenges to providing fresh produce and other perishable foods, such as long transportation routes that increase costs and harsh climatic conditions that may cause spoilage. They also cited factors influencing their decisions regarding whether to stock/discontinue certain foods, such as customers’ requests, food cost and shelf-life. Conclusions: An intervention to reduce chronic disease risk and improve dietary adequacy amongst Nunavut Inuit may be effective by supporting individual behaviour modifications with food environment changes. [ABSTRACT FROM AUTHOR]

Background: The extent to which awareness of chronic disease (CD) diagnosis affects one’s healthy food knowledge, self-efficacy and intentions or healthy dietary and physical activity (PA) behaviours remains unexplored among Inuit in Canada. Methods: A food frequency questionnaire and an adult impact questionnaire were used in a cross-sectional study to collect self-reported data on daily energy and nutrient intake, PA and the diagnosis of hypertension, diabetes, heart disease and cancer amongst adult Inuit and their family members. Associations between awareness of personal and family CD status and healthy food knowledge, self-efficacy and intentions, percentage of energy consumed from non-nutrient-dense foods and PA were assessed via ordinal logistic regression. Results: Of the 266 participants, those who self-reported CD for both themselves and their relative(s) were more likely to have high healthy food knowledge [odds ratio (OR) = 2.45] than those who did not. Reporting hypertension and heart disease amongst only relatives increased the likelihood of high knowledge (OR = 5.20) and intentions (OR = 5.10) for healthy eating. Heart disease in both participants and their relatives was associated with high levels of PA (OR = 12.24). However, there were no associations when only participants (but not their relatives) reported having CD. A joint effect between a high level of education and awareness of CD was positively related to high food knowledge (OR = 38.93). An inverse association between awareness of CD and unhealthy eating was not observed. Conclusions: Awareness of a relative having a CD was a more important factor in increasing knowledge and, to a lesser degree, self-efficacy or intentions to eat healthy than participants’ awareness of personal CD. However, awareness was not associated with lower non-nutrient-dense food intake. [ABSTRACT FROM AUTHOR]

Background: Inuvialuit in Arctic Canada are undergoing nutrition and lifestyle transitions that encourage decreased physical activity (PA) and increased body mass index (BMI), although data specific to PA and BMI within this unique population are not currently available. The present study aimed to characterise current PA and BMI levels in a sample of Inuvialuit adults. Methods: Inuvialuit adults randomly selected from a cross-sectional survey of three communities in the Northwest Territories, Canada, completed an adapted International Physical Activity Questionnaire (IPAQ) and an anthropometric questionnaire to obtain height and weight. Data were analysed using the standardised IPAQ protocol, and the results are presented by gender and age group (≤50 and >50 years). Results: One hundred and ninety-six Inuvialuit adults [148 women, 48 men; mean (standard deviation (SD)) ages 45 (14) and 41 (14) years, respectively; age range 19–84 years] completed the IPAQ (response rates 65–85%). Seventy-one percent of men and 74% of women allowed height measurements, whilst 81% and 84% allowed weight measurements, respectively; the remainder provided self-reported anthropometrics. Mean (SD) BMIs were 28.6 (7.7) kg/m2 for males and 30.5 (8.8) kg/m2 for females. The greatest percentage of participants in both gender and age groups fell into the obese BMI category. Self-reported PA was high, with means for men and participants ≤50 years in the high category of PA and means for women and participants >50 years in the medium category. Almost two-thirds (65%) of participants were classified as being overweight or obese, although 89% reported medium or high levels of PA. Conclusions: The results obtained in the present study indicate widespread overweight/obesity accompanying high levels of self-reported PA. [ABSTRACT FROM AUTHOR]