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PubMed2006

Dietary composition and contaminants in north Greenland, in the 1970s and 2004.

OBJECTIVES: The fatty acid composition and other nutrients in traditional Inuit food appear to provide some protection against diseases of affluent industrialized societies, such as cardiovascular diseases and type 2 diabetes. A transition towards increased amounts of imported food might increase the occurrence of these diseases among Inuit. However, since the 1970s it has become evident that the marine-based Inuit diet also contains high levels of potentially toxic lipophilic organic pollutants and heavy metals. Since these two opposing effects on health appear to be inseparable, the phenomenon has become known as "The Arctic Dilemma". However, both the fatty acid composition and the contaminant levels vary in Greenlandic food items. Thus, in theory, it is possible to compose a diet where the benefits outweigh the risks. Our objective was to compare traditional and modern meals in Greenland regarding dietary composition, content of n-3 fatty acids and contaminants. STUDY DESIGN: The present study was part of the Arctic Monitoring and Assessment Programme, AMAP, comparing the results of dietary composition and nutrients in 177 traditional meals collected in Uummannaq municipality, north Greenland in 1976 with 90 meals sampled in Uummannaq town in 2004 under similar conditions. Eleven pesticides, 14 PCB congeners, heavy metals, selenium, and fatty acids were analysed in meals and blood samples from the participants. Contaminant levels were compared between 1976 and 2004 after adjustment for n-3 fatty acids, indicating local food content. RESULTS: Between the traditional meals collected 30 years ago and the meals from 2004, dramatic and significant changes have occurred in the dietary composition. The percentage of local food has decreased, and with it the intake of n-3 fatty acids. Calculated as daily intake, all but three contaminants had decreased significantly. However, this could be explained by the lower intake of local food. After adjustment for n-3 fatty acid content in the food, significant declines of concentration in the local food were evident only for PCBs and lead, whereas for mercury, DDTs, and chlordanes the levels were unchanged, and for hexachlorobenzene, mirex, and toxaphenes, the levels had increased significantly. CONCLUSION: The consumption of locally produced food has decreased in Greenland during the last 30 years and this has led to a reduction in the daily intake of contaminants. However, the concentrations of contaminants in local food items have not decreased, except for PCB and Lead. Therefore, we recommend that the consumption of local products is not increased beyond the present level, until the level of contaminants is reduced to a safer level.

Diet↗
PubMed1999

Genetic prediction of atherosclerosis: lessons from studies in native Canadian populations.

The Oji-Cree from Northern Ontario have a very high prevalence of cardiovascular disease and diabetes mellitus, whereas the Inuit from Nunavut have a very low prevalence of these diseases. There are significant differences between Oji-Cree, Inuit and white subjects with respect to the frequencies of putative 'deleterious alleles' of several candidate genes in diabetes and atherosclerosis. Specifically, compared to whites, both Oji-Cree and Inuit have an excess of 'deleterious alleles' from 12 candidate genes in atherosclerosis and/or diabetes. However, it would appear that these differences in genetic architecture are not sufficient to account for the wide disparity in disease prevalence between the two aboriginal groups. It is very likely that environmental lifestyle factors, such as maintenance of a traditional diet and an increased level of activity, can override an apparent background of genetic susceptibility to these diseases in native people. Full understanding of the genetic component will require more effort because of confounding factors such as small genetic effects, non-mendelian inheritance, gene-gene interactions and gene-environment interactions. However, even before there is a full understanding of the identity of the all the genes involved, and of how their products might contribute to disease susceptibility in an individual or a community, there would be some justification to recommend an intervention strategy at this point in time. Such an intervention strategy would stress a return to a more traditional diet and lifestyle in order to avert and reverse these disease phenotypes in Canadian aboriginal communities.

Arteriosclerosis↗
PubMed2006

Impairment of cellular immunity in west Greenland sledge dogs (Canis familiaris) dietary exposed to polluted minke whale (Balaenoptera acutorostrata) blubber.

Minke whale (Balaenoptera acutorostrata) blubber is rich in organohalogen contaminants, mercury, and n-3 fatty acids. In the present study we show that a daily intake of 50-200 g of minke whale blubber causes an impairment of the nonspecific and specific cellular immune system in the West Greenland sledge dog (Canis familiaris). Immune reactions were measured by mitogen (PHA, Con A) and antigen (KLH) intradermal testing, and as the study used exposure levels similar to those of Inuits and polar bears (Ursus maritimus), it is reasonable to infer that Inuits and polar bears suffer from similar decreased resistance to diseases. It is speculated that food sources are depleted by thinning sea ice due to climate change and that more research should assess the forecasted rise in additive immunopathy effects in polar bears. Additionally, our study suggests that the fatty acid composition may be of importance when investigating combined immunotoxic effects of contaminated food resources in future Inuit and polar bear studies.

Animals↗
PubMed2000

High incidence of propionic acidemia in greenland is due to a prevalent mutation, 1540insCCC, in the gene for the beta-subunit of propionyl CoA carboxylase.

Propionyl CoA carboxylase (PCC) is a mitochondrial, biotin-dependent enzyme involved in the catabolism of amino acids, odd-chain fatty acids, and other metabolites. PCC consists of two subunits, alpha and beta, encoded by the PCCA and PCCB genes, respectively. Inherited PCC deficiency due to mutations in either gene results in propionic acidemia (PA), an autosomal recessive disease. Surprisingly, PA is highly prevalent among Inuits in Greenland. We have analyzed reverse transcriptase-PCR products of the beta-subunit mRNA, to characterize the responsible mutation(s). A 3-bp insertion, 1540insCCC, was found in homozygous form in three patients and in compound heterozygous form in one patient. The resulting PCC has no measurable activity, and the mutant beta-subunit appears to be very unstable. To test the hypothesis that a common mutation is responsible for PA in the Greenlandic Inuit population, 310 anonymous DNA samples of Inuit origin were screened for 1540insCCC. We found a carrier frequency of 5%, which is very high compared with those of most other autosomal recessive diseases. Analysis of alleles of a very closely linked marker, D3S2453, revealed a high degree of linkage disequilibrium between one specific allele and 1540insCCC, suggesting that this mutation may be a founder mutation.

Alleles↗
PubMed1995

Arctic indigenous women consume greater than acceptable levels of organochlorines.

Exposure to polychlorinated biphenyls and organochlorine pesticides through traditional food resources was examined for Arctic Indigenous women living in two cultural and environmental areas of the Canadian Arctic--one community representing Baffin Island Inuit in eastern Arctic and two communities representing Sahtú Dene/Métis in western Arctic. Polychlorinated biphenyls, toxaphene, chlorobenzenes, hexachlorocyclohexanes, dichlorodiphenyltrichloroethane, chlordane-related compounds and dieldrin were determined in local food resources as normally prepared and eaten. Quantified dietary recalls taken seasonally reflected normal consumption patterns of these food resources by women in three age groups: 20-40 y, 41-60 y and > or = 61 y. There was wide variation of intake of all organochlorine contaminants in both areas and among age groups for the Sahtú. Fifty percent of the intake recalls collected from the Baffin Inuit exceeded the acceptable daily intake for chlordane-related compounds and toxaphene, and a substantial percentage of the intake records for dieldrin and polychlorinated biphenyls exceeded the acceptable or tolerable daily intake levels. Primary contributing foods to organochlorine contaminants intake for the Baffin Inuit were meat and blubber of ringed seal, blubber of walrus and mattak and blubber of narwal. Important foods contributing organochlorine contaminant to the Sahtú Dene/Métis were caribou, whitefish, inconnu, trout and duck. The superior nutritional benefits and potential health risks of traditional food items are reviewed, as are implications for monitoring organochlorine contaminant contents of food, clinical symptoms and food use.

Adult↗
PubMed1999

Concentration of organochlorines in human brain, liver, and adipose tissue autopsy samples from Greenland.

Organochlorines are persistent lipophilic compounds that accumulate in Inuit people living in circumpolar countries. Organochlorines accumulate as a result of the Inuits' large consumption of sea mammal fat; however, available data are limited to blood lipids, milk fat, and adipose tissue. We report results of organochlorine determination in liver, brain, omental fat, and subcutaneous abdominal fat samples collected from deceased Greenlanders between 1992 and 1994. Eleven chlorinated pesticides and 14 polychlorinated biphenyl congeners were measured in tissue lipid extracts by high-resolution gas chromatography with electron capture detection. Mean concentrations of polychlorinated biphenyls, 2, 2'-bis(4-chlorophenyl)-1,1-dichloroethylene, ss-hexachlorocyclohexane, hexachlorobenzene, mirex, trans-nonachlor, and oxychlordane in adipose tissue samples from Greenlanders were 3-34-fold higher than those measured using the same analytical method in samples from Canadians in Quebec City, Quebec. Brain lipids contained lower concentrations of all organochlorines than lipids extracted from other tissues. Organochlorine residue levels in lipid extracts from liver, omental fat, and subcutaneous abdominal fat samples were similar, with the exception of ss-hexachlorocyclohexane, which reached a greater concentration in liver lipids than in lipids from both adipose tissues (4-fold; p < 0. 05). Comparisons with available international data on adipose tissue levels reveal that the organochlorine body burden in the Inuit population of Greenland is presently among the highest resulting from environmental exposure.

Adipose Tissue↗
PubMed1980

Respiratory function impairment and cardiopulmonary consequences in long-time residents of the Canadian Arctic.

Spirometry, roentgenography and electrocardiography were performed during community health surveys in 1976-78 in 176 Inuit and other long-time residents of the northeastern (Arctic Bay) and western (Inuvik) Canadian Arctic, and the results were related to age, ethnic origin, occupation and history of climatic exposure, smoking and hospitalization for tuberculosis. In Arctic Bay the young men showed excellent respiratory function, normal-sized pulmonary arteries and normal electrocardiograms, but abnormalities of all three types were increasingly frequent and severe after age 25. The forced mid-expiratory flow (FMF) fell to less than 50% of the norm by age 40, and dilatation of the pulmonary artery, hypertrophy of the right ventricle, right bundle branch block and a pseudoinfarction pattern on the ECG were frequently associated. In contrast, the men in Inuvik, an urbanized centre, maintained above normal respiratory function until age 40, and the FMF and pulmonary artery diameter remained normal in the older men except for Inuit and white trappers over 60 years old who had run fox trap lines along the Arctic coast in the 1920s and 30s. These data suggest that inhalation of extremely cold air at maximum ventilation may be a prime factor in the chronic obstructive lung disease of Inuit hunters, whereas smoking has only a minor role and hospitalization for tuberculosis appears to protect from rather than contribute to this disorder.

Adolescent↗
PubMedDate not supplied

Prenatal exposure of Canadian children to polychlorinated biphenyls and mercury.

This article documents the exposure to environmental contaminants within sub-groups of the Canadian population who are considered to be at risk as a result of the food they eat. We measured the concentrations of polychlorinated biphenyls (PCBs) and mercury in the blood drawn from the umbilical cords of newborns in various Aboriginal communities, in a coastal community and in the general population. Average concentrations of Aroclor 1260 ranged between 0.3 and 2.0 micrograms/L and were clearly highest among the Inuit of Nunavik and Baffin Island and among the Montagnais of Quebec. In these groups, we found contaminant levels in the blood of newborns that exceed the threshold beyond which cognitive impairments are expected to result. Average concentrations of mercury ranged between 1.0 and 14.2 micrograms/L; the Inuit of Nunavik and the NWT exhibited the highest exposure levels. A portion of the Nunavik and NWT Inuit had concentrations beyond the critical threshold for the appearance of neurological consequences. The variations in exposure levels resulted from the different nutritional practices of these Canadian sub-groups.

American Indian or Alaska Native↗
PubMed1998

Dorset and Thule divergence from East Central Asian roots.

The history of the immigration of East Asians to America during the last glacial period remains controversial. In an attempt to add critical data to this problem, a large sample of whole teeth derived from Southeast Asian, Mongolian, Thule, Western Inuit, and pre-Inca (Huari) people was quantified (N = 4,507 teeth from 495 individuals; approximately 30 variables per tooth). Multivariate analysis helped establish that all Native Americans were likely derived from one ancient, extinct population that resided in the region of Mongolia (east Central Asia), and that Mongolians and Southeast Asians are two independent groups. A controversial and enigmatic Central Canadian Arctic "Thule culture Inuit" group on Southampton Island that survived until 1902 was identified as a relic, mainly Paleoeskimo Dorset community. Surprisingly, there was little, or no, indication of Dorset-to-Thule gene flow. Cumulatively, the data suggest that a small population of Paleoindian founders remained resident in Beringia, may have blocked further immigration, and were the antecedents to the Thule/Inuit. With the confluence of the Arctic and Pacific oceans at the breakup of Beringia, the resulting increased availability of marine animal food sources allowed this population to increase in size and expand throughout the eastern Arctic.

Arctic Regions↗
PubMed1978

Canadian Eskimo permanent tooth emergence timing.

To identify the times of emergence of the permanent teeth of Canadian Eskimos (Inuit), 368 children and adolescents were examined. The presence or absence of all permanent teeth except the third molars was recorded and these data subjected to probit analysis. Female emergence times were advanced over males. Generally, the Inuit of both sexes showed statistically significant earlier emergence times than Montreal children, except for the incisors. The present results do not support hypotheses indicating that premature extraction of the deciduous teeth advances the emergence of their succedaneous counterparts. There is some indication the controls of deciduous tooth emergence continue to play some part in emergence of the permanent dentition, especially the first permanent teeth that emerge.

Asian People↗
PubMed2001

Variable association between genetic variation in the CYP7 gene promoter and plasma lipoproteins in three Canadian populations.

The promoter sequence variant -278A in the CYP7 gene, which encodes cholesterol 7-alpha hydroxylase, was previously reported to be associated with reduced plasma low density lipoprotein (LDL) cholesterol concentration. We tested for association of CYP7-278A with plasma lipoprotein traits in samples taken from three distinct Canadian populations: 594 Alberta Hutterites, 325 Ontario Oji-Cree and 190 Keewatin Inuit. The CYP7-278A allele frequencies in these three groups were 0.708, 0.466 and 0.490, respectively. The frequencies of CYP7-278A/A homozygotes were 0.481, 0.215 and 0.247, respectively. In the Hutterites, CYP7-278A was associated with reduced plasma HDL-cholesterol and apolipoprotein AI concentration. In the Oji-Cree, CYP7-278A was not significantly associated with any plasma lipoprotein trait. In the Inuit CYP7-278A was associated with elevated plasma total and LDL-cholesterol. There was no consistent relationship between the population mean plasma LDL-cholesterol concentration and the population CYP7-278A frequency. Our findings suggest that the common -278A promoter variant of CYP7 was inconsistently associated with variation in plasma LDL- and HDL-cholesterol in samples from three independent populations. The inconsistencies could be due to differences in genetic background or to unspecified environmental or genetic factors.

Adult↗
PubMed2002

Seasonal affective disorder in an Arctic community.

OBJECTIVE: To determine the rate of seasonal-pattern depression in an Inuit community above 70 degrees N. METHOD: One-hundred and eleven people from randomly selected households were surveyed for depression and anxiety and the effect of the seasons on their mood. Eighty-eight people provided replies on the influence of the seasons. RESULTS: One in five (22.6%) of the community sample was found to be depressed. Of these, seven (6.3%) had seasonal affective disorder (SAD), with fall onset occurring in six of these (5.4%). Subsyndromal SAD (SSAD) occurred in 11.7%, while any effect of the seasons (seasonality) occurred in 39.6%. Persons with SSAD and seasonality were significantly older than those unaffected by the seasonal effect. No other significant correlation of SAD, SSAD, or seasonality occurred with gender, age, and language preference. CONCLUSION: Seasonal mood changes in this Inuit group living in the Canadian Arctic are elevated above the rates found in other studies using similar survey methods.

Adolescent↗
PubMed2000

Psychosocial costs of transferring indigenous women from their community for birth.

OBJECTIVE: To describe the psychosocial effect of transferring Canadian Inuit women out of their communities for birth. DESIGN: Semi-structured interviews. SETTING: Two communities in the central Canadian arctic. PARTICIPANTS: Postnatal women and their partners, Inuit community members. MAIN FINDINGS: Women face many stressors as a result of being transferred from their community for the birth of their baby, not least of which is the lack of a partner and family support. Stressors were categorised as emotional, physical and economic, and women were given little choice or support for the place of birth and method of delivery. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Midwives need to be aware of the psychosocial disruption and stress faced by women and their families as a result of being transferred from their community for birth. Maternal/child policies and care need to focus more on the psychosocial aspects of labour, such as family and professional support, and less on the physical aspects which cannot be adequately addressed without culturally sensitive care. Consumers must be involved in the development of maternity services.

Arctic Regions↗
PubMed2001

The tuberculosis pandemic today: routes of transmission and new target groups.

Tuberculosis, a disease that has been with us since the dawn of time, shows little sign of disappearing. Declines in death rates observed for several centuries prior to 1960 have been reversed in recent decades. This is in spite of the fact that efficient means of controlling the disease have been available during this period. This article reviews experience in 3 communities: among the Inuit, who live in the region of the North Pole; in the Beijing Municipality in the People's Republic of China; and in a socially isolated community in South Africa. In the first 2 communities, dramatic declines in the burden of disease have been observed: in the Inuit community, this occurred after substantial intervention; in the Beijing Municipality it was done with limited resources. The third community in South Africa illustrates an alarming trend, with tuberculosis being seen in a variety of locations but in the absence of external agents such as HIV infection. Clearly we need to refocus our efforts to control this disease, making use of the new tools that are rapidly becoming available. This must be done without delay, before influences such as HIV infection put the possibility of control completely out of reach.

Arctic Regions↗
PubMed2003

Risk factors for acute respiratory tract infections in young Greenlandic children.

Acute respiratory infections cause considerable morbidity among Inuit children, but there is very little information on the risk factors for these infections in this population. To identify such factors, the authors performed a prospective community-based study of acute respiratory infections in an open cohort of 288 children aged 0-2 years in the town of Sisimiut, Greenland. Between July 1996 and August 1998, children were monitored weekly, and episodes of upper and lower respiratory tract infections were registered. Risk factor analyses were carried out using a multivariate Poisson regression model adjusted for age. Risk factors for upper respiratory tract infections included attending a child-care center (relative risk = 1.7 compared with home care) and sharing a bedroom with adults (relative risk = 2.5 for one adult and 3.1 for two adults). Risk factors for lower respiratory tract infections included being a boy (relative risk = 1.5), attending a child-care center (relative risk = 3.3), exposure to passive smoking (relative risk = 2.1), and sharing a bedroom with children aged 0-5 years (relative risk = 2.0 for two other children). Breastfeeding tended to be protective for lower respiratory tract infections. The population-attributable risk of lower respiratory tract infections associated with passive smoking and child-care centers was 47% and 48%, respectively. The incidence of acute respiratory infections among Inuit children may be reduced substantially through public health measures.

Acute Disease↗
PubMed1982

Chemoprophylaxis for Neisseria meningitidis in an isolated Arctic community.

Community chemoprophylaxis with a regimen of sequential minocycline/rifampin (adults) or rifampin alone (children [less than 12 years of age]) was undertaken in a remote Arctic community one year after an outbreak of meningitis due to Neisseria meningitidis serogroup B. Nasopharyngeal carriage rates of N. meningitidis before prophylaxis were 32.4% in Inuit (Eskimos) and 6% in Caucasians, with maximal carriage (44.8%) in adolescents. Serogroup B accounted for 63.9% of all isolates before prophylaxis. One week after prophylaxis, the nasopharyngeal carriage rates were 0.8% in Inuit who had received prophylaxis and 33.3% in those who had not received prophylaxis (P less than 0.005). This reduction persisted at nine weeks after prophylaxis, when carriage rates were 1.2% in those who had received prophylaxis and 22.6% in individuals who had not received prophylaxis. Of the strains obtained before prophylaxis, 7.8% were sulfadiazine-resistant, whereas 35% of all isolates obtained from prophylaxis were sulfadiazine-resistant. Rifampin- or minocycline-resistant strains were not identified either before or after prophylaxis.

Adolescent↗
PubMed1985

The changing epidemiology of hepatitis B virus infection in the Canadian north.

Hepatitis B virus infections are common in the Eskimo (Inuit) populations of the world. In this study, serologic markers of hepatitis B infection were measured in 172 inhabitants (78%) of an isolated Canadian Inuit settlement. Evidence of hepatitis B infection was found in 22% of residents. The prevalence increased with age, being uncommon under the age of 20 (7%), yet present in the majority of inhabitants over the age of 40 (64%). Sera from four individuals (2.3%) were hepatitis B surface antigen- (HBsAg) positive. All four HBsAg carriers were negative for immunoglobulin M (IgM) antibody to hepatitis B core antigen (IgM anti-HBc), hepatitis B e antigen (HBeAg), and DNA polymerase, but positive for antibody to hepatitis B e antigen (anti-HBe). These data suggest that hepatitis B infection has become relatively uncommon in the inhabitants of this community born during the past 20-30 years. The apparent decline in prevalence did not appear to be related to recent demographic or socioeconomic changes in the area.

Adolescent↗
PubMed1984

Forensic psychiatric assessments in the Northwest territories.

This paper is an analysis of the psychosocial and forensic factors leading to legal referrals to a northern mental health service. It was found, not surprisingly, that most criminal acts were associated with alcoholism, personality disorders, and low socioeconomic status. Young native males figured prominently in both violent and property crimes. Rape offenses and major psychopathology appeared to be more common among Inuit referrals. The influence of rapid culture change and psychosocial and biologic predisposition to the deleterious effects of alcohol were considered relevant criminogenic factors. It was also felt that the high Inuit referral rate might have been related to their willingness to accept consultation and discuss symptoms of mental illness.

Acculturation↗