fTRADITIONAL FIRST NATIONS FOODS AND TYPE 2 DIABETESgRichard T. Oster, Department of Medicine, University of AlbertakABSTR...
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Traditional First Nations foods and type 2 diabetes


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2010 (Oct) Alberta Diabetes Institute Research Day, poster presentation by Richard Oster (BRAID Research)

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Traditional First Nations foods and type 2 diabetes

  1. 1. fTRADITIONAL FIRST NATIONS FOODS AND TYPE 2 DIABETESgRichard T. Oster, Department of Medicine, University of AlbertakABSTRACTThe current health, in the biomedicalsense, of First Nations populations isgenerally poorer in comparison with thehealth of the Canadian population atlarge. Type 2 diabetes in particular,excessively impacts the Canadian FirstNations population, having reachedepidemic proportions in an acceleratedmanner. Encouraging the increasedprocurement and consumption oftraditional foods is gaining momentum asa potential strategy to prevent andmanage type 2 diabetes in First Nationscommunities. Through review of theliterature, our purpose was to present ageneral summary of the advantages anddisadvantages of this strategy.Specifically, studies of the possiblenutritional, fitness, and cultural benefits ofpromoting traditional food consumptionwere explored, as were the risks posedby environmental toxins and food securityissues. Future research needs arehighlighted.Keywords: Aboriginal; North American;Type 2 Diabetes; Traditional DietREFERENCES1. Oster RT et al. Alberta Diabetes Atlas2009:189-212.2. Willows ND. Canadian Journal ofPublic Health. 2005, 96(Suppl 3):S32-S36.3. Hu FB et al. Diabetologia. 44:805-817,2001.4. Bryan SN et al. Canadian Journal ofPublic Health. 2006, 97:271-276.5. Chandler MJ and Lalonde CE: Culturalcontinuity as a hedge against suicide inCanada’s First Nations. TransculturalPsychiatry. 35:191, 2003.6. Power EM. Canadian Journal of PublicHealth. 2008, 99:95-97.7. Sharp D. International Journal ofCircumpolar Health. 2009, 68:316-326.KSBACKGROUNDFirst Nations health compares inferiorly to that of the general Canadianpopulation, and type 2 diabetes is no exception. Studies suggest thattype 2 diabetes and its complications occur at much higher rates (2-5times) among First Nations peoples than the general Canadianpopulation1.Before the arrival of Europeans to North America, First Nations peoplessurvived for centuries by harvesting foods entirely off the land. Whatwas consumed varied depending on food availability, season,geographic location, tribe in question, as well as spiritual and culturalvalues2. Common foods included bison, caribou, moose, beaver, bear,rabbit, deer, muskrat, waterfowl, grouse, pheasant, crustaceans,shellfish, salmon, whitefish and other fish, berries, nuts, seeds, wildgreens, roots, bulbs, as well as numerous vegetables including corn,squash and potatoes2.There is a recent movement, in both academic and First Nationscommunities, to encourage the partial return to traditional lifestyles as ameans to combat type 2 diabetes.A literature review was performed to provide a general overview of thepotential advantages and disadvantages of encouraging theconsumption of traditional foods to prevent type 2 diabetes for FirstNations peoples.NutritionalA poor diet is the most common modifiable risk factor for type 2diabetes3. While many First Nations people still consume sometraditional foods, they have been largely replaced by ‘market foods’which are of poor nutritional content.Table 1 Summary of the traditional and contemporary diets of FirstNations populations based on the literature available.Physical ActivityEven independent of obesity and weight gain, physical inactivity hasbeen shown to increase the risk of type 2 diabetes4. With colonizationand the change to a more sedentary way of life, physical inactivity hasbecome extremely common in many First Nations populations4. Prior tothe 20th century, First Nations people were highly active as mostactivities of daily life were physically demanding, such as hunting,trapping, fishing, traveling and gathering.Traditional food procurement isstill a common form of activity among First Nations people.CulturalTraditional food is a central part of First Nations cultural identity,providing significant social, spiritual, and psychological benefits5. Muchof First Nations culture, including traditional food practices, wasdestroyed by the effects of colonialism, with attempted oppression andassimilation. Suicides experienced by First Nations people have beenattributed to cultural disconnection5. Only recently has the idea ofculture as a protective factor begun to be extrapolated to other healthissues, such as type 2 diabetes.PubMed and Web of Science were searched to find studies related tothe current understanding of traditional First Nations foods and type 2diabetes. Key potential advantages/disadvantages were identified,leading to more focused searching.PracticalityWhether or not traditional First Nations foods can be harvested andconsumed is affected by issues of:- Access: urban dwellers, loss of traditional lands- Availability: industry, infrastructure, climate change- Cost: equipment, travel, loss of paid time- Ability to harvest: decreased cultural knowledge transfer- Apprehension: “chemo-phobia”6Environmental ToxinsNew epidemiological research has shown an association between type2 diabetes and exposure to organo-chlorines such as polychlorinatedbiphenyls (PCBs) and dioxins7. PCBs and dioxins accumulate in theenvironment and eventually in the organs and adipose tissue ofanimals and humans. These toxins may be present at high levels inmany traditional First Nations foods, such as certain wild game andfish. However, there appears to be great variability in concentrationsdepending on the specific animals and species in question, and thegeographical location7.DISCUSSIONThe easing of this controversy likely hinges on two facets:1. The closing of research gaps- Intervention studies to examine whether collecting/consumingmore traditional foods improves nutritional status, fitness,cultural continuity, and ultimately type 2 diabetes risk.- The possible links between cultural continuity and type 2diabetes.- Mechanistic studies of PCBs/dioxins and type 2 diabetes.- Identification of where, when and which traditional foods canbe consumed to minimize risk.- Traditional food supply exploration, especially in urban FirstNations.2. Collaboration- Of First Nations organizations, academics, governments,healthcare systems and other agencies.METHODSPOTENTIAL ADVANTAGES POTENTIAL DISADVANTAGESTraditional diet Contemporary dietVery diverse, calories widelydistributedCalorie denseHigh in fiber Low in fiberHigh in polyunsaturated andmonounsaturated fatty acidsHigh in saturated and trans fattyacidsRich in micronutrients andvitaminsLow in iron, folate, calcium,vitamin D and vitamin ALow in simple carbohydrates High in sugarHigh in lean animal protein Low in fruits and vegetablesAlberta Diabetes Atlas, 2009