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BACKGROUND: Obesity incidence and prevalence is of increasing concern in First Nations communities around Canada. In addition to diet and physical activity, environmental pollutants have been suggested as a potential contributory factor to obesity associated morbidity. Owing to the exposure of Cree First Nations people to various persistent organic pollutants (POPs) and toxic metals, it is important to examine the association between obesity in these communities, and contaminant body burdens. OBJECTIVE: To determine whether selected morphometry measures (body mass index [BMI], waist circumference [WC] and body fat percentage) are associated with body burdens of 10 POPs and toxic metals. METHODS: Using data from the Nituuchischaayihtitaau Aschii Multi-community Environment-and-Health study in the eastern James Bay (Eeyou Istchee) Cree communities, this cross-sectional study examined morphometric and contaminant measures of 695 eligible participants. Sex stratified principal component analysis was conducted on blood plasma concentrations of 10 POPs and toxic metals. BMI, WC, body fat percent, and resultant contaminant components were used to create generalized linear models, and adjusted for covariates (age, total lipids, smoking, and n-3 fatty acids). RESULTS: Two principal components (PCs; PC-1 and PC-2) were extracted for both males and females. For females, PC-1 explained 73.3% and PC-2 explained 10.5%, and for males, PC-1 explained 71.6% and PC-2 explained 11.2% of the variance in contaminant burden. For both sexes, PC-1 loaded highly for polychlorinated biphenyl (PCB) congeners, organochlorine pesticides and, to a lesser extent, mercury and lead. PC-2 loaded highly for cadmium for females, and cadmium and lead for males. After adjusting for covariates, the generalized linear model showed that PC-2 was significantly and negatively associated with BMI, body fat percent, and WC in males and females. CONCLUSIONS: Our cross-sectional analysis indicates a negative association between cadmium with various obesity measures in both males and females. Null associations were found between PCBs and organochlorine pesticides and morphometry.

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Diabetes mellitus is a growing public health problem affecting persons in both developed and developing nations. The prevalence of type 2 diabetes mellitus (T2DM) is reported to be several times higher among Indigenous populations compared to their non-Indigenous counterparts. Discriminant function analysis (DFA) is a potential tool that can be used to quantitatively evaluate the effectiveness of Indigenous health-and-wellness programs (e.g., on-the-land programs, T2DM interventions), by creating a type of pre-and-post-program scoring system. As the communities of the Eeyou Istchee territory, subarctic Quebec, Canada, have varying degrees of isolation, we derived a DFA tool for point-of-contact evaluations to aid in monitoring and assessment of health-and-wellness programs in rural and remote locations. We developed several DFA models to discriminate between those with and without T2DM status using age, fasting blood glucose, body mass index, waist girth, systolic and diastolic blood pressure, high-density lipoprotein, triglycerides, and total cholesterol in participants from the Eeyou Istchee. The models showed a ~97% specificity (i.e., true positives for non-T2DM) in classification. This study highlights how varying risk factor models can be used to discriminate those without T2DM with high specificity among James Bay Cree communities in Canada.

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Type 2 diabetes mellitus (T2DM) disproportionately affects Indigenous populations. It is possible that exposure to complex mixtures of environmental contaminants contribute to T2DM development. This study examined the association between complex environmental contaminant mixtures and T2DM among Canadian Indigenous communities from the Eeyou Istchee territory, Quebec, Canada. Using data from the cross-sectional Multi-Community Environment-and-Health Study (2005-2009) Principal Component Analysis (PCA) was used to reduce the dimensionality of the following contaminants: 9-polychlorinated biphenyl congeners; 7-organic pesticides; and 4-metal/metalloids. Following this data reduction technique, we estimated T2DM prevalence ratios (PR) and 95% confidence intervals using modified Poisson regression with robust error variance across derived principal components, adjusting for a priori covariates. For both First Nation adult males (n = 303) and females (n = 419), factor loadings showed dichlorodiphenyltrichloroethane (DDT) and lead (Pb) highly loaded on the second principal component (PC) axis: DDT negatively loaded, and Pb positively loaded. T2DM was significantly associated with PC-2 across all adjusted models. Because PCA produces orthogonal axes, increasing PC-2 scores in the fully adjusted model for females and males showed (PR = 0.84; 95% CI 0.72, 0.98) and (PR = 0.78; 95% CI 0.62, 0.98), respectively. This cross-sectional study suggests that our observed association with T2DM is the result of DDT, and less likely the result of Pb exposure. Further, detectable levels of DDT among individuals may possibly contribute to disease etiology.

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Indigenous people of northern Canada traditionally lived a nomadic lifestyle subsisting on wild game and fish for thousands of years. With colonization came an increasing dependence on imported processed foods. This dietary change has often been reported to be one of the factors leading to Indigenous health and wellbeing disparities worldwide. We determined the amino acid (AA) profile including tryptophan (Trp) of wild meats (game and fish) and processed meats found in the traditional and modern diets of Indigenous subarctic communities in Canada. Trp is a limited essential AA necessary for synthesis of serotonin (5-HT), an important neurotransmitter and homeostatic regulator. The dietary ratio of Trp relative to other large neutral AAs (LNAA) can alter Trp transport and 5-HT synthesis in the brain. We determined AA composition of wild meats and processed meats using standardized NaOH and HCl hydrolysis for Trp and other AAs, respectively, followed by ultraperformance liquid chromatography. A Principal Components Analysis revealed that overall AA composition is significantly different between wild and processed meats. (M)ANOVA showed significantly higher protein in wild meats (wet weight, ww). Trp was significantly lower in processed meat samples (n=15; 0.18g/100g ± 0.02 ww) compared to wild meat samples (n=25; 0.24g/100g ± 0.06 ww). The proportion of Trp:LNAA and Trp in sample protein were not significantly different between wild (1:21-1:27, 0.92-1.27 g/100g protein) and processed (1:20-1:24, 1.03-1.27 g/100g protein) meats. Within wild meats, AA composition is significantly different between fish and waterfowl, fish and moose, and moose and goose. (M)ANOVA results indicate significantly higher protein in goose compared to moose and fish and in moose compared to fish. We compared our Trp findings to previous analyses and discuss the substantial gap in human nutritional studies of Trp.

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While policies to decrease lead in the environment have been implemented to reduce human exposure to various lead sources, the use of lead ammunition to harvest wild game may continue to contribute significantly to human blood lead levels (BLLs). As part of a multi-community environment-and-health study, BLLs representing all age groups were evaluated in the nine Cree Nations located in the James and Hudson Bay regions of Quebec, Canada. Personal, market food, traditional food and 24-h recall questionnaires were administered. Predictor variables were assessed for various exposure sources, including diet and hunting practices. Elevated BLLs were observed in association with increased hunting status, use of firearms and leaded ammunition, and consumption of traditional foods. Significant differences were observed between all communities, age groups and sexes. Recommendations include educational campaigns that promote switching to non-lead ammunition and, if lead ammunition continues to be used, careful removal from tissues of pellets, bullet fragments and ammunition paths.

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BACKGROUND: this article constitutes a report on the comprehensive Nituuchischaayihtitaau Aschii multi-community environment-and-health study conducted among the Cree peoples (Eeyouch) of northern Quebec, Canada. OBJECTIVES: to interpret observed concentrations of a suite of chemical elements in a multi-media biological monitoring study in terms of sources and predictors. METHODS: the concentrations of 5 essential and 6 toxic chemical elements were measured in whole blood, and/or in urine or hair by ICP-MS. Concentrations of essential elements are compared to those considered normal (i.e., required for good health) and, when toxic, deemed acceptable at specified concentrations in public health guidelines. Their dependence on age, sex, the specific community lived-in and diet were explored employing multivariate analysis of variance (MANOVA) involving new variables generated by principle component analysis (PCA) and correspondence analysis (CA). RESULTS: the 5 most prominent PCA axes explained 67.7% of the variation, compared to 93.0% by 6 main CA factors. Concentrations of the essential elements in whole blood (WB) and iodine(i) and arsenic (As) in urine were comparable to those reported in the recent Canadian Health Measures survey and are assigned to dietary sources. By contrast, WB cadmium (Cd) was elevated even when smoking was considered. Mercury (Hg) concentrations in WB and hair were also higher in adults, although comparable to those observed for other indigenous populations living at northern latitudes. Fish consumption was identified as the prominent source. Of the 5 coastal communities, all but one had lower Hg exposures than the four inland communities, presumably reflecting the type of fish consumed. Use of firearms and smoking were correlated with WB-lead (Pb). The concentrations of both Hg and Pb increased with age and were higher in men, while WB-Cd and smoking prevalence were higher in women when considering all communities. Hg and Pb were low in children and women of reproductive age, with few exceedances of health guidelines. Although individuals with T2D had somewhat lower WB-Cd, there is some indication that Cd may potentiate renal dysfunction in this subgroup. Plots of selected CA axes grouped those elements expected to be in a normal diet and distinguished them from those with well-known unique sources (especially Hg and As in hair; and Hg, Pb and Cd in WB). CONCLUSIONS: the use of multiple biological media in conjunction with the complementary PCA and CA approaches for constructing composite variables allowed a more detailed understanding of both the sources of the essential and toxic elements in body fluids and the dependencies of their observed concentrations on age, sex, community and diet.

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Persistent organohalogens (POHs) and metals have been linked to alterations in menstrual cycle function and fertility in humans. The Cree First Nations people living near James Bay in Ontario and Quebec, Canada, have elevated levels of POHs, mercury and lead compared to other Canadians. The present study examines the interrelationships between selected POHs and elements on menstrual cycle function in these Cree women. Menstrual cycle characteristics were derived from structured daily diaries and endocrine measurements from daily urine samples collected during one cycle for 42 women age 19-42. We measured 31 POHs in blood plasma and 18 elements in whole blood, for 31 of the participants. POHs and elements detected in ≥ 70% of the participants were transformed by principal component (PC) analysis to reduce the contaminant exposure data to fewer, uncorrelated PCA variables. Multiple regression analysis revealed that, after adjusting for confounders, PC-3 values showed significant negative association with cycle length, after adjusting for confounders (p = 0.002). PC-3 accounted for 9.2% of the variance and shows positive loadings for cadmium, selenium, and PBDE congeners 47 and 153, and a negative loading for copper. Sensitivity analysis of the model to quantify likely effect sizes showed a range of menstrual cycle length from 25.3 to 28.3 days using the lower and upper 95% confidence limits of mean measured contaminant concentrations to predict cycle length. Our observations support the hypothesis that the menstrual cycle function of these women may be altered by exposure to POHs and elements from their environment.

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A multi community environment-and-health study among six of the nine communities of Eeyou Istchee in northern Quebec, Canada provided greater insight into iodine intake levels among these Cree First Nation communities. Using data from this large population-based study, descriptive statistics of measured urinary iodine concentrations (UICs) and iodine-creatinine ratios (stratified by age, sex, community of residence, and water consumption) were calculated, and the associations between independent variables and iodine concentration measures were examined through a general linear model. Traditional food consumption contributions were examined through Pearson partial correlation tests and linear regression analyses; and the importance of water sources through ANOVA. Generally speaking, urinary iodine levels of Eeyou Istchee community members were within the adequate range set out by the World Health Organization, though sex and community differences existed. However, men in one community were considered to be at risk of iodine deficiency. Older participants had significantly higher mean iodine-creatinine ratios than younger participants (15-39 years = 90.50 µmol mol(-1); >39 years = 124.52 µmol mol(-1)), and consumption of beaver (Castor canadensis) meat, melted snow and ice, and bottled water were predictive of higher iodine excretion. It is concluded that using both urinary iodine indicators can be helpful in identifying subgroups at greater risk of iodine deficiency.

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BACKGROUND: There is concern of avian influenza virus (AIV) infections in humans. Subsistence hunters may be a potential risk group for AIV infections as they frequently come into close contact with wild birds and the aquatic habitats of birds while harvesting. This study aimed to examine if knowledge and risk perception of avian influenza influenced the use of protective measures and attitudes about hunting influenza-infected birds among subsistence hunters. METHODS: Using a community-based participatory research approach, a cross-sectional survey was conducted with current subsistence hunters (n = 106) residing in a remote and isolated First Nations community in northern Ontario, Canada from November 10-25, 2013. Simple descriptive statistics, cross-tabulations, and analysis of variance (ANOVA) were used to examine the distributions and relationships between variables. Written responses were deductively analyzed. RESULTS: ANOVA showed that males hunted significantly more birds per year than did females (F1,96 = 12.1; p = 0.001) and that those who hunted significantly more days per year did not perceive a risk of AIV infection (F1,94 = 4.4; p = 0.040). Hunters engaged in bird harvesting practices that could expose them to AIVs, namely by cleaning, plucking, and gutting birds and having direct contact with water. It was reported that 18 (17.0%) hunters wore gloves and 2 (1.9%) hunters wore goggles while processing birds. The majority of hunters washed their hands (n = 105; 99.1%) and sanitized their equipment (n = 69; 65.1%) after processing birds. More than half of the participants reported being aware of avian influenza, while almost one third perceived a risk of AIV infection while harvesting birds. Participants aware of avian influenza were more likely to perceive a risk of AIV infection while harvesting birds. Our results suggest that knowledge positively influenced the use of a recommended protective measure. Regarding attitudes, the frequency of participants who would cease harvesting birds was highest if avian influenza was detected in regional birds (n = 55; 51.9%). CONCLUSIONS: Our study indicated a need for more education about avian influenza and precautionary behaviours that are culturally-appropriate. First Nations subsistence hunters should be considered an avian influenza risk group and have associated special considerations included in future influenza pandemic plans.

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INTRODUCTION: Research investigating the body weight perceptions and eating-related weight control behaviors of First Nations (FN) youth living on reserve in Canada has been scarce. Knowledge of body weight perceptions may help to improve the relevance of initiatives promoting healthy weights. The purpose of this study was to examine the body weight perceptions and eating-related weight control behaviors of grade 6-8 on-reserve FN youth from seven Ontario communities. METHODS: Data were collected from December 2003 to June 2010 from a convenience sample of FN youth (aged 10-14 years) using the Waterloo Web-based Eating Behaviour Questionnaire (WEB-Q). Participants were categorized into body mass index (BMI) categories based on International Obesity Task Force (IOTF) cut points. Frequency statistics were computed in the comparison of measured BMI and weight perceptions and weight control behaviors. Differences by BMI category were tested using Pearson Χ2 tests. RESULTS: A total of 267 youth from seven Ontario FN communities participated in the study (48.6% male). Overall, 36.3% of youth were overweight and 21.3% were obese (combined total of 57.6%). Similar to non-Aboriginal youth, a greater proportion of FN girls who were at a normal weight were concerned that their weight was too high compared to boys. However, one-third of normal weight boys were currently trying to lose weight. A greater proportion of obese girls were trying to lose weight compared to boys. Overall, a large proportion of both overweight boys and girls were attempting to gain weight. CONCLUSIONS: The present study provides a unique investigation into the weight perceptions and weight control behaviors of on-reserve FN youth living in isolated communities in Ontario, Canada. Many of the perceptions elucidated in this study are similar to those observed in non-Aboriginal youth, while others differed. The knowledge of these perceptions and further research to investigate what factors influences them will help to customize health promoting initiatives that are relevant to the youth in the participating communities.

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BACKGROUND: The World Health Organization (WHO) recommends a mercury (Hg) hair-to-blood ratio of 250 for the conversion of Hg hair levels to those in whole blood. This encouraged the selection of hair as the preferred analyte because it minimizes collection, storage, and transportation issues. In spite of these advantages, there is concern about inherent uncertainties in the use of this ratio. OBJECTIVES: To evaluate the appropriateness of the WHO ratio, we investigated total hair and total blood Hg concentrations in 1333 individuals from 9 First Nations (Aboriginal) communities in northern Québec, Canada. METHODS: We grouped participants by sex, age, and community and performed a 3-factor (M)ANOVA for total Hg in hair (0-2 cm), total Hg in blood, and their ratio. In addition, we calculated the percent error associated with the use of the WHO ratio in predicting blood Hg concentrations from hair Hg. For group comparisons, Estimated Marginal Means (EMMS) were calculated following ANOVA. RESULTS: At the community level, the error in blood Hg estimated from hair Hg ranged -25% to +24%. Systematic underestimation (-8.4%) occurred for females and overestimation for males (+5.8%). At the individual level, the corresponding error range was -98.7% to 1040%, with observed hair-to-blood ratios spanning 3 to 2845. CONCLUSIONS: The application of the ratio endorsed by the WHO would be unreliable for determining individual follow-up. We propose that Hg exposure be assessed by blood measurements when there are human health concerns, and that the singular use of hair and the hair-to-blood concentration conversion be discouraged in establishing individual risk.

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Cadmium (Cd), a nonessential toxic metal present in the environment, accumulates in the organs of herbivorous mammals which typically are consumed by Aboriginal populations. The relative contribution of this potential exposure source to concentrations of blood Cd was investigated in 1429 participants (age >7 years) residing in the nine Cree First Nations communities of Eeyou Istchee, northern Quebec, Canada. Analysis of variance identified significant Cd concentration differences between communities, sex, and age groups, although these were complicated by significant 2-way interactions. The percentage of participants with Cd concentrations within the adopted health-based guideline categories of 'acceptable', 'concern' and 'action' pertaining to kidney damage was 56.2%, 38.3%, and 5.5%, respectively. Partial correlations (controlling for age as a continuous variable) did not show a significant association between consumption of traditional foods and Cd concentrations (r = 0.014, df = 105, p = 0.883). A significant and positive partial correlation (r = 0.390, df = 105, p < 0.001) was observed between Cd concentrations and number of cigarettes smoked daily. Analysis of covariance (with mean daily organ meat consumption over the year as a covariate) confirmed that smokers had significantly higher levels of blood Cd than non-smokers (F1,1109 = 1918.2, p < 0.001), and that traditional food consumption was not a good predictor of Cd exposure. Our findings suggest that consumption of traditional foods should not be restricted in Eeyou Istchee for fear of increased Cd exposure risk. Further studies of smoking prevalence among the Cree First Nations and additional public health initiatives to reduce smoking are recommended.

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Historically, resource development has had negative impacts on the traditional lifestyle of First Nation Cree Communities in the Province of Quebec, Canada. In response to the perceived need for fisheries restoration and for managing health concerns associated with environmental pollutants, the Mercury Program in the James Bay Region of Quebec was reconstituted in 2001 and broadened to include a wider range of chemicals of concern. Based on comprehensive surveys of the nine Cree Territory (Eeyou Istchee) communities in this region during the period 2002-2009, blood plasma concentrations are presented of Aroclor 1260, PCB congeners 28, 52, 99, 101, 105, 118, 128, 138, 153, 156, 163, 170, 180, 183, and 187, Aldrin, ß-HCH, α-Chlordane, γ-Chlordane, oxy-Chlordane, trans-Nonachlor, cis-Nonachlor, p,p'-DDT, p,p'-DDE, Hexachloro benzene (HCB), Mirex, PBB 153, PBDE 47, PBDE 99, PBDE 100, PBDE 153, Toxaphene 26, and Toxaphene 50. The organohalogenated compounds were extracted using solid-phase extraction and cleaned on florisil columns before high resolution HRGC-MS analysis. Principal component analysis (PCA) was used to reduce the large number of contaminant variables into a smaller number of uncorrelated variables. ANOVA identified significant differences between age groups, with the older participants having higher body burdens of legacy lipophilic contaminants, but not for the PBDEs. In certain female age groups, plasma concentrations of PBDEs were observed to be lower than for males; conversely, DDT was higher. Among communities, concentrations were different (p<0.001) for all contaminants. This work provides a baseline for the James Bay Eeyou Istchee communities who, to varying degrees, rely on food and other resources from the land and therefore are at higher risk of increased body burdens of legacy persistent organic pollutants (POPs).

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Lead as a toxic environmental metal has been an issue of concern for 30-40 years. Even though the exposures experienced by the general public have been significantly reduced, so have the acceptable blood lead concentrations assessed to safeguard health (specifically of children). The impact of these concurrent changes are reviewed and discussed in terms of the following: blood lead as the primary biomarker of exposure; pertinent toxicokinetic issues including modelling; legacy and newer sources of this toxic metal; improvements in lead quantification techniques and its characterization (chemical forms) in exposure media; and in vivo markers of lead sources. It is concluded that the progress in the quantification of lead and its characterization in exposure media have supported the efforts to identify statistical associations of lead in blood and tissues with adverse health outcomes, and have guided strategies to reduce human exposure (especially for children). To clarify the role of lead as a causative factor in disease, greater research efforts in biomarkers of effect and susceptibility seem timely.

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OBJECTIVE: To assess the adequacy of milk and alternatives, Ca and vitamin D intakes in First Nations (FN) youth in Ontario, Canada. Intakes were compared with the general population and dietary standards. Variation in intakes by community (proxy for remoteness) and BMI was examined. DESIGN: Data were collected by 24 h recall between November 2003 and June 2010. Intakes were analysed descriptively. Variation in intakes, by community and BMI category, was assessed using ANOVA. SETTING: Five remote FN communities of the Mushkegowuk Territory (northern Ontario, Canada) and two less-remote southern Ontario FN communities. SUBJECTS: Schoolchildren (n 457) in grades 6 to 12. RESULTS: Compared with Canada's Food Guide recommendations, 72.6 to 84.7% had an inadequate intake of milk and alternatives depending on age and sex group; 86.2% of individuals fell below the RDA for Ca; 96.4% fell below the RDA for vitamin D. Community variation in intakes was detected, although in all cases Fort Albany had higher intakes, even when it was the more northern (remote) community. A BMI × sex interaction was found for intake of milk and alternatives (P = 0.041): an inverse relationship between intake and BMI was seen in females; in males, those who were overweight had the highest intake, followed by normal-weight and obese youth. CONCLUSIONS: The nutritional inadequacies parallel the results of other Canadian studies of Aboriginal populations. Population health interventions to improve intakes are warranted. Moreover, community variation in intakes exists among FN youth in the present study (Fort Albany pairs only), but results were not as expected.

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INTRODUCTION: School snack and breakfast programs may be especially important in remote northern communities where many households are food insecure. Despite the strong potential for school programs to improve the dietary intake and eating behaviours of children and youth, very few studies have reported on the effects of school nutrition programs in Aboriginal communities. The purpose of this study was to examine the impact of a school snack program on the dietary intake of grade six to ten First Nation students living in a remote community in northern Ontario. METHODS: Data were collected in November 2004 and December 2007 with grade six to ten (aged 10-18 years) students (n=63 and n=50, respectively) using a validated web-based 24 hour diet recall survey, the WEB-Q. Food group consumption and nutrient intake of students participating in the school snack program on the previous day were compared with students who chose not to participate. In each year, ANOVA was used to assess differences between participants and non-participants, genders, and grade groups. The second data collection in December of 2007 included five questions asking students about their participation, preferences, and impressions of the snack program. RESULTS: Students participating in the snack program during the 2004 data collection (37%; n=23) compared with those who did not (63%; n=40) had significantly (p<0.05) higher mean intakes from the 'Vegetables and Fruit' food group (7.5 vs 3.4 servings), folate (420 vs 270 µg), dietary fiber (18 vs 8 g), vitamin C (223 vs 94 mg), calcium (1055 vs 719 mg) and iron (16.5 vs 11.7 mg). For the 2007 data collection, snack program participants (52%; n=26) had higher intakes from the 'Milk and Alternatives' food group (3.3 vs 2.2 servings), vitamin A (697 vs 551 RE [retinol equivalents]), calcium (1186 vs 837 mg), and vitamin D (6.9 vs 4.4 µg) and significantly lower intakes of 'Other' foods (6.0 vs 7.2 servings) compared with non-participants (48%; n=24). For 2004 and 2007, differences in intake also occurred by gender and grade groupings, with no interaction effects between snack participation and gender or grade. With the exception of 'Meat and Alternatives' in 2004, there was a trend for a higher percentage of students to meet dietary recommendations if they participated in the snack program. Students indicated that the three things they liked most about the school snack program were the juice (50%), that the program kept them from feeling hungry at school (40%), and that they got a snack at school every day (32%). Students indicated that the snack program helped them to eat healthier by motivating them (74%), eating more fruit (86%), and making better dietary choices (68%). CONCLUSIONS: Given the positive impact of the program on the food and nutrient intake of school snack program participants, qualitative feedback will be used to enhance the program and participation. Clearly, school snack programs can be an important venue to address the nutritional vulnerability of First Nation youth living in remote communities.

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This study investigated, in on-reserve First Nations (FN) youth in Ontario, Canada, the following: (a) the intakes of vegetable and fruit, "other" foods and relevant nutrients as compared to current recommendations and national averages, (b) current prevalence rates of overweight and obesity and (c) the relationship between latitude and dietary intakes. Twenty-four-hour diet recalls were collected via the Waterloo Web-Based Eating Behaviour Questionnaire (WEB-Q) (n = 443). Heights and weights of participants were self reported using measured values and Body Mass Index was categorized using the International Obesity Task Force cutoffs. Food group and nutrient intakes were compared to current standards, Southern Ontario Food Behaviour data and the Canadian Community Health Survey, Cycle 2.2, using descriptive statistics. Mean vegetable and fruit, fibre and folate intakes were less than current recommendations. Girls aged 14-18 years had mean intakes of vitamin A below current recommendations for this sub-group; for all sub-groups, mean intakes of vegetables and fruit were below Canadian averages. All sub-groups also had intakes of all nutrients and food groups investigated that were less than those observed in non-FN youth from Southern Ontario, with the exception of "other" foods in boys 12-18 years. Prevalence rates of overweight and obesity were 31.8% and 19.6%, respectively, exceeding rates in the general population. Dietary intakes did not vary consistently by latitude (n = 248), as revealed by ANOVA. This study provided a unique investigation of the dietary intakes of on-reserve FN youth in Ontario and revealed poor intakes of vegetables and fruit and related nutrients and high intakes of "other" foods. Prevalence rates of overweight and obesity exceed those of the general population.

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OBJECTIVES: To investigate factors influencing consumption of traditional foods (e.g. wild game, fish) and concerns about environmental contaminants among schoolchildren of the Mushkegowuk Territory First Nations (Moose Factory, Fort Albany, Kashechewan, Attawapiskat, and Peawanuck). STUDY DESIGN: Cross-sectional data collection from a Web-based Eating Behaviour Questionnaire (WEB-Q). METHODS: Schoolchildren in grades 6-12 (n = 262) responded to 4 of the WEB-Q questions: (a) Do you eat game? (b) How often do you eat game? (c) How concerned are you about the environmental contaminants in the wild game and fish that you eat? (d) I would eat more game if… [6 response options]. Data were collected in 2004 (Fort Albany), 2005 (Peawanuck), 2006 (Attawapiskat), 2007 (Moose Factory) and 2009 (Kashechewan). Hierarchical log-linear modelling (LLM) was used for analyses of multi-way frequency data. RESULTS: Of the schoolchildren answering the specific questions: 174 consumed game; 95 reported concerns about contaminants in game; and 84 would increase their game consumption if it were more available in their homes. LLM revealed significant differences between communities; schoolchildren in Moose Factory consumed game "rarely or never" at greater than expected frequency, and fewer than expected consumed game "at least once a day". Schoolchildren in Kashechewan had greater frequency of daily game consumption and few were concerned about contaminants in game. Using LLM, we found that sex was an insignificant variable and did not affect game consumption frequency or environmental contaminant concern. CONCLUSION: The consumption of traditional foods differed between communities and appears to be related to contamination concerns. In addition, latitudinal variation appears to influence the frequency of traditional food consumption in children; children in the most southerly location consumed traditional food less frequently.

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Although lead isotope ratios have been used to identify lead ammunition (lead shotshell pellets and bullets) as a source of exposure for First Nations people of Canada, the actual source of lead exposure needs to be further clarified. Whole blood samples for First Nations people of Ontario, Canada, were collected from participants prior to the traditional spring harvest of water birds, as well as post-harvest. Blood-lead levels and stable lead isotope ratios prior to, and after the harvest were determined by ICP-MS. Data were analyzed by paired t-tests and Wilcoxon Signed-Ranks tests. All participants consumed water birds harvested with lead shotshell during the period of study. For the group excluding six males who were potentially exposed to other sources of lead (as revealed through a questionnaire), paired t-tests and Wilcoxon Signed-Ranks tests showed consistent results: significant (p<0.05) increases in blood-lead concentrations and blood levels of (206)Pb/(204)Pb and (206)Pb/(207)Pb towards the mean values we previously reported for lead shotshell pellets; and a significant decrease in (208)Pb/(206)Pb values towards the mean for lead shotshell pellets. However, when we categorized the group further into a group that did not use firearms and did not eat any other traditional foods harvested with lead ammunition other than waterfowl, our predictions for (206)Pb/(204)Pb, (206)Pb/(207)Pb and (208)Pb/(206)Pb hold true, but there was not a significant increase in blood-lead level after the hunt. It appears that the activity of hunting (i.e., use of a shotgun) was also an important route of lead exposure. The banning of lead shotshell for all game hunting would eliminate a source of environmental lead for all people who use firearms and/or eat wild game.

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The use of lead shotshell to hunt water birds has been associated with lead-contamination in game meat. However, evidence illustrating that lead shotshell is a source of lead exposure in subsistence hunting groups cannot be deemed definitive. This study seeks to determine whether lead shotshell constitutes a source of lead exposure using lead isotope ratios. We examined stable lead isotope ratios for lichens, lead shotshell and bullets, and blood from residents of Fort Albany and Kashechewan First Nations, and the City of Hamilton, Ontario, Canada. Data were analyzed using ANOVA and regression analyses. ANOVA of isotope ratios for blood revealed significant differences with respect to location, but not sex. Hamilton differed from both Kashechewan and Fort Albany; however, the First Nations did not differ from each other. ANOVA of the isotope ratios for lead ammunition and lichens revealed no significant differences between lichen groups (north and south) and for the lead ammunition sources (pellets and bullets). A plot of (206)Pb/(204)Pb and (206)Pb/(207)Pb values illustrated that lichens and lead ammunition were distinct groupings and only the 95% confidence ellipse of the First Nations group overlapped that of lead ammunition. In addition, partial correlations between blood-lead levels (adjusted for age) and isotope ratios revealed significant (p<0.05) positive correlations for (206)Pb/(204)Pb and (206)Pb/(207)Pb, and a significant negative correlation for (208)Pb/(206)Pb, as predicted if leaded ammunition were the source of lead exposure. In conclusion, lead ammunition was identified as a source of lead exposure for First Nations people; however, the isotope ratios for lead shotshell pellets and bullets were indistinguishable. Thus, lead-contaminated meat from game harvested with lead bullets may also be contributing to the lead body burden.

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