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Objective To describe the traditional food (TF) systems of First Nations in Canada, including intake, barriers and promoters. Methods The First Nations Food, Nutrition and Environment Study is a cross-Canada participatory study of First Nations adults below the 60th parallel that obtained data for communities excluded from other national studies. A food frequency questionnaire was used to establish frequency of TF intake (number of days in a year) to allow comparisons across ecozones/regions in Canada. Grams of TF intake were also calculated using frequency multiplied by average portions from 24-h recalls. Closed- and open-ended questions attempted to identify some of the key barriers and concerns regarding TF access and use. Multivariable analyses were run to determine what factors are associated with increased TF consumption. Results Across communities, there is a strong preference by adults to have TF in the diet more often. Consumption of land animals was most frequently reported in most ecozones except for the Pacific Maritime and Mixedwood Plains, where fish and plants, respectively, were more frequently consumed. First Nations identified structural and environmental challenges such as development, government regulations and climate change, along with household barriers such as insufficient capital for equipment and transportation, lack of time and absence of a hunter in the household. Multivariable analyses revealed that the highest intake of TF occurred in the Taiga Plains ecozone, and for older individuals and men. Conclusion Identifying solutions that empower First Nations at all levels is required to overcome the multiple challenges to the inclusion of TF in the diet.

To investigate the relationships between fish/seafood consumption patterns and food security status among First Nations (FN) communities in Canada. We estimated the contribution of fish/seafood to daily nutrient requirements. Barriers to traditional food (TF) access including fish were summarized.Data were collected by the First Nations Food, Nutrition and Environment Study (2008-2018). The sample of this participatory study comprised 6258 randomly selected FN adults. Fish/seafood consumption was estimated with a food frequency questionnaire. Food security status was assessed with the Household Food Security Survey Module. The contribution of fish/seafood to protein, n-3 fatty acid, vitamin (A, B12, D, niacin) and mineral (selenium, zinc) requirements was assessed by comparison to Dietary Reference Intakes.Regional differences were observed in fish/seafood consumption patterns and their relationship with food security status. In the eastern regions (Ontario, Quebec/Labrador and the Atlantic region), consumption of fish/seafood and other TF was significantly higher among food insecure compared with food secure FN participants. Severely food insecure men (particularly in British Columbia, Alberta, Quebec/Labrador and the Atlantic region) tended to eat a higher amount of TF, including fish/seafood, compared with food secure and moderately food insecure men, while no difference was observed in women. Fish/seafood provided good sources of selected nutrients. However, the high cost of harvesting equipment, industry-related activities and climate change reduce access to fish/seafood and other wildlife.Fish/seafood continues to be vital to the diet of FN communities. Focusing on policies that support FN increased access to fish/seafood has the potential to decrease food insecurity and support sustainable livelihoods. Future policies should focus on socio-economic determinants of food insecurity and support traditional harvesting and sustainable fisheries among FN communities.RéSUMé: OBJECTIF: Étudier les relations entre les modèles de consommation de poissons/fruits de mer et l’état de la sécurité alimentaire chez les Premières Nations (PN) au Canada. Nous avons estimé la contribution des poissons/fruits de mer aux besoins quotidiens en nutriments. Les obstacles à l’accès aux aliments traditionnels (AT), y compris le poisson, ont été résumés. MéTHODES: Les données ont été recueillies dans le cadre de l’Étude sur l’alimentation, la nutrition et l’environnement chez les Premières Nations (2008–2018). L’échantillon de cette étude participative comprenait 6 258 adultes PN sélectionnés au hasard. La consommation de poissons/fruits de mer a été estimée à l’aide d’un questionnaire de fréquence alimentaire. Le niveau de sécurité alimentaire a été évalué à l’aide du Module d’enquête sur la sécurité alimentaire des ménages. La contribution des poissons/fruits de mer aux besoins en protéines, en acides gras n-3, en vitamines (A, B12, D, niacine) et en minéraux (sélénium, zinc) a été évaluée par rapport aux apports nutritionnels de référence. RéSULTATS: Des différences régionales ont été observées dans les modes de consommation de poissons/fruits de mer et leur relation avec le niveau de sécurité alimentaire. Dans les régions de l’Est (Ontario, Québec/Labrador et région atlantique), la consommation de poissons/fruits de mer et d’autres AT était significativement plus élevée chez les personnes vivant dans les ménages en situation d’insécurité alimentaire que chez celles en sécurité alimentaire. Les hommes en situation d’insécurité alimentaire sévère (en particulier en Colombie-Britannique, en Alberta, au Québec/Labrador et en région atlantique) avaient tendance à manger une plus grande quantité d’AT, y compris du poisson/fruits de mer, par rapport aux hommes en sécurité alimentaire et en insécurité alimentaire modérée, alors qu’aucune différence n’a été observée chez les femmes. Les poissons/fruits de mer ont fourni de bonnes sources de nutriments sélectionnés. Cependant, le coût élevé du matériel de chasse, les activités liées à l’industrie et le changement climatique réduisent l’accès aux poissons/fruits de mer et à d’autres espèces sauvages. CONCLUSION: Les poissons/fruits de mer continuent d’être essentiels à l’alimentation des PN. L’amélioration de l’accès aux poissons/fruits de mer a le potentiel de promouvoir la sécurité alimentaire et des moyens de subsistance durables. Les politiques futures devraient se concentrer sur les déterminants socio-économiques de l’insécurité alimentaire et soutenir la récolte traditionnelle et la pêche durable chez les PN.

Objectives To identify food sources of nutrients in First Nations adults in Canada and to establish whether these populations are meeting their nutrient requirements and whether traditional foods (TF) contribute to better nutrient intake. Methods The First Nations Food, Nutrition and Environment Study is a cross-Canada participatory study of First Nations adults living south of the 60th parallel. Twenty-four-hour recalls were conducted in 92 First Nations communities from 2008 to 2016. Repeat recalls were attempted with 20% of participants to adjust for within-person variation and estimate the proportion of individuals below recommendations according to Institute of Medicine guidelines. Nutrients from days with and without TF were compared. The main food sources of select nutrients were identified, including TF. Results Mean energy intakes among women and men ranged from 1664 to 1864 and from 1761 to 2298 kcal/day respectively. Most macronutrients were within the acceptable macronutrient diet range except for fat in most age groups and carbohydrates in men 71 years of age and older. Saturated fat was above recommendations for all ages. Only niacin was identified as above recommendations in all age and sex categories. Days where TF were eaten showed greater intakes of key nutrients. Conclusion It is imperative that we find culturally appropriate ways to improve the quality and nutritional value of First Nations Peoples food intake by improving TF access and use on the one hand and conversely providing better quality store-bought foods. For success in this, we must empower First Nations communities and health practitioners to collaboratively overcome these challenges.

Objective To describe the rationale, the participatory nature of the methodology, and the lessons learned during the First Nations Food, Nutrition and Environment Study (FNFNES), a community-based participatory research project implemented in eight Assembly of First Nations regions, which includes the entirety of Canada south of the 60th parallel. Methods FNFNES respected the First Nations principles of Ownership, Control, Access and Possession (OCAP®) (https://fnigc.ca/ocap). A random sampling strategy based on an ecosystem framework comprising 11 ecozones was adopted to collect representative nutritional and environmental health results for all First Nations adults living on-reserve south of the 60th parallel. Data collection occurred during the fall months from 2008 to 2016. Respective First Nations were involved in the planning and implementation of data collection for the five principal components: household interviews, tap water sampling for metals, surface water sampling for pharmaceuticals, hair sampling for mercury, and traditional food sampling for contaminants. Results A total of 6487 adults from 92 First Nations participated in the Study (participation rate 78%). A higher percentage of females (66%) participated than males (34%). The average age of males and females was similar (44 and 45 years, respectively). This study offers a novel body of coherent and regionally representative evidence on the human dimension of the ongoing environmental degradation affecting First Nations. Conclusion FNFNES serves as a good example of participatory research. We encourage public health professionals to develop policy and programs building on the participatory dimension of the research as well as on its results. The information collected by the FNFNES is also important for community empowerment, environmental stewardship and the general promotion of good health by and for First Nations peoples in Canada.

ObjectiveThe primary objective of this participatory study was to assess the current body burden of mercury among First Nations adults.MethodsThe First Nations Food, Nutrition and Environment Study (2008–2018) collected regionally representative data from First Nations adults living on reserves south of the 60thparallel. Mercury was analyzed in hair as a preferred biomarker for prolonged exposure. Hair samples, a 5 mm bundle cut from the occipital region, were collected from the participants who gave consent and measured for total mercury concentrations using cold vapor atomic fluorescence spectrophotometry.ResultsIn total, 3404 First Nations adults living in 92 communities provided hair samples. This represents 52.5% of the respondents to the household surveys. The mean hair mercury concentrations were 0.56 μg/g among all participants and 0.34 μg/g among women of childbearing age (WCBA). There were 64 exceedances of Health Canada’s mercury biomonitoring guidelines (44 WCBA, 8 women aged 51+ years, 3 men aged 19–50 years, and 9 men aged 51+ years).ConclusionCurrent mercury exposure no longer presents a significant clinical health risk in most of the First Nations population south of the 60thparallel across Canada. However, mercury exposure continues to be an ongoing environmental public health concern that requires continued monitoring and assessment. Women of childbearing age (19–50 years) and older individuals living in northern ecozones and Quebec have higher mercury exposures, often exceeding Health Canada’s guidelines. Careful risk communication and risk management programs need to focus on northern ecozones and Quebec.

The First Nations Food, Nutrition and Environment Study (FNFNES), a community-based participatory research project, measured the levels of metals of health concern and the levels of metals that have operational guidance (OG) and aesthetic objectives (AO) in drinking water of First Nations (FN) south of the 60Both stagnant (first draw) and flushed tap water samples were collected from participating households in 91 FN representing 11 ecozones. The concentrations of metals were quantified and compared to Health Canada's Guidelines for Canadian Drinking Water Quality (GCDWQ).In total, 1516 FN households participated in this study component. Exceedances of the 2019 GCDWQ for the health-based maximum acceptable concentration (MAC) were found for five metals: lead 8.4% of households (first draw), manganese 4.0%, uranium 1.6%, aluminum 1.3%, and copper 0.2% (flushed). Flushing taps resulted in a decrease to 0.7% of households exceeding the lead MAC. Exceedances of the current OG for aluminum were found in 14.2% and the exceedances of the proposed OG were found in 18.1% of households (flushed). Exceedances of the AO (flushed) were as follows: manganese 12.8%, sodium 5.1%, iron 3.5%, and copper 0.4%. Results of the study were compared to provincial surveys where the data were available. Taste and colour were reported to be the main reasons for limiting the use of tap water.Overall, the quality of drinking water with respect to trace metals of human health concern is satisfactory. However, elevated lead levels were found in some FN communities. Until appropriate action can take place, it was recommended to flush the water before use to reduce the lead levels.RéSUMé: OBJECTIFS: L’Étude sur l’alimentation, la nutrition et l’environnement chez les Premières Nations (EANEPN), un projet de recherche participative communautaire, a mesuré la concentration de métaux préoccupants pour la santé et ceux ayant une directive opérationnelle et des objectifs esthétiques dans l’eau potable des Premières Nations (PN) au sud du 60

Objective Our objective is to describe self-reported health status, prevalence of diabetes and obesity and their associations in participants from the First Nations Food, Nutrition and Environment Study (FNFNES) in order to identify possible correlates of health in First Nations adults. Methods FNFNES is a participatory study with First Nations Peoples living on reserve lands south of the 60th parallel. Health and diabetes were self-reported, and prevalence of obesity was evaluated. Socio-demographic and lifestyle factors and traditional food (TF) activities were investigated for associations with health parameters. Results High prevalence rates of overweight/obesity (78–91%) and diabetes (19% age-standardized prevalence) were found. Smoking rates were high and physical activity was low. In multivariable analyses, obesity was associated with region, income source, age, gender, smoking and self-reported health; diabetes and lesser self-reported health were associated with obesity and lower education. Diabetes was strongly associated with lesser self-reported health and weakly associated with being a smoker. Conclusion We have identified possible correlates of health in this population that can help to better understand the underlying concerns and identify solutions for First Nations and their partners. We urge governments and First Nations to address the systemic problems identified with a holistic ecosystem approach that takes into consideration the financial and physical access to food, particularly TF, and the facilitation of improved health behaviour. New mechanisms co-developed with First Nations leadership should focus on supporting sustainable, culturally safe and healthy lifestyles and closing the gaps in nutrition and food insecurity.

To describe the prevalence of food insecurity in First Nations households across Canada while identifying barriers and enablers to traditional food (TF) consumption.The First Nations Food, Nutrition and Environment Study is a cross-Canada participatory study of on-reserve First Nations from 2008 to 2018. The Household Food Security Survey Module was used to capture income-related challenges experienced by First Nations households. Households were classified as food secure, or marginally, moderately, or severely food insecure. Barriers and enablers to TF access and use were identified describing the Indigenous experience.Almost half of on-reserve First Nations households were food insecure and the prevalence was higher than that for non-Indigenous households in Canada. On-reserve food insecurity prevalence was higher in western regions of Canada. First Nations households with children experienced greater food insecurity than those without children. More adults experienced severe food insecurity than children. Most adults would like to have more TF in their diet but state that factors such as financial and household constraints, industrial activities, government regulations, climate change, and fear of contamination impede greater access. Food costs were substantially higher in remote First Nations communities, but remoteness was not associated with food security in multivariable analysis.Existing systems have been unsuccessful in curbing the food insecurity in First Nations households. Improving food security hinges on achieving Indigenous Food Sovereignty, the key to long-term conservation and stewardship of the land and the co-management of these by Indigenous Peoples. Studies investigating the feasibility of increasing TF from an Indigenous perspective are required.RéSUMé: OBJECTIFS: Décrire la prévalence de l’insécurité alimentaire chez les ménages des Premières Nations du Canada tout en identifiant les obstacles et les facilitateurs de l’alimentation traditionnelle (AT). MéTHODES: L’étude sur l’alimentation, la nutrition et l’environnement des Premières Nations dans les réserves est une étude participative pancanadienne des ménages des Premières Nations. Le module d’enquête sur la sécurité alimentaire des ménages a été utilisé pour tenir compte des défis liés au revenu qui confrontent les ménages des Premières Nations. Les ménages ont été classés comme étant en sécurité alimentaire ou insécurité alimentaire marginale, modérée ou sévère. Des obstacles et facilitateurs à l’accès et à l’utilisation des AT ont été identifiés pour décrire l’expérience autochtone. RéSULTATS: Près de la moitié des ménages dans les réserves des Premières Nations dans notre étude étaient en situation d’insécurité alimentaire et la prévalence était supérieure aux ménages non-Autochtones du Canada. L’insécurité alimentaire dans les réserves était plus élevée dans les régions de l’Ouest. Les ménages des Premières Nations ayant des enfants ont connu une plus grande insécurité alimentaire que ceux qui n’en ont pas. Plus d’adultes que d’enfants ont connu une insécurité alimentaire sévère. La plupart des adultes aimeraient avoir plus d’AT dans leur alimentation, mais affirment que des facteurs tels que les contraintes financières et domestiques, les activités industrielles, les réglementations gouvernementales, les changements climatiques et la peur de la contamination empêchent un meilleur accès. Les coûts des aliments étaient considérablement plus élevés dans les communautés isolées des Premières Nations, mais l’isolement n’était pas associé à la sécurité alimentaire dans l’analyse multivariée. CONCLUSION: Les systèmes existants ont échoué à freiner l’insécurité alimentaire chez les ménages des Premières Nations. L’amélioration de la sécurité alimentaire dépend de la réalisation de la souveraineté alimentaire autochtone, une clé pour la conservation à long terme des ressources naturelles et pour une gestion partagée de ces ressources par les peuples autochtones. Des études menées dans une perspective autochtone sur la faisabilité d’améliorer l’accès aux AT sont encore nécessaires.

OBJECTIVES: Recent studies show a higher prevalence of being obese or overweight in Francophones living in minority settings compared to Canada’s Anglophone majority. The objective of our study was to determine whether belonging to the linguistic minority constituted a social determinant of having a weight problem. METHODS: Descriptive variables (n=128,986) from five cycles of the Canadian Community Health Survey were stratified by respondents’ language and sex. Two logistic regression models tested the association between being overweight/obese (as defined by the measure of body mass index) and language, for men and women, while adjusting for social and behavioural determinants. RESULTS: Prevalence of excess weight was higher among Francophones compared to Anglophones of Ontario, although the difference was not significant after adjustment for socio-economic and behavioural determinants. However, Francophones were older, less educated and more likely to live in rural areas than their Anglophone counterparts, a situation which makes them more vulnerable. CONCLUSION: The study confirms the role of social and behavioural determinants of being obese/overweight. Although language does not have a direct influence on having a weight problem, the socio-economic reality of the Francophone minority makes them more likely than the Anglophone majority to fall in vulnerable strata of the population with regards to being overweight/obese. This situation should be considered when planning health services.