Traditional foods and 25(OH)D concentrations in a subarctic First Nations community
Sudaba Mansuri1, Alaa Badawi2, Sheena Kayaniyil1, David E. Cole3, Stewart B. Harris4, Mary Mamakeesick5, Thomas Wolever1, Joel Gittelsohn6, Jonathon L. Maguire7, Philip W. Connelly7, Bernard Zinman8 and Anthony J. Hanley1*
1Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada; 2Office of Biotechnology, Genomics and Population Health, Public Health Agency of Canada, Toronto, ON, Canada; 3Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; 4Center for Studies in Family Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada; 5Sandy Lake Health and Diabetes Project, Sandy Lake, ON, Canada; 6Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; 7Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, ON, Canada; 8Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada
Abstract
Background. Sub-optimal vitamin D status is common worldwide and the condition may be associated with increased risk for various chronic diseases. In particular, low vitamin D status is highly prevalent in indigenous communities in Canada, although limited data are available on the determinants of serum 25-hydroxyvitamin D (25(OH)D) concentrations in this population. The relationship between traditional food consumption and vitamin D status has not been well documented.
Objective. To investigate the determinants of serum 25(OH)D status in a First Nations community in Ontario, Canada, with a focus on the role of traditional food consumption and activities.
Methods. A cross-sectional analysis was conducted within the Sandy Lake Health and Diabetes Project (2003–2005). A total of 445 participants (>12 years of age) were assessed for serum 25(OH)D status, anthropometric and lifestyle variables, including traditional and non-traditional dietary practices and activities. Diet patterns were identified using factor analysis, and multivariate linear regression analysis was used to analyse the determinants of 25(OH)D concentrations.
Results. Mean serum 25(OH)D concentrations were 22.1 nmol/L (16.9, 29.9 nmol/L) in men and 20.5 nmol/L (16.0, 27.3 nmol/L) in women. Multivariate determinants of higher serum 25(OH)D included higher consumption of traditional and healthier market foods, higher wild fish consumption, male gender, spring/summer season of blood collection and more frequent physical activity. Significant negative determinants included hours of TV/day, higher BMI and higher consumption of unhealthy market foods.
Conclusions. Traditional food consumption contributed independently to higher 25(OH)D concentrations in a First Nations community with a high prevalence of sub-optimal vitamin D status.
Keywords: 25(OH)D; determinants; First Nations; traditional foods; traditional activities
Citation: Int J Circumpolar Health 2016, 75: 31956 –http://dx.doi.org/10.3402/ijch.v75.31956
Responsible Editor: Tracey Galloway, University of Toronto, Canada.
Copyright: © 2016 Sudaba Mansuri et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license.
Received: 21 April 2016; Revised: 19 August 2016; Accepted: 29 August 2016; Published: 22 September 2016
Competing interests and funding: This work was supported by contributions from the Canadian Institutes of Health Research, the Public Health Agency of Canada and the Dairy Research Cluster Initiative (Dairy Farmers of Canada, Agriculture and Agri-Food Canada, the Canadian Dairy Network and the Canadian Dairy Commission); S. Mansuri was supported through a University of Toronto Department of Medicine Graduate Student Award.
*Correspondence to: Anthony J. Hanley, Department of Nutritional Sciences, University of Toronto, FitzGerald Building, 150 College Street, Room 341, Toronto, ON M5S 3E2, Canada, Email: Anthony.hanley@utoronto.ca
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Sub-optimal vitamin D status is an important public health problem due to the risk of adverse bone outcomes and the emerging possibility that it may be a risk factor for other chronic diseases such as cardiovascular disease, cancer and diabetes (1). Although sub-optimal vitamin D status is prevalent worldwide (2), specific groups have been documented to have notably high prevalence rates, including migrant populations in European countries (3,4), Middle Eastern populations (5–7), as well as indigenous populations in North America (8–10) and Australia (11).
Previous studies of the determinants of sub-optimal vitamin D status have identified factors such as low vitamin D intake (i.e. vitamin D containing foods and supplement use), high body mass index (BMI), winter season, reduced sun exposure and darker skin pigmentation (5,12–15). Although a high prevalence of vitamin D deficiency (serum 25(OH)D
Little is known regarding the importance of vitamin D status of traditional foods and activities, which are potentially good sources of vitamin D (i.e. wild fish and game, hunting/fishing and other outdoor activity), but which have declined markedly over time due to nutritional transition and the adverse impact of acculturation (18,20,23,24). The objective of this study, therefore, was to investigate the determinants of serum 25(OH)D status in an indigenous community in Ontario, Canada. We hypothesized that in addition to known correlates (age, gender, sun exposure, sunscreen use, supplement use, fortified foods) of vitamin D status, the consumption of traditional foods and participation in traditional activities would contribute independently to increased 25(OH)D status in this population.
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