75
Chapter 7
Recent Dietary Studies in the Arctic
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
Bente Deutch
muskox (Ovibos moschatus), brown bear (U. arctos),
Summary
black bear (U. americanus), Dall sheep (Ovis canadensis
Dietary surveys serve several purposes, namely to de-
dalli), and a number of smaller animals are also caught.
scribe and analyze the food choice and nutritional ade-
Berries, mushrooms, roots, and green plants are also
quacy of the diet and to assess the role of food compo-
gathered. In addition to their importance as a source of
nents as sources/carriers of anthropogenic pollutants, in-
nutrition, traditional foods serve as a focus for cultural
cluding heavy metals, organochlorine (OC) compounds
and social activities and help to maintain the social
and radionuclides. Dietary surveys have been performed
bonds within societies through the traditional sharing of
among Arctic populations as part of the AMAP Human
the hunt/harvest and feasting together.
Health Programme and as part of independent studies.
The indigenous peoples are well aware of the many
A very large body of dietary information has been accu-
benefits of traditional food systems, and as such these
mulated in Canada over the last twenty years, especially
form integral parts of their holistic concept of health.
by the Centre for Indigenous Peoples' Nutrition and En-
Certain benefits are repeatedly emphasized in surveys re-
vironment (CINE).
garding attitudes toward traditional foods: well-being,
This chapter focuses mainly on recent AMAP-related
health, leisure, closeness to nature, spirituality, sharing,
dietary studies, in particular where it has been possible
community spirit, pride and self-respect, economy, and
to make comparisons between different geographic and
the education of children (Van Oostdam et al., 1999;
ethnic groups. Despite very large variations, the general
Jensen et al., 1997).
tendency is clearly that traditional/country food con-
The traditional foods vary from community to com-
sumption is gradually decreasing as imported foods be-
munity according to the availability of natural resources,
come more available and culturally acceptable to the
climatic conditions and seasonal changes, but are par-
Arctic peoples. This is most clearly shown by dietary in-
ticularly associated with the cultural traditions and asso-
dicators such as human blood lipid profiles of n-3 and
ciated technological skills which form the identity of
n-6 polyunsaturated fatty acids; the n-3 : n-6 ratio is a
the ethnic group concerned (Van Oostdam et al., 1999).
strong marker of traditional food intake, mainly indicat-
In Canada for example, Dene/M้tis food is quite dis-
ing the consumption of marine mammals, but also ter-
tinct from Inuit food, but both are generally referred to
restrial fish and game. The high levels of n-3 fatty acids
as `country food' as opposed to `market food' or im-
in traditional/country food are thought to provide some
ported food.
protection against cardiovascular disease and diabetes.
In Greenland, the traditional Inuit food `Kalaalimer-
On the other hand, human blood levels of marine-
nit' literally means `little pieces of Greenlanders' as op-
acquired n-3 fatty acids are strongly associated with lev-
posed to imported food `Qallunaamernit' meaning `little
els of persistent organic pollutants (POPs), because the
pieces of Danes'. Thus the traditional food of the Inuit is
main dietary source of POPs is fat (blubber) from ma-
considered necessary as building blocks for a human
rine animals.
being and as necessary for providing health, bodily
warmth (to withstand the cold climate), strength and
well-being in a way that imported food cannot.
7.1. Positive effects of traditional foods
The traditional food of the Arctic indigenous peoples
7.1.1. General changes in food consumption
can be defined as consisting of specific compositions of
in the various Arctic populations
local products gathered and prepared in certain ways
that are thereby meant to fulfill the nutritional and cul-
Despite their awareness of the benefits of traditional
tural needs of the population group concerned (Kuhn-
food, during the last 50 years the energy content of the
lein and Receveur, 1996). Traditional/country foods in-
diet of indigenous peoples in most Arctic communities
clude many Arctic animals and plants. Various species of
has increasingly been met by imported food products.
fish are caught, including salmon and trout (Salmo spp.),
For Baffin Island Inuit, market food now accounts for
whitefish (Coregonus spp.), burbot (Lota lota), and Arc-
approximately 62% of the diet; for Sahtu Dene/M้tis in
tic char (Salvelinus alpinus). In Arctic coastal communi-
the northwestern Canadian Arctic it is about 70%; in
ties, marine mammals, including various species of seal,
Fort Resolution in the North West Territories (NWT)
bowhead whales (Balaena mysticetus), beluga (Delphi-
90% (Kim et al., 1998); and for Greenland Inuit 75% to
napterus leucas), walrus (Odobenus rosmarus), sea lion
80% (Pars, 2000). The percentage range is very large
(Eumetopias jubatus), and polar bear (Ursus maritimus)
and in all cases dependent on location, road access, in-
are a valuable source of food. Both coastal and inland
frastructure, season, gender, and age group (Jensen et
communities fish and hunt terrestrial animals with cari-
al., 1997; Kim et al., 1998; Kuhnlein, 1995; Kuhnlein et
bou/reindeer (Rangifer tarandus) forming a significant
al., 1995a,b, 1996; Kuhnlein and Receveur, 1996; Pars,
part of the diet. Although caribou/reindeer is the most
2000). The change can best be illustrated by examining
important terrestrial mammal, moose (Alces alces),
the differences in intake of traditional food between

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76
AMAP Assessment 2002: Human Health in the Arctic
older and younger generations. Three generations of
vestigated using a 91-item food frequency questionnaire
adult women from Nuxalk, British Columbia, were in-
(FFQ) (Nobman et al., 1999). Marine mammal and fish
terviewed about present and retrospective food use.
intake, milk, syrup and pizza, and 27 different nutrients
Although outside the Arctic, their experience illustrates
were correlated with cardiovascular risk indicators, such
the steady decline throughout the twentieth century in
as the ratio between low density lipoprotein cholesterol
the use of traditional plant food, such as berries, roots
(LDL-cholesterol) and high density lipoprotein choles-
and greens, as well as a decline in the use of wildlife by
terol (HDL-cholesterol). Multiple linear regression ana-
indigenous peoples. The reasons given were the intro-
lysis indicated a complicated situation in which the foods
duction of fishing- and game Acts, and their associated
and nutrients that were significantly associated with
restrictions, better availability of market food, and in-
LDL:HDL varied according to gender and age group.
creasing employment leaving less time for the traditional
The AMAP Human Health Monitoring Programme
but time-consuming harvesting and hunting.
includes the Alaska Native cord blood monitoring pro-
A 24-hour dietary recall survey of three generations
gramme. This aims to sample 20 to 25% of the pregnant
of Baffin Island Inuit showed that traditional food ac-
women in the Arctic coastal and Bering Sea populations
counted for an average of 30% to 40% of the daily en-
each year and will include dietary assessments, analysis
ergy intake, but was much less among younger people
of blood for POPs, heavy metals, and selenium (Se), and
than older people. Among Baffin Island Inuit and NWT-
maternal urine analysis for radionuclides (AMAP, 2000).
Dene/M้tis the average traditional food consumption
varied from 200ญ300 g/day among the 13 to19 year age
7.2.2. Canada
group, to 600ญ700 g/day among the 41 to 60 year age
group (Kuhnlein et al., 1996). As caribou is the main
Dietary assessments have been included in several sur-
source of radiocaesium, whole body measurements of
veys of indigenous peoples in Canada (Kim et al., 1998;
radiocaesium may be used to indicate caribou intake.
Kuhnlein, 1995; Kuhnlein and Receveur, 1996). Some
Such a study on adults from the Baker Lake Area, NWT,
studies focused directly on the amounts of anthro-
indicated that caribou consumption had decreased from
pogenic substances in traditional food items while others
> 250 g/day in 1967 to < 70 g/day in 1989 (Jensen et al.,
presented comprehensive profiles of their nutritional
1997).
components. Nutritional intakes and their distribution
Consumption of traditional Inuit food in Greenland
between traditional and market foods were determined
(reported as monthly meals of seal, whale, wildfowl, and
for Inuit from the Baffin region based on data collected
local fish) ranged from 20 meals/month among the 18 to
in 1987/1988 (Kuhnlein et al., 1996). This study found
24 year age group to more than 40 meals/month among
marine mammals to represent 20 to 28% of the total en-
people over 60 years old (Bjerregaard et al., 1997).
ergy intake, terrestrial animals 9%, fish 2%, and market
The same association between age and the intake of
foods 66%. A dietary survey of 16 Dene/M้tis commu-
traditional foods was thus found in Canada and Green-
nities (Receveur et al., 1997) and Inuit from the Baffin
land. Men generally consume traditional food more fre-
region (Kuhnlein, 1995; Kuhnlein and Receveur, 1996)
quently than do women.
concluded that their diets were deficient in calcium, vita-
A decrease in the consumption of traditional food
min A, and folic acid. Twelve years of data concerning
in the Russian Arctic, especially of reindeer meat, is less
the risks and benefits of food in Nunavik were inte-
evident, despite the fact that since 1992 the quantity
grated in the Arctic Environmental Protection Strategy
of market food transported to rural settlements and
Report (Dewailly, 1998). The report concluded that vi-
towns has increased considerably (Klopov, pers. comm.,
tamin A intakes were insufficient due to seasonal varia-
2001). The continuing emphasis on traditional food rel-
tion in food availability; that iron deficiency was com-
ative to market food reflects tradition, low income, and
mon among young women despite an apparently ade-
the high price of imported foods. Consumption of rein-
quate iron intake, and that vitamin C intakes were only
deer meat by the indigenous peoples of the Taymir
25% of the recommended daily intake. The report also
Peninsula is still about 400 g/day (Klopov, pers. comm.,
concluded that calcium intakes among Inuit were low, at
2001). The non-indigenous peoples of Arctic Russia
around 50% of the recommended daily intake.
also eat local reindeer meat; approximately 80 to 200
A recent survey has studied the traditional and mar-
g/day. The main reason for the majority of residents in
ket food intake of 426 Nunavik Inuit by 24-hour recall
the remote Russian Arctic relying on subsistence food,
(Blanchet et al., 2000). Habitual food intake over a year
hunting, and fishing, is economic (Klopov, pers. comm.,
was studied in 246 women using an FFQ. Energy and
2001).
nutritional profiles (only 10 different nutrients were con-
sidered) were calculated and the relative contributions of
7.2. Recent and ongoing dietary surveys
traditional and market foods were determined. Tradi-
in Arctic populations
tional food was identified as an important source of vi-
tamin D, iron, Se, and phosphorus, and was the major
7.2.1. Alaska
source of the n-3 fatty acids eicosapentaenoic acid (EPA)
In 1987/1988, eleven indigenous communities in Alaska
and docosahexaenoic acid (DHA). Vitamin A and cal-
participated in a study of dietary intake. The study eval-
cium were low in these diets. Market food was an im-
uated the nutritional contributions of various food items
portant supplement for carbohydrates, and several other
and listed some of the important sources of nutrition in
nutrients, such as vitamin A, calcium, and magnesium.
traditional and imported foods (Egeland et al., 1998a).
The situation for vitamin C was not reported. In the
More recently nutritional intake in a small number of
same survey, the intake of fatty acids, plasma phospho-
Siberian Yupik in Alaska (29 men, 35 women) was in-
lipid fatty acids and cardiovascular risk indicators were

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Chapter 7 ท Recent Dietary Studies in the Arctic
77
measured and compared between sexes and two age
included a 24-hour recall survey for 48 men from Uum-
groups (below and above 40 years old) (Dewailly et al.,
mannaq and an SQFFQ for 50 men and 50 women from
2001b). Men and women over 40 years old had a signif-
Scoresbysund (Ittoqqortoormiit) and Ammassalik (Tas-
icantly higher intake of traditional foods and n-3 fatty
siilaq) (Deutch, in prep.).
acids than either men or women under 40 years old, cor-
Figure 7ท1 illustrates the distribution of traditional
responding to a higher relative concentration of EPA
and imported food intake in East Greenland and repre-
and DHA in plasma phospholipids. No correlation stud-
sents the outcome of a survey of 180 people (50 men and
ies were reported between intake of fatty acids and their
40 women from both Tassiilaq and Ittoqqortoormiit).
levels in blood.
Traditional food represents 27% of the total solids in-
Canada is currently implementing the AMAP Phase
take, and is slightly but not significantly higher in Ittoq-
II Human Health Programme. Maternal blood contami-
qortoormiit than in the more southern Tassiilaq. The in-
nant monitoring has been completed or is underway in
take of polar bear was higher in Ittoqqortoormiit, while
the Baffin, Kitikmeot, Kivalliq and Inuvik regions, and
fish intake was higher in Tassiilaq, which also had a
the results to date are reported in section 5.2.1.1. Di-
more varied diet in terms of imported fruit and vegeta-
etary surveys have been completed in nineteen Inuit
bles (Deutch, in prep.). There is currently no documented
communities and the data are currently being analyzed
record of the dietary nutritional intake profile for the
(AMAP, 2000).
Greenland population. The data on which Figure 7ท1 is
based could be used to calculate nutritional intakes,
however this has not been done to date.
7.2.3. Greenland
The use of traditional food in Greenland has been exam-
Table 7ท1. Dietary nutrient intake of pregnant women in the Faroe
ined in a countrywide study (n=1500) in which the re-
Islands and Finnish Lapland compared to the Nordic Nutrient Rec-
sults of different dietary survey methods (FFQs and
ommendations for pregnant women.
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
semi-quantitative food frequency questionnaires; SQF-
Nordic
FQs) were compared with the results of 48-hour and 24-
Faroe
Finnish
Nutrient
hour recall (Pars, 2000). Within this wider investigation,
Islands1
Lapland2 Recommendations3
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
a more in-depth study was carried out focusing on Disko
Sample size
150
127
Bay, with a sample size of 250 persons (Pars, 2000).
Total energy (kJ)
10200
7500
To date, the information on intake of traditional food
Protein (E%)
14.7
16.3
15
items (i.e., frequency and amount or weight) has been
Lipid (E%)
33
36
30
analyzed for different gender and age groups. As in most
Carbohydrate (E%)
52
47.6
55ญ60
Saturated fat (E%)
16.2
10
Arctic communities, the relative and absolute intake of
Monounsaturated fat (E%)
11.1
10
traditional food increased with age and was higher in
Polyunsaturated fat (E%)
4.6
> 3
settlements than in towns. The AMAP Human Health
Fiber (g/day)
19
Programme includes a small, 10-item, purely qualitative
Retinol (equivalents/day)
878
800
Folic acid (ตg/day)
260
400
FFQ; the responses to which supported the general pat-
Vitamin C (mg/day)
114
70
tern of traditional food intake (Deutch, 1999, Deutch
Vitamin D (์g/day)
3.7
10
and Hansen, 2000). There was a reasonably good corre-
Vitamin E (mg/day)
7.4
10
lation between consumption of marine foods and blood
Calcium (mg/day)
1170
900
Fe (mg/day)
10 + suppl.
104
mercury (Hg) levels (Pearson's bivariate correlation co-
Zn (mg/day)
11.5
9
efficient 0.417, P< 0.001) and between marine food and
Se (mg/day)
68
55
n-3 fatty acids in plasma (0.42, P< 0.001) or erythro-
Sum of n-3 fatty acids (E%)
0.5
cytes (0.39, P< 0.001). In 1999/2000, more detailed di-
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
E%: percentage of total energy intake.
etary surveys were carried out in relation to the AMAP
1Weihe (pers. comm., 2002); 2Mussalo and Soininen (pers. comm.,
Human Health Effects Monitoring Programme. These
2002); 3Nordisk Ministerrๅd (1996).
4Supplement recommended.
Polar bear
23 g/d
7.2.4. Faroe Islands and Iceland
Seal meat and blubber
41 g/d
Walrus
14 g/d
An FFQ study of the adult population in the Faroe Is-
Whale meat and blubber
lands showed an average daily consumption of 72 g fish,
37 g/d
12 g whale muscle, and 7 g blubber (Weihe et al., 2000).
Fish
A detailed dietary survey by FFQ and 24-hour recall was
78 g/d
undertaken in 2001 for 150 pregnant women in accor-
dance with the AMAP Human Health Effects Monitor-
Reindeer,
ing Programme. Table 7ท1 shows a provisional calcula-
hare, muskox
50 g/d
tion of mean nutritional intake values, for macronutri-
ents only, based on three interviews, 24-hour recall, six
food diaries per person, and using the Dankost Nutrient
database (Weihe, pers. comm., 2002). The data are pre-
Imported food
sented together with data for pregnant women in
638 g/d
Finnish Lapland obtained by a comparable method (a
food diary, and by using the Nutrica Nutrient database).
Figure 7ท1. Estimated daily intake of traditional and imported
foods in East Greenland in 2001 by semi-quantitative food fre-
No recent dietary surveys have been reported for
quency questionnaire (n=180).
Iceland.

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78
AMAP Assessment 2002: Human Health in the Arctic
7.2.5. Northern Scandinavian Saami
Table 7ท2. Estimated intake of trace elements and heavy metals by
pregnant women in Finnish Lapland. Mussalo and Soininen (pers.
7.2.5.1. Sweden
comm., 2002).
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
In 1987, food and nutritional intake were examined in
Finland1
a Swedish population (indigenous and non-indigenous)
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
by repeated 24-hour recalls. The Saami had a high in-
mean
min ญ max
take of protein and fat and a low intake of carbohy-
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
Iron, Fe (mg/day)
10.06
4.9 ญ 19.0
drates. Reindeer-breeding Saami had a lower than rec-
Manganese, Mn (mg/day)
4.92
1.8 ญ 10.4
ommended intake of vitamin C (Becker, 1995). In 1990,
Zinc, Zn (mg/day)
11.45
5.8 ญ 20.3
the nutritional intake of a group of Saami was compared
Copper, Cu (ตg/day)
1187.31
598.7 ญ 2206.9
to that of the local Swedish population. The Saami car-
Cobalt, Co (ตg/day)
13.36
6.6 ญ 31.9
bohydrate intake had increased and had become more
Nickel, Ni (ตg/day)
121.72
39.1 ญ 357.3
like that of the non-indigenous Swedish population,
Chromium, Cr (ตg/day)
23.5
9.0 ญ 59.1
Fluorine, F (ตg/day)
385.77
173.6 ญ 777.2
while their intake of certain minerals (Fe, zinc (Zn), and
Iodine, I (ตg/day)
210.09
94.2 ญ 413.5
Se) and vitamin B-12 was also higher (Hๅglin, 1988,
Selenium, Se (ตg/day)
68.18
34.4 ญ 123.7
1991).
Arsenic, As (ตg/day)
28.71
9.2 ญ 221.7
Aluminium, Al (mg/day)
4.29
2.3 ญ 7.8
Mercury, Hg (ตg/day)
3.65
0.9 ญ 16.4
7.2.5.2. Norway
Cadmium, Cd (ตg/day)
10.38
4.5 ญ 19.1
Lead, Pb (ตg/day)
48.25
20.4 ญ 118.3
In 1999, the dietary pattern of a group of Saami living in
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
northern Norway (n=75) was compared to that of other
1sample size = 127.
Norwegians by dietary history interview. Their nutri-
tional profiles were determined and the contributions
7ท2. The macronutrient distribution and the nutritional
made by various food items were calculated. The find-
intakes for pregnant women in Finnish Lapland gen-
ings indicated that their diet was generally adequate ex-
erally fall within the Nordic Nutrient Recommenda-
cept for folic acid for which their intake was too low.
tions, although intakes for folic acid and vitamins D
Calcium and iron intakes were slightly below recom-
and E are slightly below recommendations. The results
mendations for females. The diet of the Saami group
also indicated that dietary Hg intake was correlated
was found to be changing towards a more typical Nor-
with the Hg concentration in maternal whole blood
wegian diet (Nilsen et al., 1999). Reindeer accounted for
(r = 0.293, P< 0.01) (Mussalo and Soininen, pers.
7% of their total energy intake, relative to 1.5% for the
comm., 2001).
typical Norwegian diet; their intake of lean plus fatty
In general there was very good agreement between
fish was almost the same, representing approximately
the two methods used (i.e., FFQs and food diaries) so
12% of energy intake.
only food diary results are reported here. Protein ac-
counted for 16.3% of the total energy intake and was
higher than the recommended intake in Finland (i.e.,
7.2.5.3. Finland
10ญ15%). Fat accounted for 36.0% of the total energy
The Finnish National Public Health Institute has moni-
intake and was slightly higher than recommended (i.e.,
tored adult health behavior (including dietary habits)
about 30%). Saturated fat accounted for 16.2% of the
since 1978 using annual postal surveys of 5000 persons.
total energy intake and was considerably higher than the
Since 1999, data have been gathered to investigate
recommended intake of 10% in Finland. Essential poly-
the variability in health characteristics between Finnish
unsaturated fatty acids accounted for 4.6% of the total
provinces (Nummela et al., 2000). The surveys indicate
energy intake, which is less than the recommended 5%
that women in Lapland eat less bread than elsewhere in
for pregnant women in Finland (Finnish national recom-
Finland, and that they prefer lighter food alternatives
mendation), but more than the 3% Nordic Nutrient
on bread. Also, that men in Lapland drink more fatty
Recommendation. The energy intake from carbohy-
milk, and that both sexes eat fresh vegetables less often
drates (47%) was also below the Finnish recommended
than in other parts of Finland. Healthy dietary habits
level (55ญ60%). The estimated mean fiber intake was
were rarer in Lapland than elsewhere in Finland. Ab-
19.3 g/day, which is below the minimum recommended
sence of teeth was common, perhaps because dental vis-
intake (25ญ35 g/day), and 80% of the pregnant women
its were rare.
had a fiber intake below the recommended minimum of
During the period 1996 to 1998, as a part of the
25 g/day. Reported alcohol use was very low, at below
AMAP Phase I follow-up, 147 pregnant women from
1% of total energy intake.
seven communities in the most northern and northeast-
The mean intakes of vitamins D and E, thiamin and
ern parts of Finnish Lapland completed a questionnaire
folic acid were below recommended levels in Finland for
concerning information on age, occupation, lifestyle,
pregnant women. Iron intake from the diet was 10.1
hobbies, parity, miscarriages, illnesses, use of medi-
mg/day, which is below the recommendation for women
cines, and diet. These women completed an FFQ dur-
(12ญ18 mg/day), but 40% of the women increased their
ing their third trimester and 124 also kept a 7-day food
intake using iron supplements. Relative to the values
diary. The nutritional intakes of these women were cal-
used by the Nutrica nutrient calculating program, the
culated using the Nutrica nutrient calculating program
mean intake of heavy metals (Hg, lead (Pb) and cad-
from the Finnish Social Insurance Institute. Mean nu-
mium (Cd)) among the pregnant women in the study
tritional intake values are shown in Table 7ท1 and trace
were low, whereas the mean intakes of Zn, copper (Cu)
element and heavy metal intakes are shown in Table
and Se were above the requirement levels.

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Chapter 7 ท Recent Dietary Studies in the Arctic
79
7.2.6. Russia
7.3. Changes in dietary habits
7.3.1. Impact of changes in food consumption
As part of a motherญinfant study undertaken during
on other lifestyle factors
AMAP Phase I, FFQs were used to obtain dietary infor-
mation from obstetric patients in northern Siberia, in-
The hunting, gathering, production, and preparation of
cluding non-indigenous mothers (Norilsk, n=49; Salek-
traditional food uses local knowledge and skills and can
hard, n=31; Dudinka, n=27) and indigenous mothers
serve as a full-time occupation. A successful hunt or har-
(Taymir, n=18; Yamal, n=12). For rural indigenous moth-
vest brings respect from others and increases self-esteem
ers the intake of reindeer meat was 320 g/day; ten times
(Van Oostdam et al., 1999).
higher than for non-indigenous mothers in towns. Also,
These activities also result in many types of natural
their fish intake was double and game intake 3 to 5 times
physical activity and lead to the construction of tools,
higher (Klopov, pers. comm., 2000). In contrast to the
weapons, and traps; and the manufacture of specialized
situation in other Arctic populations, the blood levels of
clothes for hunting. They also provide opportunities for
anthropogenic contaminants were lower among indige-
the learning, development, and teaching of associated
nous than non-indigenous mothers (Klopov, 1998; Klo-
skills. The catch must also be transported and processed
pov et al., 1998; see also section 5.2.1.4.).
and the animal products shared. Because these activities
A more general dietary survey based on indigenous
require hard physical exercise that occurs outdoors at
and non-indigenous men and women from the Taymir
low temperatures, energy requirements are very high. As
Peninsula, the rural areas of Khatangskiy and Ustj-
a local product economy is gradually replaced by wage
Yeniseyskiy, and the towns of Dudinka and Norilsk
earning in a market economy the strenuous physical ac-
(Klopov, pers. comm., 2001), confirmed the outcome of
tivities associated with a subsistence diet are replaced by
the study on the obstetric patients.
the considerably less energy consuming tasks of picking
The results for the Ustj-Yeniseyskiy and Dudinka dis-
up food items at the local markets or supermarkets.
tricts (Table 7ท3) illustrate the differences between in-
Thus, the energy requirements of the population will in
digenous and non-indigenous peoples versus the trend
general decrease.
between country and town. Indigenous populations in
In 1936 the diet of a young male Inuit hunter in Am-
rural Ustj-Yeniseyskiy consume more reindeer and game
massalik, Greenland was analyzed over a six-day period.
and less vegetables and imported meat than the non-in-
The food intake averaged 2300 g traditional food per
digenous populations. This difference is also found in
day, with the food comprising almost exclusively meat
the more urban area of Dudinka. At the same time the
and fish and with an estimated energy content of 16 000
rural populations consume more traditional food, espe-
kJ/day (Hansen et al., 1997). In 1994 to 1996, the aver-
cially reindeer, than the urban populations. In addition
age energy intake for 180 men in Disko Bay was esti-
to the items listed both indigenous and non-indigenous
mated at 11 000 kJ/day (Pars, 2000). Thus, energy in-
peoples consume equal amounts, 40 to 50 g/day, of local
takes (and requirements) appear to have decreased in
`treated' meat and 380 to 400 g/day of imported bread.
Greenland by more than 40% since 1936.
The total food intake was lower in the urban population
Among the Dene and M้tis in Canada a shift away
than in the rural areas, probably reflecting different lev-
from traditional food toward market food has been
els of physical activity.
characterized by a significant increase in the absolute en-
In a study of dietary habits among indigenous school
ergy intake (Receveur et al., 1997), which together with
children in 1997 the nutritional intake and energy values
a more sedentary lifestyle can lead to obesity.
were calculated for children in boarding schools in the
Traditional foods are often high in protein and very
Taymir Peninsula (Volotchanka, n=63; Dudinka, n=155;
low in carbohydrates. The imported goods are often not
Khatanga, n=130; and Norilsk, non-indigenous, n=360).
sufficiently healthy alternatives to traditional foods,
The total energy intake, and the protein, iron, and Zn
often being higher in fat content, sugar, and other
intakes were sufficient but the calcium, vitamin C, and
`empty calories', and low in nutritional value; a transi-
iodine intakes were below recommended levels (Panin
tion that has been termed `cocacolonization', meaning a
and Kiseleva, 1997).
transition to a fast-food and soft-drink consuming soci-
Further health and dietary surveys were undertaken
ety. Consequently the transition can lead to obesity and
in Russia in 2001 as part of an ongoing project on `Per-
nutritional deficiencies and to increases in chronic dis-
sistent Toxic Substances (PTS) and Food Security of In-
eases such as heart disease, osteoporosis, diabetes and
digenous Peoples of the Russian North'.
cancer (see also chapter 3).
Table 7ท3. Food intake in the Russian Arctic for indigenous (Nenets) and non-indigenous peoples (g/day per person).
Source: Klopov, pers. comm., (2001).
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
Fish (fresh
Imported
Reindeer
or treated)
Game
Vegetables
meats
Dairy
Total
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
Ustj-Yeniseyskiy district
Indigenous, male, n=77
402
511
50
180
98
118
1798
Indigenous, female, n=91
380
484
45
156
86
113
1694
Non-indigenous, male, n=81
243
417
31
311
157
111
1734
Non-indigenous, female, n=98
210
255
24
270
113
98
1381
Dudinka area
Indigenous, female, n=64
140
361
44
168
100
100
1228
Non-indigenous, female, n=87
80
217
35
382
215
130
1411
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ

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80
AMAP Assessment 2002: Human Health in the Arctic
In remote communities in Alaska, Canada and Green-
Iron intake and iron status is considered good among
land (Egeland et al., 1998a) the local stores have a lim-
both Dene and Inuit due to the high intake of haem iron
ited supply of goods, and these are mainly preserved,
from red meat; caribou, moose, beluga, seal, and walrus
canned, or dried foods with few fresh products, such as
etc. (Jensen et al., 1997). A recent comparative autopsy
meat, dairy products, fruit, and vegetables. These foods
study of Greenland Inuit and Danes showed that older
are also comparatively expensive. Thus the replacement
Inuit (> 50 years old) in particular have a higher hepatic
costs of subsidizing subsistence food with imported food
iron index than the Danes (Milman et al., 2000). Trace
may present considerable economic burdens on local
mineral status, including iron, is also satisfactory in
indigenous groups in Canada, Alaska (Egeland et al.,
northern Norway, the Kola Peninsula and Arkhangelsk
1998a), and Greenland (Hansen et al., 1997).
(Odland et al., 1996).
Owing to different sampling and reporting methods,
or simply to a lack of data, it is not, at present, possible
7.3.3. Dietary changes and hygiene
to make direct comparisons between the prevailing di-
etary habits in the various Arctic regions and their vari-
As local knowledge about traditional food preparation
ability over time, but the overall trend is clear: among all
diminishes or is lost, different hygiene issues arise con-
Arctic indigenous groups diets are gradually including
cerning the prevention of parasitic diseases and food
more and more imported foods.
poisoning due to bacterial toxins.
Some traditional methods of preparing and preserv-
ing food by anaerobic fermentation procedures are po-
7.3.2. Impacts of changes in food consumption
tentially dangerous because toxin-producing Clostrid-
on nutritional intake
ium perfringens and C. botulinum grow under the same
Traditional food systems have been developed through
anaerobic conditions. C. botulinum poisonings are, how-
generations, relying on many different combinations of
ever, very rare.
local products each with their own unique contribution
Many predatory animals, especially bears but also
to the integrated nutritional composition of the diet.
walrus, and some seals, dogs, and foxes, etc., can con-
Under normal circumstances (i.e., with the exception of
tain Trichinella spiralis. If the meat from these animals is
starvation conditions), traditional diets are nutritionally
very infected and not cooked for long enough, people
sufficient to meet a broad range of dietary requirements.
eating the meat can acquire trichinosis (Hansen et al.,
During the transition toward greater use of imported
1997).
foods, specific items diminish in importance or disap-
Microorganisms associated with mass production
pear from the diet and are replaced by alternatives with
have been introduced with imported foods, e.g., Salmo-
a different nutritional composition. Also, local knowl-
nella sp., Campylobacter sp. and other zoonotic bacte-
edge and skills associated with collection and prepara-
ria, and these can cause food-borne infections if proper
tion of traditional foods diminish and may be lost.
hygiene procedures are not followed. As an example,
In many Arctic regions fish are caught locally and
Table 7ท4 shows diagnosed bacterial food-borne diseases
shared or sold in the local market. When fish are not
reported by the Danish Food Agency for Greenland in
available locally they are often not substituted in the diet
1996 and Denmark in 1995 (only a small fraction of the
by fish products purchased from supermarkets, since
total number of cases of diarrhea are usually diagnosed
these may be too expensive. Instead, miscellaneous other
by positive cultivation of pathogens). The much higher
products are used instead of fish, and thus an important
incidence of food poisonings in Greenland suggests that
source of calcium, vitamin D and iodine is consumed
the understanding of hygiene issues and the standard of
less often.
hygiene practices are not appropriate for dealing with
In Greenland, iodine intake (measured as ตg urine-
imported products.
iodine / g creatinine) has dropped as the degree of im-
ported food intake has increased. In the villages it is still
7.3.4. Risk of imbalance of certain micronutrients
sufficient but in the capital of Nuuk the intake is only
in traditional foods
50% of that recommended (Andersen et al., 2000).
While iodine intake is normally sufficient among ethnic
Despite a normally high iron intake among rural Arctic
groups with a high intake of marine food, it may be a
populations in Alaska (Yup'ik Eskimos), high levels of
problem in ethnic groups that are more reliant on terres-
iron deficiency have been observed, and are thought
trial foods. In the Yamal-Nenet Autonomous Okrug in
to result from gastrointestinal bleeding caused by He-
northwestern Siberia, iodine deficiency goiter is highly
licobacter pylori infections (Yip et al., 1997). Gastric
prevalent (Luzina et al., 1998) and iodine intake among
biopsies revealed chronic active gastritis associated with
boarding school children is below recommended levels.
H. pylori among 99% of the populations studied.
Table 7ท4. Food poisoning and infections in Greenland (1996) and Denmark (1994ญ1995) diagnosed by positive cultivation of pathogens.
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
Bacillus
Clostridium
Campylo-
Salmonella
Massive micro-
cerus
perfringens
bacter sp.
sp.
bial contamination
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
Greenland, number of persons affected1
68
20
62
128
14
Greenland, cases/100000 capita
124
36
112
232
25
Denmark, number of persons affected2
18.
30
2177
4307
5
Denmark, cases/100000 capita
0.33
0.54
39.6
78.3
0.9
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
1Hansen et al. (1997); 2Danish Food Agency.

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Chapter 7 ท Recent Dietary Studies in the Arctic
81
A screening for Helicobacter antibodies in Greenland
7.3.5. Long-chain fatty acids
showed a prevalence of about 40%, equivalent to that in
Canadian Inuit populations (Koch et al., 2000), al-
For diets in which the food mainly originates from the
though possible adverse effects on iron status have not
hunting of wildlife and the gathering of wild plants, di-
been studied.
etary composition in terms of fatty acids differs from
Calcium intake is traditionally low among the Inuit,
that of diets based mainly on modern industrially pro-
who have a low intake of dairy products (and possible
duced foods. In general, the saturated fat content of tra-
lactose intolerance) and, with the exception of fish bones
ditional foods is less, and the n-3 : n-6 polyunsaturated
and skin, their diets comprise few good sources of cal-
fatty acid ratios are higher. This is particularly the case
cium (Jensen et al., 1997). In this respect it is important
for marine wildlife in which n-3 fatty acids are biomag-
to retain the consumption of locally caught fish as op-
nified and/or elongated through the complex food webs
posed to filets from the market. The low calcium intake
from microalgae to zooplankton, invertebrates, fishes,
may favor the uptake of other bivalent metals, such as
marine mammals and birds. The same is true for terres-
Pb and Hg.
trial plants: mosses, lichens, herbs, and berries (Simopo-
The Se level in traditional food is very high, with the
lous, 1991); as well as for the secondary producers: hare,
main sources being muktuk (whale skin), and meat and
deer, caribou/reindeer, muskox, etc. In all cases the fat
liver from whales, seals, and seabirds. A dietary survey
composition depends on the particular food chain, and
of 400 adults in Disko Bay (Greenland) in 1995/1996
food chains can now be manipulated. For example, fish
resulted in an estimated Se intake of > 600 ตg/day, but
are mostly wild, however fish farming is increasing, and
the authors considered this an over-estimate (Johansen
research indicates that farmed fish have lower n-3 : n-6
et al., 2000). An AMAP study from 1997 (Deutch et al.,
ratios than the same species living wild. In modern agri-
in prep., see section 5.3.1.2.), which included 96 preg-
cultural practice livestock are fed n-6 rich grain instead
nant women from Disko Bay, found an average whole
of grass, and the popular n-6 rich vegetable oils com-
blood Se concentration of 140 ตg/L. In a 1986 survey,
prise a high percentage of fats, cooking oils, and other
the range in whole blood Se levels among 95 Qaanaaq
industrial products. It has been proposed that humans
Inuit was 320 to 4400 ตg/L, with the average concentra-
have evolved on a diet close to the diet of hunters and
tion over ten times higher than among local Danes
gatherers and that dietary recommendations should aim
(Hansen, 2000). This means that the daily intakes in
at this `Paleolithic diet'. Thus, in addition to reducing
northern Greenland are substantially higher than the
the dietary fat content they should attempt to balance
maximum safe daily intake of 500 ตg recommended by
the relative fat content, in particular the n-3 : n-6 ratio. It
Yang et al. (1989).
must be emphasized that DHA (an n-3 fatty acid) is es-
Selenium concentrations in reindeer/caribou meat are
sential for fetal retinal- and neuro-development and that
relatively high at 24 to 30 ตg/100 g meat. Thus rein-
low birth weight, birth length and head circumference
deer/caribou consumers have a reasonable Se intake, at
are significantly correlated with low levels of maternal
least in Finland (see Table 7ท8) (Nไyha and Hassi, 1993).
and cord plasma arachidonic acid (AA) and DHA
The question of vitamin C intake and requirements
(Crawford et al., 1989).
among the Inuit are very complex and recommendations
Emphasis on addressing the relative fat content, in
for western populations may not be applicable. Because
particular the n-3:n-6 ratio, rather than focusing entirely
of their high iron status and Se levels, the need for vita-
on reducing dietary fat content is in accordance with the
min C as an antioxidant is normally filled and high in-
many beneficial effects of n-3 fatty acids reported in re-
takes of the vitamin may even sometimes be harmful.
lation to the development of chronic diseases. Neverthe-
However among young women in Nunavik with a vita-
less, susceptibility to chronic diseases such as coronary
min C intake of only 25% of the recommended daily
heart disease, hypertension, and diabetes, is to some ex-
intake (RDI), iron deficiency anemia was common de-
tent determined genetically, e.g., through the response to
spite intakes of iron at the recommended level. Vitamin
dietary fats, and so different populations should not
C also enhances the absorption of various other metals,
simply copy each other's dietary recommendations.
including Hg, from the intestinal tract (Chapman and
Recent reviews of epidemiological and experimental
Chan, 2000).
studies (Bjerregaard et al., 2000; Connor and Connor,
There are few known sources of vitamin C in Arctic
1997; Simopolous, 1999) show that the n-3 fatty acids
diets and the local supply, which depends on wild
in the marine diet have important biological effects on
berries and plants, seaweed, raw seafood products,
several pathways leading to atherosclerosis. Experimen-
and the skin and liver of fish and seals, is seasonal.
tal studies show that n-3 fatty acids have antithrombotic
Historically, therefore, low vitamin C intake has been
and antiarrhythmic vascular effects etc., and modify the
a matter of concern. However, use of local wild green
serum lipid pattern toward that associated with lowered
leafy vegetables, fruits, and seaweed are not sufficiently
cardiovascular risk, in both the normal population and
documented (Kuhnlein and Receveur, 1996), and nu-
in coronary heart disease patients, thereby lowering
trition tables do not cover all products. In addition,
coronary heart disease mortality.
fresh raw meat and fish are consumed by many Arctic
A few studies have analyzed this phenomenon within
groups and all fresh raw products, e.g., reindeer/cari-
Arctic populations. During 1993/1994 a random sample
bou meat and organ meats, contain some vitamin C
of Greenlanders (n=259) participated in a health study
(Nไyha and Hassi, 1993; Nummela et al., 2000). Thus
(Bjerregaard et al., 1997, 2000). Multiple linear regres-
vitamin C intake is probably underestimated, and
sion analysis showed a significant inverse correlation
scurvy is not usually a problem among indigenous Arc-
between several cardiovascular risk factors and plasma
tic peoples.
n-3 : n-6 ratios, total Hg levels (as a dietary marker), and

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82
AMAP Assessment 2002: Human Health in the Arctic
seal consumption. The pattern for serum lipids was the
some evidence to suggest that they are associated with a
same as that for the effects found in intervention studies
lower intake of fish and marine mammals, lower plasma
using fish or seal oil in other populations, namely that
n-3 levels and higher levels of saturated fat (Ebbeson et
n-3 significantly lowered VLDL (very low density lipo-
al., 1999). In the Greenland health study, fasting blood
protein) and triglyceride levels, increased HDL levels
glucose was significantly correlated with the plasma
and had little effect on LDL and total cholesterol levels
n-3 : n-6 ratio and the intake of seal (Bjerregaard et al.,
(Bonefeld-J๘rgensen et al., 2001b; Connor and Connor,
2000). While n-3 polyunsaturated fatty acids may pro-
1997; Deutch et al., 2000).
tect against thrombogenesis and diabetes, very high lev-
The diet of Yup'ik living in southwestern Alaska is
els (as occur in Greenlanders) may be a risk factor for
based on fish and marine mammals and their EPA : AA
hemorrhagic strokes (Pedersen et al., 1999). Canadian
plasma ratios are 9 to 14 times higher than in non-in-
standardized mortality statistics indicate 70 and 34 deaths
digenous Alaskan adults (Ebbeson et al., 1999). Based
per 100 000 person-years due to cerebrovascular events
on the outcome of an FFQ for Siberian Yupik in Alaska
among Nunavik Inuit and Quebec citizens, respectively,
(n=64), dietary nutritional intakes were correlated with
and 96 and 246 deaths per 100 000 person-years, re-
cardiovascular risk factors. The HDL levels were higher
spectively, due to ischemic heart disease plus myocardial
and the triglyceride levels lower than in the general
infarction (Dewailly, 1998). Thus the benefits of an n-3
North American Caucasian population (Nobman et al.,
rich diet appear to be greater than the risks, but this may
1999), however, within the population sample studied,
depend on the level of n-3 intake. The incidences of dia-
beneficial effects of n-3 could not be demonstrated. Adi-
betes and cardiovascular disease in northern areas are
pose fat and plasma lipid profiles of polyunsaturated
confounded by other dietary factors, drinking water
fatty acids indicate that the diets of Alaskan Natives are
composition, lifestyle, latitude/climate, and genetics; and
already more `Americanized', with considerably lower
thorough consideration of all these factors is a vast area
n-3 levels than the Inuit population of Greenland
of research, beyond the scope of this report.
(Deutch et al., 2000; Ebbeson et al., 1999; Pedersen,
Although single food items have been analyzed for
2000). Their diets are basically similar to those of north
fatty acid content (Kuhnlein et al., 1991), for most Arc-
Europeans (Danes) and non-indigenous Canadians (see
tic populations there are no studies providing compre-
Tables 7ท5 and 7ท6).
hensive information about the total dietary content of
Prevalence of diabetes was relatively low among the
n-3 and n-6 fatty acids except for Canadian Sahtu
Alaskan Yup'ik and Canadian NWT/Nunavut Inuit
Dene/M้tis (Kuhnlein, 1997; Kuhnlein et al., 1995b).
compared to other Natives in North America (Young et
Several studies have indicated that adipose fat and
al., 1992). This could be explained by lower fasting in-
blood levels of fatty acids are good biomarkers of the di-
sulin and lower insulin resistance. However, the preva-
etary polyunsaturated fatty acids and good indicators of
lence of diabetes has increased over the last 30 years (see
the intake of marine mammals and fish (correlation co-
chapter 3). Insulin resistance increases with increasing
efficients: 0.4ญ0.5) (Andersen et al., 1999; Marckman et
obesity (Schraer et al., 1998). The reasons for the rap-
al., 1995; Willet, 1998). Adipose tissue polyunsaturated
idly increasing prevalence of non-insulin demanding dia-
fatty acids show good correlation with long-term dietary
betes mellitus and impaired glucose tolerance among
intake. Plasma fatty acids occur in different lipid frac-
Alaskan Yup'ik is only partly understood, but there is
tions and with different half-lives; total plasma fatty
Table 7ท5. Polyunsaturated fatty acid profiles for subcutaneous adipose tissue from recent population studies. Fatty acids are ex-
pressed as a percentage of total lipid content.
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
18:2, n-6
20:4, n-6
20:5, n-3
22:6, n-3
n-3
n-6
n-3 : n-6
linoleic acid
AA
EPA
DHA
fatty acids fatty acids
ratio
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
Greenland1, n=99
7.57
0.14
0.2
0.56
1.74
7.71
0.23
Denmark2, n=77
11.88
0.3
0.06
0.16
1.18
12.7
0.09
Alaskan natives 1, n=129
12.27
0.16
0.11
0.3
1.28
12.5
0.10
Alaskan non-natives1, n=115
13.06
0.2
0.05
0.13
0.95
13.3
0.07
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
1Pedersen (1999); 2Deutch et al. (2000a).
Table 7ท6. Polyunsaturated fatty acid profiles for blood lipids (phospholipids) from recent population studies. Fatty acids are ex-
pressed as a percentage of total lipid content.
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
18:2, n-6
20:4, n-6
20:5, n-3
22:6, n-3
n-3
n-6
n-3 : n-6
linoleic acid
AA
EPA
DHA
fatty acids fatty acids
ratio
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
Inuit, Nuuk1, n=15
14
5.24
4.9
7.89
14.6
21.4
0.68
Inuit, Uummanaq2, n=48
14.2
4.68
5.5
5.89
13.4
21.5
0.62
Alaska, Yup'iks3, n=436
24.8
5.4
5.05
4.3
15.3
36.4
0.42
Inuit, Canada4, n=426
19
6.22
3.01
4.95
9.7
28.4
0.34
Indigenous, Koryaks, Russia5,6, n=74
28.6
6.13
0.98
1.92
3.7
36.2
0.10
Indigenous, Koryaks, Russia3,7, n=57
23.6
3.32
4.67
3.24
9
28.3
0.32
Denmark8, n=42
29.9
6.3
0.82
2.53
4.5
36.2
0.13
Canada (general population), n=16
18.4
10
1.3
4.23
6.9
32.7
0.21
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
1Stark et al. (1999); 2Deutch et al. (2002); 3Ebbeson et al. (1999); 4Dewailly et al. (2001b); 5Klopov, pers. comm. (2001); 6reindeer
breeders; 7coastal population; 8Deutch et al. (2000a).

---

Chapter 7 ท Recent Dietary Studies in the Arctic
83
acids represent intake within the last few weeks,
of linoleic acid is not optimal, with possible inhibition of
whereas erythrocyte or phospholipid fatty acids repre-
the metabolic pathway regulated by -5 and -6 desat-
sent intake within the last month or so.
urases (Young et al., 1999), and that AA is supplied di-
A recent dietary study of 426 Nunavik Inuit (De-
rectly by the diet from the same sources which supply
wailly et al., 2001b), based on 24-hour recall and using
EPA. It is thus fortunate that AA is high in traditional
measurements of plasma phospholipid fatty acids and
diets consisting of mammals and fish (see Table 7ท6).
several cardiovascular risk indicators (total-cholesterol,
This highlights the importance of retaining these diets to
LDL, HDL, and triglycerides), showed that plasma n-3
supply the essential fatty acids for fetal development.
was negatively correlated with the cholesterol :HDL ratio
and with the triglycerides :HDL ratio. These risk factors
7.4. Traditional food
were low among the study group. Plasma n-3 fatty acids
as a source of anthropogenic substances
were positively correlated with plasma glucose but there
was no significant association with plasma insulin or
It has been known for more than twenty years that a
with diastolic and systolic blood pressure. However, De-
range of anthropogenic substances bioaccumulate and
wailly et al. (2001b) do not report the correlation fac-
biomagnify in the higher trophic levels with older and
tors between individual fatty acid intakes, plasma fatty
more predatory fish, mammals and birds containing the
acids, and the various cardiovascular risk factors.
highest concentrations. These animals comprise the bulk
of the traditional diet of Inuit and other indigenous peo-
ples of the Arctic. A substantial amount of literature
7.3.6. Genetic aspects of metabolism
highlights an association between a diet high in tradi-
In addition to reflecting dietary composition, the fatty
tional food and high body burdens of anthropogenic
acid profiles of adipose tissue and blood lipids in Tables
substances (AMAP, 1998), such as POPs and heavy met-
7ท5 and 7ท6 depend on the ability to elongate and desat-
als. Epidemiological investigations, especially regarding
urate dietary fatty acids such as linoleic and linolenic
exposure parameters, are best supported by long-term
acids. Linoleic acid levels are high in almost all types of
diet surveys. However, almost all dietary surveys con-
diet since linoleic acid is ubiquitous. Among Caucasian
cern present daily intakes using methods such as 24-
populations linoleic acid is a major substrate for the for-
hour recall or food diaries covering a number of days,
mation of the essential fatty acid AA by elongation and
although some do attempt to cover longer periods, e.g.,
desaturation.
for up to a year, through retrospective FFQs. If their pur-
Both AA and DHA are essential for the development
pose is to estimate exposure from persistent OCs or met-
of the fetal brain and visual function (Innis, 2000), and
als then it is generally assumed that present day dietary
selective partitioning appears to exist between the devel-
intakes are the same, or similar to the long-term intake,
oping fetus and its mother, namely a magnification of
which may not actually be the case. For example some
the two essential fatty acids from maternal to cord blood
individuals may have changed their dietary habits in
(see Figure 7ท2). Furthermore, within the fetus DHA
response to contaminant information and also most
is selectively partitioned between the liver and brain
diets exhibit day-to-day and seasonal variations (Willett,
(Crawford et al., 1989).
1998). In Arctic areas, seasonal variations may be more
The ratio between linoleic acid and AA in plasma
extreme because of the influence of climatic conditions,
phospholipids or erythrocytes is much higher among the
supply problems, and extent of hunting and gathering
Inuit of Chukotka, Alaska, Canada and Greenland, than
seasons. In Greenland, for example, seal consumption is
among Caucasians. This indicates that the desaturation
constant throughout the year, but the consumption of
other species such as walrus and birds varies seasonally.
Fatty acids ratio,
The same is true for consumption of whales, with baleen
cord blood:maternal blood
whales (e.g., bowhead whale) more commonly taken in
5.0
the fall and toothed whales (e.g., beluga, narwhal) in the
4.5
spring (Pars, 2000). Thus associations between reported
dietary intakes and human blood levels of contaminants
4.0
should be accepted with caution unless supported by
3.5
other techniques such as biomarkers.
3.0
2.5
7.4.1. Heavy metals
2.0
Contaminant databases for wildlife have recently been
1.5
established for several Arctic areas: Canada (Berti et al.,
1998; Chan, 1998; Kim et al., 1998) and Greenland
1.0
(Dietz et al., 1996; Johansen et al., 2000). Such data
0.5
may be combined with dietary survey data, concerning
0
relative and absolute intakes of traditional food, to esti-
Linoleic acid
Arachidonic
Eicosapenta-
Docosa
mate the average habitual intake of heavy metals or
18:2 n-6
acid
enoic acid
hexaenoic acid
20:4 n-6
22:6 n-3
20:5 n-3
other contaminants and to indicate the major sources of
intake. Heavy metal concentrations in wildlife products
Figure 7ท2. Selective partitioning of essential fatty acids from mater-
vary widely between species, and for the same species by
nal to cord blood. The ratio of essential fatty acids in cord blood:
maternal blood is based on 50 motherญinfant pairs from the Disko
geographical location (Egeland et al., 1998a), as well as
Bay area in 1996 to 1997.
by age, gender and size of the animal, tissue or organs.

---

84
AMAP Assessment 2002: Human Health in the Arctic
In general, fish liver and liver and kidney of large marine
methods showed good agreement. Table 7ท1 shows the
and terrestrial mammals contain higher metal concen-
food diary results together with comparable data for
trations than muscle (meat). Caribou/reindeer and moose
pregnant women in the Faroe Islands. A Nutrica data-
liver contains very high concentrations of Pb, Cd, and
base was used to estimate daily trace element intakes
Hg; seal and toothed whale liver and kidney contain
(see Table 7ท2). The estimated weekly mean intakes in
very high concentrations of Cd and Hg (resulting in an
Finland were: Pb 337 ตg, Cd 73 ตg, Hg 26 ตg, and Se
`allowable lifetime weekly intake' (ALWI) of 40 to 140 g
476 ตg (Mussalo and Soininen, pers. comm., 2002).
of the food source for Cd) (Egeland et al., 1998a). How-
These are shown in Table 7ท8 together with the esti-
ever, most of the Hg in liver is not methylated and has
mated heavy metal intakes in other Arctic/ Nordic and
low bioavailability (Egeland et al., 1998a). Thus seal
Canadian populations.
meat and toothed whale meat are the most important
All populations have additional Cd exposure from
sources of Hg. Marine birds and bird liver can be impor-
smoking (Egeland et al., 1998a) and there are particu-
tant sources of Pb (Berti et al., 1998; Chan, 1998; Jo-
larly high rates of smoking among the Inuit (Bjerregaard
hansen et al., 2000).
et al., 1997).
Tables (7ท7 and 7ท8) show estimates of dietary expo-
The total Hg intake of 850 ตg estimated for Green-
sure to heavy metals from traditional food for indige-
land and Canadian Inuit includes a contribution of
nous peoples in Greenland and Canada. These estimates
about 500 ตg from seal and whale liver. However, in
are based on the contribution from traditional food
fatty tissue such as liver, inorganic Hg makes up than
items only and do not include the contribution from
90% of the total Hg (Egeland et al., 1998a). The bio-
market food. Since traditional food represents 20% to
availability of inorganic Hg, which is Se-bound, is low
30% of the total energy intake, market food (from Den-
and the estimated exposure should be modified accord-
mark or Canada) adds to the total contaminant burden,
ingly (Hansen, 1990), resulting in an estimate closer to
most significantly for Pb.
450 ตg. Other dietary components (e.g., calcium, Se and
In Greenland, contamination of waterfowl by lead
fatty acids) interact with the uptake, metabolism, and
shot is considered the most important single dietary
probably the toxicity of Hg and vice versa. Thus to eval-
source of Pb. The intake of one murre (Uria spp.) boiled
uate the possible health impacts of Hg many factors
in soup could yield as much as 50 ตg of Pb (Johansen et
must be considered (Chapman and Chan, 2000).
al., 2000).
In Finland the nutritional and trace element intakes
7.4.2. Persistent organic pollutants
of 147 pregnant Lappish (Saami) women were estimated
by FFQ and a 7-day food diary. The results of the two
Diet is the main source of human exposure to organic
xenobiotic compounds, chemicals foreign to the bios-
Table 7ท7. Estimated heavy metal intakes (ตg/person/week) from ma-
phere, although their transport to the Arctic is mainly
rine food in the Disko Bay region, West Greenland 1995ญ96 (Johan-
via winds and water currents. These lipophilic chemicals
sen et al., 2000).
accumulate in the fatty tissues of all biota, they accumu-
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
late with age due to their slow metabolism, and some are
Pb
Cd
Hg
Se
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
biomagnified in food chains. They are therefore preva-
Fish meat
1.7
26
24
34
lent in large Arctic mammals, especially those at the top
Fish liver
0.5
63
1
75
of the food chains, and are concentrated in their fatty
Seal meat
6.2
62
147
129
tissues and organs, such as blubber, liver, brain, and kid-
Seal liver
2.0
693
507
212
Whale meat
1.7
7
52
36
ney. Almost without exception, OC levels are lower in
Whale liver
0.03
7
6
6
the terrestrial environment than the marine environment
Whale skin
0.8
11
60
3833
due to the longer food chains and higher fat content of
Bird meat
1.1
34
29
152
marine mammals and large fish. But birds, especially
Bird liver
0.6
101
20
92
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
bird liver, can contain high concentrations of OCs due to
Total
15
1004
846
4569
their high metabolic rate. Analyses of the OC content in
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
a growing list of wildlife species have been published
Table 7ท8. Provisional tolerable weekly intake of heavy metals and the estimated weekly intake of heavy
metals from traditional food (ตg/week) for a 60 kg person. The data are based on wildlife contaminant
databases for Greenland Inuit and Canadian Arctic populations and estimated daily food intakes. The
Finnish data are based on a dietary survey and calculated heavy metal data from the Nutrica database.
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
Pb
Cd
Hg
Se
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
PTWI (World Health
1500
420
200
28001
Organization unless
4000 (Canada)
otherwise indicated)
2400 (United States)
-------------------------------------------------------------------------------------------------------------------------------------
Greenland, Inuit2
15
1000
850
4500
Canada, Inuit2
470
1000
850
Canada, Dene/M้tis3,4,5
< 42
32 (2406)
42
Denmark, general population2
162
100
35
340
Canada, general population2
168
88
Finland, Saami7
337
73
26
476
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
1Yang et al. (1989); 2Johansen et al. (2000); 3Berti et al. (1998); 4Chan (1998); 5Kim et al. (1998); 6tra-
ditional food + market food + smoking; 7Mussalo and Soininen (pers. comm., 2002).

---

Chapter 7 ท Recent Dietary Studies in the Arctic
85
Table 7ท9. Estimated daily intake of OCs by Inuit in towns and villages in south-western Greenland. Estimates based on a
semi-quantitative food frequency questionnaire for 410 adults with traditional food intakes (Pars, 2000) and contaminant
concentrations in Greenland species (Johansen et al., 2000). Canadian TDI guideline values are given for comparison (Berti
et al., 1998).
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
Chlordanes
DDT
HCHs
HCB
PCB10
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
18ญ24 years, n=50 ng/day
9190
24765
5998
1759
21270
35ญ59 years, n=175 ng/day
11553
27095
6026
1737
22159
All, n=410 ng/day
9920
23992
5446
1578
19862
All, n=410, ตg/kg/day
0.165
0.399
0.09
0.026
0.331
Canadian TDI, ตg /kg/day
0.05
20
0.3
0.27
1 (Arochlor)
0.3 PCB14
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
for Canada (Berti et al., 1998; Kuhnlein and Receveur,
Contaminant levels have not been analyzed in rein-
1996) and West Greenland (Johansen et al., 2000). Berti
deer, and have only been determined in one species of
et al. (1998) combined a regionally adjusted contam-
saltwater fish from West Greenland (Aarkrog et al.,
inant database with a nutritional database and dietary
1997). Also, only one whale species, minke whale, has
survey based on 24-hour recall for 1012 Dene/M้tis and
been included, even though the concentrations of con-
compared the 99th percentile values with the present
taminants in toothed whales, e.g., beluga and narwhal
Canadian guideline values. Only chlordane and toxa-
(Monodon monoceros) are known to be higher (Kuhn-
phene intakes approached the guideline values, with
lein and Receveur, 1996). Whale blubber was analyzed
three and five people, respectively, exceeding the guide-
but not whale meat. The contaminant level in whale
line values. For the estimated intakes of all other OCs
meat was estimated for the calculations based on the rel-
the 99th percentiles are below 20% of the guideline
ative fat content of whale meat and was estimated to be
values. Compared with the Inuit, however, the Dene/
10% of the content in whale blubber.
M้tis are not consuming such large quantities of marine
The estimated contaminant intakes from the tradi-
foodstuffs.
tional food for Greenland Inuit are slightly lower but of
Johansen (in prep.) presents concentrations of poly-
the same order of magnitude as for Baffin Inuit (Kuhn-
chlorinated biphenyls (PCBs) and DDT on a 5-decade
lein, 1995; Kuhnlein and Receveur, 1996), but are
logarithmic scale, on which the lowest concentrations
higher than for Sahtu Dene/M้tis by factors of 10 to 20
occur in Arctic hare (Lepus arcticus) muscle and liver
(Berti et al., 1998). Traditional food intake in Greenland
and the highest in ringed seal (Phoca hispida) and minke
varies by district and is lower on the southwest coast
whale (Balaenoptera acutorostrata) blubber. In general,
than on the east and northwest coasts. This is consistent
the prevalence of the various OCs in the environment
with measured blood levels of POPs in younger men and
strongly coincides although there may be minor differ-
women from seven districts in Greenland (Deutch and
ences from tissue to tissue. The distribution pattern is
Hansen, 2000; and section 5.2.1.2).
also similar to that of total Hg.
The estimated contributions from various tradi-
Table 7ท9 shows the estimated dietary POP exposure
tional food items to daily -HCH, total chlordanes,
for a 60 kg person from towns and villages of south
hexachlorobenzene (HCB), PCB10, and DDT expo-
western Greenland (Disko Bay). The estimate was de-
sure are shown in Figure 7ท3. These data are based on
rived using:
relatively few species. However, the relative contribu-
tions from seal blubber and meat are so predominant
1. estimated dietary intakes in g/day of 25 different lo-
that the missing food items can be considered of minor
cal traditional food items (for which contaminant
importance.
levels are available) yielding a total intake of 200 g
Seal is the most important source of dietary POP ex-
traditional food per day (Pars, 2000); and
posure because it is the most common traditional food
2. POP concentrations in Greenland animal species de-
item and its intake is greater than that of whale prod-
termined by Johansen (in prep.).
ucts. Traditional food intake in rural communities (30%)
-HCH
Chlordanes
DDTs
Hexachlorobenzene
PCBs
Fish Birds
1.9 %
7.2 % 0.6 %
Seal blubber
2.2 %
1.6 % 1.0 %
3.8 %
7.7 %
3.8 %
9.9 %
9.2 %
13.5 %
Whale meat
44.2 %
7.0 %
85 %
63.0 %
14.6 %
30.5 %
16.1 %
50.6 %
19.9 %
27.1 %
4.5 %
Whale blubber
32.4 %
3.9 %
5.0 %
29.1%
Seal meat, liver and kidney

4.3 %
Figure 7ท3. The contribution of different traditional foods to dietary exposure to organochlorines in southwestern Greenland. Relative OC
contributions from different food groups are based on estimates of daily food intake by Pars (2000) multiplied by contaminant levels reported
by Johansen et al. (2000). The relative contributions from terrestrial animals are not shown but are below 0.5%.

---

86
AMAP Assessment 2002: Human Health in the Arctic
Table 7ท10. Average concentration of OCs (ng/g) in 0ญ3 year old male ringed seal blubber from four
districts in Greenland (AMAP, 1997).
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
PCB
DDT
HCH
HCB
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
Avernarsuaq, NW Greenland
505
4218
1636
116
Qeqertarsuaq, Disko Bay, W Greenland
275
4408
1256
116
Nanortalik, S Greenland
573
7464
1182
141
Ittoqqortoormiit, NE Greenland
706
9649
1805
163
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
is greater than in towns (19%), especially regarding seal.
and PCBs. All the grain- and vegetable products had
However, whale intake is higher in towns and accounts
very low concentrations of POPs, except for HCH
for some of the difference in exposure to POPs. Tradi-
which was high. The meat and fats from farm animals
tional food accounts for 22% of the total energy intake.
had considerably higher concentrations and were 3 to
The remaining 78%, from imported food, also adds to
10 times higher than the corresponding levels in Nor-
the total contaminant burden (Pars, 2000). This addi-
way (Polder et al., 2002b). This applied particularly to
tional contribution has not been measured directly, but
pig meat and fat, for which the DDT concentrations
based on human blood levels of PCBs and DDT in
were 10 and 130 ng/g respectively. A 60 kg person con-
northern Europe and Canada it is estimated at 25% to
suming a pork chop per day (170 g meat and 30 g fat)
35% (AMAP, 1998). This implies that previous esti-
would consume 0.1 ตg DDT/kg/day, however this is
mates (based on traditional food alone) are too opti-
still only 25% of the estimated intake in Greenland
mistic and should be at least 25% to 35% higher. The
(Table 7ท9).
mean intakes of chlordanes and PCBs already exceed the
Canadian guideline values and the mean -HCH intakes
7.4.3. Dietary intakes, anthropogenic blood levels
represent one third. This means that a large proportion
and dietary indicators
of people exceed the guideline intake values as sup-
ported by measured blood levels of contaminants from
A correlation between the intake of traditional food
another study (Deutch and Hansen, 2000). Organochlo-
items measured by dietary surveys and blood levels of
rine concentrations were analyzed in several marine ani-
xenobiotic substances has been demonstrated on a
mals from four locations in Greenland, Table 7ท10
group and population basis for heavy metals (Hansen,
(Aarkrog et al. 1997). The data for ringed seals clearly
1990) and OCs (Van Oostdam et al., 1999). However,
illustrate the general geographical distribution of pol-
to describe and analyze dietary risk behavior in more
lutants. Blood levels of OCs measured in 1997 in a
detail it would be extremely useful to be able to demon-
small geographical survey (Deutch and Hansen, 2000)
strate this correlation at the level of an individual. This
follow approximately the same pattern. The urban pop-
is obviously more difficult to achieve owing to the large
ulation in southwest Greenland has the lowest pollution
day-to-day variation concerning dietary behavior and to
burden and Ittoqqortoormiit in the northeast the high-
the seasonal variation in traditional food availability.
est, with > 60% of men exceeding the Canadian PCB
Also, individuals may accumulate contaminants at dif-
guideline level for action (100 ตg PCB-Arochlor 1260
ferent rates owing to genetic causes and other lifestyle
per liter plasma).
factors modifying their metabolism.
The estimated PCB intake of Inuit in southwestern
Organochlorine compounds are metabolized by a
Greenland exceeds the TDI value (Table 7ท9). If seal blub-
number of enzymes: CYP1A1, CYP1A2, phenobarbital-
ber were the only source of PCB (and compared to the
CYP, etc., which are part of the P-450 cytochrome oxi-
TDI value it is the most critical), the daily intake of ringed
dase system (Lagueux et al., 1999). Different OCs are
seal blubber should not exceed 300 g in Disko Bay or
metabolized by the same enzyme systems and may com-
100 g in Ittoqqortoormiit. However, seal blubber contri-
pete or interact with each other in terms of uptake and
butes about 50% of the PCB intake, which changes
excretion. These same enzymes metabolize nicotine and
these limits to 150 g and 50 g respectively. In Disko Bay
its breakdown products, which may also influence en-
the average daily intake of seal blubber is about 30 g
zyme expression. Tobacco smoking has been correlated
(Pars, 2000).
with higher OC levels in plasma (Deutch, 1999; Deutch
Taking another example, locally grown and pro-
and Hansen, 1999, 2000). In residents of Nunavik,
duced farm products were collected in Arkhangelsk,
northern Quebec, with a high marine food intake and
northern Russia, in 2000 and analyzed for pesticides
OC exposure, CYP1A1 activity in placenta tissue was
Table 7ท11. Correlations between reported monthly intake of marine food items (based on a food fre-
quency questionnaire), plasma phospholipid n-3:n-6 ratios, whole blood Hg (ตg/L) and lipid adjusted
plasma PCB levels (ตg/kg lipid) in male Inuit hunters from Uummanaq, northwest Greenland, n=48 (bi-
variate Pearson correlation coefficients) (Deutch et al., 2002).
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
Marine food intake
n-3 : n-6 ratio
Whole blood Hg
Plasma PCB
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
Marine food intake
0.39**
0.26 ns
0.22 ns
n-3 : n-6 ratio
0.39**
0.72**
0.63**
Whole blood Hg
0.26 ns
0.72**
0.65**
Plasma PCB
0.22 ns
0.63**
0.65**
ญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญญ
ns: not significant; *P < 0.05; ** P < 0.01; *** P 0.001.

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Chapter 7 ท Recent Dietary Studies in the Arctic
87
statistically correlated with DDE, PCB congeners and
The diet of Arctic indigenous peoples includes tradi-
HCB levels, as well as with levels of smoking (Lagueux
tional food and imported (market) foods. Although
et al., 1999). Therefore, to identify individuals at risk of
varying by country, location, gender, and age group, tra-
high OC burden is a multi-factorial issue, and is not just
ditional food currently yields 10% to 40% of the total
a question of diet.
energy intake; a considerably smaller percentage than 30
Thus, although it is well documented that marine
to 40 years ago. Traditional foods are the main sources
mammals in the traditional diet contain high levels of
of protein, fat, most minerals (iron, Zn, Se, iodine), vita-
OCs (AMAP, 1998; Chan, 1998; Johansen et al., 2000;
min D, and particularly the essential long-chain n-3 fatty
Kuhnlein, 1995; Kuhnlein and Receveur, 1996) at the
acids, which supply some protection toward heart dis-
present time it is only possible to demonstrate:
ease and diabetes. The ratio between n-3 and n-6 fatty
acids in human lipid fractions serves as an indicator of
1. the overall correlation between self-reported high in-
the relative intake of traditional food.
takes of traditional food and selected dietary bio-
Imported foods are the main sources of carbohy-
markers such as blood Hg (Bjerregaard and Hansen,
drate, water-soluble vitamins, vitamin A, and calcium.
2000; Deutch, 1999) or n-3 fatty acids in plasma,
Composite diets are sufficient in terms of most nutri-
phospholipids, erythrocytes or adipose tissue (Bjerre-
tional requirements. However, those elements of most
gaard et al., 2001; Deutch and Hansen, 1999, 2000);
importance in relation to meeting required intakes in
and
Arctic populations are vitamin A, vitamin C, and folic
2. the correlation between these dietary indicators (fat-
acid due to the low intake of vegetables, and calcium
ty acids, blood Hg levels etc.) and OC levels.
due to the low intake of milk products. The iodine in-
In the Canadian reports (Chan, 1998; Kuhnlein,
take of inland indigenous populations is sometimes
1995; Kuhnlein and Receveur, 1996) the question of di-
below recommended levels.
rect associations between self-reported marine food in-
Analyses of food items of animal origin have pro-
take and blood levels of OCs is not considered. In other
vided ample proof that traditional food is a major
reports such associations are described as being weak or
source of heavy metals (Hg, Cd and sometimes Pb) and
non-significant (Bjerregaard and Hansen, 2000; Deutch,
persistent organic substances. Exposure estimates of
1999; Deutch and Hansen, 1999, 2000; see also Table
heavy metals calculated from dietary intake data show
7ท11).
good correlation with human tissue concentrations.
Dietary exposure estimates of POPs have so far only
been compared with human body burdens of POPs on a
7.5. Conclusions and recommendations
population basis. Correlations between estimates of in-
Within the last five years most countries have performed
dividual dietary intakes and individual blood levels of
one or more dietary surveys among their Arctic indige-
xenobiotic substances are not yet available. However,
nous populations. However, these have been undertaken
several studies show very significant positive associa-
for different reasons, with different target groups, and
tions between n-3 fatty acids in human lipid fractions
using different sampling and reporting methods. It is dif-
and blood levels of both Hg and POPs, which makes
ficult to make direct comparisons between dietary sur-
a connection between intake of marine mammal fat
vey data obtained by different methods, e.g., interviews
(e.g., blubber) and organic pollutants highly probable.
versus recording or food frequency questionnaires. Also,
It is also evident that POP concentrations in animal fat
some studies report results as intake frequency or weight
vary with the age, gender and geographical location of
of listed food items whereas others calculate nutritional
the animals.
profiles. Some dietary surveys report traditional food in-
Uptake, metabolism, and excretion of OCs are influ-
take only, whereas others consider total diet. Therefore,
enced, among others, by genetic factors. Tissue levels are
in most cases, only qualitative comparisons can be made
influenced by various lifestyle factors such as smoking
between countries, or between ethnic groups within
(Deutch, 1999; Deutch and Hansen, 1999, 2000; La-
countries. This should be considered when planning
gueux et al., 1999) and body mass index (Deutch et al.,
sampling methods for future dietary surveys and when
2002). Therefore, identification of individuals at risk of
considering more standardized means of reporting. The
accumulating high POP burdens is not just a question of
aim should at least be to report both daily intakes, e.g.,
dietary exposure but also a more complex question of
g/day (rather than portions), and daily nutritional in-
interacting genetic and biochemical factors. These should
takes in absolute and relative units, e.g., per 10000 kJ.
receive more attention in future studies.

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