Tuesday, March 11, 2008

You are what you eat

The traditional food sources in the eastern arctic are collectively referred to as country foods. Here in the eastern arctic many people still eat country foods at least some of the time. The traditional Inuit diet was based on food items that were locally available. Although contact with traders has been ongoing since the 1500's it has been sporadic, and not reliable for everyday needs like food until very recently.

Traditional foods include caribou, arctic char, seal, whale, arctic hare, tarmigen, polar bear, shellfish, berries and seaweed. The diet is meat rich, but most of the meats are high in good fats, low in bad fats and since overall food was scarce this meat rich diet was not traditionally a problem in terms of overall caloric intake.

As is the case for First Nations populations around the world the typical 'western diet' hasn't improved health at all for Inuit people. The more western food available, the more diabetes and obesity are seen. It is a familiar story in the Arctic, across Canada, in Hawaii and the Polynesian islands, and in Australia and New Zealand.

Grocery store food is expensive here in the arctic, probably about 3X the average cost down south. On average a cart full of regular everyday groceries probably rings through the cash register at about $350, a pretty hefty price tag. Often the cheapest items are also the worst in terms of health. To purchase a diet rich in fruits, veggies, and complex carbs would be considerably more expensive than the above quoted number (fresh fruits and veggies in particular are priced out of reach in many northern communities). Country food is not free either, and in fact has some pretty high cost items attached to it. In order to hunt one must be healthy, have access to a rifle and a boat in summer, snow machine in winter, and have time available to go out hunting.

Below is a copy of the Nunavut food guide. It's actually one of the nicest food guides I've ever seen, and blends country food and store food in a realistic way. It's great to talk about in theory, but in reality very few people here can afford to follow the guide. The cost of buying healthy food, or procuring healthy food from the land is an unreachable goal for many people, and that means there is little alternative to a diet rich in carbs and bad fats.

I also have a copy ofthe guide in Inuktitut syllabics, if anyone reading wishes a copy in translation, please let me know and I can make it available.


Xavier Emmanuelle said...

Very nice. The characters at the bottom in kamiks and imautis as part of the physical activity section are a nice touch. (I'm probably spelling those wrong, cause I usually only hear them, I don't see them written down, but you know what I mean.)

MIL said...

Geart blog, Aaron. One a Dietitian would appreciate! I'd love to have a copy of the Food Guide(get it next month when we're there!)
Your MIL

medstudentitis said...

I live in one of the little green houses on the first road on the left as you walk up center/veterans road from the hospital. We are followed home by our new pet "brown doggie" every day and are tempted to bring him inside, but our roommate is afraid of getting fleas :)

Thanks for all of your input - what are some of the rarer diseases that are common in the population you work with?

Karlie said...

Hello - I wandered onto your blog, and I found it really interesting. The only time I've spent in the north is 3 weeks (2 in summer, one in March) in Yellowknife, but it was beautiful anyway.

I've had some serious (and mysterious) health problems pop up in the last 8 months, and "had it up to here" with most ER doctors. Though my GI has been pretty great, I've found a large number of ER docs are too eager to either ignore what I'm telling them or too eager to fill me with narcotics.

Long story short, I was happy and honoured to hear the stores of how you two deal with patients. You sound like wonderful, caring, attentive physicians, and I'm sure not all your patients get to tell you that, so I thought I would.

Thanks. :)

Shawn Johnston said...

Can you send me a couple of those for my Land, Food and Community prof? It would make a great example of cultural appropriateness, a topic we often explore.

Dr. J. said...

Medstudentitis: Some of the cases we see fairly frequently here that are supposedly rare in the rest of Canada are tuberculosis, rickets, severe lower respiratory infection in pediatrics and HTLV. If you can believe it the hospitalization rate for lower respiratory infection for babies in the first year of life in western Nunavut is 640 per 1000 per year! (that's 64% of babies hospitalized during the first year of life with LRTI!) The public health TB program typically has about 100 people on treatment for active or latent TB at any one time, out of a population of only 15,000 here in Baffin region.

Shawn: I'll mail a copy in each language to you (he gets special favors as he's my brother)!

Midwife with a Knife said...

That's a great food guide. I have to say, the seals look too cute to eat, under the traditional foods area. They should have made the seals look mean. :)