Table 2 Descriptive summary of 45 articles that met the inclusion criteria for full text review
From: Determinants of dietary behavior and physical activity among Canadian Inuit: a systematic review
Study/Authors | Major thematic areas | Sample size | Mean Age ± SD OR age range | Gender male; female | Location | Methology/Design | Major findings |
|---|---|---|---|---|---|---|---|
Beaumier & Ford, 2010 [48] | Determinant-Socioeconomic factors | 49 participants; 1 community | ≥18 | Female: (100 %) | Nunavut | Qualitative/Cross-sectional | Education, income, food preferences, climate change, and the absence of full-time hunters in households are barriers to food security |
Egeland et al., 2010 [33] | Behaviour-Dietary | 388 participants; 16 communities | 3–5 | Male: 47 %; Female: 53 % | Nunavut | Quantitative/Cross-sectional | In Nunavut households 70 % of preschoolers were food insecure, 31 % of preschoolers were moderately food insecure, and 25.1 % experienced severe food insecurity. |
Egeland et al., 2011 [53] | Determinant-Socioeconomic factors | 388 participants; 16 communities | 3–5 | Male: 47 %; Female: 53 % | Nunavut | Quantitaive/Cross-sectional | Children from food insecure households were more likely to have consumed more TFs and less milk compared to children from food secure homes. TF consumption was associated with higher protein and lower carbohydrate intakes and decreased iron deficiency, regardless of household food security status. |
Egeland et al., 2011 [20] | Behavior-Dietary | 2595 participants; 36 communities | 41 ± 14.7 | Male: 38 %; Female: 62 % | Nunavut; Inuvialuit; Nunatsiavut | Quantitative/Cross-sectional | The prevalence of food insecurity among adults was 62.6 %. In men, food insecurity was correlated with reduced intake of energy, fibre, Iron, Magnesium, Zinc and vitamin C In women, food insecurity was correlated with higher intake of carbohydrate and lower intake of fibre, folate, vitamins C, and D, Magnesium and Calcium TF consumption was associated with higher intakes of protein, vitamins A and C, lower intakes of carbohydrate, saturated fat, fibre, and Sodium. |
Erber et al., 2010 [31] | Behaviour-Dietary | 64 participants; 1 community | Male: 46 ± 13; Female:45 ± 13 | Male: 22 %; Female: 78 % | Inuvialuit | Quantitative/Cross-sectional | The majority of the participants consumed less than their daily requirements of vitamin A while the intake of vitamin D was below recommendations for majority of women. TFs contributed significantly to protein and Iron intake. Store-bought foods particularly juices contributed primarily to carbohydrate and Calcium consumption |
Erber et al., 2010 [47] | Determinant-Socioeconomic factors | 230 participants; 3 communities | Male: 42 ± 14; Female: 45 ± 14 | Male: 24 %; Female: 76 % | Inuvialuit | Quantitative/Cross-sectional | Intakes of non-nutrient dense foods were seven times higher than TF consumption. Respondents with higher SES were more likely to consume nutrient-dense foods compared to those with lower SES. |
Findlay, 2011 [40] | Behaviour-Physical activity | 359 participants; | ≥ 12 | Male: 56.4 %; Female: 43.6 % | Inuit across Canada | Quantitative/Cross-sectional | There was no significant difference between Inuit and non-Aboriginal respondents who were at least moderately physically active in their leisure time. First Nations respondents who lived off-reserve and Métis were more likely to be physically active than Inuit and non-Aboriginal respondents. |
Ford & Beaumier, 2011 [49] | Determinant-Socioeconomic factors | 19 participants; 1 community | ≥ 18 | Not reported | Nunavut | Quantitative/Cross-sectional | Determinants of food insecurity included decreased participation in hunting activities, high cost of traditional harvesting, affordability of store-bought foods, food knowledge and preferences as well as impact of climate change. |
Ford et al., 2012 [51] | Determinant-Socioeconomic factors | 94 participants; I community | ≥ 18 | Male: 56 %: Female: 44 % | Nunavut | aMixed/Cross-sectional | Users of the community food programs were likely to belong to the lower SES class, unemployed and on social assistance. They were likely to not have hunters in their households. |
Gagne et al., 2012 [25] | Behaviour-Dietary | 217 participants; 10 communities | 2 ± 0.88 | Male: 52 %; Female: 48 % | Nunavik | Quantitative/Cross-sectional | Although the TF intake was generally low, children who consumed TFs had higher intakes of protein and several micronutrients, and less intakes of energy and carbohydrate, compared to those who did not consume TFs. |
Gagne et al., 2013 [62] | Determinant-Intervention | 217 participants; 10 communities | 2 ± 0.88 | Male: 52 %; Female: 48 % | Nunavik | Quantitative/Intervention | Greater proportion of children who participated in the nutrition intervention program met their nutritional requirements of fruits, vegetables, and grains, as well as daily requirements of vitamins, irons, and other micronutrients. |
Hopping et al., 2010 [13] | Behaviour-Dietary | 75 participants; I community | Male: 42 ± 19; Female: 44 ± 16 | Male: 9 %; Female; 91 % | Nunavut | Quantitative/Cross-sectional | Dietary intakes of fibre and micronutrients including Calcium, Iron, vitamins A, D, E, were below requirements. TFs were the primary source of protein and Iron while store-bought energy-dense foods were the largest source of fat and carbohydrates in diets. |
Hopping et al., 2010 [46] | Determinant-Socioeconomic factors | 211 participants; 3 communities | Male: 42.1 ± 15: Female: 42.2 ± 13.2 | Male: 17 %; Female: 83 % | Nunavut | Quantitative/Cross-sectional | Respondents who were below 50 years of age consumed non-nutrient dense foods, fruits and vegetables more frequently, and TFs less frequently compared to respondents who were 50 years and over. Respondents with higher education and income were more likely to consume more fruits and vegetables and less TFs. |
Hopping et al., 2010 [38] | Behaviour-Physical activity | 218 participants; 3 communities | Male: 42.3 ± 13.0; Female: 42.4 ± 14.8 | Male: 17 %; Female: 83 % | Nunavut | Quantitative/Cross-sectional | Although a large proportion (72 %) of participants was either overweight or obese, 89 % of participants reported moderate to high levels of physical activity. |
Hopping et al., 2010 [39] | Behaviour-Physical activity | 196 participants; 3 communities | Male: 41 ± 14; Female: 45 ± 14.8 | Male: 24 %; Female: 76 % | Inuvialuit | Quantitative/Cross-sectional | Although a large proportion (65 %) of participants was either overweight or obese, 89 % of participants reported moderate to high levels of physical activity. |
Huet et al., 2012 [52] | Determinant-Socioeconomic factors | 2595 participants; 36 communities | 43.3 ± 0.4 | Not reported | Inuvialuit, Nunatsiavut & Nunavut | Quantitative/Cross-sectional | Food insecurity was associated with lower healthy eating index score, intakes of lower vegetables, fruits, grains, and dairy products, and greater consumption of energy-dense non-nutrient foods. This was also associated with lower income and housing inadequacy. |
Johnson-Down & Egeland, 2010 [30] | Behaviour-Dietary | 388 participants; 16 communities | 3–5 | Male: 47 %; Female: 53 % | Nunavut | Quantitative/Cross-sectional | Most of the children met their dietary requirements of energy and micro nutrients through consumption of TFs. The findings further showed that energy-dense foods and beverages contributed significantly to their diets and placed the children at increased risk of overweight, obesity, and tooth decay. |
Kolahdooz et al., 2013 [59] | Determinant-Smoking | 92 participants; 3 communities | 19–44 | Female: 100 % | Inuvialuit | Quantitative/Cross-sectional | No significant differences were observed in nutrients intakes between smokers and non-smokers. Regardless of their smoking status, over 60 % of respondents did not meet their daily recommendations for fibre, vitamins D, E, and Potassium. |
Kolahdooz et al., 2013 [60] | Determinant-Drinking | 92 participants; 3 communities | 19–44 | Female: 100 % | Inuvialuit | Quantitative/Cross-sectional | Energy consumption was significantly higher among drinkers in comparison to non-drinkers. Although there were no significant differences in most nutrients intakes between drinkers and non-drinkers, drinkers tended to have decreased nutrient density compared to non-drinkers. |
Kuhnlein et al., 1996 [29] | Behaviour-Dietary | 366 participants; 1 community | ≥ 3 | Not reported | Nunavut | Quantitative/Cross-sectional | TFs provided significantly higher levels of protein and micro nutrients, and less energy and carbohydrates for most age groups than store-bought foods. There was a significant seasonal variation in the consumption of TFs in contrast to store-bought foods. |
Kuhnlein et al. 2004 [16] | Behaviour-Dietary | 3851 participants: 44 communities | ≥ 13 | Not reported | Yukon, NWT & Nunavut | Quantitative/Cross-sectional | TF intake was associated with lower fat, carbohydrate, and sugar, greater protein, vitamins and most micronutrients, in the diet. Adults 40 years and over had significantly higher intakes of TFs compared to younger respondents. |
Kuhnlein & Receveur, 2007 [28] | Behaviour-Dietary | 3851 participants; 44 communities | ≥ 13 | Not reported | Yukon, NWT, & Nunavut | Quantitative/Cross-sectional | TFs contributed about 6–40 % of energy among adults compared to 0.4–15 % among children. Greater amount of energy was contributed by sugar-sweetened beverages and other energy-dense foods in children diets. |
Lambden et al., 2006 [50] | Determinant-Socioeconomic factors | 1711: 838 Inuit; 511 Dene/Métis; 422 First Nation; participants; 44 communities | ≥ 20 | Female: 100 % | Canadian Arctic | aMixed/Cross-sectional | There were significant regional variations across communities in terms of affordability of foods, ranging from 40 to 70 %. These variations were also reflected on other measures such as accessibility and affordability of hunting/fishing equipment; significant proportion of respondents could not afford hunting/fishing equipment. |
Lambden et al., 2007 [42] | Determinant-Historical and cultural factors | 1711: 838 Inuit; 422 Yukon First Nations; 511 Dene/Métis; 44 communities | ≥ 20 | Female: 100 % | Yukon & NWT | aMixed/Cross-sectional | Although TFs are emblematic of cultural identity, and are socially well received, the quality of many local food species has however deteriorated in the last few decades. |
Lardeau et al., 2011 [54] | Determinant-Socioeconomic factors | 8 participants; 1 community | ≥18 | 37.5 % male; 62.5 % female | Nunavut | Qualitative/Cross-sectional | Affordability was a major factor influencing food security in Iqaluit. Community members with low SES relied on social support networks to meet their basic dietary needs. |
Martin, 2011 [43] | Determinant-Historical and cultural factors | 24 participants; 1 community | ≥ 16 | Male: 46 %; Female: 54 % | Nunatsiavut | Qualitative/Cross-sectional | Dietary transitions from locally sourced, unstable food environment to contemporary times that presented a choice between healthy and unhealthy store-bought foods posed a challenge to residents. TF gathering activity was identified as an opportunity for physical activity. |
Mead et al., 2010 [41] | Determinant-Historical and cultural factors | 43 participants; 2 communities | ≥19 | 14 % male: 84 % female | Nunavut | Qualitative/Cross-sectional | Dietary transition was due to changes from traditional ways of life to Euro-Canadian lifestyles. Although TFs were perceived as healthier than store-bought foods, high cost of hunting materials affected the availability of TFs. Cost was also a major barrier of access to healthy store-bought foods, while transportation and harsh climate hindered access to fruits and vegetables. |
Mead et al., 2010 [55] | Determinant-Psychosocial factors | 266 participants; 3 communities | 41.2 ± 13.6 | Not reported | Nunavut | Quantitative/Cross-sectional | Greater knowledge about healthy foods and self-efficacy were associated with intentions toward healthy food consumption. . Self-efficacy was associated with decreased acquisition of unhealthy foods and increased acceptance of healthier food preparation methods. Additionally, SES was positively correlated with healthy food knowledge, acquisition, and preparation behaviors. |
Mead et al., 2010 [56] | Determinant-Psychosocial factors | 231 participants; 3 communities | 43.4 ± 13.6 | Not reported | Inuvialuit | Quantitative/Cross-sectional | Greater intention toward healthy food consumption was positively correlated with increased frequency of healthy food acquisition and decreased frequency of unhealthy food acquisition. The choice of healthier food preparation methods was associated with knowledge of healthy foods, intentions, and self-efficacy. |
Mead et al., 2012 [61] | Determinant-Intervention | 379 participants; 6 communities | Male: 42.4 ± 13.1; Female: 42.3 ± 12.8 | Male: 18 %; Female: 82 % | Nunavut & Inuvialuit | Quantitative/Intervention | Respondents from intervention communities demonstrated greater food-related self-efficacy and intentions compared to respondents from control communities. Over-weight, obese, and higher SES respondents demonstrated greater improvements compared to control. |
Nancarrow & Chan, 2010 [45] | Determinant-Climatic factors | 17 participants; 2 communities | ≥ 18 | Male: 76 %; Female: 24 % | Nunavut | Qualitative/Cross-sectional | Climate change had both positive and negative effects on accessibility and availability of TF species. |
Rittmueller et al., 2012 [57] | Determinant-smoking | 218 participants; 3 communities | 19–79 | 21 % male; 79 % female | Inuvialuit | Quantitative/Cross-sectional | Both male and female smokers reported higher intakes of energy and some other nutrients compared to non-smokers. However, more than 50 % of both male and female smokers had insufficient intakes of fibre, Potassium, and vitamin E. Additionally, TFs contributed about 3–6 % less energy and protein intakes among smokers compared to non-smokers. |
Rittmueller et al., 2012 [58] | Determinant-Smoking | 208 participants; 3 communities | 19–79 | 15 % male; 85 % female | Nunavut | Quantitative/Cross-sectional | Smokers were likely to consume lower amounts of nutrient-dense TFs but higher energy-dense foods, compared to non-smokers, suggesting increased dietary inadequacies among smokers. |
Rode & Sheppard, 1984 [36] | Behaviour-Physical activity | 344 participants; 1 community | Male: 9–76 | Male: 58.4 %; Female: 41.6 % | Nunavut | Quantitative/Longitudinal | There was a decreased fitness level in the population determined by a 15 % decrease in predicted maximum oxygen intake, a 2–4 kg rise in BMI, build up of subcutaneous fat, and reduced leg extension strength in all age groups except 9–15 years old, in comparison to the 1970–71 data. |
Rode & Sheppard, 1994 [37] | Behaviour-Physical activity | 221 participants; 1 community | 20–69 | Male: 57.5 %; Female: 42.5 % | Nunavut | Quantitative/Longitudinal | Fitness levels had remarkably deteriorated over a 20-year period (1970–1990). However, community members who actively engaged in regular sports had maintained their fitness at levels observed in the 1970s, based on data comparison. |
Rosol et al., 2011 [32] | Behaviour-Dietary | 2595 participants; 36 communities | ≥ 18 | Not reported | Inuvialuit; Nunatsiavut & Nunavut | Quantitative/ Cross-sectional | The severity of food insecurity differed across the three regions of study. Nunavut had the highest prevalence at 68.8 %, followed by Nunatsiavut and Inuvialuit regions at 45.7 % and 43.3 %, respectively. |
Sharma et al., 2009 [34] | Behaviour-Dietary | 101 participants; 2 communities | ≥ 19 | 47.5 % male; 52.5 % female | Inuvialuit | Quantitative/Cross-sectional | Dietary intakes of fibre and most micronutrients were lower than requirements. Less nutrient-dense, store-bought foods were the most frequently consumed food items. Among these, sugar and sugar-sweetened beverages were the leading contributors to energy intake. |
Sharma et al., 2010 [35] | Behaviour-Dietary | 87 participants; 2 communities | 19–87 | 47 % male; 53 % female | Nunavut | Quantitative/Cross-sectional | Dietary intakes of fibre and most micronutrients were significantly below recommendations. Less nutrient-dense store-bought foods were more frequently consumed than nutrient-rich TFs. |
Sharma et al., 2013 [1] | Behaviour-Dietary | 211 participants; 3 communities | Male: 42.4 ± 13.2; Female: 42.1 ± 15 | Male: 17 %; Female; 83 % | Nunavut | Quantitative/Cross-sectional | Less than 10 % of respondents met their dietary requirements. 22 % of saturated fat, 30 % of energy, and 73 % of sugar came from non-nutrient dense foods, while TFs contributed 49 % of Iron and 56 % of protein intake among women. |
Sheehy et al., 2013 [11] | Behaviour-Dietary | 211 participants; 3 communities | Male: 42.4 ± 13.2; Female: 42.1 ± 15 | Male: 17 %; Female; 83 % | Nunavut | Quantitative/Cross-sectional | TFs including caribou, muktuk and arctic char were widely consumed. Additionally, sugar-sweetened beverages and other energy-dense foods were consumed in significant amounts as of the time of study compared to the past. |
Sheikh et al., 2011 [10] | Behaviour-Dietary | 2595 participants; 36 communities | 41 ± 14.7 | Male: 38 %; Female: 62 % | Inuvialuit, Nunavut & Nunatsiavut | Quantitative/Longitudinal | Contribution to energy from TFs had significantly decreased over the ten year period, while consumption of store-bought foods rose remarkably. BMI also significantly increased over the period, particularly for women. |
Wein & Freeman, 1992 [26] | Behaviour-Dietary | 71 participants; 1 community | ≥10 | Not reported | Inuvialuit & NWT | Quantitative/Cross-sectional | Climate change was associated with lower TF availability and use. This resulted to reduced intakes of nutrients normally sourced from TFs. |
Wein et al., 1996 [27] | Behaviour-Dietary | 164 participants; 1 community | ≥12 | Not reported | Nunavut | Quantitative/Cross-sectional | TFs were preferred, rated high, and consumed by majority of adults and young people. However, from a total of 41 foods, adults ranked 25 TFs higher and two store-bought foods lower than young people using a five point hedonic scale. |
Wesche & Chan, 2010 [18] | Determinant-Climatic factors | 30 communities; ample size not reported | ≥15 | Not reported | Inuvialuit, Nunavut, Nunavik & Nunatsiavut | Qualitative/Cross-sectional | TF availability was influenced differentially across the communities studied by factors including impact of climate change, harvesting patterns, individual species reliability, availability and access to other food species. |
Zotor et al., 2012 [12] | Behaviour-Dietary | 230 participants; 3 communities | Male:44 ± 14; Female: 41 ± 13 | Male: 24 %; Female: 76 % | NWT | Quantitative/Cross-sectional | Non-nutrient dense foods were consumed at significantly higher frequencies per day, compared to TFs, fruits, and vegetables. |