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Tahir E, Ayotte P, Little M, Bélanger RE, Lucas M, Mergler D, Laouan Sidi EA, McHugh NGL, Lemire M. Anemia, iron status, and associated protective and risk factors among children and adolescents aged 3 to 19 years old from four First Nations communities in Quebec. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2020; 111:682-693. [PMID: 32170646 PMCID: PMC7501325 DOI: 10.17269/s41997-020-00304-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 02/13/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Anemia and iron deficiency (ID) are frequent among Indigenous children of Canada, but few data are available in Quebec. The present study aimed to characterize anemia and ID prevalence and associated protective and risk factors among First Nations youth in Quebec. METHODS The 2015 First Nations (JES!-YEH!) pilot study was conducted among children and adolescents (3 to 19 years; n = 198) from four First Nations communities in Quebec. Blood and urine samples and anthropometric measurements were collected. Hemoglobin (Hb), serum ferritin (SF), plasma hs-CRP, and urinary cotinine levels were measured. Factors associated with anemia and ID (including traditional and market food consumption) were assessed using an interview-administered food frequency questionnaire, based on which nutritional intakes were calculated. Structural equation models were used to test associations. RESULTS The prevalence of anemia and ID was elevated (16.8% and 20.5% respectively). Traditional meat, fruit, and fruit juice (natural and powdered)-via their positive association with vitamin C intake-were the only food variables positively associated with SF (coefficient [95% CI] 0.017 [0.000, 0.114]; 0.090 [0.027, 0.161]; and 0.237 [0.060, 0.411]). Male sex was also associated with higher SF (0.295 [0.093, 0.502]). Inflammation status (hs-CRP > 5 mg/L) was inversely associated with Hb (- 0.015 [- 0.025, - 0.005]), whereas SF was positively associated with Hb (0.066 [0.040, 0.096]). Fruit and juice consumption was also positively associated with Hb, via vitamin C intake and SF (0.004 [0.001, 0.010]; 0.008 [0.003, 0.017]). CONCLUSIONS Interventions fostering healthier food environments as well as higher consumption of traditional meats and foods naturally rich in vitamin C, which is known to enhance iron absorption, and fighting inflammation could contribute to decrease the high prevalence of anemia and ID in this young Indigenous population.
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Affiliation(s)
- Emad Tahir
- Département de médecine sociale et préventive, Université Laval, Quebec City, QC, Canada
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Université Laval, Quebec City, QC, Canada
| | - Pierre Ayotte
- Département de médecine sociale et préventive, Université Laval, Quebec City, QC, Canada
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Université Laval, Quebec City, QC, Canada
- Centre de toxicologie du Québec, INSPQ, Quebec City, Canada
| | - Matthew Little
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Université Laval, Quebec City, QC, Canada
- School of Public Health and Social Policy, University of Victoria, Victoria, Canada
| | - Richard E Bélanger
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Université Laval, Quebec City, QC, Canada
- Département de pédiatrie, Université Laval, Quebec City, QC, Canada
| | - Michel Lucas
- Département de médecine sociale et préventive, Université Laval, Quebec City, QC, Canada
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Université Laval, Quebec City, QC, Canada
| | - Donna Mergler
- CINBIOSE, Université du Québec à Montréal, Montreal, QC, Canada
| | - Elhadji A Laouan Sidi
- Département de médecine sociale et préventive, Université Laval, Quebec City, QC, Canada
| | - Nancy Gros-Louis McHugh
- First Nations of Québec and Labrador Health and Social Services Commission, Wendake, QC, Canada
| | - Mélanie Lemire
- Département de médecine sociale et préventive, Université Laval, Quebec City, QC, Canada.
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Université Laval, Quebec City, QC, Canada.
- Centre de Recherche du CHU de Québec, Hôpital du Saint-Sacrement, 1050 chemin Sainte-Foy, Quebec City, QC, G1S 4L8, Canada.
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Drivers and health implications of the dietary transition among Inuit in the Canadian Arctic: a scoping review. Public Health Nutr 2020; 24:2650-2668. [PMID: 32914743 DOI: 10.1017/s1368980020002402] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The current study undertook a systematic scoping review on the drivers and implications of dietary changes among Inuit in the Canadian Arctic. DESIGN A keyword search of peer-reviewed articles was performed using PubMed, Web of Science, CINAHL, Academic Search Premier, Circumpolar Health Bibliographic Database and High North Research Documents. Eligibility criteria included all full-text articles of any design reporting on research on food consumption, nutrient intake, dietary adequacy, dietary change, food security, nutrition-related chronic diseases or traditional food harvesting and consumption among Inuit populations residing in Canada. Articles reporting on in vivo and in vitro experiments or on health impacts of environmental contaminants were excluded. RESULTS A total of 162 studies were included. Studies indicated declining country food (CF) consumption in favour of market food (MF). Drivers of this transition include colonial processes, poverty and socio-economic factors, changing food preferences and knowledge, and climate change. Health implications of the dietary transition are complex. Micro-nutrient deficiencies and dietary inadequacy are serious concerns and likely exacerbated by increased consumption of non-nutrient dense MF. Food insecurity, overweight, obesity and related cardiometabolic health outcomes are growing public health concerns. Meanwhile, declining CF consumption is entangled with shifting culture and traditional knowledge, with potential implications for psychological, spiritual, social and cultural health and well-being. CONCLUSIONS By exploring and synthesising published literature, this review provides insight into the complex factors influencing Inuit diet and health. Findings may be informative for future research, decision-making and intersectoral actions around risk assessment, food policy and innovative community programmes.
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Sivtseva AI, Sivtseva EN, Shadrina SS, Melnikov VN, Boyakova SI, Dokhunaeva AM. Microelement composition of serum in Dolgans, indigenous inhabitants of the Russian Arctic, in the conditions of industrial development of territories. Int J Circumpolar Health 2020; 79:1764304. [PMID: 32452725 PMCID: PMC7448911 DOI: 10.1080/22423982.2020.1764304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The geochemical conditions of landscapes are the content in the environment of certain chemical elements and their compounds, the lack or excess of which causes deviations in the state of human health. This problem has arisen in connection with the extraction of alluvial diamonds and the forthcoming development of the Tomtor deposit of rare-earth metals in the territories where the indigenous peoples of the North live. The study included 107 indigenous people of the North, belonging to the ethnic group of Dolgans living in the village of Yuryung-Khaya, Anabar district, Yakutia of Russia. The method of mass spectrometry was used to study the content of 13 trace elements in blood serum (P, Sc, Ti, Cr, Mn, Fe, Ni, Cu, Zn, Rb, Sr, Cs, Pb). The study revealed an increase in the content of the macroelement phosphorus (148 mg/L) and trace elements of chromium (277 μg/L), manganese (133 μg/L), iron (5219 μg/L), nickel (57 μg/L) in serum of Dolgans, which may affect the development of diseases of the cardiovascular system and other diseases among indigenous inhabitants of the Arctic under conditions of industrial development of territories.
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Affiliation(s)
- A I Sivtseva
- M.K. Ammosov North-Eastern Federal University , Yakutsk, Russia
| | - E N Sivtseva
- M.K. Ammosov North-Eastern Federal University , Yakutsk, Russia
| | - S S Shadrina
- M.K. Ammosov North-Eastern Federal University , Yakutsk, Russia
| | - V N Melnikov
- Institute of Physiology and Basic Medicine , Novosibirsk, Russia
| | - S I Boyakova
- Institute for Humanities Research and Indigenous Studies of the North , Yakutsk, Russia
| | - A M Dokhunaeva
- M.K. Ammosov North-Eastern Federal University , Yakutsk, Russia
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Kenny TA, Hu XF, Jamieson JA, Kuhnlein HV, Wesche SD, Chan HM. Potential impact of restricted caribou ( Rangifer tarandus) consumption on anemia prevalence among Inuit adults in northern Canada. BMC Nutr 2019; 5:30. [PMID: 32153943 PMCID: PMC7050786 DOI: 10.1186/s40795-019-0292-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Accepted: 04/30/2019] [Indexed: 11/10/2022] Open
Abstract
Background Caribou (Rangifer tarandus) is the top dietary source of iron and several micronutrients necessary for red blood cell production (erythropoiesis) in the contemporary diet of Inuit adults across Canada. Many caribou populations across the circumpolar north, however, have experienced dramatic declines in recent decades. Restricted access to caribou may negatively impact the nutrition and health of Inuit communities. Methods We used data from the Inuit Health Survey, a cross-sectional survey of 2550 Inuit adults in thirty-six communities across northern Canada (conducted in 2007-2008) to examine the relationship between caribou consumption, hemoglobin (Hb), and blood biomarkers of nutrient intake and contaminant exposure. Multivariable linear regression was used to investigate the potential public health impact of a theoretical restriction in caribou consumption, by estimating the response of Hb concentrations (and the attendant change in anemia prevalence), to theoretical changes in caribou consumption (with and without substitution of caribou with other country food meat). Results Mean (95% CI) daily caribou meat consumption differed by an order of magnitude 4.3 (3.9-4.7), 51.1 (48.5-53.8), and 236.7 (224.7-248.7) grams/day between tertiles of caribou consumption. Mean (95% CI) hemoglobin levels increased from 129.1 (128.1-130.2) g/L to 132.5 (131.3-133.7) g/L between the highest and lowest tertiles of caribou consumption. In multivariable regression analyses, average daily caribou meat consumption was positively associated (P< 0.001) with hemoglobin levels. This relationship translated into approximately 4 g/L hemoglobin increase in participants in the third tertile of caribou consumption. The overall prevalence of anemia observed in the study population was 26.5% (24.5 - 28.3%) and a modelled restriction in caribou consumption (i.e. caribou = 0) increased the overall prevalence of anemia by approximately 6%. The maximum negative effect of caribou restrictions was related to a complete restriction on caribou consumption, coupled with the substitution of caribou with other country food meat (35.4% prevalence). Conclusions Given the importance of caribou to Inuit culture, health and wellbeing, and the high price of healthful market foods in remote northern communities, strategies to promote the sustainable harvest of country foods are urgently required to ensure the health and nutrition security of the Inuit, in the context of rapidly changing Arctic environments and ecosystems.
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Affiliation(s)
- Tiff-Annie Kenny
- 1Department of Biology, University of Ottawa, 30 Marie Curie Private, Ottawa, ON K1N 6N5 Canada
| | - Xue Feng Hu
- 1Department of Biology, University of Ottawa, 30 Marie Curie Private, Ottawa, ON K1N 6N5 Canada
| | - Jennifer A Jamieson
- 2Department of Human Nutrition, St. Francis Xavier University, 2320 Notre Dame Avenue, Antigonish, NS B2G 2W5 Canada
| | - Harriet V Kuhnlein
- 3Centre for Indigenous Peoples' Nutrition and Environment, McGill University, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, H9X 3V9 QC Canada.,4School of Dietetics and Human Nutrition, McGill University, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, H9X 3V9 QC Canada
| | - Sonia D Wesche
- 5Department of Geography, Environment and Geomatics, University of Ottawa, 60 University, Ottawa, ON K1N 6N5 Canada
| | - Hing Man Chan
- 1Department of Biology, University of Ottawa, 30 Marie Curie Private, Ottawa, ON K1N 6N5 Canada
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Longvah T, Khutsoh B, Meshram II, Krishna S, Kodali V, Roy P, Kuhnlein HV. Mother and child nutrition among the Chakhesang tribe in the state of Nagaland, North-East India. MATERNAL AND CHILD NUTRITION 2019; 13 Suppl 3. [PMID: 29359431 DOI: 10.1111/mcn.12558] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 10/02/2017] [Accepted: 10/03/2017] [Indexed: 01/11/2023]
Abstract
Despite the importance of the nutritional status and food systems of Indigenous Peoples, the subject has received very little attention, especially in North-East India. Therefore, a community-based cross-sectional descriptive study was carried out among Chakhesang mothers with children under 5 years of age to evaluate their nutritional status and prevalence of chronic diseases in the context of their dietary habits. From 558 households (HHs), 661 children and 540 mothers were covered using standard anthropometric measurements as well as blood collection for haemoglobin and vitamin A. Data were collected from mothers on HH socio-demographic particulars and infant and young child feeding practices. The results showed that the prevalence of underweight, stunting, and wasting among children <5 years of age was 14%, 22%, and 7%, respectively. The prevalence of anaemia and vitamin A deficiency was 26% and 33% among children <5 years, whereas it was 33% and 26%, respectively, among mothers. Hypertension was observed in 16% of women, whereas diabetes was seen in 0.8%. Approximately 35% and 24% of HHs suffered mild or moderate food insecurity, respectively, which was associated with literacy of the parents, per capita income, and family size. Utilization of the rich agrobiodiversity and wild foods by the Chakhesangs appears to be a strong reason for their better nutritional and health status as compared to the rest of India. Therefore, this Indigenous knowledge and food system must be documented and kept vital, especially in policies and intervention programmes addressing food and nutrition security among the Chakhesangs.
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Affiliation(s)
| | | | | | | | | | - Phrang Roy
- Indigenous Partnership for Agrobiodiversity and Food Sovereignty, c/o Bioversity International, Rome, Italy
| | - Harriet V Kuhnlein
- Centre for Indigenous Peoples' Nutrition and Environment (CINE), McGill University, Montreal, Québec, Canada
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Chyne DAL, Meshram II, Rajendran A, Kodali V, Getti N, Roy P, Kuhnlein HV, Longvah T. Nutritional status, food insecurity, and biodiversity among the Khasi in Meghalaya, North-East India. MATERNAL AND CHILD NUTRITION 2019; 13 Suppl 3. [PMID: 29359437 DOI: 10.1111/mcn.12557] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 09/19/2017] [Accepted: 09/19/2017] [Indexed: 11/27/2022]
Abstract
A community-based cross-sectional study was carried out with 603 children ages 5 and under and 500 of their mothers from 510 households to examine the prevalence of undernutrition and chronic diseases among the Khasis of North-East India. Anthropometric measurements including Mid-Upper Arm Circumference, height, and weight were taken. Dry blood spots to estimate haemoglobin and vitamin A were collected from children and women separately by finger prick. Mothers provided data about household socio-demographic particulars and infant and young child feeding practices. The prevalence in children of underweight was 31%, stunting was 57%, and wasting was 10%. Undernutrition was higher among boys as compared to girls. Nutrient intakes were below recommended levels. The prevalence of anaemia among children ages 1 to 5 years old was 68%, and vitamin A deficiency was 59%, and they were 83% and 48%, respectively, among women. Hypertension was observed in 15% of women, whereas diabetes was less than 1%. Only about 20% of households were food secure, and this was associated with parental literacy, per capita income, and family size. Undernutrition was unacceptably high among the Khasis despite rich food biodiversity. Proper implementation of nutritional intervention programs such as Integrated Child Development Services, Mid Day Meal, and the Public Distribution System will improve the nutrient intake and nutritional status of the population. Additionally, preservation of forest lands and products paired with judicious use of the rich food biodiversity available will promote dietary diversity and ultimately better nutrition and health.
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Affiliation(s)
| | | | | | | | | | - Phrang Roy
- The Indigenous Partnership for Agrobiodiversity and Food Sovereignty, c/o Bioversity International, Rome, Italy
| | - Harriet V Kuhnlein
- Centre for Indigenous Peoples' Nutrition and Environment (CINE), McGill University, Montreal, Canada
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Plante C, Blanchet C, Rochette L, O’Brien HT. Prevalence of anemia among Inuit women in Nunavik, Canada. Int J Circumpolar Health 2016; 70:154-65. [DOI: 10.3402/ijch.v70i2.17811] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Jamieson JA, Weiler HA, Kuhnlein HV, Egeland GM. Prevalence of unexplained anaemia in Inuit men and Inuit post-menopausal women in Northern Labrador: International Polar Year Inuit Health Survey. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2016; 107:e81-e87. [PMID: 27348115 PMCID: PMC6972421 DOI: 10.17269/cjph.107.5173] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 03/22/2016] [Accepted: 11/19/2015] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To identify correlates of hemoglobin (Hb) and anaemia unexplained by iron deficiency (UA) in Canadian Inuit adults. METHODS A cross-sectional survey assessed diet, demographic information, anthropometry, fasting Hb, ferritin, soluble transferrin receptor (on a subset), high-sensitivity C-reactive protein (hs-CRP) in serum, red blood cell (RBC) fatty acid composition, blood lead, and antibodies to Helicobacter pylori in non-pregnant, Inuit adults (n = 2550), ≥18 years of age from randomly selected households in 36 Inuit communities in Inuvialuit Settlement Region, Nunavut Territory and Nunatsiavut of Northern Labrador, Canada. RESULTS Hb concentrations were lower and UA prevalence higher in Inuit men after 50 years of age. Rate of anaemia was constant among Inuit women but changed from primarily iron deficiency anaemia pre-menopause, to primarily UA in post-menopause. Low education levels and hs-CRP were associated with increased risk of UA. For Inuit men, % RBC eicosapentaenoic acid (EPA) and elevated blood lead were also associated with increased risk of UA. Frequency of traditional food intake was positively associated with Hb. CONCLUSION Age patterns and regional variation of anaemia suggest that ethnicity-related physiological differences cannot explain anaemia prevalence for Inuit. High RBC EPA status, inflammation and infections, and lower education levels may contribute to the prevalence of anaemia in this population, which is not related to iron status. Thus, traditional lifestyle may protect Inuit from nutritional anaemia but contribute to lower Hb through environmental exposures. The clinical significance of UA for older Inuit adults requires further investigation, as the prevalence represents a moderate public health problem.
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Affiliation(s)
- Jennifer A Jamieson
- Department of Human Nutrition, St. Francis Xavier University, PO Box 5000, Antigonish, NS, B2G 2W5, Canada.
| | - Hope A Weiler
- School of Dietetics and Human Nutrition, McGill University, Montreal, QC, Canada
| | - Harriet V Kuhnlein
- School of Dietetics and Human Nutrition, McGill University, Montreal, QC, Canada
- Centre for Indigenous Peoples' Nutrition and Environment, McGill University, Montreal, QC, Canada
| | - Grace M Egeland
- Department of Global Public Health and Primary Care, University of Bergen & Norwegian Institute of Public Health, Bergen, Norway
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Pacifico L, Osborn JF, Tromba V, Romaggioli S, Bascetta S, Chiesa C. Helicobacter pylori infection and extragastric disorders in children: a critical update. World J Gastroenterol 2014; 20:1379-401. [PMID: 24587617 PMCID: PMC3925850 DOI: 10.3748/wjg.v20.i6.1379] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 11/10/2013] [Accepted: 01/06/2014] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) is a highly prevalent, serious and chronic infection that has been associated causally with a diverse spectrum of extragastric disorders including iron deficiency anemia, chronic idiopathic thrombocytopenic purpura, growth retardation, and diabetes mellitus. The inverse relation of H. pylori prevalence and the increase in allergies, as reported from epidemiological studies, has stimulated research for elucidating potential underlying pathophysiological mechanisms. Although H. pylori is most frequently acquired during childhood in both developed and developing countries, clinicians are less familiar with the pediatric literature in the field. A better understanding of the H. pylori disease spectrum in childhood should lead to clearer recommendations about testing for and treating H. pylori infection in children who are more likely to develop clinical sequelae. A further clinical challenge is whether the progressive decrease of H. pylori in the last decades, abetted by modern clinical practices, may have other health consequences.
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Helicobacter pylori Infection and Anemia in Taiwanese Adults. Gastroenterol Res Pract 2013; 2013:390967. [PMID: 24348534 PMCID: PMC3852401 DOI: 10.1155/2013/390967] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 09/30/2013] [Accepted: 10/17/2013] [Indexed: 12/21/2022] Open
Abstract
Background. Chronic Helicobacter pylori infection and iron-deficiency anemia (IDA) are common in adults. Although the most common causes of IDA usually arise from the gastrointestinal tract, the association between chronic Helicobacter pylori infection and anemia remains unclear. Aim. To evaluate the association of chronic Helicobacter pylori infection and IDA. Materials and Methods. We enrolled 882 patients from January 2010 to April 2013. The status of Helicobacter pylori (H.p) infection was confirmed and blood samples from the same participants were taken on the same day to check the level of hemoglobin, serum iron, ferritin, and total iron-binding capacity (TIBC). Results. No significant difference was noted from the demographic data. The average level of hemoglobin (Hb) was not different between negative and positive groups, pos 13.57 g/dL versus neg 13.65 g/dL (P = 0.699). Although the levels of serum IDA related parameters were expected in positive group (lower serum iron and ferritin and higher TIBC) these differences did not reach statistical significance (P = 0.824 for iron, P = 0.360 for ferritin, and P = 0.252 for TIBC). Conclusion. Chronic Helicobacter pylori infection is not attributed to IDA. The levels of hemoglobin, serum iron and ferritin, and TIBC remain unaffected after chronic H.p infection. Large-scale clinical studies are needed to prove the association.
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Jamieson JA, Kuhnlein HV, Weiler HA, Egeland GM. Higher n3-fatty acid status is associated with lower risk of iron depletion among food insecure Canadian Inuit women. BMC Public Health 2013; 13:289. [PMID: 23547888 PMCID: PMC3623721 DOI: 10.1186/1471-2458-13-289] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 03/25/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND High rates of iron deficiency and anemia are common among Inuit and Arctic women despite a traditional diet based on animal source foods. However, representative data on iron status and relevant determinants for this population are lacking. The objectives were to determine the prevalence of anemia and depletion of iron stores, then to identify correlates of iron status in non-pregnant Canadian Inuit women. METHODS In a cross-sectional survey of 1550 women in the International Polar Year Inuit Health Survey, 2007-2008, hemoglobin, serum ferritin, soluble transferrin receptor (on a subset), C-reactive protein (CRP), RBC fatty acid composition, and H pylori serology were analyzed on fasting venous blood. Sociodemographic, food security status, anthropometric, dietary, and health data were collected. Correlates of iron status were assessed with multivariate linear and logistic models. RESULTS Anemia was observed in 21.7% and iron deficient erythropoiesis in 3.3% of women. For women with CRP ≤ 10 mg/L (n = 1260) 29.4% had depleted iron stores. Inadequate iron intakes were observed in 16% of premenopausal and <1% of postmenopausal women. Among food insecure women, higher long-chain (n-3) polyunsaturated fatty acid (LC-PUFA) status, which reflects a more traditional food pattern, was associated with reduced risk of iron depletion. CONCLUSIONS Iron depletion and anemia are a concern for Inuit women despite adequate total dietary iron intake primarily from heme sources. The high prevalence of H. pylori exposure, together with dietary iron adequacy, suggests an inflammation-driven iron deficiency and mild anemia. The anti-inflammatory properties of LC-PUFA may be important for iron status in this population.
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Affiliation(s)
- Jennifer A Jamieson
- Centre for Indigenous Peoples’ Nutrition and Environment (CINE), McGill University, Montreal, Canada
- School of Dietetics and Human Nutrition, McGill University, Montreal, Canada
| | - Harriet V Kuhnlein
- Centre for Indigenous Peoples’ Nutrition and Environment (CINE), McGill University, Montreal, Canada
- School of Dietetics and Human Nutrition, McGill University, Montreal, Canada
| | - Hope A Weiler
- School of Dietetics and Human Nutrition, McGill University, Montreal, Canada
| | - Grace M Egeland
- Centre for Indigenous Peoples’ Nutrition and Environment (CINE), McGill University, Montreal, Canada
- School of Dietetics and Human Nutrition, McGill University, Montreal, Canada
- Department of Public Health and Primary Health Care, University of Bergen and The Norwegian Institute of Public Health, Bergen, Norway
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Jamieson JA, Weiler HA, Kuhnlein HV, Egeland GM. Traditional food intake is correlated with iron stores in Canadian Inuit men. J Nutr 2012; 142:764-70. [PMID: 22378332 DOI: 10.3945/jn.111.140475] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Accelerated loss of traditional lifestyles may place Inuit at risk of iron depletion given that anemia has been observed among Arctic men. The objectives of this study were to determine the prevalence of anemia, storage iron depletion, and iron overload and to identify correlates of iron status in Canadian Inuit men. In a cross-sectional survey of 994 men in the International Polar Year Inuit Health Survey, 2007-2008, hemoglobin, serum ferritin (SF), soluble transferrin receptor (on a subset), CRP, RBC fatty acid composition, and Helicobacter pylori serology were measured in venous blood drawn from fasting men. Anthropometric, dietary, sociodemographic, and health data were collected. Dietary and nondietary correlates of iron status were assessed with multiple linear and logistic models. For men with CRP ≤10 mg/L (n = 804), 6.5% had depleted, 19.8% had low, and 10.3% had elevated iron stores. Anemia was moderately prevalent (16.1%), but iron deficiency anemia was less common (2.4%). There was a low probability of dietary iron inadequacy (2.4% < Estimated Average Requirement) and excess iron intakes (10.7% > Tolerable Upper Intake Level). Food-insecure men and those without a household hunter had a higher risk of low or depleted iron stores. Adiposity, traditional food intake, long-chain RBC PUFA status, and inflammation were positively associated with SF and food insecurity, smoking, and H. pylori seropositivity were negatively associated with SF. Despite a moderate prevalence of anemia, iron stores are largely adequate in this population, although lower than expected based on iron intake. The regulation of iron metabolism in this population and the high prevalence of anemia in older men warrants further investigation.
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Affiliation(s)
- Jennifer A Jamieson
- Centre for Indigenous Peoples' Nutrition and Environment, McGill University, Montreal, Canada
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Rittmueller SE, Corriveau A, Sharma S. Dietary quality and adequacy among Aboriginal alcohol consumers in the Northwest Territories, Canada. Int J Circumpolar Health 2012; 71:17341. [PMID: 22456041 PMCID: PMC3417643 DOI: 10.3402/ijch.v71i0.17341] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Revised: 10/20/2011] [Accepted: 12/09/2011] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES The present study aimed to assess dietary adequacy and quality among Inuvialuit alcohol consumers and non-consumers in the Northwest Territories (NWT), Canada. STUDY DESIGN Cross-sectional study. METHODS A validated quantitative food frequency questionnaire was administered to individuals (n = 216) of randomly selected households in 3 NWT communities to capture dietary intake and alcohol consumption over a 30-day recall period. The daily energy and nutrient intake, dietary adequacy and the top food sources of energy and selected nutrients were determined by alcohol consumption status. RESULTS Energy intake was higher among all alcohol consumers regardless of gender. Male alcohol consumers had lower nutrient intake density (per 4,184 kJ) of protein, cholesterol and several micronutrients (p ≤ 0.05), and female alcohol consumers had lower intake density of saturated fat (p ≤ 0.01), thiamine, folate and sodium (p ≤ 0.05). Among all men and women, 70-100% had inadequate intakes of dietary fibre, vitamin E and potassium. Non-nutrient-dense foods contributed similar amounts and traditional foods (TF) contributed 3% less to energy comparing alcohol consumers to non-consumers. CONCLUSION Nutrient inadequacies are prevalent among Aboriginal populations in the Canadian Arctic and may be exacerbated by alcohol consumption due to alcohol's effects on dietary intake, nutrient transport and metabolism. Adult Inuvialuit who consumed alcohol had increased caloric intake and consumed similar amounts of non-nutrient-dense foods and less nutrient-dense TF. Fewer dietary inadequacies were observed among alcohol consumers than non-consumers, which might be due to the increase in overall food intake among alcohol consumers; however, further exploration of volume and pattern of drinking might help explain this result.
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Affiliation(s)
| | | | - Sangita Sharma
- Department of Medicine, University of Alberta, Edmonton, Canada
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Dietary adequacy and dietary quality of Inuit in the Canadian Arctic who smoke and the potential implications for chronic disease. Public Health Nutr 2012; 15:1268-75. [PMID: 22269176 DOI: 10.1017/s1368980011003521] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To compare dietary intake and quality among adult Inuit by smoking status. DESIGN A cross-sectional study using data from a validated quantitative FFQ. SETTING Three isolated communities in Nunavut, Canada. SUBJECTS Adult Inuit (n 208), aged between 19 and 79 years, from randomly selected households. RESULTS Average energy intake did not differ between male smokers (n 22) and non-smokers (n 14; 16 235 kJ and 13 503 kJ; P = 0·18), but was higher among female smokers (n 126) compared with non-smokers (n 46; 12 704 kJ and 8552 kJ; P < 0·0001). Average daily nutrient intakes were similar among men and higher among female smokers compared with non-smokers for all nutrients (P ≤ 0·05) except n-3 fatty acids, vitamin A, vitamin D and Se. Female smokers had lower intake densities of thiamin, niacin, vitamin B6, folate, Mg, Na (P ≤ 0·05), protein, n-3 fatty acids, cholesterol, Fe (P ≤ 0·01), vitamin B12 and Se (P ≤ 0·001). Between 20 % and 50 % of male and female smokers were below the Dietary Reference Intake (DRI) for Ca, folate, Mg and vitamins A and K, and more than 50 % were below the DRI for fibre and vitamin E. The proportion of smokers below the DRI was lower for all nutrients, except fibre and folate among men. Among smokers, non-nutrient-dense foods and traditional foods contributed less to energy (-2·1 % and -2·0 %, respectively). CONCLUSIONS Adult smokers consumed fewer nutrient-dense, traditional foods, but had increased energy intake, which likely contributed to fewer dietary inadequacies compared with non-smokers. Promoting traditional food consumption supplemented with market-bought fruits and vegetables is important to improve dietary quality, especially among smokers.
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Mead MN. Cadmium confusion: do consumers need protection? ENVIRONMENTAL HEALTH PERSPECTIVES 2010; 118:a528-34. [PMID: 21123140 PMCID: PMC3002210 DOI: 10.1289/ehp.118-a528] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
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Gessner BD. Early childhood hemoglobin level is a strong predictor of hemoglobin levels during later childhood among low-income Alaska children. Int J Circumpolar Health 2010; 68:459-70. [PMID: 20044964 DOI: 10.3402/ijch.v68i5.17378] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES For unknown reasons, Arctic Indigenous children have iron deficiency and anemia prevalences up to 10 times higher than national reference populations. The current study sought to identify the importance of Alaska Native status, residence and hemoglobin (Hb) level at age 10 to 23 months for predicting Hb levels at age 24 to 59 months when controlling for potential confounders. STUDY DESIGN Retrospective cohort. METHODS A birth certificate database was linked to a database containing hemoglobin levels determined through the U.S. Supplemental Nutrition Program for Women, Infants and Children (WIC) among Alaskan children age 10 to 59 months evaluated from 1999-2006. RESULTS Of children with a birth certificate matched to WIC data, Alaska Native status and residence in western and northern Alaska were associated strongly with anemia at both ages. Nevertheless, of 5,796 children with Hb levels determined at both ages, the single strongest predictor of Hb level at age 24 to 59 months was Hb level at age 10 to 23 months. The community-level anemia prevalence among children age 10 to 23 months was predictive of community-level anemia prevalence among children age 24 to 59 months. CONCLUSIONS The early onset of anemia and the strong association between earlier and later Hb levels or anemia at both the individual and community levels suggest a role for prenatal effects that remain until at least age 5 years. This is true particularly of Yupik and Inupiat children, who make up the primary residents of western and northern Alaska.
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Affiliation(s)
- Peter J Hotez
- Department of Microbiology, Sabin Vaccine Institute, The George Washington University, Washington, DC, United States of America.
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Abstract
Anemia is a frequent finding in most diseases which cause malabsorption. The most frequent etiology is the combination of iron and vitamin B12 deficiency. Celiac disease is frequently diagnosed in patients referred for evaluation of iron deficiency anemia (IDA), being reported in 1.8%-14.6% of patients. Therefore, duodenal biopsies should be taken during endoscopy if no obvious cause of iron deficiency (ID) can be found. Cobalamin deficiency occurs frequently among elderly patients, but it is often unrecognized because the clinical manifestations are subtle; it is caused primarily by food-cobalamin malabsorption and pernicious anemia. The classic treatment of cobalamin deficiency has been parenteral administration of the vitamin. Recent data suggest that alternative routes of cobalamin administration (oral and nasal) may be useful in some cases. Anemia is a frequent complication of gastrectomy, and has been often described after bariatric surgery. It has been shown that banding procedures which maintain digestive continuity with the antrum and duodenum are associated with low rates of ID. Helicobacter pylori (H pylori) infection may be considered as a risk factor for IDA, mainly in groups with high demands for iron, such as some children and adolescents. Further controlled trials are needed before making solid recommendations about H pylori eradication in these cases.
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Duan S, Huang RS, Zhang W, Mi S, Bleibel WK, Kistner EO, Cox NJ, Dolan ME. Expression and alternative splicing of folate pathway genes in HapMap lymphoblastoid cell lines. Pharmacogenomics 2009; 10:549-63. [PMID: 19374514 DOI: 10.2217/pgs.09.8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM Folate is vital for cell growth and development through its important role in one-carbon metabolism - an essential process in the synthesis of amino acids and nucleic acids. Folate pathway genes have been considered as therapeutic targets of drugs for the treatment of cancer and other diseases. Racial and ethnic disparities of folate metabolism and outcome of antifolate therapies have been reported. In this study, we evaluate the genetic regulation for expression and alternative splicing of folate related genes in HapMap lymphoblastoid cell lines (LCLs) of individuals of European and African descent. MATERIALS & METHODS Gene and exon level expression and alternative splicing of folate pathway genes were compared in LCLs derived from the Centre d'Etude du Polymorphisme Humain (CEPH) from Utah (CEU) and the Yoruba from Ibadan (YRI) using a permutation-based test. A genome-wide association study was performed to search for SNPs associated with folate pathway gene expressions and alternative splicing in the combined population samples. RESULTS A total of 52 folate pathway genes were evaluated in the analysis of which 46 were expressed in the LCLs. There were 12 genes (26%) with differential gene-level expression and 23 genes (50%) with differential alternative splicing for exons or UTRs between the CEU and the YRI (permutation p <or= 0.05). The expression level of FPGS and the splicing indices of eight genes (ATP13A2, ASCC3L1, IFIH1, SMARCA5, SMARCA2, SETX, DDX52 and RUVBL2) were found to be associated with SNP genotypes in the combined populations (p < 3.2 x 10(-8), Bonferroni corrected p < 0.05). CONCLUSION Our study suggests that LCLs are an in vitro system suitable to evaluate the expression levels of folate pathway genes. The differential transcript-level expressions and the differentially alternative splicing events of exons or UTRs and associated SNP markers in 2 populations will enhance our understanding of the folate pathway and, thus, facilitate research in the areas of nutrition and folate metabolism.
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Affiliation(s)
- Shiwei Duan
- The University of Chicago, Chicago, IL 60637, USA
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