First Nations Food, Nutrition and Environment Study
(FNFNES) 2008-2018
Funding for this study was provided by the First Nations Inuit Health Branch, Health Canada.
The information and opinions expressed in this presentation are those of the authors/researchers and do not necessarily reflect the official views of
the FNIHIB or other participating institutions.
❖ In Canada, there remain large gaps in health between First Nations and the non-Indigenous population. For example:❖ First Nations experience a lower life expectancy, higher
rates of chronic and infectious diseases, and mental health issues; and
❖ Rates of obesity, diabetes and heart disease among First Nation citizens have reached epidemic levels.
❖ First Nations have expressed concerns about the impacts of environmental pollution on the quality and safety of traditionally-harvested foods.
Introduction
Goals
Prior to FNFNES, very little was known about the composition of First Nations’ diets, or about the level of contaminants in traditional foods. v Goals have included to fill this gap in knowledge about
the diet of First Nations citizens living on-reserve in the eight Assembly of First Nation (AFN) regions south of the 60th parallel in Canada; and
v To provide more and better information for the promotion of healthy environments and healthy foods for healthy First Nations citizens.
Key Questions
1. What kinds of traditional and market foods were people eating?
2. What was the diet like?3. What contaminants, if any, were in a
community’s traditional foods and water?
4. Is traditional food safe to eat?5. Is the water safe to drink?
Study Partners
University of Ottawa (Dr. Laurie
Chan)
University of Montreal (Dr. Malek
Batal)
Assembly of First Nations
(Dr. Tonio Sadik)
Health Canada, First Nations and Inuit Health
Branch (Dr.
Constantine Tikhonov, Dr.
Harold Schwartz)
Participating First Nations
(92 total)
Partnership and Community Participation
❖ Participating First Nations were involved at all stages of the project.
❖ Canadian Institute of Health Research (CIHR) guidelines were followed.
❖ All data are treated as confidential. ❖ Each First Nation owns its own data and received a full
dataset following completion of the study.❖ The principles of Ownership, Control Access and
Possession (OCAP®) were followed.❖ Data were given to the First Nation for safekeeping, and
AFN securely stores a copy solely as a backup.
❖ Systematic Random Sampling by region and ecozone
❖ ~10 First Nations surveyed per year
Selection of Participant First Nations
First Nations Food, Nutrition
and Environment
Study(FNFNES)
2.Traditional Food
Sampling for Contaminants
3.Water
Sampling for trace metals
4.Surface water
Sampling for
Pharmaceuticals
5.Hair sampling
for Mercury
1.Household
Questionnaire
5 Study Components
First Nations Food, Nutrition and Environment Study
• Up to 100 Households per First Nation• 1 person per Household• 19 years or older• Able to provide written consent• Self-identified as a First Nations person living on reserve• Questions on diet, health, harvesting, and food security
• 30 different foods were collected from each First Nation andanalyzed for a set of chemical contaminants and nutrientanalyses as needed
• Each food tested was a composite of up to 5 samples fromdifferent animals/plants
FNFNES Study Components
1.Household
Questionnaire
2. Traditional
Food Sampling for
Contaminants
First Nations Food, Nutrition and Environment StudyFNFNES Study Components
3.Sampling of
drinking water (households)
5.Hair
sampling for mercury
• Approximately 20 households in each First Nation had their water tested for a range of metals (eg, lead).
• Testing for pharmaceuticals was undertaken at 3 sites selected by each First Nation.
• All participants were invited to provide a hair sample to verify the mercury exposure estimate from food intake.
4. Sampling
ofsurfacewater
Capacity Building
• Data Training Workshops were provided for all participating First Nations.
• Training was provided to:• 542 Community Research Assistants• 50 Nutritionists• 40 Students• 20 Staff members
Capacity Building
92 First Nations Involved
PartnerBC
First Nations2008-2009
Tahltan
Iskut Fort Nelson
Tsay Keh Dene
Prophet River
Doig River
Saulteau
HagwilgetWitset
KitsumkalumTl'azt'en
Lake BabineSkidegate
Nuxalk
Namgis
Tla'amin Lil'wat
Samahquam
Douglas (Xa’xtsa)
Lower NicolaSplatsin
T'oyaxsut 'nüünSne kalyëghmeeduhmisiyhMussi chosunachailyaSne kalyëghSoga sénláʼWuujǫ aasanalááʔhay! hay!haawastutwiniitscwǥilakas'lačɛčɛhatanapɛč qʷaləptin tᶿokʷKukwstuúlhkaapkʷukʷscémxʷKukwstsétselp !
PartnerManitoba
First Nations2010
MiigwechMîkwêcAyhayKinanâskomitin !
PartnerOntario
First Nations2011-2012
MiigwechAnushiikNyawehNia:wen !
PartnerAlberta
First Nations2013
Mashi Choo Masi
KinanâskomitinMerciHyhi
Musi-choAhiy
Is-n-i yishHai Hai
Ninanaskomon !
PartnerAtlantic
First Nations2014
WoliwonWelaliogWe’lalinOelalinWelaliek !
PartnerSaskatchewanFirst Nations
2015
Marci ChoTenikiTiniki
Hiy HiyEkosi,
TapwekeechewMeequatch
Meegwetch MiigwichKinanāskomitánKinanaskomitin
KitatamihinPinamayaPidamaya !
Partner Quebec and
Labrador First Nations
2016
Tshe-neshk-emutenChinshkumitin
MegwetchTshinashkumitin
MigwetchMeegwetch
Niá:wenWli WniWelalin
Wela’lin !
Study Participants
Region Number ofFirst Nations
Number ofHouseholds
Number ofWomen / Men
British Columbia 21 1103 706 / 397
Manitoba 9 706 477 / 229
Ontario 18 1429 896 / 533
Alberta 10 609 387 / 222
Atlantic 11 1025 670 / 355
Saskatchewan 13 1042 721 / 321
Quebec 10 573 420 / 153
TOTAL 92 6487 4277 / 2210
Key FindingsStudy Participants
Key FindingsResults: Health, Diet and Food Insecurity
37%
17%
19%
52%
said health was very good or excellent
physically active
at a healthy weight
have diabetes(type 2 diabetes is more common)
smoke
26%
Overall well-being across regions
Overweight & Obesity
82 78 78 81 83 8591
79
62
0
25
50
75
100
All reg
ions BC AB SK MB ON QC AT
Canad
a
Traditional Food
Daily Intake of Traditional Food*
*for those who ate TF on the day of their interview
Nutrient intake on days with and without Traditional Food (TF)
Days with TF, higher intakes of:• Protein• Linolenic acid (omega-3)• Iron• Zinc• Magnesium• Copper• Potassium• Phosphorus• Vitamins A & D• Vitamin C• Riboflavin• Niacin• Vitamins B6 & B12
Days without TF, higher intakes of:• Sugar• Saturated fat• Sodium (salt)
Top sources of saturated fat, salt and sugar
Salt• soup• white bread• cold cuts/
sausages
Sugar• soft drinks• sweet condiments• iced tea/
fruit flavoured drinks
Saturated Fat• cold cuts/
sausages• beef• cheese
Traditional Food - Barriers
Food Insecurity by Region
4850
6049
4639
4839
12
0 10 20 30 40 50 60 70
All regions
BC
AB
SK
MB
ON
QC
AT
Canada
Food Insecurity by Ecozone
FNFNESregional average
Maximum cost per region
Major urban centre
$240
$327
$145
$262
$336
$196
$221
$238
$220
$258
$479
$177
AB $216maximum $377Edmonton $204
SK
maximum
Saskatoon
MB
maximum
W innipeg
ON $247maximu
m$411
Ottawa $205
QC
maximum
Montréal
Atlantic
maximum
Halifax
Weekly Food Costs
* to feed a family of four comprised of 2 adults and 2 children(pricing not undertaken in BC)
Results: Water quality, mercury in hair and contaminants in traditional food
• These pharmaceutical results point to potential sewage contamination.
• Most FNFNES results are lower than those found in other surface waters and wastewater studies in Canada, the United States, Europe, Asia and Central America.
stimulant
diabetes
heart medication
a metabolite of nicotine from tobaccoand nicotine patches
anticonvulsant
antibiotic
antacid
pain medication, anti-inflammatory
pain medication
antibiotic
pain medication
Pharmaceuticals found in surface water in 10% or more of all participating First Nations
Mercury in hair
• Women of childbearing age and older individuals (51+) living in northern ecozones tend to have a higher mercury exposure that exceeds Health Canada’s guidelines.
• Community-based/intervention studies in northern ecozones may be beneficial to investigate the prevalence of higher mercury exposures and to provide coherent risk communication and nutrition advice on the importance of traditional food and on how to reduce mercury exposure.
• The findings suggest that sources of mercury include both locally harvested fish as well as commercial fish.
Contaminant Analysesof Traditional Food
1. Food Sampling for contaminant analysis
• A total of 2,062 food samples (mix of 1 to 5 replicates) representing 250 species were collected
• Over 20,000 concentrations of the following contaminants were measured.
• Trace metals (As, Hg, Cd, Pb)• PCB/DDT (Legacy POPs)• Perfluorinated Compounds (3M)• PAH (oil and gas byproduct)• Pesticides• Dioxin and furans• PBDE (Fire retardants)
Cadmium Concentrations
Cadmium concentrations in traditional food by ecozoneSample Number of
communities/pooled
samples
Mean (ug/g)
SD (ug/g)
Median (ug/g)
Minimum (ug/g)
Maximum (ug/g)
Pacific Maritime (n=65 food species collected)Moose kidney 1 5.37 NA 5.37 5.37 5.37
Seaweed 5 3.99 2.10 4.81 0.61 5.76Mussel 3 3.67 4.15 2.75 0.05 8.20Oyster 1 3.56 NA 3.56 3.56 3.56
Moose liver 2 2.86 1.08 2.86 2.09 3.62Boreal Cordillera (n=6 food species collected)
Moose liver 1 8.46 NA 8.46 8.46 8.46Caribou Weed 1 1.54 NA 1.54 1.54 1.54Moose meat 2 0.02 0.01 0.02 0.02 0.03
Sockeye Salmon 2 0.01 0.00 0.01 0.01 0.01Blueberries 1 0.00 NA 0.00 0.00 0.00
Montane Cordillera (n=46 food species collected)Moose kidney 2 7.31 4.09 7.31 4.41 10.20Moose liver 2 1.54 0.39 1.54 1.26 1.81Deer Liver 1 0.32 NA 0.32 0.32 0.32Yew bark 1 0.31 NA 0.31 0.31 0.31
Devils Club bark 1 0.26 NA 0.26 0.26 0.26
Organochlorine Concentrations
Traditional FoodNumber of
communitiesMean SD Median Minimum Maximum
p,p’-DDE (ng/g)Harp Seal meat 1 28.50 - 28.50 28.50 28.50
Eulachon grease 5 21.12 6.22 19.60 15.00 30.30
Beaver kidney 1 16.10 - 16.10 16.10 16.10
Beaver liver 1 13.80 - 13.80 13.80 13.80
Duck meat 25 10.36 25.14 1.57 0.00 102.00
Catfish 6 9.74 6.58 12.75 0.26 16.30
Trout 75 9.34 19.71 2.00 0.00 109.00
Bass 9 9.22 17.43 2.43 0.00 53.90
Eel 8 8.98 11.18 4.38 1.10 35.10
Salmon eggs 11 7.88 18.88 2.17 0.00 64.30
Sturgeon 13 6.16 7.71 2.91 0.77 26.20
Principal traditional food contributors for exposure to cadmium
0
1
2
3
4
5
6
7
8
Moose ki
dney
Moose liv
er
Mussels
Seawee
d
Oysters
Deer k
idney
Caribou ki
dney
Lobste
r
Herring
eggs
Deer li
ver
Moose m
eat
Rabbit/
Hare hea
rt
Caribou liv
er
Scallo
ps
Ptarmigan
mea
t
Clams
Cockles
Beave
r mea
t
Elk kidn
ey
Prawns
Cd_ugday, consumers only
Principal traditional food contributors for exposure to lead
0
2
4
6
8
10
12
14
Bison m
eat
Deer m
eat
Moose
meat
Grouse m
eat
Beaver
meat
Goose m
eat
Elk mea
t
Duck m
eat
Halibut
Black B
ear m
eat
Caribou
mea
t
Squirre
l mea
t
Caribou
heart
Deer liv
er
Musse
ls
Shrimp
Seawee
d
Moose
kidney
Oyster
s
Prawns
Pb_ugday, consumers
Principal traditional food contributors for exposure to mercury
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
1.8
Walleye
/ Picke
rel
Northern
Pike/ J
ackfi
sh
Halibut
Rockfis
h
Salmon
Whitefis
h
Lobste
r
Salmon eg
gs
Sturgeon
Caribou ki
dney
Trout
Sauger
Perch
CodShrim
p
Atlantic
Salmon
Cockles
Ling Cod/ M
ariah/
Burbot
Striped
Bass
Moose m
eat
Hg_ugday
Contaminant Exposure from Traditional Food
1. Adults who are heavily reliant on organ meats may have an elevated risk of exposure, especially among those who are also smokers.
2. An elevated risk of exposure, due to lead-containing ammunition, was estimated for adults who are heavily reliant on traditional food.
3. An elevated risk of exposure to mercury from traditional food was seen among some women of child-bearing age.
Key Findings (1/3) 1. This study offers for the first time a body of coherent evidence on the human
dimension of the ongoing environmental degradation affecting First Nation
citizens and communities.
2. Traditional food systems remain foundational to First Nations.
3. Traditional food has multiple core values for First Nations. These include cultural,
spiritual, and traditional values, along with enhanced nutrition and health, food
security, ways of knowing, and an ongoing connection to land and water.
4. Traditional food access does not meet current needs. Over half of all adults
reported that harvesting traditional food is impacted by industry-related activities, as
well as climate change.
5. Generally preferred to store-bought food, traditional food is of superior
nutritional quality, and its inclusion significantly improves diet quality.
Key Findings (2/3)6. Traditional food is safe for consumption, with two primary exceptions:
a. Large predatory fish (such as walleye and northern pike) in some areas have
higher levels of mercury, and some women of childbearing age have elevated
levels of mercury exposure, particularly in the northern parts of Saskatchewan,
Manitoba, Ontario and Quebec.
b. The use of lead-based ammunition resulted in very high levels of lead in many
harvested mammal and bird samples. As a result, there is an elevated risk of
exposure to lead for some adults and women of childbearing age. The use of
other forms of ammunition can eliminate this exposure to lead.
7. Many First Nations face the challenge of extremely high rates of food
insecurity. Overall, almost half of all First Nation families have difficulty putting
enough food on the table. Families with children are affected to an even greater
degree.
8. The price of healthy foods in many First Nation communities is much higher than in
urban centres, and is therefore beyond the reach of many families.
9. The current diet of many First Nation adults is nutritionally inadequate, which is
strongly tied to food insecurity and limited access to healthy food options.
10. The health of many First Nation adults is compromised with very high rates of
smoking, obesity (double the obesity rate among Canadians), and with one-fifth of the
adult population suffering from diabetes (more than double the national average).
11. There continue to be issues with water treatment systems in many communities,
particularly exceedances for metals that affect colour and taste, which limit theacceptability and use of tap water for drinking.
12. Pharmaceutical residues were found in surface waters in and around many
communities, indicating potential sewage contamination.
Key Findings (3/3)
v The FNFNES team would like to thank allparticipating communities for giving us your timeand your trust.
v Your participation, effort and help is what made thiswork possible.
v We would also like to thank all of our partners fortheir help in making this project a reality.
Acknowledgements
Discussion
~ Question & Answer ~
FNFNES Recommendations
• Recommendations from the FNFNES are currently being finalized, subject to feedback received at this Forum.
• A number of recommendations are currently being considered.
1. The authors of this study urge governments and decision-makers to urgently address systemic problems relating to food, nutrition and the environment affecting First Nations, and to do so in a manner that supports First Nations-led leadership and solutions.
Recommendations (1/3)
2. Close gaps in nutrition and food (in)security
3. Support sustainable and healthy lifestyles
4. Support communities to increase their reliance on the traditional food system
5. Ensure good drinking water quality and trust in safety of public water systems
6. Ensure that pharmaceuticals are not present in levels potentially harmful to humans or animals
Recommendations (2/3)
Recommendations (3/3)
At the individual level:
§ To decrease exposure to metals from pipes, use water from the cold water tap only for drinking, cooking and making baby formula.
§ Limit the use of lead-ammunition.
§ To help protect the environment, return all unused medication to local pharmacies or health centresfor proper disposal.
In Regional Breakouts Sessions…
Questions to Consider: 1. What do the recommendations mean
to you – are they accurate?
2. Do any of the recommendations need to change?
3. What other recommendations do you have?
