For millennia, the Inuit, inhabiting the Arctic and Subarctic regions of North America and Russia, have adapted to a unique environment and diet. Their traditional way of life, heavily reliant on marine mammals and fish, has sparked both admiration and controversy in the realm of nutrition and health. This article examines the complexities surrounding the Inuit diet, its impact on their health, and its relationship to life expectancy, dispelling myths and revealing the realities of this unique population.
The Inuit: A People of the Arctic
The Inuit, descended from Aboriginal people who historically inhabited the Arctic regions of Canada, Alaska, Greenland, and Siberia, have a rich cultural heritage shaped by their environment. They are known by various names, including Kalaallit in Greenland and Iñupiat in Alaska. The term "Eskimo," while historically used, is now considered offensive by many, with "Inuit" being the preferred autonym.
Traditional Inuit Diet: A Carnivorous Existence?
The traditional Inuit diet is characterized by high protein and fat intake, primarily from marine mammals, fish, and land animals. The Inuit consumed an average of 75 percent of their daily energy intake from fat. While plant cultivation is impossible in the Arctic, Inuit traditionally gathered naturally available plants.
Hunted animals, including birds, caribou, seals, walrus, polar bears, whales, and fish, provided all the nutrition for the Eskimos for at least 10 months of the year. In the summer season people gathered a few plant foods such as berries, grasses, tubers, roots, stems, and seaweeds. Animal flesh was, by necessity, the only food available most of the time. The fat, not the protein, from animal foods provided most of the 3,100 calories required daily for these active people.
Eating raw meat indirectly provided Eskimos with enough carbohydrates in the form of glycogen (found in the muscles and liver of animals) to meet their necessary nutrient requirements and keep them out of a starvation condition called ketosis. Plants (not people) synthesize Vitamin C, yet the Eskimo was able to avoid scurvy with the 30 mg of vitamin C consumed daily found in land and sea animals. Low levels of sunlight, and preformed vitamin D from fish, met the "sunshine D vitamin" requirement for Eskimo health.
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The "Eskimo Paradox": Myth vs. Reality
The notion that the Inuit remained free of heart disease and other chronic illnesses due to their high-fat diet gained traction in the 1970s, sparking the "Eskimo paradox" theory. This theory attributed the supposed protection to omega-3 fatty acids found in fish. However, this idea has faced increasing scrutiny and has been found to be largely a myth.
A thorough review of the evidence concludes that "Eskimos have a similar prevalence of CAD (coronary artery disease) as non-Eskimo populations, they have excessive mortality due to cerebrovascular strokes, their overall mortality is twice as high as that of non-Eskimo populations, and their life expectancy is approximately 10 years shorter than the Danish population."
Genetic Adaptations to a High-Fat Diet
Recent research has revealed genetic adaptations in Greenlandic Inuits that help them process their high-fat diet. A study published in Science identified mutations in genes encoding the enzymes FADS1, FADS2, and FADS3, which regulate polyunsaturated fatty acid levels. These mutations seem to help Inuits produce less fatty acids, potentially compensating for their high omega-3 intake.
The mutations in the Inuit population were associated with lower "bad" cholesterol and insulin levels, which protects against cardiovascular disease and diabetes. The mutations also seem to have reduced their height by two centimetres, nearly an inch.
Life Expectancy: A Complex Picture
Life expectancy figures are regularly published for Quebec's Nunavik health region, and since 2000, for the territory of Nunavut, covering the entire population of those areas, including non-Inuit. Results for 2000 to 20026 showed that life expectancy at birth was about 67 years in Nunavik and about 69 years in Nunavut, or approximately 13 and 11 years less than for Canada as a whole at the time.
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In 1991 (1989-1993), life expectancy at birth (both sexes combined) in the Inuit-inhabited areas was about 68 years. By 2001 (1999 to 2003), life expectancy in these areas had not increased, and may even have declined by about a year. In 1991, life expectancy in the Inuit-inhabited areas had been 10 years less than in Canada overall, with a wider gap for females (11 years) than for males (9 years). By 2001, the difference was more than 12 years, and the gap was similar for males and females.
In 2001, life expectancy in Canada's Inuit-inhabited areas was the same as in Greenland, which is largely Inuit-populated; slightly lower than for all Alaskan natives; and about 6 years less than for Canada's First Nations.
These findings for the Inuit-inhabited areas do not distinguish life expectancy for Inuit from that of non-Inuit. If the life expectancy of the 15% of the population who were non-Aboriginal is assumed to be the same as that for all Canada (79.5 years in 2001), and that of the 5% of the population who were other Aboriginal to be the same as that of all Registered Indians in Canada (72.8 years in 2000), then, taking into account the relative population sizes of each group, the life expectancy of Inuit-identity residents would have been 64.2 years - or 2.7 years less than that of all residents of the Inuit-inhabited areas, and 15 years less than that for Canada as a whole.
Socioeconomic Factors and Health Disparities
The socio-demographic characteristics of the population in the Inuit-inhabited areas differed from those of the total population of Canada. In 2001, adults in the Inuit-inhabited areas tended to have less formal education. As well, their employment-to-population ratio was somewhat lower, and while households were larger, household incomes were lower, resulting in much lower average income per person. Finally, the percentage of homes in need of major repairs was three times as high as in Canada overall.
From 1991 to 2001, the population of the Inuit-inhabited areas increased considerably, mainly because of high birth rates among the Inuit and other Aboriginal inhabitants.
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Analysis of 2001 census data revealed lower levels of education and income, and poorer employment and housing conditions in the Inuit-inhabited areas compared with Canada as a whole, and within the Inuit-inhabited areas, for Inuit compared with the non-Aboriginal population. Any or all of these factors, in addition to others such as lifestyle risk factors and environmental conditions, could be at least partly responsible for the lower life expectancy in the Inuit-inhabited areas.
The Impact of Modernization
Over the past 50 years, the traditional Inuit diet has been modified with the addition of western foods. Obesity, type-2 diabetes, tooth decay, and cancers of the breast, prostate, and colon have been added to the Eskimo's traditional health problems of artery disease, bone loss, and infectious diseases. Instead of hunting, people use the "green lure" (the dollar bill) and catch their meals through an open car window at the local fast-food restaurant.
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