Abstract
OBJECTIVES: Inuit in Canada experience alarming levels of food insecurity, but nutritional and physiological consequences are poorly documented, especially in school-age children. The objective of this study was to assess the relation of food insecurity to iron deficiency and stature in school-aged Inuit children from Nunavik (Northern Quebec).
METHODS: Food insecurity, iron deficiency, and stature were assessed in a cohort of children. Food insecurity was determined by interviewing the children’s mothers. Multiple logistic regression was used to evaluate the association of food insecurity to iron deficiency and short stature. We defined short stature as a height in the lowest tertile for age and sex, based on Canadian growth charts. The relation of food insecurity to height (cm) was analyzed with a general linear model. Statistical models controlled for age, sex, normal/overweight/obese status, prenatal lead exposure and postnatal polychlorinated biphenyls exposure.
RESULTS: Half of the children (49.7%, n=145) were food insecure, while one third were iron depleted, 12.6% had anaemia, and 8.7% had irondeficiency anaemia. The multivariate odds ratio of anaemia was 1.82 (95% CI: 0.97, 3.42, p=0.06) for food-insecure children. Prevalence of short stature was 18.7%. Food-insecure children were an average of 2 cm shorter (95% CI: -0.48, -3.17) than food-secure children (p<0.01).
CONCLUSION: In this population, food-insecure children have greater burdens of nutritional deficiencies and slower linear growth. Considering the high prevalence of food insecurity among Inuit children in Nunavik, nutritional deficiencies and adverse effects on development should be carefully monitored.
Key Terms: Food insecurity, nutritional deficiencies, iron, growth, children, indigenous health
Résumé
OBJECTIFS : Les Inuits du Canada présentent des niveaux d’insécurité alimentaire alarmants dont les conséquences nutritionnelles et physiologiques sont méconnues, surtout chez les enfants d’âge scolaire. L’objectif de notre étude était d’évaluer la relation entre l’insécurité alimentaire, d’une part, et la carence en fer et la taille, d’autre part, chez les enfants inuits du Nunavik (Nord-du-Québec) en âge de fréquenter l’école.
MÉTHODE : Nous avons évalué l’insécurité alimentaire, la carence en fer et la taille dans une cohorte d’enfants. L’insécurité alimentaire a été déterminée en interviewant les mères des enfants. Par régression logistique multiple, nous avons évalué l’association entre l’insécurité alimentaire et la carence en fer et la petite taille. Nous avons défini la petite taille comme étant la taille dans le tertile inférieur pour l’âge et le sexe, selon les fiches de croissance canadiennes. Le rapport entre l’insécurité alimentaire et la taille (en centimètres) a été analysé selon un modèle linéaire général. Des modèles statistiques ont permis de rajuster les données selon l’âge, le sexe, le poids normal/le surpoids/l’obésité, l’exposition prénatale au plomb et l’exposition postnatale aux biphényles polychlorés.
RÉSULTATS : La moitié des enfants (49,7 %, n=145) étaient confrontés à l’insécurité alimentaire, le tiers des enfants étaient carencés en fer, 12,6 % faisaient de l’anémie, et 8,7 % présentaient une anémie ferriprive. Le rapport de cotes multivarié de l’anémie était de 1,82 (IC de 95 %: 0,97, 3,42, p=0,06) chez les enfants confrontés à l’insécurité alimentaire. La prévalence de la petite taille était de 18,7 %. Les enfants touchés par l’insécurité alimentaire mesuraient en moyenne 2 cm de moins (IC de 95 %: -0,48, -3,17) que les enfants épargnés par l’insécurité alimentaire (p<0,01).
CONCLUSION : Dans cette population, les enfants confrontés à l’insécurité alimentaire avaient un plus lourd fardeau de carences alimentaires et une croissance linéaire plus lente. Étant donné la forte prévalence de l’insécurité alimentaire chez les enfants inuits du Nunavik, les carences alimentaires et leurs effets indésirables sur le développement devraient être suivis attentivement.
Mots Clés: insécurité, alimentaire, carences alimentaires, fer, croissance, enfant, santé autochtone
Footnotes
Financial Support: This study was supported by grants from the National Institute of Environmental Health Sciences/NIH (R01-ES007902 to JLJ); the Northern Contaminants Program, Indian and Northern Affairs Canada (to GM); and the Joseph Young, Sr., Fund from the State of Michigan (to SWJ).
Conflict Of Interest: None to declare.
Dr. Éric Dewailly passed away while this manuscript was being revised. He was an authority on environmental and human health in the circumpolar world, an exceptional mentor, and a brilliant mind.
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