The aims of the present study were to (1) characterise the diets of adult Inuit; (2) highlight foods for a nutritional and lifestyle intervention programme; (3) develop a quantitative FFQ (QFFQ) to evaluate the programme and monitor changes in dietary intake in this population over time. A dietary survey using single 24-h dietary recalls was conducted among Inuit aged between 19 and 87 years in two communities in Nunavut, Canada. Eighty-seven subjects completed the recalls (response rate was approximately 73 %). The mean energy intake for men and women was 9530 and 6939 kJ, respectively. The intakes of dietary fibre and the majority of vitamins and minerals (especially vitamins A, D, and E, total folate and Ca) were far below the recommendations. Traditional foods contributed 40 and 42 %, respectively, to protein and Fe intakes. Non-nutrient-dense store-bought foods were consumed much more frequently than the nutrient-dense traditional foods. Foods high in fat and sugar were highlighted, and will be replaced by healthier, more nutrient-dense alternatives to address the dietary inadequacies for the nutritional intervention programme. A 154-item QFFQ was developed and pilot tested in the Arctic Inuit. The present study highlighted foods to be targeted for a nutritional and lifestyle intervention programme not previously undertaken in this population. This QFFQ is culturally appropriate and specific for evaluating the effectiveness of the programme, as well as monitoring nutritional transition in this population.

Objective: To develop a community-based chronic disease prevention program for Inuit in Nunavut, Canada. Methods: Stakeholders contributed to intervention development through formative research (in-depth interviews (n=45), dietary recalls (n=42)), community workshops, group feedback and implementation training. Results: Key cultural themes included the perceived healthiness of country foods, food sharing, and importance of family. During community workshops, key problem foods for interven-tion were identified as well as healthier culturally and economically acceptable alternatives for these foods. Behaviors for promotion were identified and prioritized. Conclusions: This approach resulted in project acceptance, stakeholder collaboration, and a culturally appropriate program in stores, worksites, and other community venues.Am J Health Behav. 2010;34(4):453-464 T his paper describes the development of the Healthy Foods North (HFN) program, a community-based inter-vention to reduce risk factors for chronic disease in Inuit communities in the Canadian Arctic. We present a model for integrating formative research findings and participation by community members to develop a culturally appropriate intervention.Formative research combines qualitative and quantitative methods to describe the beliefs, perceptions, and behaviors of a specific group and does so within a specific sociocultural, environmental, and economic context. The resulting data allow for the development of intervention strategies and materials that are tailored to the group's needs and preferences and to the setting in which they live. 1-4 Formative research is a common first step in developing interventions to modify human health behavior. 3,5-7 Furthermore, conducting formative research can build trust, collaboration, and acceptance of the project by community members and other key stakeholders.

Diet-related chronic diseases are highly prevalent among indigenous populations in the Canadian Arctic. A community-based, multi-institutional nutritional and lifestyle intervention-Healthy Foods North-was implemented to improve food-related psychosocial factors and behaviors among Inuit and Inuvialuit in four intervention communities (with two comparison communities) in Nunavut and the Northwest Territories, Canada, in 2008. The 12-month program was developed from theory (social cognitive theory and social ecological models), formative research, and a community participatory process. It included an environmental component to increase healthy food availability in local stores and activities consisting of community-wide and point-of-purchase interactive educational taste tests and cooking demonstrations, media (e.g., radio ads, posters, shelf labels), and events held in multiple venues, including recreation centers and schools. The intervention was evaluated using pre- and postassessments with 246 adults from intervention and 133 from comparison communities (311 women, 68 men; mean age 42.4 years; 78.3% retention rate). Outcomes included psychosocial constructs (healthy eating knowledge, self-efficacy, and behavioral intentions), frequency of healthy and unhealthy food acquisition, healthiness of commonly used food preparation methods, and body mass index (kg/m(2)). After adjustment for demographic, socioeconomic status, and body mass index variables, respondents living in intervention communities showed significant improvements in food-related self-efficacy (β = 0.15, p = .003) and intentions (β = 0.16, p = .001) compared with comparison communities. More improvements from the intervention were seen in overweight, obese, and high socioeconomic status respondents. A community-based, multilevel intervention is an effective strategy to improve psychosocial factors for healthy nutritional behavior change to reduce chronic disease in indigenous Arctic populations.

Background:  Food intake amongst Canadian Inuit is currently in transition with a concurrent increase in diet‐related chronic disease. There is a lack of current data on nutrient intake and dietary adequacy in this population. The present study aimed to assess dietary intake and adequacy amongst Inuit adults in a community in Nunavut, Canada. Methods:  Random sampling of 130 households in a remote Inuit community in the Kitikmeot region of Nunavut, Canada, was used for this cross‐sectional study. Up to three 24‐h dietary recalls were collected on nonconsecutive days, capturing weekday and weekend consumption. Data were analysed to estimate energy and nutrient intake, to determine dietary adequacy, and to summarise the most commonly reported foods and the top food contributors to selected nutrients. Results:  The response rate was 69%, with 75 Inuit adults participating (mean (standard deviation (SD)) age 44 (SD = 17) years). Mean (SD) daily energy intake was 9.3 (4.4) MJ and 8.7 (3.5) MJ for men and women, respectively. Intakes of dietary fibre, calcium, total folate and vitamins A, D and E were below the Dietary Reference Intakes (Estimated Average Requirements where available) for 60–100% of all men and women. Traditional foods contributed substantially to protein and iron intake, whilst shop‐bought foods were primary contributors to total fat, carbohydrate and sugar intake. Conclusions:  The present study reports an in‐depth assessment of total dietary quality amongst Inuit adults in Nunavut, Canada. The results obtained indicate inadequate intakes of several essential nutrients, as well as a reliance on a nontraditional diet. A nutrition intervention is needed to prevent a continued rise in diet‐related chronic disease incidence.

Background:  Increasing consumption of non‐nutrient‐dense foods (NNDF), decreasing consumption of traditional foods (TF) and low consumption of fruit and vegetables (FV) may contribute to increasing chronic disease rates amongst Inuit. The present study aimed to assess the daily frequency and socioeconomic and demographic factors influencing consumption of TF, FV and NNDF amongst Inuit adults in Nunavut, Canada. Methods:  Using a cross‐sectional study design and random household sampling in three communities in Nunavut, a food frequency questionnaire developed for the population was used to assess frequency of NNDF, TF and FV consumption amongst Inuit adults. Socioeconomic status (SES) was assessed by education level, ownership of items in working condition, and whether or not people in the household were employed or on income support. Mean frequencies of daily consumption were compared across gender and age groups, and associations with socioeconomic indicators were analysed using logistic regression. Results:  Two hundred and eleven participants (36 men, 175 women; mean (standard deviation) ages 42.1 (15.0) and 42.2 (13.2) years, respectively; response rate 69–93%) completed the study. Mean frequencies of consumption for NNDF, TF and FV were 6.3, 1.9 and 1.6 times per day, respectively. On average, participants ≤50 years consumed NNDF (P = 0.003) and FV (P = 0.01) more frequently and TF (P = 0.01) less frequently than participants >50 years. Education was positively associated with FV consumption and negatively associated with TF consumption. Households on income support were more likely to consume TF and NNDF. Conclusions:  These results support the hypothesis that the nutrition transition taking place amongst Inuit in Nunavut results in elevated consumption of NNDF compared with TF and FV.