Obesity risks: towards an emerging Inuit pattern

BackgroundThe prevalence of obesity and obesity-related conditions varies by population groups. Indigenous women of the circumpolar north are believed to be at high risk of obesity.ObjectiveWe studied, first the obesity prevalence in indigenous Arctic women, Nenets, compared to urban Russian women. Second, the association between obesity and cardiometabolic risk factors in the combined group of Nenets and Russian women. Third, ethnic differences in the association between obesity and cardiometabolic risk factors.DesignCross-sectional study performed in 2008–2009. Subjects: 93 Nenets women, aged 19–77 (the indigenous village, the Nenets Autonomous Area) and 132 Russian women, aged 21–72 (Arkhangelsk city). Obesity was defined as body mass index (BMI)≥30 kg/m2, waist circumference (WC)≥88 cm and or waist-to-hip ratio (WHR)≥0.85%. We assessed associations between obesity and cardiometabolic risk factors by linear and logistic regression models that included covariates of ethnicity, age, smoking and physical activity. We also tested for interaction between obesity measurements and ethnicity.ResultsPrevalence of obesity estimated through BMI, WC and WHR were 42.5, 45.3 and 41.9% in Nenets and 34.4, 46.4 and 29.5% in Russians, respectively, with no differences found. BMI, WC and WHR associated positively with triglycerides, fasting insulin and Homeostasis Model Assessment of Insulin Resistance index. In addition, BMI and WC correlated negatively with high-density lipoprotein cholesterol and positively with systolic blood pressure and apolipoprotein B/apoliporotein A–I ratio. WC explained significant variation in fasting glucose (FG) level. BMI predicted type 2 diabetes history. FG level associated strongly with ethnicity and was found to be higher in Russians.ConclusionsWe found no differences in prevalence of obesity between Nenets and Russian females. Obesity was associated with cardiometabolic risk factors independently of ethnicity in the sample studied. There was no link between obesity measurements and ethnicity.

Section: Discussionsupporting

confidence: 92%

Obesity and obesity-associated cardiometabolic risk factors in indigenous Nenets women from the rural Nenets Autonomous Area and Russian women from Arkhangelsk city

Petrenya

Brustad

Добродеева

et al. 2014

“…All means were weighted to achieve population representativeness. Hence, the number of participants is indicated for informational purposes only.bp-Values based on a Student's t-test except for physical activity, smoking, drinking and education level which were determined using the Chi-square test in SAS.cThese data have already been reported in a previous publication (3). …”

Section: Resultsmentioning

confidence: 99%

“…This shift away from the traditional Inuit lifestyle has been associated with an increased prevalence of coronary heart disease (CHD) risk factors such as obesity (2,3), high blood pressure (BP) (2) and diabetes (4). High-sensitivity C-reactive protein (hs-CRP), a pro-inflammatory marker that has previously been shown to independently predict CHD outcomes in Caucasian populations (5,6), has recently been positively associated with cardiovascular disease (CVD) prevalence and carotid intima media thickness in the Inuit population of Alaska (7,8).…”

mentioning

confidence: 99%

Population-based study of high plasma C-reactive protein concentrations among the Inuit of Nunavik

Labonté

Dewailly

Château-Degat

et al. 2012

Self Cite

BackgroundThe shift away from traditional lifestyle in the Inuit population over the past few decades has been associated with an increased prevalence of coronary heart disease (CHD) risk factors such as obesity, high blood pressure (BP) and diabetes. However, the impact of this transition on the pro-inflammatory marker high-sensitivity C-reactive protein (hs-CRP) has not been documented.ObjectivesTo examine the prevalence of elevated plasma hs-CRP concentrations in Inuit from Nunavik in the province of Quebec (Canada) and identify anthropometric, biochemical and lifestyle risk factors associated with elevated hs-CRP.DesignA population-representative sample of 801 Inuit residents from 14 villages of Nunavik, aged between 18 and 74 years, was included in the analyses. Subjects participated in a clinical session and completed questionnaires on lifestyle. Multivariate logistic regression was used to determine risk factors for elevated hs-CRP.ResultsElevated plasma hs-CRP concentrations (≥2 mg/L) were present in 32.7% (95% confidence interval (CI) 29.5–35.8) of the Inuit adult population and were more prevalent among women than among men (36.7% vs. 29.0%, p=0.007). Multivariate logistic regression analysis indicated that every 1 mmHg increase in systolic BP was associated with a 3% increase in the odds of having hs-CRP concentrations ≥2 mg/L in the Inuit population (95% CI 1.01–1.04). The combination of older age (≥50 vs. <30 years) and elevated waist circumference (gender-specific cut-off values) in a multivariate logistic model was also associated with a 13.3-fold increase in the odds of having plasma hs-CRP concentrations ≥2 mg/L (95% CI 5.8–30.9).ConclusionsThese data indicate that elevated hs-CRP is relatively prevalent among Inuit with values that are similar to those seen in Canadian Caucasian populations. Sex, age, waist circumference and systolic BP are major factors that increase the risk of this inflammatory phenotype among Inuit from Nunavik, despite their different lifestyle background compared with Caucasians.

“…Inuit body build differs from that of Caucasians in that Inuit have larger torsos and shorter limbs (15,16). This increases BMI independent of the degree of body fat as the torso carries more weight per centimetre than legs (17), and 31% of young, fit hunters in Greenland investigated around 1963 were classified as overweight when using the WHO cut-off points (10).…”

Section: Body Build and Bmi In Inuitmentioning

confidence: 98%

Raised BMI cut-off for overweight in Greenland Inuit – a review

Andersen

Rex

Noahsen

et al. 2013

BackgroundObesity is associated with increased morbidity and premature death. Obesity rates have increased worldwide and the WHO recommends monitoring. A steep rise in body mass index (BMI), a measure of adiposity, was detected in Greenland from 1963 to 1998. Interestingly, the BMI starting point was in the overweight range. This is not conceivable in a disease-free, physically active, pre-western hunter population.ObjectiveThis led us to reconsider the cut-off point for overweight among Inuit in Greenland.Design and findingsWe found 3 different approaches to defining the cut-off point of high BMI in Inuit. First, the contribution to the height by the torso compared to the legs is relatively high. This causes relatively more kilograms per centimetre of height that increases the BMI by approximately 10% compared to Caucasian whites. Second, defining the cut-off by the upper 90-percentile of BMI from height and weight in healthy young Inuit surveyed in 1963 estimated the cut-off point to be around 10% higher compared to Caucasians. Third, if similar LDL-cholesterol and triglycerides are assumed for a certain BMI in Caucasians, the corresponding BMI in Inuit in both Greenland and Canada is around 10% higher. However, genetic admixture of Greenland Inuit and Caucasian Danes will influence this difference and hamper a clear distinction with time.ConclusionDefining overweight according to the WHO cut-off of a BMI above 25 kg/m2 in Greenland Inuit may overestimate the number of individuals with elevated BMI.