Inuit country food and nutrition in early life in Nunavut
The ‘nutrition transition’ in Inuit communities has been characterized by a decreased intake of country food and an increased intake of retail food, with shifts in nutrient intake introducing potential health impacts for Inuit communities. Given that prenatal and infant nutrition environments can impact health over the life course, early life nutrition is of particular concern. Country food represents a rich source of nutrition and is high in vitamin D; vitamin D deficiency in early life is a known, yet poorly described challenge in Nunavut. Therefore, this dissertation research characterized nutrition for Inuit women and children in Nunavut, with a focus on the role of country food and on the early life period. A scoping review examined Inuit country food and nutrition in the early life period, and identified research gaps in areas of food security, micronutrient deficiency, and Inuit perspectives. Next, informed by a community-based approach, Inuit and non-Inuit researchers identified nutrition and food security research priorities in Nunavut, privileging country food and Inuit knowledge. Following this, a mixed methods approach was undertaken. Quantitative methods described nutrition and vitamin D supplement experiences in pregnancy and infancy through a retrospective chart review (n=2522) and examined the odds of rickets diagnosis in children engaging univariable and multivariable exact logistic regression. While most pregnant women consumed country food daily or weekly, high food insecurity and low vitamin D supplement use exist, and the odds of rickets diagnosis was lower in children whose mothers were food secure. Qualitative data were gathered through in-depth research conversations (n=16) with Inuit women knowledge holders (n=10). Thematic analyses were guided by an iterative, grounded theory approach. Women described the centrality of country food for food security, identify, culture, mental health, nourishment, healing, and medicine. This dissertation research confirms the critical role of country food for food security, health, and well-being for Inuit women, and describes food and supplement practices influencing vitamin D in pregnancy and infancy. Further, this research highlights that maternal food security is a pressing child health issue, and underscores country food and other opportunities to support good nutrition in the early life period, with impacts for generations to come.