Didier Garriguet

1
Obesity and eating habits of the aboriginal
population

• Didier Garriguet
• Health Information and Research Division
  (Statistics Canada)
• May 29th, 2008

2
Background

• Obesity rates have increased over the last 25
  years
• Obesity / Overweight rates of aboriginal people
  are particularly high
• Shields, 2006 (CCHS 2.2)
• Tjepkema, 2006 (CCHS 2.2)
• Tremblay et al, 2005 (CCHS 1.1, 2.1)

3
Whats new

• Using CCHS 2.2 - Nutrition
• Study aboriginal people characteristics
• Use measured BMI
• Study Nutrition module (24-hr recall)
• 43 nutrients, food groups

4
Data source
CCHS 2.2 sample size for off reserve aboriginal
adults by province and sex, household population
aged 19 to 50, 2004, Canada, territories not
included

• CCHS 2.2
• Adults 19-50 years old
• Provincial representativity required
• Eating habits differ by region
• Study Ontario and western provinces only

5
Data source

• Exclusions
• Null (4) and invalid (5) intakes
• Pregnant (108) or breastfeeding (77) women
• Special weight (response rate of 57) to study
  measured BMI

6
Definitions

• BMI weight kg / (height m2)
• For adults Overweight (BMI 25), obesity (BMI
  30)
• Ethnicity
• People living in Canada come from many different
  cultural and racial backgrounds. Are you
• White?
• Aboriginal (North American Indian, Métis or
  Inuit)?

7
Definitions

• Leisure physical activity level based on dietary
  energy expenditure (DEE)
• DEE lt 1.5 ? Sedentary (inactive)
• DEE 1.5 ? Active
• Highest level of education
• At least one member of the household has at least
  a secondary school diploma
• Household income based on the number of people in
  the household and household total income
• Low income
• Middle or high income

8
Percentage overweight/obese (BMI 25) and obese
(BMI 30), by sex and Aboriginal identity,
household population aged 19 to 50, Ontario and
western provinces, 2004
Overweight/Obese
71
67
64
Obese
62
55
47


E
Men
Women
Total
Significantly different from non Aboriginal
estimate
9
Percentage overweight/obese (BMI 25) and obese
(BMI 30), by leisure-time physical activity and
Aboriginal identity, household population aged 19
to 50, Ontario and western provinces, 2004



E

Overweight/Obese
Obese
Significantly different from inactive in same
identity group
Significantly different from non Aboriginal
estimate
10
Percentage overweight/obese (BMI 25) and obese
(BMI 30), by highest level of schooling and
Aboriginal identity, household population aged 19
to 50, Ontario and western provinces, 2004






E
E
E
Overweight/Obese
Obese
Significantly different from secondary
education or more in same identity group
Significantly different from non Aboriginal
estimate
11
Percentage overweight/obese (BMI 25) and obese
(BMI 30), by household income and Aboriginal
identity, household population aged 19 to 50,
Ontario and western provinces, 2004

E
E
Overweight/Obese
Obese
Significantly different from non Aboriginal
estimate
12
Adjusted odds ratios of selected characteristics
by overweight and obese individuals and obese
only individuals, household population aged 19 to
50, Ontario and western provinces, 2004
Significantly different from estimate for
reference category (p lt 0.05).
13
Adjusted odds ratios of selected characteristics
for overweight individuals, by Aboriginal
identity, household population aged 19 to 50,
Ontario and western provinces, 2004
Significantly different from estimate for
reference category (p lt 0.05).
14
Adjusted odds ratios of selected characteristics
for obese individuals, by Aboriginal identity,
household population aged 19 to 50, Ontario and
western provinces, 2004
Significantly different from estimate for
reference category (p lt 0.05).
15
Dietary intakes

• CCHS Nutrition module
• 24-hr recall, all consumption from midnight to
  midnight the day before
• Collection AMPM to maximize recall
• Get nutrients profile from the Canadian Nutrient
  File 2001b
• Recoded according to food groups from the
  Canadian Food Guide to Healthy Eating (1992) -
  CFG
• Vegetables and fruits
• Dairy products
• Grain products
• Meat and alternatives (grams of cooked meat)
• Other food

16
Dietary intakes

• List of nutrients

Also analyzed in percent of energy from that
source
17
Average number of servings (or kcal or grams)
from each food group by sex and Aborginal
identity, household population aged 19 to 50,
Ontario and western provinces, 2004
Significantly different from the estimate for
the non aboriginal category (p lt 0.05). Meat
and alternatives are shown as cooked meat
equivalent
18
Average energy intake in kcal, by Aboriginal
identity, sex and age group, household population
aged 19 to 50, Ontario and western provinces, 2004

359 kcal
Men
Women
Significantly different from non Aboriginal
estimate
19
Percentage distribution of sources of calories,
by food group and Aboriginal identity, male
household population aged 19 to 50, Ontario and
western provinces, 2004
Non aboriginal
Aboriginal

Significantly different from the estimate for
the non aboriginal category (p lt 0.05).
20
Percentage distribution of sources of calories,
by food group and Aboriginal identity, female
household population aged 19 to 50, Ontario and
western provinces, 2004
Non aboriginal
Aboriginal



Significantly different from the estimate for
the non aboriginal category (p lt 0.05).
21
Percentage distribution of sources of calories,
by food group and Aboriginal identity, female
household population aged 19 to 50, Ontario and
western provinces, 2004
Non aboriginal
Aboriginal



Significantly different from the estimate for
the non aboriginal category (p lt 0.05).
22
Eating habits

• Aboriginal 19 to 30 year-old women also consume
• More energy from food between meals (snacks)
  (36 vs 28)
• More snacks from the other food category (63 of
  snacks calories vs 43 of snacks calories)
• Energy from snacks also different for 31 to 50
  year-old women
• No differences in men

23
Eating habits

• Regular soft drinks are the main source of
  calories from the other food category
• Aboriginal men and women aged 31 to 50 drink more
  regular soft drinks
• Aboriginal women aged 19 to 30 years
• Consumed more reg. soft drinks the day prior to
  the interview (62 vs. 26)
• Consumed 450 g. per day on average to 139 g. per
  day on average for non aboriginal women in same
  age group

24
Eating habits

• The sandwiches category (pizzas, sandwiches,
  submarines, hamburgers, hot-dogs) is the main
  source of total fat
• Aboriginal women aged 19 to 30 are consuming more
  food/calories from this category than non
  aboriginal women
• 68 of consumers the day before the interview
  vs. 48 for non aboriginal women
• Accounts for 18.5 of daily energy for
  aboriginal women vs. 12.5 for non aboriginal
  women

25
Other nutrients

• 31 to 50 year-olds
• Men no difference between aboriginal and non
  aboriginal people
• Women
• Fibre
• Vitamin A
• Magnesium
• Folacin
• Naturally occurring folate
• Total folate (in dietary folate equivalent)

26
Other nutrients

• 19 to 30 year-olds
• Men
• Energy from proteins
• Proteins
• Calcium
• Riboflavin

27
Other nutrients

• 19 to 30 year-olds
• Women
• Energy
• Energy from carbohydrates
• Carbohydrates
• Sugar
• Energy from proteins
• Total fat
• Polyunsaturated fatty acid
• Energy from linoleic fatty acid
• Monounsaturated fatty acid
• Sodium

28
Limitations

• 24-hr recall
• Recall itself
• Day of the week
• A Guide to Accessing and Interpreting the Data
  from Health Canada
• BMI
• Fat Tissues
• Classification
• Physical activities
• Recall
• Excludes the ones from school or work
• Off reserve aboriginal people from Western Canada
  only

29
Concluding remarks

• Overweight and obesity rates higher in off
  reserve aboriginal people than in non aboriginal
  people
• Significant differences in women
• Bigger impact of inactivity in aboriginal people
• Similar physical activity for both populations
• Level of education plays a different role
• Explanation for 19 to 30 year-old aboriginal
  women
• Higher consumption of energy
• From other foods
• Impact on intake of macronutrients

30
Concluding remarks

• Similar consumption implies the same deficiencies
  for the aboriginal and non aboriginal populations
  in terms of fruits and vegetables dairy products
  for example.
• Consequences seem more important (inactivity for
  example)
• Recommendations appropriate for aboriginal
  people?