title: Quality of diet is associated with insulin resistance in the Cree (Eeyouch) indigenous population of northern Québec.
abstract: OBJECTIVE
  Indigenous people worldwide have a greater disease burden than their non-aboriginal counterparts with health challenges that include increased obesity and higher prevalence of diabetes. We investigate the relationships of dietary patterns with nutritional biomarkers, selected environmental contaminants and measures of insulin resistance in the Cree (Eeyouch) of northern Québec Canada.
  
  
  RESULTS
  The cross-sectional 'Nituuchischaayihitaau Aschii: A Multi-Community Environment-and-Health Study in Eeyou Istchee' recruited 835 adult participants (≥18 y) from 7 communities in the James Bay region of northern Québec. The three dietary patterns identified by principal component analysis (PCA) were: inland and coastal patterns with loadings on traditional foods, and a junk food pattern with high-fat and high-sugar foods. We investigated dietary patterns scores (in quantiles) in relation with nutritional biomarkers, environmental contaminants, anthropometry, blood pressure, fasting plasma glucose and insulin, and insulin resistance. Homeostatic model assessment (HOMA-IR) was used as surrogate markers of insulin resistance. ANCOVA ascertained relationships between dietary patterns relationship and outcomes. Greater scores for the traditional patterns were associated with higher levels of n-3 fatty acids, mercury and polychlorinated biphenyls (PCBs) (P trend <0.001). Higher scores for the junk food pattern were associated with lower levels of PCBs and Vitamin D, but higher fasting plasma insulin and HOMA-IR.
  
  
  CONCLUSIONS
  Our results suggest that poor diet quality accompanied greater insulin resistance. Impacts of diet quality on insulin resistance, as a sign of metabolism perturbation, deserve more attention in this indigenous population with high rates of obesity and diabetes.
authors.affiliation: Centre for Indigenous Peoples' Nutrition and Environment, McGill University, Montreal, QC, Canada; School of Dietetics and Human Nutrition, McGill University, Montreal, QC, Canada. Electronic address: louise.johnson-down@mcgill.ca.
authors.forename: L
authors.initials: L
authors.lastname: Johnson-Down
authors.affiliation: Institute of Nutrition and Functional Foods, Laval University, Québec, QC, Canada.
authors.forename: M E
authors.initials: ME
authors.lastname: Labonte
authors.affiliation: Environment and Resource Studies, University of Waterloo, Waterloo, ON, Canada.
authors.forename: I D
authors.initials: ID
authors.lastname: Martin
authors.affiliation: Environment and Resource Studies, University of Waterloo, Waterloo, ON, Canada.
authors.forename: L J S
authors.initials: LJ
authors.lastname: Tsuji
authors.affiliation: Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Nieboer
authors.affiliation: Department of Social & Preventive Medicine, Laval University, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Centre, Québec, QC, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Dewailly
authors.affiliation: Centre for Indigenous Peoples' Nutrition and Environment, McGill University, Montreal, QC, Canada; School of Dietetics and Human Nutrition, McGill University, Montreal, QC, Canada; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Norwegian Institute of Public Health, Bergen, Norway.
authors.forename: G
authors.initials: G
authors.lastname: Egeland
authors.affiliation: Department of Social & Preventive Medicine, Laval University, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Centre, Québec, QC, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Lucas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001110:Arctic Regions / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology* / Q000378:metabolism; D004032:Diet / Q000009:adverse effects* / Q000208:ethnology; D005260:Female; D019456:Health Transition; D006801:Humans; D007198:Indians, North American; D007333:Insulin Resistance / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology* / Q000378:metabolism; D015995:Prevalence; D025341:Principal Component Analysis; D011792:Quebec / Q000453:epidemiology; D012111:Residence Characteristics; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: Diabetes; Dietary patterns; Hyperinsulinemia; Insulin