Kelly Skinner


2023

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Dietary Intake Estimated From a 24-Hour Recall Questionnaire in the Dene and Métis Communities of the Northwest Territories, Canada
Mylène Ratelle, Kelly Skinner, Maria Ramirez Prieto, Brian Laird
Current Developments in Nutrition, Volume 7, Issue 5

Food security and nutrient deficiencies are frequent issues for people living in northern remote regions of Canada.The objective of this study is to describe the nutrient intake of residents living in the Dene/Métis communities of the Dehcho and Sahtú regions of the Northwest Territories.A 24-h dietary recall survey was used to collect information from participants of a study completed in 9 communities during the winter seasons of January 2016 to March 2018. Intakes for food groups, vitamins, macroelements, and microelements were calculated. Nutrient intakes were compared with the available DRIs.In total, there were 197 participants. On average, 37% of their energy was consumed from fat, and fruit/vegetable consumption was low (2.8 servings). Some vitamin levels (i.e., folate and vitamins A, B-6, C, and D) indicated a risk of nutritional deficiency for at least half of the participants. Of the nutrients examined, the nutrients least likely to meet the DRIs, according to the age/sex category of respondents were vitamin D (6%-20%), fiber (0%-11%), and calcium (4%-30%). Males tended to have a higher rate of nutrient adequacy above the DRIs. Importantly, 52% of the childbearing age female participants appeared deficient in folate, 48% deficient in zinc, 41% deficient in B12, and 22% deficient in iron, which might affect pregnancy and children's development.A focus on supporting a higher intake of nutrient-dense foods would benefit the health of these communities. Nutrition and health promotion programs should be implemented to improve public health efforts in the region.

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Characterizing the development and dissemination of dietary messaging in the Inuvialuit Settlement Region, Northwest Territories
Julia Gyapay, Sonja K. Ostertag, Sonia Wesche, Brian B. Laird, Kelly Skinner
Canadian Food Studies / La Revue canadienne des études sur l'alimentation, Volume 10, Issue 1

Public health communication about diet in Inuit communities must balance the benefits and risks associated with both country and store-bought food choices and processes to support Inuit well-being. An understanding of how dietary messages—public health communication addressing the health and safety of country and store-bought food—are developed and disseminated in the Arctic is currently lacking. As part of the Country Foods for Good Health study, this participatory research sought to characterize dietary messaging in the Inuvialuit Settlement Region (ISR), Northwest Territories (NWT), from the perspective of territorial, regional and local dietary message disseminators to further improve message communication in the region. We conducted an in-person interview (n=1) (February 2020), telephone interviews (n=13) (May-June 2020), and follow-up telephone interviews (n=5) (June 2021) with key informants about their involvement in developing and/or disseminating dietary messages about the health benefits and risks of country foods and/or store-bought foods in/for the ISR. Key informants interviewed included health professionals (n=5), government employees (n=6) and community nutrition or food program coordinators (n=3) located in Inuvik, Tuktoyaktuk, Paulatuk and Yellowknife, NWT. We conducted a thematic analysis on the 19 interviews. Our findings indicate that publicly disseminated dietary messages in the ISR are developed at all scales and communicated through a variety of methods. Dietary messages focus predominantly on encouraging healthy store-bought food choices and conveying nutritional advice about store-bought and country foods. As federal and territorial messaging is seldom tailored to the ISR, representation of the Inuvialuit food system and consideration of local food realities is generally lacking. There is a need to evaluate dietary messages and improve collaborations among Inuvialuit country food knowledge holders, researchers, and public health dietary message disseminators at all scales to develop more locally tailored and culturally relevant messaging in the ISR. We recommend utilizing a participatory, collaborative, culture-centered approach to dietary message development and dissemination in northern Indigenous contexts.

2022

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Drinking water perception and consumption in Canadian subarctic Indigenous communities and the importance for public health
Mylène Ratelle, Andrew Spring, Brian Laird, Leon Andrew, Deborah C. Simmons, Alexa Scully, Kelly Skinner
FACETS, Volume 7

Resource development and climate change are increasing concerns regarding safe water for Indigenous people in Canada. A research study was completed to characterize the consumption of water and beverages prepared with water and identify the perception of water consumption in Indigenous communities from the Northwest Territories and Yukon, Canada. As part of a larger research program, data for this study were available from a 24-hour recall dietary survey ( n = 162), a health messages survey ( n = 150), and an exposure factor survey ( n = 63). A focus group was conducted with Elders in an on-the-land camp setting. The consumption of water-based beverages in winter was 0.9 L/day on average, mainly consisting of tea and coffee. Of the 81% of respondents who reported consuming water-based beverages in the previous 24 hours of the survey, 33% drank more bottled water than tap water. About 2% of respondents consumed water from the land (during the winter season). Chlorine smell was the main limiting factor reported to the consumption of tap water. Results from the focus group indicated that Indigenous knowledge might impact both the perception and consumption of water. These findings aim to support public health efforts to enable people to make water their drink of choice.

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A Comparative Policy Analysis of Wild Food Policies Across Ontario, Northwest Territories, and Yukon Territory, Canada
Connor Judge, Andrew Spring, Kelly Skinner
Frontiers in Communication, Volume 7

Access to and availability of food harvested from the land (called traditional food, country food, or wild food) are critical to food security and food sovereignty of Indigenous People. These foods can be particularly difficult to access for those living in urban environments. We ask: what policies are involved in the regulation of traditional/country foods and how do these policies affect access to traditional/country food for Indigenous Peoples living in urban centers? Which policies act as barriers? This paper provides a comparative policy analysis of wild food policies across Ontario, the Northwest Territories (NWT), and the Yukon Territory, Canada, by examining and making comparisons between various pieces of legislation, such as fish and wildlife acts, hunting regulations, food premises legislation, and meat inspection regulations. We provide examples of how some programs serving Indigenous Peoples have managed to provide wild foods, using creative ways to operate within the existing system. While there is overwhelming evidence that traditional/country food plays a critical role for the health and well-being of Indigenous Peoples within Canada, Indigenous food systems are often undermined by provincial and territorial wild food policies. Provinces like Ontario with more restrictive policies may be able to learn from the policies in the Territories. We found that on a system level, there are significant constraints on the accessibility of wild foods in urban spaces because the regulatory food environment is designed to manage a colonial market-based system that devalues Indigenous values of sharing and reciprocity and Indigenous food systems, particularly for traditional/country foods. Dismantling the barriers to traditional/country food access in that system can be an important way forward.

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Dietary Intakes of Traditional Foods for Dene/Métis in the Dehcho and Sahtú Regions of the Northwest Territories
Maria Ramirez Prieto, Mylène Ratelle, Brian Laird, Kelly Skinner
Nutrients, Volume 14, Issue 2

A dietary transition away from traditional foods and toward a diet of the predominantly unhealthy market is a public health and sociocultural concern throughout Indigenous communities in Canada, including those in the sub-Arctic and remote regions of Dehcho and Sahtú of the Northwest Territories, Canada. The main aim of the present study is to describe dietary intakes for macronutrients and micronutrients in traditional and market food from the Mackenzie Valley study. We also show the trends of contributions and differences of dietary intakes over time from 1994 data collected and reported by the Centre for Indigenous People's Nutrition and Environment (CINE) in 1996. Based on 24-h dietary recall data, the study uses descriptive statistics to describe the observed dietary intake of the Dene First Nations communities in the Dehcho and Sahtú regions of the NWT. Indigenous people in Canada, like the sub-Arctic regions of Dehcho and Sahtú of the NWT, continue to consume traditional foods, although as a small percentage of their total dietary intake. The observed dietary intake calls for action to ensure that traditional food remains a staple as it is critical for the wellbeing of Dene in the Dehcho and Sahtú regions and across the territory.

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Informing the Co-Development of Culture-Centered Dietary Messaging in the Inuvialuit Settlement Region, Northwest Territories
Julia Gyapay, Kanelsa Noksana, Sonja K. Ostertag, Sonia Wesche, Brian Laird, Kelly Skinner
Nutrients, Volume 14, Issue 9

Northern Indigenous communities require collaborative approaches to health communication about food that are grounded in Indigenous knowledges and cultures; however, preferences and best methods for this process remain understudied. This participatory study discusses how Inuvialuit (Inuit from the Western Arctic) knowledge and the perspectives of territorial, regional, and local dietary message stakeholders can inform the co-development of culture-centered dietary messaging to support healthy, safe, and culturally appropriate diets in Tuktoyaktuk, NWT. A community researcher in Tuktoyaktuk conducted storytelling interviews with country food knowledge holders (n = 7) and community members (n = 3), and a talking circle with local public health dietary message disseminators (n = 2) in June-July 2021. The lead author conducted key informant telephone and videoconference interviews with territorial and regional dietary message disseminators (n = 5) in June 2021. Interviews were coded and analyzed thematically. Our findings indicate that participants at all levels support increased inclusion of cultural and community perspectives about food to develop regionally and locally tailored dietary messaging. While most dietary message stakeholders wish to be involved in co-development processes, some country food knowledge holders in Tuktoyaktuk expressed a desire to lead local communications about country foods. Informed by participants' experiences and needs, we provide recommendations for future community-led approaches to further (co-)develop and communicate effective, culturally meaningful dietary messaging that promotes Inuvialuit food sovereignty.

2021

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Human biomonitoring results of contaminant and nutrient biomarkers in Old Crow, Yukon, Canada
Mallory Drysdale, Mylène Ratelle, Kelly Skinner, Joshua Garcia-Barrios, Mary Gamberg, Megan A. Williams, Shannon E. Majowicz, Michèle Bouchard, Ken D. Stark, Dan Chalil, Brian Laird
Science of The Total Environment, Volume 760

Several large-scale human biomonitoring projects have been conducted in Canada, including the Canadian Health Measures Survey (CHMS) and the First Nations Biomonitoring Initiative (FNBI). However, neither of these studies included participants living in the Yukon. To address this data gap, a human biomonitoring project was implemented in Old Crow, a fly-in Gwich'in community in the northern Yukon. The results of this project provide baseline levels of contaminant and nutrient biomarkers from Old Crow in 2019. Samples of hair, blood, and/or urine were collected from approximately 44% of community residents (77 of 175 adults). These samples were analyzed for contaminants (including heavy metals and persistent organic pollutants (POPs)), and nutrients (including trace elements and omega-3 fatty acids). Levels of these analytes were compared to health-based guidance values, when available, and results from other human biomonitoring projects in Canada. Levels of lead (GM 0.64 μg/g creatinine in urine/24 μg/L blood), cadmium (GM 0.32 μg/g creatinine in urine/0.85 μg/L blood), and mercury (GM < LOD in urine/0.76 μg/L blood/0.31 μg/g hair) were below select health-based guidance values for more than 95% of participants. However, compared to the general Canadian population, elevated levels of some contaminants, including lead (approximately 2× higher), cobalt (approximately 1.5× higher), manganese (approximately 1.3× higher), and hexachlorobenzene (approximately 1.5× higher) were observed. In contrast, levels of other POPs, including insecticides such as dichlorodiphenyltrichloroethane (DDT), its metabolite, dichlorodiphenyldichloroethylene (DDE), and polychlorinated biphenyls (PCBs) were similar to, or lower than, those reported in the general Canadian population. This study can be used along with future biomonitoring programs to evaluate the effectiveness of international initiatives designed to reduce the contaminant burden in the Arctic, including the Stockholm Convention and the Minamata Convention. Regionally, this project complements environmental monitoring being conducted in the region, informing local and regional traditional food consumption advisories.

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Virtual barriers: unpacking the sustainability implications of online food spaces and the Yellowknife Farmers Market’s response to COVID-19
Josalyn Radcliffe, Kelly Skinner, Andrew Spring, Lise Picard, France Benoit, Warren Dodd
Nutrition Journal, Volume 20, Issue 1

Abstract Background Through their support of local agriculture, relationships, and healthy diets, farmers markets can contribute to a sustainable food system. Markets like the Yellowknife Farmers Market (YKFM) are social spaces that support local food, yet the COVID-19 pandemic has forced changes to their current model. We explore the potential of online marketplaces to contribute to a resilient, sustainable food system through a case study of the YKFM. Methods In 2019, a collaborative mixed-method evaluation was initiated by the YKFM and university partners in the Northwest Territories (NWT), Canada. The evaluation included an in-person Rapid Market Assessment dot survey and questionnaire of market patrons from two YKFM dates prior to the pandemic. Due to COVID-19, a vendor survey and interviews were deferred. Data collected from the two patron surveys, alongside researcher observations, available literature, public announcements, and informal email and phone discussions, inform the discussion. Results For the patron surveys, 59 dot survey and 31 questionnaire participants were recruited. The top motivators for attendance were eating dinner, atmosphere, and supporting local businesses, and most patrons attended as couples and spent over half of their time talking to others. The YKFM did not move online; instead, they proposed and implemented a “Shop, don’t stop” market. Informal conversations suggested the small scale of the market and technology challenges were perceived barriers to moving online. The physically-distanced market was well-attended and featured in local media. Conclusions NWT food strategies rely on farmers markets to nurture a local food system. Data suggest a potential incongruence between an online model and important market characteristics such as the event-like atmosphere. Available literature suggests online markets can support local food by facilitating purchasing and knowledge-sharing, yet they do not replicate the open-air or social experience. The decision not to move online for the YKFM reflects market patron characteristics and current food context in Yellowknife and the NWT. While online adaptation does not fit into the YKFM plan today, online markets may prove useful as a complementary strategy for future emerging stressors to enhance the resiliency of local systems.

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Game bird consumption in Dene communities of the Northwest Territories, Canada
Mylène Ratelle, Laurie Haig, Brian Laird, Kelly Skinner
Public Health Nutrition, Volume 24, Issue 6

Abstract Objective: Game bird consumption is an important part of the diet of Indigenous populations in Canada and, as part of country food consumption, is associated with improved nutritional status. The objective of this project was to document the consumption of game birds for Dene First Nations in the Northwest Territories (NWT), Canada. Design: Participants were invited to complete a FFQ using an iPad to document the types of country foods consumed, as well as consumption frequency and preparation methods, including thirteen types of game birds. Setting: The project was implemented in nine communities in the Dehcho and Sahtú regions of the NWT, Canada. Participants: A total of 237 children and adult participants from Dene First Nations in the Mackenzie Valley region of the NWT took part in the current study. Results: FFQ findings indicated that game birds were frequently consumed in both Dehcho and Sahtú communities. Canada goose and mallard were found to be consumed by the largest number of participants. Five different species (including Canada goose and mallard) were found to be consumed by at least 25 % of participants over the last year. When consuming game birds, most participants reported consuming the meat as well as most, if not all, other parts of the bird. Conclusions: Differences were observed since the last country food assessment in the 1990s in the same regions. These findings increase knowledge of the current Dene diet patterns and support the understanding of diet transition.

2020

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Virtual Barriers: Unpacking the Sustainability Implications of Online Food Spaces and the Yellowknife Farmers Market’s Response to COVID-19
Josalyn Radcliffe, Kelly Skinner, Andrew Spring, Lise Picard, France Benoit, Warren Dodd

Abstract Background Through their support of local agriculture, relationships, and healthy diets, farmers’ markets can contribute to a sustainable food system. Markets like the Yellowknife Farmers Market (YKFM) are social spaces that support local food, yet the COVID-19 pandemic has forced changes to their current model. This paper explores the potential of online marketplaces to contribute to a resilient, sustainable food system and the barriers to making this transition for the YKFM. Methods In 2019, a collaborative mixed-method evaluation was initiated by the YKFM and university partners in the Northwest Territories (NWT), Canada. The co-created evaluation plan included two patron surveys, a vendor survey and vendor interviews. The evaluation began with an in-person Rapid Market Assessment dot survey and questionnaire of market patrons from two YKFM dates prior to the pandemic. Due to COVID-19, we determined it was not a good time to conduct the vendor survey and interviews. Ongoing engagement with the market facilitated an assessment of the COVID-19 response. Results For the patron surveys, 59 dot survey and 31 questionnaire participants were recruited. The top motivators for attendance were eating dinner, atmosphere, and supporting local businesses, and most patrons attended as couples and spent over half of their time talking to others. The YKFM did not move online, citing concerns about meeting produce demand, incongruence between the online model and market strengths, low dependency on the YKFM by vendors, and potential challenges for patrons using new technology. Conclusions NWT food strategies rely on farmers’ markets to nurture a local food system. Online markets can support local food by facilitating purchases and knowledge-sharing, yet they do not replicate the open-air or social experience. Challenges to the online transition reflect the survey findings and current food context in the NWT. While online adaptation does not fit into the YKFM plan today, online markets may prove useful as a complementary strategy for future emerging stressors to enhance the resiliency of local systems.

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Drivers and health implications of the dietary transition among Inuit in the Canadian Arctic: a scoping review
Matthew Little, Hilary Hagar, Chloe Zivot, Warren Dodd, Kelly Skinner, Hing Man Chan, Amy Caughey, Josephine Gaupholm, Mélanie Lemire
Public Health Nutrition, Volume 24, Issue 9

The current study undertook a systematic scoping review on the drivers and implications of dietary changes among Inuit in the Canadian Arctic.A keyword search of peer-reviewed articles was performed using PubMed, Web of Science, CINAHL, Academic Search Premier, Circumpolar Health Bibliographic Database and High North Research Documents. Eligibility criteria included all full-text articles of any design reporting on research on food consumption, nutrient intake, dietary adequacy, dietary change, food security, nutrition-related chronic diseases or traditional food harvesting and consumption among Inuit populations residing in Canada. Articles reporting on in vivo and in vitro experiments or on health impacts of environmental contaminants were excluded.A total of 162 studies were included. Studies indicated declining country food (CF) consumption in favour of market food (MF). Drivers of this transition include colonial processes, poverty and socio-economic factors, changing food preferences and knowledge, and climate change. Health implications of the dietary transition are complex. Micro-nutrient deficiencies and dietary inadequacy are serious concerns and likely exacerbated by increased consumption of non-nutrient dense MF. Food insecurity, overweight, obesity and related cardiometabolic health outcomes are growing public health concerns. Meanwhile, declining CF consumption is entangled with shifting culture and traditional knowledge, with potential implications for psychological, spiritual, social and cultural health and well-being.By exploring and synthesising published literature, this review provides insight into the complex factors influencing Inuit diet and health. Findings may be informative for future research, decision-making and intersectoral actions around risk assessment, food policy and innovative community programmes.

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Food frequency questionnaire assessing traditional food consumption in Dene/Métis communities, Northwest Territories, Canada
Mylène Ratelle, Kelly Skinner, Sara Packull-McCormick, Brian Laird
International Journal of Circumpolar Health, Volume 79, Issue 1

Food Frequency Questionnaires (FFQ) can be used to document food consumption and to estimate the intake of contaminants for Indigenous populations. The objective of this project was to refine and i...

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The Retail Food Environment, Store Foods, and Diet and Health among Indigenous Populations: a Scoping Review
Gabriella Luongo, Kelly Skinner, Breanna Phillipps, Ziwa Yu, Debbie Martin, Catherine L. Mah
Current Obesity Reports, Volume 9, Issue 3

Describe the state of knowledge on how the retail food environment contributes to diet-related health and obesity among Indigenous populations, and assess how the literature incorporates Indigenous perspectives, methodologies and engagement throughout the research process. Outcomes included dietary behaviour (purchasing, intakes and diet quality) and diet-related health outcomes (weight-related outcomes, non-communicable diseases and holistic health or definitions of health as defined by Indigenous populations involved in the study).

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Strengthening Sustainable Northern Food Systems: Federal Policy Constraints and Potential Opportunities
Amanda Wilson, Charles Z. Levkoe, Peter Andrée, Kelly Skinner, Andrew Spring, Sonia Wesche, Tracey Galloway
ARCTIC, Volume 73, Issue 3

This paper explores how Canadian federal policy and frameworks can better support community-based initiatives to reduce food insecurity and build sustainable food systems in the North. Through an examination of the current state of food systems infrastructure, transportation, harvest, and production in the Yukon, Northwest Territories, Nunavut, Nunavik, and Nunatsiavut, we argue in favour of a multi-sector approach that supports diversified food systems, including traditional/country food production and distribution, in a way that values and prioritizes community-led initiatives and Indigenous peoples’ self-determination and self-governance. The challenge of developing sustainable, northern food systems requires made-in-the-North solutions that are attuned to cultural, geographic, environmental, and political contexts. Recent policy developments suggest some progress in this direction, however much more work is needed. Ultimately, sustainable northern food systems must be defined by and for Northerners at community, local, and regional levels, with particular attention paid to treaty rights and the right to self-determination of First Nations and other Indigenous communities.

2018

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Design of a human biomonitoring community-based project in the Northwest Territories Mackenzie Valley, Canada, to investigate the links between nutrition, contaminants and country foods
Mylène Ratelle, Matthew Laird, Shannon E. Majowicz, Kelly Skinner, Heidi K. Swanson, Brian Laird
International Journal of Circumpolar Health, Volume 77, Issue 1

Community-based projects place emphasis on a collaborative approach and facilitate research among Indigenous populations regarding local issues and challenges, such as traditional foods consumption, climate change and health safety. Country foods (locally harvested fish, game birds, land animals and plants), which contribute to improved food security, can also be a primary route of contaminant exposure among populations in remote regions. A community-based project was launched in the Dehcho and Sahtù regions of the Northwest Territories (Canada) to: 1) assess contaminants exposure and nutrition status; 2) investigate the role of country food on nutrient and contaminant levels and 3) understand the determinants of message perception on this issue. Consultation with community members, leadership, local partners and researchers was essential to refine the design of the project and implement it in a culturally relevant way. This article details the design of a community-based biomonitoring study that investigates country food use, contaminant exposure and nutritional status in Canadian subarctic First Nations in the Dehcho and Sahtù regions. Results will support environmental health policies in the future for these communities. The project was designed to explore the risks and benefits of country foods and to inform the development of public health strategies.

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Implementation of human biomonitoring in the Dehcho region of the Northwest Territories, Canada (2016–2017)
Mylène Ratelle, Kelly Skinner, Matthew Laird, Shannon E. Majowicz, Danielle Brandow, Sara Packull-McCormick, Michèle Bouchard, Denis Dieme, Ken D. Stark, Juan J. Aristizabal Henao, Rhona M. Hanning, Brian Laird
Archives of Public Health, Volume 76, Issue 1

Human biomonitoring represents an important tool for health risk assessment, supporting the characterization of contaminant exposure and nutrient status. In communities where country foods (locally harvested foods: land animals, fish, birds, plants) are integrated in the daily diet, as is the case in remote northern regions where food security is a challenge, such foods can potentially be a significant route of contaminant exposure. To assess this issue, a biomonitoring project was implemented among Dene/Métis communities of the Dehcho region of the Northwest Territories, Canada.Participants completed dietary surveys (i.e., a food frequency questionnaire and 24-h recall) to estimate food consumption patterns as well as a Health Messages Survey to evaluate the awareness and perception of contaminants and consumption notices. Biological sampling of hair, urine and blood was conducted. Toxic metals (e.g., mercury, lead, cadmium), essential metals (e.g., copper, nickel, zinc), fatty acids, and persistent organic pollutants (POPs) were measured in samples.The levels of contaminants in blood, hair and urine for the majority of participants were below the available guidance values for mercury, cadmium, lead and uranium. However, from the 279 participants, approximately 2% were invited to provide follow up samples, mainly for elevated mercury level. Also, at the population level, blood lead (GM: 11 μg/L) and blood cadmium (GM: 0.53 μg/L) were slightly above the Canadian Health Measures Survey data. Therefore, although country foods occasionally contain elevated levels of particular contaminants, human exposures to these metals remained similar to those seen in the Canadian general population. In addition, dietary data showed the importance and diversity of country foods across participating communities, with the consumption of an average of 5.1% of total calories from wild-harvested country foods.This project completed in the Mackenzie Valley of the Northwest Territories fills a data gap across other biomonitoring studies in Canada as it integrates community results, will support stakeholders in the development of public health strategies, and will inform environmental health issue prioritization.