The Inuit Diet

With obesity rates at an all-time high, cardiovascular health is a major concern for most U.S. citizens. Every year Americans die of cardiovascular related illness with heart disease topping the list of leading causes of death according to the Centers for Disease Control. (1) For the Inuit population the most common cause of death was found to be self-inflicted injury. (2) In fact, heart disease and other cardiovascular illnesses are not the buzzing topics that they are in the lower forty eight states. With cardiovascular disease as less of a concern in such populations there is much speculation as to what it is about the Inuit culture that decreases their risk for disease. The Inuit is a native culture, sometimes known as Eskimos, which can be found in areas such as Canada, Alaska and Greenland. (3) The distinct cultural practice to be examined that serves as the Inuits source of lowered cardiovascular risk is their eccentric, omega-3 rich diet. Many studies have been conducted to examine the relationship between heart health and the benefit of omega-3 intake from the diet such as a traditional Inuit or Eskimo diet in comparison to a western or American diet. With similar obesity rates between some Inuit populations and U.S. populations it is clear that there is a distinct difference effecting risk among the two groups. Relationships have recently been developed between omega-3 intake and risk of heart disease, acute coronary syndrome and atrial fibrillation specifically. The Inuit people consume large amounts of seafood ranging from sources common in the U.S. such as salmon, to sources you would not normally find on an American seafood menu such as seal. It is the frequent consumption of both fish and marine mammals that sets the Inuit/Eskimo traditional diet aside from a western diet that would be seen in the lower states of the U.S.. These traditional practices ensure that the Inuit people consume a large amount of the

heart-healthy omega-3 fatty acids, much larger than most Americans consume. In fact, the U.S. population is frequently encouraged to strive to reach an omega-6 to omega-3 ratio of 1:1 although it is difficult due to the high amount of omega-6 fatty acids found in our diet. The Inuit people have their diet to thank for their respectable ratio coming extraordinarily close to 1:1, putting them on a good path to heart health. Their high consumption of the omega-3 fatty acids promotes Prostaglandin 3 production which is an anti-inflammatory agent. When the omega-6 to omega-3 ratio falls to an unfavorable imbalance, inflammation is triggered by the increased levels of Prostaglandin 2 produced by high levels of omega-6 fatty acids. This inflammation is a major contribution to much of the U.S. populations cardiovascular diseases since it is thought that the American diet has a ratio as high as 20:1. (4) A major difference in the traditional Inuit diet versus the western/American diet is that while fried foods are commonly consumed in the western tradition, the Inuit consume almost all of their meals raw or frozen. Frying fish in the Inuit culture is almost unheard of.(5) It is very likely that these cooking practices play a role in the difference in the two populations ability to maintain an ideal ratio of omega-6 fatty acids to omega-3 fatty acids. For these reasons, many studies have compared the prevalence of cardiovascular disease in Inuit population to population with a much lower consumption of omega-3 fatty acids and if it is in fact the omega-3 levels that are responsible for Inuit health. One recent study concluded results similar to those of an older study which focused on the Greenland Inuit. This particular study compared the blood content of obese Inuit people in Alaska among other obese individuals of the same ethnicity. This format was decided due to the similar obesity pattern of this culture in comparison with the lower U.S. population. The blood content of the participants was measured for triglyceride levels, C - reactive protein levels and omega-3 fatty acid levels. The relationship between these factors was measured because

increased levels of triglyceride and CRP (a marker of inflammation) are both thought to be risk factors for the development of heart disease. The omega-3 levels were measured due to their common presence in the diet of this population and their association with lowered risk of heart disease and cardiovascular complications. The relationship discovered was that those who were considered at risk for heart disease due to increased levels of both triglycerides and CRP had much lower concentrations of omega-3 fatty acids in the blood. The inverse was true as well where as those with high omega-3 fatty acid concentrations in the blood had significantly lower concentrations of the two risk factors for heart disease. This discovery could serve as critical findings in that obesity alone is a risk factor for heart disease but increased levels of omega-3 fatty acids in the blood could decrease that risk despite weight. This also suggests that although the U.S. is experiencing an obesity epidemic it may not be the sole reason heart disease is a major leading cause of death in the states outside of Alaska. It supports the idea that maintaining a proper omega-6 to omega-3 ratio can play a significant role in decreasing ones risk for developing cardiovascular disease. (6) Other cardiovascular complications that involve a sudden blockage in the heart stopping blood flow fall in a category known as Acute Coronary Syndrome. (7) A common example of an ACS would be a frequently fatal condition known as a myocardial infarction or heart attack. These, like most cardiovascular disease, are thought to be potentially prevented by a large intake of omega-3 fatty acids from sources such as fish. Traditional Inuit food sources are perfect examples of the dietary intake with a large omega-3 fatty acid concentration. A cohort study was done in order to establish a relationship between Acute Coronary Syndrome risk and omega-3 intake since diet can be considered a modifiable risk factor in the prevention of the condition. The dietary intake was calculated by a food frequency question with twenty four of the one

hundred and ninety two items focusing on seafood consumption. These items were used to break down the recorded intake of omega-3 fatty acids into the individual intake of EPA, DHA and DPA respectively. Aside from the careful measurement of the omega-3 intake of the individual participants, risk factors for congestive heart disease, life style and medical history were also taken into consideration via interviews and questionnaires. The study concluded that the men had a significant inverse relationship between their omega-3 intake and cases of ACS. It was so significant that the men with the highest intake were thought to have as much as a fifteen percent lower risk for ACS. Even when adjusting the findings for risk factors the same association remained between intake and risk. Even individually EPA, DHA and DPA displayed the same relationship to risk/cases of ACS which further supports the benefits of the traditional Inuit diet as all three are consumed in significant quantities. In general a diet high in omega-3 fatty acids is once again proven to be beneficial for cardiovascular health and prevention of disease. (8) Atrial fibrillation is a type of arrhythmia which can lead to a category of cardiovascular disease known as heart failure. (9) It is also another area of research in which omega-3 fatty acids are being looked at as a preventative factor of the condition. One study looked at the relation between the concentration of these fatty acids in the plasma and the risk for AF. The study excluded those who were using fish oil supplements in order to observe the effects of diet specifically since their theory was based on the effect of seafood intake. The results showed a distinct inverse correlation between the incidence of AF and omega-3 concentration in the plasma even when lifestyle and cardiovascular risk factors were taken into consideration. Those with the highest omega-3 plasma concentration where thought to have a twenty five percent lower risk for AF, in turn putting them at lower risk for heart failure. (10) This study perfectly correlates with traditional Inuit practices as seafood high in omega-3 fatty acids make up a

significant portion of the diet, as it was the only source of omega-3 intake in the study. These results can be tied to Inuit diet by a study that measured the direct correlation between the Inuit diet and omega-3 levels in the blood. Carefully constructed food frequency questionnaires were created to focus on traditional Inuit fat intake aside from a more modernized diet. This data was also combined with data from 24-hour recalls by the subjects in order to develop an accurate perception of individual dietary patterns. After the food frequency questionnaires blood samples were taken in order to measure the levels of omega-3 fatty acids in the blood of the over six hundred subjects. The study concluded that the dietary fat intake correlated with traditional Inuit sources, such as fish and mammals, was a major contributing factor to increased levels of omega-3 fatty acids in the blood. Marine mammal intake in particular was found to have a strong effect on the omega-3 fatty acids levels as well. With marine mammal and fish consumption being popular with traditional Inuit practices, it can be concluded from both studies that the Inuit should in fact be at lower risk for conditions such as AF. (11) It seems clearly evident that the consumption of omega-3 rich foods, in particular in such amounts of the traditional Inuit diet, benefits cardiovascular health. Those who follow the traditional Inuit diet are said to have almost an ideal omega-6 to omega-3 ratio which has long been emphasized as a large step in the right direction towards heart health. It is also very impressive that with obesity as such an epidemic in the lower U.S. states and a risk factor for many cardiovascular illnesses, those Inuit or Eskimo people displaying similar obesity rates still showed less risk for heart conditions when omega-3 levels were maintained. Data such as this can help prevent obesity related heart conditions in those who struggle to lose weight but can increase their intake of omega-3 fatty acids. Not only has the omega-3 concentration of the blood been proven to protect against heart conditions such as ACS and AF but, it was proven that the

Inuit diet is directly related to significant increases in these concentrations. This evidence creates a valid argument that the traditional Inuit or Eskimo diet containing frequent consumption of marine mammals and fish has proven benefits when it comes to heart health.

1. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 27 Jan. 2012. Web. 7 Apr. 2012. <http://www.cdc.gov/nchs/fastats/lcod.htm>. 2. Inuit Tapirtiit Kanatami Health Indicators of Inuit Nunangat within the Candian Context 1994-1990 and 1999-2003 Statistics Canada and Health Canadas First Nations and Inuit Health Branch, page 6 July 13, 2010 <http://www.itk.ca/sites/default/files/20100706Health-Indicators-Inuit-Nunangat-EN.pdf > April 7, 2012 3. "Inuit." The Free Dictionary. Farlex, 2009. Web. 7 Apr. 2012. <http://www.thefreedictionary.com/Inuit>. 4. Bohemier, Gerry. "Taking a Closer Look at the Inuit Paradox and Cardiovascular Disease." Natural Health News. 21 Mar. 2008. Web. 7 Apr. 2012. <http://www.naturalnews.com/022868.html>. 5. "The Inuit Diet." Diets in Review. 24 Oct. 2010. Web. 10 Apr. 2012. <http://www.dietsinreview.com/diets/the-inuit-diet/>. 6. Makhoul,Z., Kristal, A.R., Gulati, R., Luick, B., Bersamin, A., OBrein, D., Hopkins, S.E., Stephensen, C.B., Stanhope, K.L., Havel, P.J.B., Boyer Associations of Obesity with Triglycerides and C-Reactive Proteins are Attenuated in Adults with High Red Blood Cell Eicosapentaenoic and Docosahexaenoic Acids European Journal of Clinical Nutrition 2011; 10:1038 7. "Acute Coronary Syndrome." Www.heart.org. American Heart Association, 20 Mar. 2012. Web. 10 Apr. 2012. <http://www.heart.org/HEARTORG/Conditions/HeartAttack/AboutHeartAttacks/AcuteCoronary-Syndrome_UCM_428752_Article.jsp>. 8. Joensen, A.M., Schmidt, E.B.,Dethlefsen, C., Johnsen, S.P., Tjonneland, A., Rasmussen, L.H., Overvad, K. Dietary Intake of Total Marine n-3 Polyunsaturated Fatty Acids, Eicosapentaenoic Acid, Docosahexaenoic Acid and Docosapentaenoic Acid and the Risk of Acute Coronary Syndrome A Cohort Study British Journal of Nutrition 2010;103:602-607 9. "What Is Atrial Fibrillation?" Health.com. Ed. E. Gregory Thompson, MD and John M. Miller, MD. Healthwise, Incorporated, 18 Nov. 2008. Web. 7 Apr. 2012. <http://www.health.com/health/condition-article/0,,20189044,00.html>. 10. Wu, J.H.Y., Lemaitre, R.N., King, I.B., Song, X., Sacks, F.M., Rimm, E.B., Heckbert, S.R., Siscovick, D.S., and Mozaffarian, D. Association of Plasma Phospholipid LongChain Omega-3 Fatty Acids With Incident Atrial Fibrillation in Older Adults of the American Heart Association Circulation 2012;125:1084-1093

11. Lucas, M., Proust, F., Blanchet, C., Ferland, A., Dery,S., Abdous,B., Dewailly,E., Is Marine Mammal Fat of Fish Intake Most Strongly Associated with Omega-3 Blood Levels Among the Nunavik Inuit? Of Elsevier Prostaglandins, Leukotrienes and Essential Fatty Acids 2010;83:143-150