FNFNES Summary of Key Findings for Eight Assembly of First Nations

FNFNES First Nations Food, Nutrition and Environment Study

Summary of key findings for eight Assembly of First Nations regions 2008-2018

University of Ottawa Université de Montréal Assembly of First Nations NOVEMBER 2019 The first comprehensive study to address gaps in knowledge about 1 TITLE AND METHODS diet, traditional food and environmental contaminants.

Why was FNFNES undertaken? FNFNES: a community-based participatory This is the first comprehensive study to address gaps research project in knowledge about the diet, traditional food and FNFNES is the largest nutrition, food security and food environmental contaminants to which First Nations are safety study conducted in Canada with First Nations. exposed. FNFNES used a standard approach, with identical tools 3 There has been a gap in our understanding of dietary and methodology to conduct a survey of First Nations patterns, nutrition and exposure to contaminants from adults living on reserves in each of the eight AFN regions food because of the exclusion of the First Nations south of the 60th parallel in Canada. To ensure the study population on reserve from other national studies. assessed and represented the diversity of First Nations’ diets, a random sampling strategy was adopted, based on Key objectives included determining: an ecosystem framework that included 11 ecozones. patterns of use of food security status Participating First Nations were involved in the planning traditional and store- of households and implementation of data collection for the five bought foods and principal study components: nutrient intake among w household interviews adults living on reserve w tap water sampling for metals w surface water sampling for pharmaceuticals exposure to chemical kinds and amounts w hair sampling for mercury contaminants in of agricultural, w traditional food sampling for contaminants traditional food and veterinary and human tap water pharmaceuticals present Data collection in surface water bodies on reserve 2008 september to mid-december fall months 2016 First Nations Food, Nutrition and Environment Study — Summary of key findings for eight Assembly of First Nations regions 2008-2018 2 PARTICIPATION ACROSS EIGHT AFN REGIONS 92 First Nations

Location of 2,210 First Nations men average age 6,487 of 45 participants 4,277 women AFN # of # of data community regional average 39% 3% 18% regions FNs households collection reporting back DTW* report release age of 44 50-350km >350km fly-in only 2010 BC 21 1103 2008-09 4 2011 2011 5 2012 MB 9 706 2010 60% 2012 2012 2013 ON 18 1429 2011-12 2014 2014 2015 AB 10 609 2013 2016 2016

>50km 2016 40% NB NL NS PEI 11 1025 2014 (Atlantic region) 2017 2017 2017

SK 13 1042 2015 <50km 2018 2018 2018

service QC & LAB 10 573 2016 centre 2019 2019 *Data training workshop

100% 91% 46 86% 23 4 94% 41 4 5 Pacific Maritime 109 6 Boreal Cordillera 96 4 6 Montane Cordillera 21 92% 4 6 Taiga Plains Almost all adults reported eating 5 10 6 7 Boreal Plains traditional food. 6 7 7 Prairies 62 5 54 3 The types of foods eaten across the 46 15 7 Boreal Shield 5 3 9 11 ecozones were diverse. 5 7 40 9 Taiga Shield 28 7 Hudson Plains There were higher intakes in 7 the western and northernmost 7 20 19 Pacific Maritime(n=486) (n=313) Cordillera Montane Boreal Shield (n=1317) ShieldTaiga (n=272)

Mixedwood Plains Boreal Plains (n=1248) (n=577) Prairies Hudson Plains (n=322) Mixedwood Plains (n=681) Atlantic Maritime (n=1039) Boreal Cordillera (n=80) Cordillera Boreal Taiga PlainsTaiga (n=152) 13 Across ecozones Percentage of participants ecozones. 12 Atlantic Maritime who ate traditional food % (n = no. of adults)

First Nations Food, Nutrition and Environment Study — Summary of key findings for eight Assembly of First Nations regions 2008-2018 First Nations Food, Nutrition and Environment Study — Summary of key findings for eight Assembly of First Nations regions 2008-2018 Average daily intake of traditional food was 61 grams (¼ cup) while Across the regions some adults reported and ecozones, most eating more than 1,000 Calories from traditional food households were grams (4 cups). 35% actively engaged in 55% 40% food harvesting and Pacific 27% production. Maritime 32% 87% 87% Boreal 4% On days traditional 57% Cordillera 9% Daily intake of traditional food (TF) food (TF) was eaten, 57% the intake of almost 61% Montane 2% all nutrients was 52% Pacific Maritime 304 941 Cordillera 28% significantly higher 66% 69% Boreal Cordillera 274 586 while the intake of 7% Percentage of Taiga 62% saturated fat was lower. Plains 26% households 439 1443 Montane Cordillera 4 HARVESTING 47% 44% participating in 8 Boreal 2% 9 Taiga Plains 410 1099 24% any harvesting 4.6% Plains 15% and production 34% Boreal Plains 288 809 26% practices by Food harvesting barriers 1% All adults 34% ecozone Prairies 312 776 mean % of calories from TF Prairies 20% 50% All adults 60% Boreal Shield 393 984 34.6% 95th percentile % of calories from TF 1% Boreal 32% Shield 14% Taiga Shield 285 747 external household level 71% 68% When we excluded those who did not eat traditional food on • industrial activities (forestry, • insufficient resources Taiga 8% Hudson Plains 504 1393 their dietary 24-recall interview (detailed information about all the 49% farming, mining, hydro) to purchase/operate Shield 2% foods and beverages eaten in the previous 24 hours), intakes of TF equipment increased. • recreational activities 68% Mixedwood Plains 210 480 (non-Indigenous harvesters) • lack of a hunter 65% Hudson 2% 12% • government regulations • time Plains Atlantic Maritime 303 1106 6% • climate change (impacting 22% Adults with TF on 24-hour recall availability and lifecycle) 40% 303 981 25.4% mean % of calories from TF 1% hunted All ecozones Mixedwood 32% Adults with TF on 24-hour recall • access issues Plains 47% fished th grams/day 58.4% 95 percentile % of calories from TF • availability of traditional food 33% collected seafood 46% collected plants mean grams of TF Atlantic 20% th 25% 95 percentile grams of TF Maritime 16% planted a garden First Nations Food, Nutrition and Environment Study — Summary of key findings for eight Assembly of First Nations regions 2008-2018 First Nations Food, Nutrition and Environment Study — Summary of key findings for eight Assembly of First Nations regions 2008-2018 5 WELL-BEING, FOOD SECURITY AND DIET

Measures of health continue to show that there remain large Well-being inequities in well-being Overall well-being across regions between First Nations 24 26% said health was very good and the non-Indigenous 55 or excellent population. 48 55 37% physically active 46 55 17% at a healthy weight 19% have diabetes Household food security 60 (type 2 diabetes is more common) 55 40

52% smoke 52 FNFNES measured the financial ability of households 32 on-reserve to purchase store-bought food. Access to 6 28 traditional foods was captured through questions about Percentages of total 27 10 harvest practices, barriers to traditional food use and household food insecurity 11 adequacy and availability of traditional food supplies. 16 26 12 25 22 23 27 8 48% 22 21 of households are food insecure, i.e. they lack economic 29 29 Foods from the traditional food system are currently also 21 20 access Pacific Maritime out of reach for many families. 22 Boreal Cordillera 24 Montane Cordillera 24-60% said that they had run out of Taiga Plains range of food insecurity traditional food before they could by ecozone 47% Boreal Plains 23 35 3-5X higher replenish their supplies Prairies Health status perceptions were household food insecurity compared to general Boreal Shield influenced by location, gender, rates Canadian population (12%) would like to serve traditional food Taiga Shield education, income, weight and Percentage reporting diabetes 77% more often than currently Hudson Plains (data not collected for Boreal Cordillera) diabetic status of participants, Mixedwood Plains Percentage reporting very good and participation in harvesting Atlantic Maritime or excellent health activities.

Grocery costs for High quality The diet of First Nations adults does not meet nutrition a family of four acceptable drinking recommendations. Intake of vitamins A, D and C, folate, water is a basic calcium and magnesium are inadequate. need and important Intakes of many nutrients were significantlyhigher for AB $216 6 ENVIRONMENTAL CONCERNS for limiting use of those able to include some traditional food in their diet maximum $377 $258 sugar-sweetened compared to those who only ate store-bought food. Edmonton $204 $479 beverages.

SK $258 Game meat Fish was a maximum $479 was a key key source of Saskatoon source of iron vitamin D $177 Drinking Water Quality and Safety

Similar to the general Canadian population, intake of MB $240 This study provides a snapshot of the levels of metals Taste and colour of water are two common reasons that sodium were above recommended levels. Reducing maximum $327 typically found in tap waters of houses in First Nation limit the use of drinking water, despite the quality of sodium intake has the potential to decrease the risk of 12 13 Winnipeg $145 communities. drinking water being satisfactory for those metals that can chronic disease. Canned soup was a major source of impact human health. sodium. ON $247 maximum $411 Food costs 1,516 453 29 avoided using tap water for Ottawa $205 25%+ drinking because of the taste and 30% 1.9% other aesthetic values households that exceedances for exceedances for In all regions, food costs were higher for communities QC $262 had drinking metals that affect metals of human outside major urban centres. A healthy food basket maximum water tested taste and colour health concern remains far out of reach for many communities with food $336 costs often two to three times higher in communities Montréal $196 FNFNES The common issues identified are usually associated with regional the aesthetic or taste of the water. Regular maintenance more than 50 km away from a major urban centre. Costs average and improvement of the water treatment and/or delivery were even higher in fly-in communities. Atlantic 3 lead $221 Maximum cost system need to be implemented to improve the quality of Insufficient employment and wages relative to food per region maximum $238 24 uranium the drinking water supply. Some First Nation communities costs, and insufficient availability or access to traditional Halifax Major urban need to continue flushing their water before use to food systems are key contributors to high levels of food $220 centre 1 arsenic reduce the lead levels. Lead pipes need to be replaced in insecurity. households with elevated lead levels in drinking water. Grocery costing only undertaken after data collection in BC was completed 1 selenium

These pharmaceuticals were found in surface water in 10% In three First Nations in Ontario and one in Quebec, caffeine levels were 14 trace metals of human persistent 15 or more of communities. present at surface water sites in amounts elements health concern organic exceeding Australian and Californian pollutants Pharmaceutical no. of communities First Nations guideline levels. caffeine 57 In two First Nations in Ontario, 17 atenolol 28 alpha-ethinylestradiol exceeded the Traditional food contaminant analyses BC guideline set to protect aquatic life. 2,062 cotinine 28 Levels found could affect the fertility of food samples collected* First Nations some fish. metformin 27 To evaluate if there was any health risk of exposure at representing These pharmaceutical results point to potential the levels of the contaminants found in traditional food, carbamazepine 18 250 sewage contamination. The concentrations of other contaminant intake was compared to Health Canada foods sulfamethoxazole 15 pharmaceuticals in the FNFNES study would not pose a guidelines for the protection of health. cimetidine 15 threat to human health or the aquatic environment. One Based on current consumption patterns, the risk of would have to drink hundreds of glasses of water per day exposure to contaminants through traditional food is naproxen 13 from these surface water sites for a prolonged period to negligible for most adults. Where some traditional samples were not collected from acetaminophen 13 experience health effects. At the ecozone level, adults eating at the upper level a community, contaminant levels in traditional food found Most FNFNES results are lower than those found in other of intake (95th percentile) may have an elevated risk of in the same ecozone or region were used instead. clarithromycin 10 surface waters and wastewater studies in Canada, the exposure to cadmium, lead and mercury. ketoprofen *by local hunters or fishermen and/or obtained from household freezers and 10 United States, Europe, Asia and Central America. analysed.

52.5% of respondents 972 men 3,404 total 2,432 This study offers for the first time a Traditional food access does not Traditional food is safe for women 1 body of coherent evidence on the 4 meet current needs. Over half of 6 consumption, with two primary human dimension of the ongoing all adults reported that harvesting exceptions: Adults who volunteered to have hair sampled and tested for mercury environmental degradation affecting traditional food is impacted by First Nation citizens and communities. industry-related activities, as well as w Large predatory fish (such as climate change. walleye and northern pike) in 2 micrograms/gram in hair for Traditional food systems remain some areas have higher levels Elevated Health Canada women of childbearing age risk of Key traditional food mercury guideline 6 micrograms/gram in hair for 2 foundational to First Nations. 5 Generally preferred to store-bought of mercury, and some women of exposure Ecozones high in metals adult males and women aged 51+ 16 food, traditional food is of superior childbearing age have elevated 17 Traditional food has multiple core nutritional quality, and its inclusion levels of exposure, particularly Boreal Cordillera Organ meats1 Cadmium 3 values for First Nations. These include significantly improves diet quality. in the northern parts of Taiga Plains (kidney, liver) Mercury body burden 95.5% is below established cultural, spiritual and traditional Saskatchewan, Manitoba, Ontario had mercury guidelines of 6 values, along with enhanced nutrition and Quebec. micrograms/gram Boreal Plains Animals and birds levels below 2 and health, food security, ways of Lead micrograms/gram in hair in all regions w The use of lead-based ammunition Prairies contaminated with lead- except Québec knowing and an ongoing connection Montane Cordillera containing ammunition2 to land and water. resulted in very high levels of lead in many harvested mammal and Women of childbearing age and older individuals (51+) bird samples. As a result, there Mercury Boreal Shield Walleye, Northern pike, enhanced nutrition is an elevated risk of exposure to Taiga Shield trout3 living in northern ecozones tend to have a higher mercury and health exposure that exceeds Health Canada’s guidelines. cultural lead for some adults and women core food security Traditional spiritual of childbearing age. Use of Community-based/intervention studies in northern values ways of knowing food traditional other forms of ammunition can ecozones may be beneficial to investigate the prevalence ongoing connection eliminate exposure to lead. 1. Adults who are heavily reliant on organ meats may have an elevated risk of of higher mercury exposures and to provide coherent risk to land and water exposure, especially among those who are also smokers. communication and nutrition advice on the importance of 2. An elevated risk of exposure, due to lead-containing ammunition, was estimated for adults who are heavily reliant on traditional food. traditional food and on how to reduce mercury exposure. 3. An elevated risk of exposure to mercury from traditional food was seen The findings suggest that sources of mercury include both among some women of child-bearing age. locally harvested fish as well as commercial fish.

Beyond addressing individual and These findings highlight the need household barriers to accessing to continue to build upon current high quality foods from both market efforts at the community, regional, Many First Nations face the The current diet of many First There continue to be issues and traditional food systems, it is provincial and national levels to challenge of extremely high rates Nation adults is nutritionally with water treatment systems in 7 9 11 The authors of this study urge imperative to reduce threats to improve food security and nutrition of food insecurity. Overall, almost inadequate, which is strongly tied to many communities, particularly the health of ecosystems and the in First Nations through a social half of all First Nation families have food insecurity and limited access to exceedances for metals. Metals can governments and decision- quality and availability of traditional determinants of health approach. difficulty putting enough food on healthy food options. affect colour and taste, which limit makers to urgently address food. Over half of all adults reported the table. Families with children are the acceptability and use of tap systemic problems relating that harvesting was impacted by Indigenous priorities and values affected to an even greater degree. The health of many First Nation adults water for drinking. industry-related activities, as well need to be recognized and included to food, nutrition and the 10 is compromised with very high rates as climate change. First Nations within relevant frameworks that The price of healthy foods in many of smoking, obesity (double the Pharmaceutical residues were found 18 environment affecting First reported that they have a limited affect decisions around land use, 19 8 First Nation communities is much obesity rate among Canadians), and 12 in surface waters in and around many Nations, and to do so in a manner ability to affect decisions relating to conservation, habitat protection, and higher than in urban centres, and is with one-fifth of the adult population communities, indicating potential that supports First Nations-led natural resource management and the access to high quality and sufficient therefore beyond the reach of many suffering from diabetes (more than sewage contamination. foods available for purchase within a traditional food. families. double the national average). leadership and solutions. community.

Almost half of all obesity limited First Nation diabetes acceptability families have and use of tap water difficulty colour and taste affected for drinking putting by metals enough food 2X rate of on the table. Canadians

New mechanisms need to be co-developed with First Nations to address Develop pan-Canadian programming weaknesses in current policy and program approaches, in order to: Support communities to Ensure good drinking water increase their reliance on the for the safe and affordable quality and trust in safety of Close gaps in nutrition and Improve families’ financial ability to Support sustainable and traditional food system replacement of lead-based public water systems ammunition and fishing weights. food (in)security purchase healthy market food and to healthy lifestyles Recognize and include Indigenous In order to promote the use of regular engage in local harvesting and food Improve access to the traditional values and priorities in all federal, (tap) water over sugar-sweetened production activities. The high levels of smoking, obesity Develop region and ecozone food system through a combination provincial and local government beverages, concerns about the taste and diabetes reflect inequities in with respect to land use, specific advisories and guidance of subsidies that support harvesting, decisions that would and/or appearance of drinking Continue monitoring nutrition access to health-woriented food and development, conservation, habitat for fish consumption growing, sharing, and preservation. promote the importance of fish in water need to be addressed. and food insecurity, and create built environments (e.g. walkability, protection, with intention to maintain diets, but would also inform sensitive appropriate mechanisms to establish recreational opportunities), and or enhance access to and availability Regular maintenance and inspection Improve local availability and access populations such as women of accountabilities in progress and sufficient community prevention of high quality traditional food. programs of water treatment and/ to healthier foods independent childbearing age (WCBA), about reporting. and health service delivery options. 20 or delivery systems need to be 21 of imports (gardens, greenhouses, decreasing exposure to mercury. hydroponic units, agricultural Additional investments are needed Recognize First Nations priority implemented to improve the quality Monitor the effectiveness of food for communities to provide a to harvest in preferred areas of the drinking water supply. activity and animal husbandry when rights First Nations WCBA living in northern access programs for First Nations in healthier environment and culturally to meet food needs, and minimize appropriate). ecozones in Saskatchewan, Manitoba, curbing food insecurity. appropriate and safe primary and compensate any potential Lead pipes need to be replaced in Ontario and particularly Quebec prevention, acute and chronic disease infringements on these rights to communities with elevated lead levels Reduce food price differences would benefit from management. harvest. sustained public in drinking water. between major urban centres and health risk-benefit communication by increasing local First Nations efforts aiming to promote the Ensure support by all levels of community eligibility for subsidy importance of continued reliance on government to monitor, protect and programs (such as Nutrition North) fish as a food source, while decreasing ensure local ecosystems are healthy and providing financial support exposure to environmental mercury. to increase First Nation operated and can support First Nations ability and owned food production and to access sufficient traditional food. distribution businesses/organizations. Develop a long-term nation-wide traditional food contaminant monitoring program.

Ensure that pharmaceuticals are not present More information and in levels potentially harmful to humans or Full Draft Comprehensive Summary Report: animals www.fnfnes.ca Develop pan-Canadian guidelines and a monitoring program for the protection of aquatic, land and human health to avoid unnecessary exposure to pharmaceuticals If you have any questions about these results or the and other contaminants. project itself, please contact: Lynn Barwin, FNFNES National Coordinator Develop detailed planning for appropriate sewage (613) 562-5800, x7214 waste treatment and disposal. [email protected]

Ensure support for the return or proper disposal of 22 unused or expired prescription drugs and medications Funding for this study was provided by the First Nations as an alternative to flushing them down the toilet or Inuit Health Branch (formerly of Health Canada), throwing them into the regular garbage. Indigenous Services Canada. The information and opinions expressed in this publication are those of the authors/researchers and do not necessarily reflect the official views of the Department of FNIHB.

Thank you to all the participants and contributors!

First Nations Food, Nutrition and Environment Study — Summary of key findings for eight Assembly of First Nations regions 2008-2018 FNFNES PARTICIPATING COMMUNITIES

Kitsumkalum First Nation Wauzhushk Onigum Nation Elsipogtog First Nation Hagwilget Village Kitchenuhmaykoosib Inninuwug First Pictou Landing First Nation Tahltan First Nation Nation (Big Trout Lake) We'koqma'q First Nation Iskut First Nation Kingfisher Lake First Nation Potlotek First Nation Witset First Nation Webequie First Nation Eskasoni First Nation Tsay Keh Dene Nation Fort William First Nation Membertou First Nation Tl'azt'en Nation Marten Falls First Nation Miawpukek First Nation Lake Babine Nation Batchewana First Nation of Ojibways Fond du Lac Denesuline First Nation Fort Nelson First Nation Sagamok Anishnawbek First Nation Black Lake Denesuline First Nation Prophet River First Nation Atikameksheng Anishnawbek Lac La Ronge Indian Band Doig River First Nation Fort Albany First Nation Pelican Lake First Nation Saulteau First Nations Attawapiskat First Nation Onion Lake Cree Nation Skidegate Nation Moose Cree First Nation Ahtahkakoop Cree Nation Nuxalk Nation Garden River First Nation Shoal Lake Cree First Nation Namgis First Nation Aamjiwnaang First Nation James Smith Cree Nation Tla'amin Nation Munsee-Delaware Nation The Key First Nation Samahquam First Nation Six Nations of the Grand River Muskeg Lake Cree Nation Douglas First Nation (Xa’xtsa) Mohawk Nation at Akwesasne Beardy's and Okemasis First Nation Lil'wat Nation Dene Tha' First Nation Mosquito, Grizzly Bear's Head, Lean Man Lower Nicola Indian Band Little Red River Cree Nation First Nation Splatsin First Nation Horse Lake First Nation White Bear First Nation Swan Lake First Nation Driftpile First Nation Naskapi Nation of Kawawachikamach Sandy Bay Ojibway First Nation Mikisew First Nation Whapmagoostui First Nation Pine Creek First Nation Whitefish Lake #128 (Goodfish Lake) The Crees of Waskaganish First Nation Chemawawin Cree Nation Wesley First Nation Montagnais de Unamen Shipu Sagkeeng First Nation Chiniki First Nation La Nation Anishnabe du Lac Simon Hollow Water First Nation Louis Bull First Nation Cree Nation of Mistissini Cross Lake Band of Indians Ermineskin Cree Nation Mohawks of Kahnawá:ke Sayisi Dene First Nation Woodstock First Nation Odanak First Nation Northlands Denesuline First Nation Saint Mary's First Nation Micmacs of Gesgapegiag Asubpeeschoseewagong Netum Eel Ground First Nation Listuguj Mi'gmaq First Nation Anishinabek (Grassy Narrows) Esgenoôpetitj First Nation