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Childhood Diet in Relation to Sa´Mi and Norwegian Ethnicity in Northern and Mid-Norway – the SAMINOR Study

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Childhood Diet in Relation to Sa´Mi and Norwegian Ethnicity in Northern and Mid-Norway – the SAMINOR Study Public Health Nutrition: 11(2), 168–175 DOI: 10.1017/S1368980007000432 Childhood diet in relation to Sa´mi and Norwegian ethnicity in northern and mid-Norway – the SAMINOR study M Brustad1,*, CL Parr2, M Melhus1 and E Lund1 1Centre for Sa´mi Health Research, Institute of Community Medicine, University of Tromsø, N-9037 Tromsø, Norway: 2Institute of Basic Medical Sciences, Department of Biostatistics, University of Oslo, Oslo, Norway Submitted 6 December 2006: Accepted 27 March 2007: First published online 5 July 2007 Abstract Objective: The purpose of this work was to identify dietary patterns in the past using cluster analysis of reported diet in childhood, and to assess predictors for dietary patterns in relation to ethnicity in the population in the Sa´mi core areas in Norway. The Sa´mis are an indigenous population living in the border areas of Norway, Sweden, Finland and Russia. Design: Population-based, cross-sectional study, using self-administered ques- tionnaires. A food-frequency questionnaire covering selected food items eaten in childhood was used. The questionnaire also provided data on ethnicity. Subjects and setting: This study was based on data collected from 7614 subjects participating in The Population Based Study of Health and Living Conditions in Areas with a Mixed Sa´mi and Norwegian Population (the SAMINOR study) who grew up in the SAMINOR geographical areas, i.e. areas with mixed Sa´mi and Norwegian populations in Norway. Results: Four dietary clusters were identified: a reindeer meat cluster; a cluster with high intakes of fish, traditional fish products and mutton, in addition to food sources from the local environment; a Westernised food cluster with high intakes of meat balls and sausages; and a cluster with a high intake of fish, but not any Keywords Sa´mi people other foods in the questionnaire. The cluster distribution differed by ethnicity, but Diet the effect of ethnicity on diet differed by coastal and inland residence. Indigenous Conclusion: Our study has shown that data gathered through the limited ques- Traditional food tionnaire could be used to group the study sample into different dietary clusters, Ethnicity which we believe will be useful for further research on relationships between diet Cluster analysis in childhood and health in the Sa´mi core areas in Norway. SAMINOR The Sa´mi people are an indigenous population con- foods, has been negatively associated with dietary change stituting an ethnic minority in Norway. Only a few recent towards a more ‘modern’ dietary pattern among Arctic studies have investigated diet in the population living in populations7,8. Therefore, rapid dietary change towards the Sa´mi core areas in Norway and these studies are decreased use of traditional foods and its impact on based on rather small sample sizes1–4. Dietary assessment health are of special concern7,9. studies among indigenous peoples, mainly from Arctic No former comprehensive nutritional epidemiological North America, have shown that indigenous traditional study has been carried out in the Sa´mi areas of Norway on food with its high nutrient density constitutes an impor- diet in relation to ethnicity. Significantly lower incidence tant source of essential nutrients, in addition to having rates of cancer in colon, breast, lung and prostate have social and cultural benefits5. For Inuit women living in been found in the Sa´mi people in Norway compared with Nunavik, northern Quebec, Canada, Blanchet et al.6 the regional reference population10. Both genetic11 and found that although market food contributed most to the lifestyle factors including diet and physical activity10 have women’s energy intake, 40% of the intake of several been proposed as possible explanations for the observed nutrients including protein, vitamin D, phosphorus and differences. zinc was derived from traditional food. Furthermore, low Diet in childhood has been proposed to affect adult intakes of some nutrients have been observed to risk of some health outcomes and may be an important accompany a reduction in the consumption of a tradi- parameter among several lifestyle factors that serve as tional diet. In particular, the intake of vitamin D, which is predictors for cancer risk12. However, little is known found in high concentrations in a limited number of about the dietary intake in childhood of adult and elderly *Corresponding author: Email [email protected] r The Authors 2007 Downloaded from https://www.cambridge.org/core. 26 Sep 2021 at 18:52:07, subject to the Cambridge Core terms of use. Childhood diet in the SAMINOR study 169 Sa´mi living today. Most of our knowledge about the diet of Norwegian Sa´mi in the past is limited to ethnographic and historical descriptions of food use. In the 1960s a number of quantitative assessments of diet were under- taken in communities with a concentrated Sa´mi popula- tion, but the studies were small and ethnicity not always recorded13–15. Thus, the development of methods for assessing childhood diet are needed and can be of great value in further research on predictors for cancer risk in the Sa´mi population. The purpose of the present work was to identify dietary patterns in the past using cluster analysis of reported diet in childhood in the population living in the Sa´mi core areas in Norway. We also investigated predictors of diet- ary patterns, including ethnicity, geographical residence in childhood (coast or inland), age, gender and boarding school attendance, and whether the diet has been subject to dietary change. Method The SAMINOR study This paper is based on data from The Population Based Study of Health and Living Conditions in Areas with a Mixed Sa´mi and Norwegian Population (the SAMINOR study), which has been described in detail elsewhere16. The overall aim of the SAMINOR project has been to Fig. 1 Municipalities investigated in the SAMINOR study. study health and diseases in relation to living conditions Finnmark county: Karasjok, Kautokeino, Porsanger, Tana, among the Sa´mi population and compare them with the Nesseby, Lebesby, Alta, Loppa, Kvalsund. Troms county: Norwegian population in the same area. The SAMINOR Ka˚fjord, Kvænangen, Storfjord, Lyngen, Ska˚nland og Lavan- study was conducted by the Centre for Sa´mi Health gen. Nordland county: Tysfjord, Evenes and parts of Hattfjell- dal, Grane and Narvik. Nord Trøndelag county: Røyrvik and Research, Institute of Community Medicine at the Uni- parts of Namskogan and Sna˚sa. Sør Trøndelag county: part of versity of Tromsø. The administration and data collection Røros for the study were carried out in collaboration with the National Health Screening Programme, now incorporated municipalities with an overall lower proportion of sub- in the Norwegian Institute of Public Health. The data jects with Sa´mi ethnicity. Altogether, 24 municipalities, collection for the SAMINOR study was carried out in 2003 often referred to as the core area for Sa´mi settlement, and 2004. Biological samples (blood samples), physical stretching from mid-Norway to the Russian border in measures (blood pressure, pulse recording) and anthro- northern Norway were included in the survey. Figure 1 pometric measurements were gathered in addition to shows the geographical areas referred to as the SAMINOR questionnaire data on social conditions, ethnicity, area in the text. self-reported physical and mental health, and diet in childhood and today. The questionnaires were self- administered and machine-readable. Sample Everyone in the defined SAMINOR area (Fig. 1) aged 36–79 years was initially invited to participate in the Geographical area SAMINOR study, some 27 151 subjects in total. The initial The SAMINOR study was conducted in geographical questionnaire was completed by 16 404 individuals with a areas of Norway with a mixed Sa´mi/Norwegian popula- response proportion of 60.4%. Questions on diet and tion. The study intended to cover all municipalities in residence during childhood were asked in an additional Norway where more than 5–10% of the population questionnaire having 13 419 respondents (49.4%). Among reported themselves as Sa´mi in the 1970 census17, based these respondents, 174 subjects had missing on the on the definition of Sa´mi as a person with at least one questions on diet in childhood, thus leaving 13 245 grandparent with Sa´mi as the spoken home language. In (48.8%) subjects with data on childhood diet. Our ana- addition, some selected districts were included from lyses were further restricted to the 7631 subjects who Downloaded from https://www.cambridge.org/core. 26 Sep 2021 at 18:52:07, subject to the Cambridge Core terms of use. 170 M Brustad et al. lived in the SAMINOR area in their childhood (7–14 of the questionnaire, it was difficult to estimate reason- years), based on self-reported residence. Subjects with able consumption frequencies as wild foods are seasonal missing data on ethnicity (n 5 16) or immigrants (n 5 1) and may be eaten irregularly. The remaining foods had were excluded from the analysis. Thus, the final sample the response options of ‘never’, ‘1–11 per year’, ‘1 per size of the present study was 7614. month’, ‘2–3 per month’, ‘1 per week’, ‘2 per week’ and ‘$3 per week’. Participants were also asked about their intake of cod-liver oil supplements (yes/no) and fresh Ethnicity cod-liver oil served with food. The final question was ‘Is In Norway, no systematic registration of ethnicity is the food you eat now different from what you got during available for research purposes, except for the last census childhood?’, with response options of ‘no’, ‘slightly dif- in 197017. To capture ethnicity (Norwegian, Sa´mi, Kven or ferent’, ‘quite different’ and ‘very different’. ‘other’), the SAMINOR study included questions on the language used at home by the grandparents, parents and Statistical analysis the subject, in addition to the ethnic background of the SAS statistical software, version 9.1 (SAS Institute), was parents and the subjects, and also a question on self- used for statistical analysis.
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