Protecting traditional cultural food practices: Trends in diet quality and intake of ultra-processed foods by Indigenous status and race/ethnicity among a nationally representative sample of adults in Canada

Dana Lee Olstad; Sara Nejatinamini; Rosanne Blanchet; Jean-Claude Moubarac; Jane Polsky; Lana Vanderlee; Katherine M Livingstone; Seyed Hosseini Pozveh

doi:10.1016/j.ssmph.2023.101496

Protecting traditional cultural food practices: Trends in diet quality and intake of ultra-processed foods by Indigenous status and race/ethnicity among a nationally representative sample of adults in Canada

SSM Popul Health. 2023 Aug 22:24:101496. doi: 10.1016/j.ssmph.2023.101496. eCollection 2023 Dec.

Authors

Dana Lee Olstad¹, Sara Nejatinamini¹, Rosanne Blanchet², Jean-Claude Moubarac³, Jane Polsky⁴, Lana Vanderlee⁵, Katherine M Livingstone⁶, Seyed Hosseini Pozveh¹

Affiliations

¹ Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
² Département de Médecine Sociale et Préventive, École de Santé Publique, Université de Montréal, 7101 Avenue du Parc, 3e étage, Montréal, Québec, H3N 1X9, Canada.
³ Département de Nutrition, Faculté de Médecine, Université de Montréal, Pavillon Liliane de Stewart, Montréal, Québec, H3T 1A8, Canada.
⁴ Health Analysis Division, Statistics Canada, 150 Tunney's Pasture Driveway, Ottawa, Ontario, K1A 0T6, Canada.
⁵ École de Nutrition, Université Laval, Québec, Québec, G1V 0A6, Canada.
⁶ Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 1 Gheringhap St, Geelong, Victoria, 3220, Australia.

Abstract

Background: The traditional cultural food practices of Indigenous people and adults from racial/ethnic minority groups may be eroded in the current food system where nutrient-poor and ultra-processed foods (UPF) are the most affordable and normative options, and where experiences of racism may promote unhealthy dietary patterns. We quantified absolute and relative gaps in diet quality and UPF intake of a nationally representative sample of adults in Canada by Indigenous status and race/ethnicity, and trends between 2004 and 2015.

Methods: Adults (≥18 years) in the Canadian Community Health Survey-Nutrition self-reported Indigenous status and race/ethnicity and completed a 24-h dietary recall in 2004 (n = 20,880) or 2015 (n = 13,970) to calculate Healthy Eating Index-2015 (HEI-2015) scores from 0 to 100 and proportion of energy from UPF. Absolute and relative dietary gaps were quantified for Indigenous people and six racial/ethnic minority groups relative to White adults and trends between 2004 and 2015.

Results: Adults from all six racial/ethnic minority groups had higher mean HEI-2015 scores (58.7-61.9) than White (56.3) and Indigenous adults (51.9), and lower mean UPF intake (31.0%-41.0%) than White (45.9%) and Indigenous adults (51.9%) in 2015. As a result, absolute gaps in diet quality were positive and gaps in UPF intake were negative among racial/ethnic minority groups-indicating more favourable intakes-while the reverse was found among Indigenous adults. Relative dietary gaps were small. Absolute and relative dietary gaps remained largely stable.

Conclusions: Adults from six racial/ethnic minority groups had higher diet quality and lower UPF intake, whereas Indigenous adults had poorer diet quality and higher UPF intake compared to White adults between 2004 and 2015. Absolute and relative dietary gaps remained largely stable. Findings suggest racial/ethnic minority groups may have retained some healthful aspects of their traditional cultural food practices while highlighting persistent dietary inequities that affect Canada's Indigenous people.

Keywords: Adults; Diet quality; Ethnicity; Indigenous status; Race; Ultra-processed food.