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Diabetes mellitus in Alaskan Yup'ik Eskimos and Athabascan Indians after 25 yr.

OBJECTIVE: To estimate the prevalence of diabetes mellitus and overweight in two populations of Alaska Natives and to compare the results with previous data. RESEARCH DESIGN AND METHODS: Participants' heights, weights, and random plasma glucose levels were determined. Those with a glucose of greater than or equal to 6.72 mM received a follow-up glucose-tolerance test, interpreted by WHO criteria. Overweight was defined by National Center for Health Statistics criteria and also by criteria used in previous studies. The subjects were Eskimo and Athabascan residents greater than or equal to 40 yr of age in 15 villages in southwestern Alaska. RESULTS: Diabetes prevalence was 4.7% for Eskimos and 10.0% for Indians. Among Eskimo men and women, the prevalence of overweight was 34 and 56%, respectively, among Indian men and women, it was 29 and 55%, respectively. Comparisons with past data indicate that the prevalence of diabetes has increased from 1.7% in 1962 for Eskimos and 1.8% in 1969 for Indians. CONCLUSIONS: The prevalence of diabetes appears to have increased among Eskimos and Indians in Alaska. Overweight appears to be a significant problem in both groups.

Alaska↗

THE ESKIMOS OF THE NORTHWEST PASSAGE: A SURVEY OF DIETARY COMPOSITION AND VARIOUS BLOOD AND METABOLIC MEASUREMENTS.

In 1959 and 1960, during the annual survey conducted by the Federal Northern Health Services in the area of the Northwest Passage, the diet and living conditions of some 1500 Eskimos who live in this area were studied and blood and urine samples were obtained from 40-50% of this population. Hemoglobin, blood cell morphology, serum protein-bound iodine, serum proteins, serum lipids and serum total cholesterol estimations, urinalyses, and agglutination studies for brucellosis were carried out. Hemoglobin levels were in the normal range; however, increased contact with civilization appeared to be associated with lower hemoglobin levels. Eleven per cent of the Eskimos showed eosinophilia. Serum proteins were normal. Serum lipids and serum cholesterol levels were higher in Eskimo children living in a government residential school than in a comparable group living on the Barren Lands. Serum protein-bound iodine levels were in the upper euthyroid range. Diabetes mellitus occurs among Eskimos. Sporadic cases of brucellosis also occur.

Adolescent↗

Long bone growth in Western Eskimo and Aleut skeletons.

The pattern of long bone growth in Eskimo and Aleut juvenile skeletons reflects that in living Eskimos and Aleuts. There is a pre-adolescent growth spurt which is particularly intense in females. After age 14 male long bones supercede those of females in length. The characteristic Eskimo and Aleut adult body proportion is established early in childhood. Eskimos and Aleuts have shorter bones than whites at all ages. The difference in length of the forearm and lower leg in comparison with whites appears to increase especially at adolescence.

Adolescent↗

Infanticide and fertility among Eskimos: a computer simulation.

Until recently, certain Eskimo groups were reported to practice female infanticide in the belief that the time spent suckling a girl would delay the mother's next opportunity to bear a son, males being preferred to females because of their future role as providers in a hunting economy. From sex ratios in census data, rates of female infanticide of up to 66% for some groups have been inferred, leading some ethnographers to conclude that these groups were headed for extinction. Eskimo beliefs regarding the effects of infanticide on fertility, however, are in accord with the results of research on the relation of fertility and lactation: The cessation of lactation following infanticide would significantly shorten the expected interval until the next birth. Given this fact and available field data regarding the parameters of Eskimo population growth, the present computer simulation indicates that Eskimo populations could sustain a rate of 30% female infanticide and still survive. Higher reported rates are explained as the combined result of female infanticide plus the tendency of ethnographers to overestimate the ages of juvenile females relative to juvenile males.

Computers↗

Genetic variation in the Aleuts of the Pribilof Islands and the Eskimos of Kodiak Island.

A sample of Aleuts residing in the Pribilof Islands of St. Paul (N = 163) and St. George (N = 62) and Eskimo residents of Kodiak Island (N = 294) have been typed for genetic variation at 31 discrete genetic markers. Of these, 16 were polymorphic and 15 were monomorphic. Several private polymorphisms previously reported in Eskimo or Alaskan Amerindian populations were absent in both the Aleuts and Kodiak Island Eskimos. Genetic distance analysis shows considerable genetic differentiation between Aleuts and Kodiak Island Eskimos.

Alaska↗

Early primary infection and high Epstein-Barr virus antibody titers in Greenland Eskimos at high risk for nasopharyngeal carcinoma.

In a comparative study of populations at high and low risk of nasopharyngeal carcinoma (NPC), sera from 442 Eskimo and 770 Danish children and adolescents were tested for the presence of antibodies against Epstein-Barr virus (EBV). Eskimo children in Greenland were seropositive at an early age and showed significantly higher titers of IgG antibody to the viral capsid antigen (VCA) (p less than 0.0001) and soluble (S) antigen (p less than 0.005) than Danes matched for age and sex, but had similar levels of IgA antibody to VCA and IgG antibody to the early antigen (EA). The high geometric mean VCA (IgG) titers found in certain age groups of Eskimo children were as high as those previously reported from areas in Africa highly endemic for Burkitt's lymphoma. In Greenland, neither location nor household size was a determining factor for prevalence or titer of VCA (IgG). The high antibody titers among Eskimo children probably reflect exposure to a large inoculum of EBV at the time of primary infection, infection early in life and/or re-exposure due to the higher incidence of EBV infection in Greenland. In view of the high incidence of NPC in Greenland and the known association of this tumor with EBV, we speculate that the time and quantitative aspects of the primary infection are also factors of relevance in the etiology of NPC.

Adolescent↗

A unique pattern of apo(a) polymorphism in an isolated east Greenlandic Inuit (Eskimo) population.

Eskimos of the east coast of Greenland very rarely had contacts with Caucasians until late in the 19th century. Their genes are therefore likely to be similar to those in the original Eskimo gene pool. We have compared serum concentrations of Lp(a) and apo(a) phenotypes in 78 East Greenland Eskimos (EGE) with those in Eskimos from Western Greenland (WGE) (n = 100) and Caucasian Danes (n = 466). Lp(a) levels were higher in EGE (median: 11.9 mg/dl [95% CI: 9.1-16.4]) than in Danes (p < 0.01), (median: 6.3 mg/dl [95% CI: 5.5-7.3]) and WGE (p < 0.01), (median: 7.8 mg/dl [95% CI: 5.7-10.2]). Lp(a) concentrations above 30 mg/dl were (p < 0.05) more common in EGE (19%) than in WGE (9%) and similar (p = 0.89) to those in Danes (20%). Apo(a) molecules as small as S2 or smaller (S1, B and F) were present in 26% of Danes and in 3% of WGE but were absent in EGE (p < 0.01). In contrast, a large apo(a) variant (VS4) was present in 54% of EGE and 62% of WGE, whereas it was very rare in Danes (2%). Lp(a) concentrations were inversely associated with apo(a) size in EGE (p < 0.05), WGE (p < 0.01) and Danes (p < 0.01), but EGE with S3 or S4 had significantly higher Lp(a) levels than Danes (p < 0.05) with the same phenotypes.

Adolescent↗

The Eskimo diet. Prophylactic effects ascribed to the balanced presence of natural cis unsaturated fatty acids and to the absence of unnatural trans and cis isomers of unsaturated fatty acids.

In addition to the well recognised roles of eicosapentaenoic acid and possibly docosahexaenoic acid, there are two other major important, but unrecognised, features of the traditional Eskimo staple diet namely that it contains the unsaturated fatty acids (UFA) cis oleic, cis linoleic and cis alpha-linolenic as well as their respective C20 and C22 metabolites in physiologically optimal concentrations and, it is virtually totally devoid of unnatural and potentially hazardous trans and cis isomers of these fatty acids. Large quantities of unnatural trans and cis isomers of UFA are found in the Western diet as partially hydrogenated UFA in many foods. These isomers are formed during the manufacture of margarines and related compounds, as food contaminants during excessive heating of cooking oils for deep-frying and other excessive heat-requiring mass food preparation procedures and it is suggested, as the result of excessive feeding with an unnatural diet of ruminants and non-ruminants for increased meat and/or milk production and of poultry for increased egg and/or meat production. These isomers have been shown to display potentially hazardous metabolic effects which include the competitive inhibition of UFA metabolism at various steps and have been causally implicated in the etiology of ischemic heart disease and cancer. It is suggested that the myth of the safety of trans fatty acids arises from misinterpretation of the observation that increasing dietary cis linoleic acid reduces the toxic effects of trans UFA. It is suggested that the decrease of 20% in the ischemic heart disease mortality in the USA during the past two decades is directly related to a shift in the dietary ratio of unnatural trans and cis UFA isomers: cis linoleic acid in favour of the latter. It is predicted that this ratio will be found to correlate with ischemic heart disease patterns in other countries. Eskimos consume the bulk of their food frozen, raw or dried, seldom boiled, but never deep-fried or after exposure to excessive heat. Moreover the proportionality of cis UFA and their metabolites in their traditional staple diet would render gross tissue UFA utilization relatively independent of desaturase enzyme activity. In the Eskimo tissues these enzymes would function to make the minute, critical UFA metabolic adjustments required to ensure the presence of structural UFA in membranes in functionally optimal quantities and, ensure the synthesis of eicosanoids from dihomogamma-linolenic acid, arachidonic acid and eicosapentaenoic acid in balanced, optimal physiological concentrations for the genetic make-up of Eskimos.(ABSTRACT TRUNCATED AT 400 WORDS)

Dietary Fats↗

Low prevalences of coronary heart disease (CHD), psoriasis, asthma and rheumatoid arthritis in Eskimos: are they caused by high dietary intake of eicosapentaenoic acid (EPA), a genetic variation of essential fatty acid (EFA) metabolism or a combination of both?

The low prevalences of CHD, psoriasis, asthma and rheumatoid arthritis in Eskimos have been attribute to the high dietary intake of EPA from fish and marine mammals. However, even on a Western diet, Eskimos have plasma arachidonic acid (AA) levels far below those seen in Europeans while dihomogammalinolenic acid (DGLA) levels are higher in Eskimos. These low AA and high DGLA levels seem to be due to a genetic abnormality in EFA desaturation since they are found even when EPA intakes are low. Since AA is known to be important in the pathogenesis of CHD, asthma, psoriasis and arthritis, while DGLA has properties which make it of likely therapeutic value in these conditions, the genetically high DGLA and low AA are likely to be as important as dietary EPA in determining Eskimo disease patterns.

Arthritis, Rheumatoid↗

Haemostatic function and platelet polyunsaturated fatty acids in Eskimos.

Death from cardiovascular disease is rare among Eskimos. Haemostasis was investigated in twenty-one Greeland Eskimos and twenty-one age and sex matched Danish controls. Platelet lipid analysis demonstrated that a high consumption of omega-3 polyunsaturated fatty acids (such as cis 5, 8, 11, 14, 17-eicosapentaenoic acid [C20:5]) by Eskimos increased the proportion of omega-3 polyunsaturated fatty acids in the platelets. The Eskimos had a significantly longer bleeding-time due to a reduction in platelet aggregation. It is suggested that C20:5 in the platelets is converted by the vascular-wall tissue to an anti-aggregatory prostacyclin. Partial dietary substitution of arachidonic acid by eicosapentaenoic acid may reduce the incidence of thrombotic disorders, including myocardial infarction.

Adult↗

Carbohydrate and lipid metabolism in the Alaskan Arctic Eskimo.

The effect of a low total carbohydrate low sucrose diet on various parameters of lipid and carbohydrate metabolism was studied among residents of a North Slope Alaskan Eskimo village. For comparative purposes a group of Eskimo youths consuming a higher carbohydrate institutional diet was also stidied. Those Eskimos consuming their native diet had unusually low serum triglycerides and very low density lipoproteins and normal glucose and tolbutamide tolerance tests. Eskimos on a higher carbohydrate diet exhibited significant elevations of triglycerides and minor alterations in glucose tolerance testing. Differences in cholesterol intake between these groups were accompanied by changes in serum cholesterol and low density lipoprotein levels. Unusually high levels of free fatty acids without ketonemia in the North Slope sample were noted as well.

Adolescent↗

Fecal steroids of the coprolite of a Greenland Eskimo mummy, AD 1475: a clue to dietary sterol intake.

BACKGROUND: Sterols in feces reflect sterols in the diet. In previous analyses of the fecal steroids in 1000-2000-y-old Native American coprolites found in the dry caves of Nevada, we showed that the sterol nucleus was stable. The coprolites provided useful dietary information. OBJECTIVE: In the present study, we analyzed the fecal steroids of an Eskimo mummy buried and frozen >500 y ago in Greenland. We compared these analyses with our findings in the coprolites from Nevada and in present-day stool samples from Tarahumara Indians of Mexico and Americans consuming low- and high-cholesterol diets. DESIGN: The fecal material from the Eskimo mummy was subjected to saponification, extraction, and digitonin precipitation. The sterols and bile acids were further analyzed by thin-layer chromatography and gas-liquid chromatography. RESULTS: The fecal steroids of the Greenland Eskimo mummy were remarkably similar to those of present-day stool samples. However, unlike in the stool of modern humans, a portion of the neutral steroids in the coprolite had been converted to sterol epimers. Instead of deoxycholic acid, 3alpha,6beta,12alpha-trihydroxycholanic acid was one of the major fecal bile acids. The plant sterol output in the coprolite was only 0.4% of the output of Americans consuming 250-400 mg plant sterols/d. The ratio of bile acid to cholesterol in the coprolite was similar to that in stool from Tarahumara Indians consuming a low-cholesterol diet. CONCLUSION: The sterol nucleus is stable when frozen. The analysis of coprolite showed that the young Eskimo woman had consumed a diet very low in plant sterols and moderate to low in cholesterol content.

Bile Acids and Salts↗

137Cs concentrations in northern Alaskan Eskimos, 1962-79: effects of ecological, cultural and political factors.

Concentrations of worldwide fallout 137Cs were measured in the lichen-caribou-Eskimo food chain of northern Alaska during the period 1962-79. Pronounced inputs of fallout occurred after major nuclear weapons tests in the atmosphere and 137Cs was transmitted through the food chain to Eskimos with about a 2-yr delay due to environmental parameters. Caribou (Rangifer tarandus) meat sampled during spring harvest contained 4 times the 137Cs concentration of lichens obtained from their winter range. Calculated caribou meat ingestion rates of Anaktuvuk Pass Eskimos during winter ranged from approximately 1 kg/day in 1964 to 0.16 kg/day in 1977. Several environmental factors affected seasonal patterns and amounts of 137Cs transferred through the food chain. Maximum 137Cs concentrations of approximately 20 nCi/kg body weight in ESkimos occurred in 1964 and have now decreased to approximately 0.5 nCi/kg, largely because of cultural and political factors. Radiation doses from 137Cs body burdens during the study period ranged from 60 mrad/yr in 1962 to approximately 140 mrad/yr during the 1962-64 maxima and decreased to 8 mrad/yr in 1979.

Alaska↗

Prediction of 90Sr body burdens and radiation dose in Anaktuvuk Pass Alaska Eskimos due to fallout.

Strontium-90 concentrations in skeletons of Eskimo residents of Anaktuvuk Pass. Alaska during 1954-79 were predicted from two models based on (1) Sr kinetics in human bond and (2) estimated annual 90Sr ingestion rates via caribou meat. Predicted skeletal burdens of adult Eskimos gradually increased through 1961 and then rapidly achieved maximal values during 1964-66, reflecting fallout 90Sr levels in caribou meat which contributed 80-97% of dietary 90Sr intake. Concentrations of 90Sr in male Eskimo bone samples were similar using either model. Predicted values in vertebrae of adult Eskimo males were slightly lower than values reported in New York City adults until 1980 and subsequently declined by 9% per yr, while samples from adults in New York City and San Francisco declined by 6 and 5%, respectively. Predicted skeletal burdens in Anaktuvuk Pass residents born in 1954 and 1959 achieved maxima in 1971 and 1974, respectively; concentration in children born in 1964 were still increasing in 1979 but had achieved a lower level than older age cohorts. Estimated radiation dose rates to adult skeletons during 1964-66 were 13-15 mrad/yr based on predicted vertebrae 90Sr concentrations. Those dose rates were less than or equal to 1% of recommended ICRP limits for general populations.

Adolescent↗

Hemostatic factors and renin in Greenland Eskimos on a high eicosapentaenoic acid intake. Results of the Fifth UmanaK Expedition.

The Fifth UmanaK expedition compared the fatty acid composition of platelets, bleeding times before and after ingestion of acetylsalicylic acid, 24-hour urinary tetranorprostanedioate, creatinine and Na output, as well as plasma renin, serum electrolytes and antithrombin III in 20 Greenland Eskimos and 20 Danes. The results indicate that the prostaglandin production was not inhibited in the Eskimos, and that the antiaggregatory prostanoids predominate in Eskimos compared to Danes. Although blood pressure and 24-hour urinary Na output were similar, the plasma renin level was significantly higher in the Eskimos on a high eicosapentaenoic acid intake.

Adult↗

Mother-child interaction among the Alaskan Eskimos.

This is an exploration of the world of the Yup'ik Eskimos, who live on the Bering seacoast in rural Alaska. The Eskimos have an ancient culture that has survived the harshest of environments. Although geographically isolated, the Eskimos have become increasingly acculturated to the Western culture. The authors studied maternal-child interaction and quality of the home environment in two remote villages and report their experiences, the Yup'ik Eskimo culture, research findings, and implications for nursing practice.

Child↗

Corneal diameter in Greenland Eskimos. Anthropometric and genetic studies with special reference to primary angle-closure glaucoma.

In a population survey the corneal diameter (DC) was measured in 1,211 adult Greenland Eskimos from six districts. Using a Wessely keratometer, trnasversal and vertical readings were performed, and the CD value taken as the average. The unimodal distributions obtained were found to differ from normality. The results suggested a small decrease of CD with age whereas the sex difference (0.2 mm) was highly significant. Geographical variation was found, a West Greenland group (Umanaq) being below the others, while the purest Eskimos (from Angmagssalik) showed higher mean values. A Danish control sample had significantly larger corneae, about 0.5 mm above the Eskimos, and agreed with other reports on Europeans. The CD values and the anterior chamber depth (ACD) were positively correlated. The Eskimo primary angle-closure glaucoma patients showed a slight deviation towards the lower CD classes. The familial CD distributions suggested a mainly genetic determination of corneal size.

Adolescent↗

Prevalence of episcleral and subconjunctival lipid deposits in Eskimos.

Slit lamp examinations of 340 Eskimos in Greenland revealed lipid deposits in 12%. The prevalence was significantly lower than in a Copenhagen series of Caucasians (45% out of 689 subjects) recorded for 10-year age groups. The numbers of lipid deposits seemed to be equal in lipid-positive subjects of the 2 ethnic groups, but the globules were more often localized temporally and more rarely superiorly in Eskimos than in Caucasians. The relatively rare occurrence of lipid deposits in Eskimos may possibly be due to the special composition of lipids on the blood and the rare occurrence of arteriosclerosis in Eskimos.

Adolescent↗