Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, 209 Human Ecology Building, Winnipeg, MB, R3T 2N2, Canada.
Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Can J Public Health. 2022 Jun;113(3):374-384. doi: 10.17269/s41997-021-00580-x. Epub 2022 Jan 11.
The Truth and Reconciliation Commission includes a call to action to close gaps in health outcomes, including type 2 diabetes, of which diet quality must be considered an important mediator. The objectives of this study were to compare diet quality between off-reserve Indigenous and non-Indigenous adults in 2004 and 2015, and examine food security as a predictor of diet quality.
We employed a repeated cross-sectional design using the 2004 and 2015 Canadian Community Health Surveys-Nutrition. Both surveys include a representative sample of the Canadian population in the 10 provinces, excluding the northern territories and people living on-reserve. Healthy Eating Index (HEI) values were estimated, using 24-hour dietary recalls, for the Indigenous and non-Indigenous population in each time period. After matching, a generalized linear model was applied to test for differences in HEI between groups across time period, adjusting for household food security.
Overall, HEI scores were not significantly different for Indigenous men and women in 2015 as compared with 2004, but continued to be lower compared with those of the non-Indigenous population. Indigenous adults reported significantly lower diet quality independent of food security status and other factors. Scores pertaining to percent energy from 'other' foods improved in 2015 compared with 2004.
Dietary disparities persist between Indigenous and non-Indigenous populations. While addressing household food insecurity among Indigenous populations is necessary to improve diet quality, it is not sufficient. Results suggest that factors other than food insecurity and socio-economic status are impacting disparities in diet quality among Indigenous adults.
真相与和解委员会呼吁采取行动，缩小健康结果差距，包括 2 型糖尿病，而饮食质量必须被视为一个重要的调节因素。本研究的目的是比较 2004 年和 2015 年非保留地原住民和非原住民成年人的饮食质量，并研究粮食安全状况对饮食质量的预测作用。
我们采用了重复的横断面设计，使用了 2004 年和 2015 年加拿大社区健康调查-营养。这两个调查都包括了加拿大 10 个省份的代表性人群样本，不包括北部地区和保留地的居民。利用 24 小时膳食回忆法，对每个时期的原住民和非原住民人口的健康饮食指数（HEI）值进行了估计。在匹配后，应用广义线性模型来检验不同时期不同群体之间的 HEI 差异，同时调整家庭粮食安全状况。
总体而言，2015 年原住民男性和女性的 HEI 得分与 2004 年相比没有显著差异，但仍低于非原住民人口。独立于粮食安全状况和其他因素，原住民成年人的饮食质量明显较差。与 2004 年相比，2015 年“其他”食物能量百分比的得分有所提高。
原住民和非原住民人群之间的饮食差异仍然存在。虽然解决原住民家庭的粮食不安全问题对于改善饮食质量是必要的，但这还不够。结果表明，除了粮食不安全和社会经济地位之外，还有其他因素影响着原住民成年人的饮食质量差异。
