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Food patterns, shopping habits and food beliefs of Indian families on selected isolated and non-isolated… Stepien, Yolanda Z 1978

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FOOD PATTERNS, SHOPPING HABITS AND FOOD BELIEFS OF INDIAN FAMILIES ON SELECTED ISOLATED AND NON-ISOLATED RESERVES IN BRITISH COLUMBIA by YOLANDA Z. STEPIEN B.Sc, Simon Fraser University, 1970 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE in THE FACULTY OF GRADUATE STUDIES (Division of Human Nutrition, School of Home Economics) We accept this thesis as conforming to the required standard THE UNIVERSITY OF BRITISH COLUMBIA October, 1978 © Yolanda Z. Stepien, 1978 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of Brit ish Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the Head of my Department or by his representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. Department of The University of British Columbia 2075 Wesbrook Place Vancouver, Canada V6T 1W5 Date Qd II jit ABSTRACT Recent reports indicate that the nutritional status of native Indians is poorer than that of the general population. The culture of native Canadians is currently in a state of transition, with many factors affecting traditional l i f e patterns, producing rapid changes in li f e s t y l e s . The present study was undertaken in order to gain f u l l e r understanding of those problems related to food intake and the influence of social and cultural factors. By use of a 24-hour rec a l l , the nutrient content of diets of 144 individuals living at three reserves adjacent to urban centres was compared with diets of 105 individuals at four relatively isolated Indian reserves. Interviews were conducted with 92 women from the seven reserves and information regarding food beliefs, shopping habits, meal planning, food practices, as well as selected socio-economic and family variables, was collected. In addition, data on food prices and foods available in local stores was gathered. Analysis of nutrient intake data showed that low intakes were frequent for calories, calcium, iron and vitamin C. Low caloric intakes were observed for adolescents and most adults, regardless of reserve location. Calcium intakes were lowest on isolated reserves, while iron status was i i i poorest in non-isolated communities . Vitamin C intakes on isolated reserves were considerably lower than on non-isolated reserves. Rank correlation coefficients using Kendall's tau beta demonstrated that several independent variables were related to the dependent variable, food practices of the female household head. These included the location of the reserve, education of respondents, the women's attitudes toward" nutrition, household size, and the level reached on the household f a c i l i t i e s scale. The most significant factor related to food consumption was isolation (p<.001), with diets in urban areas being more adequate than those in • rural areas. Overall food selection was poorest in isolated reserves, notably Babine and Fort Ware. The items most often in short supply were dairy products, fresh meats and fresh fruits and vegetables. Food costs were also highest in the most isolated reserves. It was concluded that food practices of native Indians are poorer at isolated reserves than at those adjacent to urban centres. Indications are that this is a consequence of the interaction of a number of factors: high food prices, poor selection, unemployment, inadequate housing and house-hold f a c i l i t i e s , depleting natural food resources, a lack of food/nutrition information, as well as a lack of involvement in health-related programmes. iv ACKNOWLEDGEMENTS My most sincere thanks are extended to my research director Dr. Melvin Lee, for his guidance and encouragement throughout the course of this study; Dr. Harriet Kuhnlein for her enthusiasm and advice with the thesis preparation; and Dr. Tom Abernathy for his advice with the s t a t i s t i c a l analysis and thesis preparation. I am grateful to the personnel of the Pacific Region, Medical Services Branch, Department of National Health and Welfare, and in particular to Dr. Pyper, Dr. Habgood, Dr. Murie and Dr. Butler for their assistance in selecting the reserves and in execution of the study; with a special thanks to Public Health Nurses Ruby Siemens and Maxine Ingles, CHR Joyce White and nutritionist Karen Loose for their advice and assistance; the Community Health Represen-tatives who accompanied us on the reserves and introduced us to the people, along with the Indian chiefs, councillors and band members from the reserves; and Dan for his cheerful encouragement throughout the course of this project and his help in the thesis preparation. And most importantly, I would like to thank the women and other residents of the reserves who so patiently answered a l l the questions, making this study possible. V TABLE OF CONTENTS Page ABSTRACT t i i ACKNOWLEDGEMENTS iv LIST OF TABLES . v i i LIST OF FIGURES x Chapter I INTRODUCTION 1 II REVIEW OF THE LITERATURE 7 Pricing and food buying practices 7 Food ideology and beliefs 13 Food habits of native Indians 18 III MATERIALS AND METHODS 24 Population and Sample 24 Description of Reserves 28 Description of Sample Population 4-5 Data Collection and Analysis 51 1. Questionnaire 51 2. Food practices 53 3. Food pricing and food availability 55 Statistical Analysis 56 IV RESULTS 60 Food patterns 60 A. Analysis of nutrient intake data . . . . 60 B. Food frequencies 81 Food ideology 90 A. Food beliefs of homemakers 90 B. Food beliefs as related to pregnancy, lactation, infancy and illness 92 Shopping practices 97 Meal planning and preparation 104-Food practices of homemakers 113 A. Food scores 113 B. Relationship betvzeen food practices and selected variables 117 v i Chapter'. Page Food pricing and food availability ,123 V DISCUSSION AND IMPLICATIONS 126 VI SUMMARY AND CONCLUSIONS 149 BIBLIOGRAPHY 154 APPENDICES A. Questionnaire 165 B. Scoring system for food practice test 176 C. Food l i s t used for food pricing and food availability 178 D. Table VII-3: Daily nutrient intakes of a l l children and adolescents compared to median intakes of the Nutrition Canada Survey 183 Table VII-4: Daily nutrient intakes of a l l adults compared to median intakes of the Nutrition Canada Survey 184 Table IX-2 to IX-7: Percentage contributions of food groups to calories and nutrients for each age and sex category 185 Legend to Appendix E 191 E. Raw Data — Individual nutrient values calculated from 24-hour dietary recalls for subjects from the seven reserves 192 v i i LIST OF TABLES Page Table I Indian reserves in British Columbia involved in the study 27 II Age distribution of sample population 46 III Household characteristics of sample population 47 IV Education level attained by family heads of household 49 V Occupation of household heads 50 VI Distribution of family income 51 VII-1 Daily nutrient intakes of children and adolescents from isolated and non-isolated reserves 61 VII-2 Daily nutrient intakes of adults from isolated and non-isolated reserves 62 VIII Number of individuals, by age and sex, with daily nutrient intakes less than two-thirds of the Canadian Dietary Standards , 63 IX-1 Percentage contribution of food groups to calories and nutrients ( a l l ages). 64 X Frequency of consumption of specific food items by isolation 82 XI-1 Sample daily menus, taken from dietary re c a l l forms collected on "isolated reserves" 88 v i i i Page Table XI-2 XII XIII XIV XV XVI XVII XVIII XIX XX XXI . XXII XXIII Sample daily menus, taken from dietary re c a l l forms collected on "non-isolated" reserves 89 Number of women who listed a food group as important in the diet and gave a valid nutritional reason for i t s importance 91 Percentage of women indicating specific foods as beneficial or harmful during pregnancy 93 Percentage of women indicating specific -foods as beneficial or harmful during lactation 94 Percentage of women indicating specific foods as beneficial or harmful during infancy 95 Percentage of women indicating specific foods as beneficial or harmful during illness 96 Type of store where majority of food shopping is done 98 Reasons for selecting store 99 Frequency of shopping for major and minor food purchases 99 Person who does majority of food shopping 101 Food-shopping requests of children.. 101 Frequency of selected shopping practices 102 Distribution of monthly food expenditure 103 ix Page Table XXIV Changes in food buying with increasing food prices 104 XXV Factors identified by respondents as influencing foods purchased 105 XXVI Person who does majority of cooking.... 106 XXVII Use of and frequency of meal plans 107 XXVIII Household f a c i l i t i e s 107 XXIX Food and cooking education of respondents 108 XXX Sources of nutrition information identified by respondents 109 XXXI Use of vitamin and mineral supplements. H I XXXII Traditional food patterns 112 XXXIII Food practice scores achieved by respondents H4-XXXIV Food scores of respondents based on major food groups 115 XXXV Inter-relationship between food groups and food practices 117 XXXVI Multiple range test of mean scores for food practices with respect to reserve H8 XXXVII Relationship of dependent variables and food practice scores H9 XXXVIII Interrelationship between variables.... 121 XXXIX Food availability at selected communities 124-XL Cost of 30 food items in selected communities relative to the cost of these items in Vancouver 125 X LIST OF FIGURES Figure Page 1. British Columbia Indian Reserves involved in the study 25 2. Non-isolated and isolated mean intakes of calories 65 3. Non-isolated and isolated mean intakes of proteins 67 4. Non-isolated and isolated mean intakes of calcium 69 5. Non-isolated and isolated mean intakes of iron 71 6. Non-isolated and isolated mean intakes of Vitamin A 73 7. Non-isolated and isolated mean intakes of thiamin 75 8. Non-isolated and isolated mean intakes of riboflavin 76 9. Non-isolated and isolated mean intakes of niacin 78 10. Non-isolated and isolated mean intakes of Vitamin C 80 1 CHAPTER I INTRODUCTION The existence of problems of malnutrition among various groups within the Canadian population was confirmed recently by the Nutrition Canada Survey (1973). The most striking problem identified by the survey was that of obesity, with about half of the Canadian adult population being overweight. While nutritional inadequacies were found throughout the general population, a higher proportion of deficiencies was apparent among native Indians. In the Indian population, dietary and biochemical assessment showed poor iron, calcium, folate and vitamin A status. Vitamin C nutriture, as indicated by low serum ascorbic acid levels, was also found to be inadequate, particularly in remote areas. These results were in agreement with previous reports dealing with the native Indian population (Lee et a l , 1970; Dong and Feeny, 1967; Pett, 1950). The poor nutritional status of Indians revealed by Nutrition Canada is a part of the overall inferior health conditions that exist among native Indians (Butler, 1975; Stanbury, 1975). The average age at death of Indians in British Columbia, for example, is forty-four years as compared to seventy-two years for a l l British Columbians. 2 The death rate from accidents and violence, largely-associated with alcohol, is almost three times the provin-c i a l rate. The infant mortality rate, although decreasing rapidly, is s t i l l three times the rate for non-Indians. Inadequate maternal nutrition and poor sanitation are thought to be largely responsible,(Stanbury, 1975). On a per capita basis, Indians use twice the number of hospital days as do non-Indians. Dental surveys conducted by Medical Services indicate that the dental health of natives is worse than that of the Provincial population as a whole (Foulkes, 1973). The 1973 Foulkes Report c r i t i c i z e d these conditions:. "The health of the native peoples of this Province, both 'status' and 'non status' is such that i t is a manifestation, of social injustice so great that it s correction demands the highest priority." The nutritional problems experienced by the Indian people may be in part explained by their poverty and thus by their in a b i l i t y to obtain the foods necessary for a. proper diet. They may also lack basic information about the foods required for good health, a problem shared by the general population. The situation of native Indians is made more complex, however, because their culture is in a state of transition. In recent years a number of factors have combined to affect traditional l i f e patterns and produce rapid changes in l i f e s t y l e . Increased industrialization has led to increased mobility, and the degree of isolation 3 for many reserves has decreased. While the interaction with white centres is minimal for some, the majority of reserves are in close proximity to non-Indian settlements. A small number are, in fact, physically integrated with larger white urban centres. Closer contact with the white culture undoubtedly has affected food resources and eating habits. Indications are that traditional food practices based on fishing, hunting, and gathering have greatly diminished (Smith, 1975; Lee et a l , 1971; Schaefer, 1977). The extent to which families make use of game, fish and berries varies with the season and locality. Many families now depend on local grocery stores for their food supply. It is possible that such changes in food habits are impairing the quality of diets. In some areas native Indians are faced with an increased availability of non-traditional foods, including fast or convenience foods, processed foods and beverages, current food fads — a l l of which may lead to new dietary problems. In more remote areas communities are frequently handi-capped by higher food prices and a poor selection of nutritious foods. A study in the Northwest Territories (Stiles, 1971) showed that stores in isolated communities stocked about 125 items on the shelves as compared to 8,000 in a large urban supermarket. Prices in predominantly Indian centres ranged from 30 to 45 percent higher than city 4 prices. The concern that our food distribution system may not be operating effectively throughout the population was expressed recently by the Food Prices Review Board (1975), who recommended that: "In particular, further study should be done about the special needs and interests of specific groups, such as our native population, persons living in remote, isolated or rural areas ...." As such, there is a need for consumer and nutrition education to better equip native Indians to deal with these conditions. To be effective, however, nutrition education must be presented in a way that w i l l motivate people to accept and use nutrition information. In developing effective programmes, nutritionists must f i r s t understand the l i f e patterns of the people they want to reach. We must know the attitudes, beliefs and 'whys' of food behaviour, identifying positive dietary habits and working within that framework. Recently, many researchers studying food habits have called for a broader ecological approach (Mead, 1965; Sanjur and Scoma, 1971; Sims et a l , 1972). They stress that a study of dietary habits should not only deal with actual diets, but should investigate the total environment in which these habits occur. Mead (1965) has commented on the urgent need for a frame-of-reference for the subject of food habits. She suggests a multidimensional code for describing and recording a people's dietary pattern. Within the proposed code, food habits could be described from 5 different standpoints: in physiological-sensory terms, in chemical terms, in nutritional terms, in cultural terms, etc. Within the context of Mead's ideas, Sanjur and Scoma (1971) developed a model, using four specific dimensions to collect and assess food habits data: — in food consumption terms — in food preference terms — in food ideology terms — in socio-cultural terms The code allows for a description of food habits from different standpoints, collecting information to provide a base for the development of effective nutrition education methods. Few studies have analyzed the food habits of Canadian Indians in a socio-cultural context. Most studies have been limited to an examination of nutrient intake. The quality and quantity of the several nutrients supplied by different food patterns is measured against existing stand-ards. Such an approach ignores the meanings and s i g n i f i -gances which underlie food behaviour. Thus there is a need for a study using a socio-cultural approach to gather information that would be helpful in the development of a nutrition education programme to deal with present dietary problems of B.C. Indians. The main purpose of this research project was to learn more about the food habits of Indian families living at ' selected isolated and non-isolated reserves in British 6 Columbia, and to investigate the relationship of food practices to certain socio-cultural characteristics of the families, especially the female head of household. The specific objectives of the study were: 1) To compare diets of B.C. Indians living on isolated reserves with those on non-isolated reserves in terms of nutrient content. The sources of nine major nutrients in the diet as provided by eight selected food groups was also determined. 2) To investigate the relationship between the food practices of the female head of household and the family's socio-economic variables. Descriptive inform-ation regarding certain characteristics of cultural dietary patterns such as food ideology, purchasing habits, meal time practices, food beliefs, etc., which may determine or are highly associated with ultimate food behaviour, was collected. 3) To determine the selection and price of foods available in local stores. The study sample consisted of 92 native Indian families living on reserves in British Columbia. Seven reserves varying in population from 100 to 550 were selected, with an equal representation of families from isolated and non-isolated reserves. Personal interviews were conducted with the female head of household to obtain information related to food practices, shopping habits and meal preparation. 7 CHAPTER II REVIEW OF THE LITERATURE Pricing and food buying practices Few studies in Canada have attempted to deal with good purchasing practices of families and with the factors which motivate food selection. Generally, food-buying and food expenditures are considered as part of larger studies of consumer spending. Our food market is rapidly changing, with food becoming more and more costly. Between 1969 and 1974 for example, food costs as measured by the Consumer Price Index rose 5270 and the overall cost of living by 36% (Food Prices Review Board, 1975). In addition, new foods and food analogs are being created, while other foods are being enriched, f o r t i f i e d or processed. With the changing consumer food market, individuals now require considerable more expertise to ensure that proper foods are purchased. Concern with findings of the Nutrition Canada Survey, together with rapidly rising food costs led to the formation of a government agency, the Food Prices Review Board, to monitor food costs in Canada. Studies by the Board determined that most Canadians pay more for food than they need for a nutritious diet (Food Prices Review Board, 1975). Their investigations revealed that while 'a reference 4-person urban family 1 could purchase a basic nutritious diet for 8 approximately $2,000 annually, most families spent $2,900 a year. The report claimed that although most four-person families in the country can afford a nutritious diet, an estimated 9% of the 1.1 million four-person families in Canada cannot. Although these families were not identified, the report gave recognition to specific groups, notably the elderly, native Indians and those livi n g in isolated communities who face their own unique food purchasing problems, and recommended further study with respect to these groups. Individuals in remote or isolated communities must frequently contend with poor shopping f a c i l i t i e s , as well as a limited selection of goods and high prices. Many of these problems are a result of high transportation costs, limited volume of sales, and inaccessability to suppliers, which result in high expenses for shopkeepers. These costs, in turn, are passed on to the consumer. On native Indian reserves, problems may be compounded further, as illustrated in a survey in the Fort Smith Region of the Northwest Territories (Stiles, 1970). In that study both White and Indian residents were interviewed and groceries in stores in 9 communities were priced, with the cost of similar items in Edmonton used as a reference point. Comparisons showed that while food costs in predominantly white ("other") centres were within 20 to 25% of Edmonton prices, the price of groceries in smaller Indian 9 communities were 30 to 45% higher. Indian families with an average income of $4,500 spent $178 per month on food, or 48% of their income compared to 21% ($185 per month) for 'other' families with annual incomes of $9,000. Many Indians, however, harvested food from the land and although no estimate was made of the relative contribution of these collected foods, they did provide some assistance in bridging the gap between employment, income and food costs. The study report recommended that: "The Government of the Northwest Territories should subsidize transportation cost for foods, as well as storage costs and the interest costs on capital investment in foods in isolated areas". The higher cost of food on native reserves has been documented by other investigators. In another study Lee et al (1970) reported that native residents at the coastal reserve of Ahousat, British Columbia shopped for groceries at a local store or in the nearby town of Tofino. Food costs at the local store were about 30% higher than in Victoria, while prices at Tofino were only 10%, higher. At the inland reserve of Anaham the authors surveyed grocery prices in six stores in nearby towns. Prices were recorded as 13.670 and 18.6% higher than the larger nearby centre of Williams Lake, where costs were less than one percent higher than Vancouver. At both reserves, income was low, but many families collected and preserved foods, managing f a i r l y well, as judged by nutritional adequacy of the diet. 10 Lack of transportation often prevents many Indian families from shopping in neighbourhood non-Indian community supermarkets where prices are lower than on reserves (Bass and Wakefield, 1974). They are thus restricted to local stores where prices are high and supplies limited. Whether or not the poor pay more for food than those of higher incomes has been the subject of a number of studies in the U.S. Myers (1970) claims that the poor consumer is held back by a lack of time, place, quality, amount and method of purchase. Immediate needs often overrule budget plans or shopping during weekly 'specials'; a lack of transportation forces them to shop in more costly local stores; they are not able toLtake advantage of bulk buying. The types of grocery stores in many low-income areas are limited. Dixon and McLaughlin (1968) concluded that low-income residents in the "inner c i t y " of Philadelphia bought most of their food in small neighbourhood stores and thus incurred increased cost. Prices in stores located in poverty and non-poverty areas in Omaha, Nebraska were examined by Captain (1969). He found no significant differences between the average food prices in the two income areas when the same foods and types of stores were compared. Few large chain stores, however, were found in low-income areas. Regardless of location, prices in small neighbourhood stores were higher than in large supermarkets. The small independent stores also tended to carry smaller quantity units of goods which 11 were more expensive. Captain concluded that low-income families pay more for food because of the kinds of stores patronized and unit sizes purchased. The investigations of Goodman (1968), however, contradicted these observations. In interviews with 520 low-income families, the majority of whom were black, he found that 92% of the respondents went outside of their neighbourhoods to purchase the bulk of their groceries. Eighty-one percent shopped at supermarkets while 8% used competitively priced, moderate-sized stores. Families used small local stores mainly for " f i l l - i n " and emergency shopping. Over half of the respondents believed that prices at supermarkets were lower, and so made special effort to go outside their neighbourhood to shop at these stores. Goodman claimed that because families were aware of price differences and shopped competitively, they did not pay more for their food than did high-income families. Goodman noted the limitation of this study in that those individuals with incomes below $4,000 were not adequately represented. While income is undoubtedly an important factor in food selection, other factors also exert an influence on food buying practices. Various studies have shown the relationship between food marketing practices of the homemaker and education (Bishop, 1965), nutrition or food-buying knowledge (Mize, 1962; Hammett and Blackstone, 1964a, 1964b; 12 Lamkin, 1970; Fusillo and Belsian, 1977), age (Stubbs, 1961; Dickins, 1965; Hammett and Blackstone, 1964b; Bishop, 1965), employment status (Dickins, 1961; Metheny et al, 1962b), race (Dickins, 1961, 1962; Larson, 1968), exposure to food information sources (Bishop, 1965; Hammett, 1968; Dickins, 1962a; Stubbs, 1961)1 and family members (Casper and Wakefield, 1975; Lamkin, 1978; Metheny, 1962; Dickins, 1962a, 1963; Van de Mark, 1962) . Bishop (1965) found that among a sample of 1,915 Virginia homemakers, younger women over 20 were more willing than those over 60 to try new products. Older homemakers had more established food-buying and meal-preparation patterns and were not as easily influenced by food information and advertisements. In general, women were most influenced by advertisements in newspapers. Other influencing factors included label information, recipes in cookbooks, requests of family members, and magazine articles on food. Increase education was also related to willingness to try new foods. Similar observations were made by Hammett and Blackstone (1964b) in a study of 1,654 Alabama, homemakers. They observed that use of various food information sources was closely related to age, income, and education.. Women under 30 or over 60 years of age showed greater economic concerns, and responded less to outside influences. Employment of women outside the home can affect food selection. Metheny et a l , (1962) interviewed 93 mothers of 13 preschool children in a comprehensive study of childrens food patterns and family influences. Among mothers who reported a recent change in family food practices, 15%, who were newly employed, reported purchase of foods that can be prepared more quickly. Dickins (1961) compared changes in marketing practices among urban and rural employed homemakers. Urban families were found to purchase more meat, fish, poultry, fruits and vegetables than rural families. They were also less traditional in their food patterns and more lik e l y to use new foods (i.e. f r u i t juices, instant coffee, frozen meat pies, canned biscuits). Families of rural employed women were shifting from home production of foods to purchased foods. Mize (1962) examining food marketing practices of 1,000 Georgian homemakers, identified four determinants in food purchasing. One-third of the women were concerned with cost, while about one-fifth each were influenced by family preferences, the application of food and nutrition knowledge, and innovation in food preparation practices (use of new products). Cost was a greater concern to low-income families ($2,000 - $3,000), while those with more than a $5,000 annual income were more influenced by family preferences. Food Ideology and Beliefs Many investigators have stressed the importance of attitudes toward food and suggested that effective nutrition education programmes must be based on a knowledge of food patterns and attitudes. Food habits are generally realized 14 to be one of the most deeply rooted aspects of culture. Within their cultural framework individuals learn which foods are proper, and associate emotional feelings, together with taste, with them (Cassell, 1965). It is essential that dietary patterns be viewed in the context of cultural ideologies. Cooper (1966) defines ideology as "an individuals outlook on self and society". Food ideology would then be the person's way of thinking about food as part of his l i f e pattern (Gifft, 1970). Beliefs (along with attitudes and values) are components of ideology systems. According to Cooper (1966) beliefs are "attitudes which incorporate a large amount of cognitive structuring". They may be founded on cultural learning, reasoning, observation, factual information, or the authority of a credible source (Gifft, 1970). Beliefs provide individuals with the means of orientating themselves in their environment in ways that are gratifying (Goodenough, 1963). They function in relation to human purpose as: 1. a basis of action. 2. instruments of social purpose. 3. a means of emotional gratification (Goodenough, 1963). According to Sanjur (1974) beliefs, together with customs, taboos, and prejudices "enter as value orientation affecting diet and nutrition". The relationship between food ideology and nutritional status has not been widely investigated. One area that is 15 well documented, however, is the effect of the Latin American "hot-cold" theory of dood ideology and disease etiology. (Sanjur et a l , 1970a, 1970b, 1972, 1974; Ahmed and Van Veen, 1968). In one such study in a small Mexican village Sanjur et al (1970) studied the effect of this belief system on the feeding pattern of young children. The authors observed that the traditional concepts of health and disease are linked to food beliefs, and in general almost any degree of illness leads to the withdrawal of part of the childs food intake. Among Puerto Rican and Mexican-American families, food beliefs were found to be linked to cultural variants of this "hot-cold" theory. In a study of low-income Puerto Rican families in New York, Sanjur (1974) found that diseases were grouped into 'hot' and 'cold' classifications, while food and medications were classified as 'hot1, 'cold', or 'cool'. Sixty-two percent of the mothers studied withheld food from sick children, most frequently eggs and milk, and during illnesses such as fever, measles, cold and diarrhea. Attitudinal factors, as they relate to the total pattern of food intake and lifestyles were investigated as part of a nutritional survey on the island of St. Vincent in the Caribbean (Beaudry - Darisme et a l , 1972). Data were collected from 200 households in two villages and one suburban area. In examining the knowledge and attitudes towards the consumption of different foods women were asked to l i s t foods they 16 considered as being 'good' or 'bad' during infancy, pregnancy, and lactation. Respondents generally gave traditional or non-specific reasons for feeling a particular food was good or bad at a particular l i f e stage. It appeared to the authors that: "Habits and practices relating to food consumption and avoidance are an integral part of the local culture pattern and that most women's behaviour is conditioned by environmental factors interrelated with the traditional way of l i f e " . Food beliefs of Mexican-American women in the post-partum period were reported by Bailey (1970). Foods considered harmful to the mother and child at this time include; hot c h i l i peppers, pickles, vinegar (or food prepared with vinegar), tomatoes, spinach, pork, and most f r u i t . Beneficial foods which contribute to lactation and rich milk are: chicken, toasted t o r t i l l a s and bread, eggs, milk, cooked cereal, chocolates and meats other than pork. The relation of nutritional beliefs and practices to several ecological variables was studied by Jalso et al (1965) among 340 subjects in New York State. The authors assessed beliefs in a nutritional opinions questionnaire, while food practices were measured by means of another questionnaire which tested use of food supplements, "health" foods, methods of weight control, special diets, and food avoidances. They found a high positive correlation between nutritional opinions scores and food practice scores, which suggested that the 17 subjects beliefs were reflected in their dietary practices. A study of 600 urban slum youth between the ages of 14 and 21, in 8 Columbian cities showed that social and cultural factors were more significant than economic factors in influencing dietary intake (Walter, 1973). Of 13 variables studied, the youths attitude toward his actual diet was the most influential factor. Youths who rated their diets as "good" or "very good" had better diets or a better food quality index (FQI). Pearson's (1972) study of nutrition opinions as they relate to health practices among a nationwide sample of 2,893 American adults, however, indicated that practices are not always supported by specific beliefs. While the majority of respondents believed that vitamin and mineral supplementation give more pep and energy and keep one healthy, only 20% were using vitamin p i l l s . Similarly, more than half of the respondents believed in the merits of "health.foods", but only 15% indicated that they ate or avoided particular foods because of their beliefs about food healthfulness. Schaefer (1969) has stressed that attitudes towards food ought to be given prime consideration and measures to combat malnutrition must be based on food patterns and attitudes related to foods. In developing countries the introduction of high protein plant foods has not always been well accepted. According to Schaeffer (1969) a general increase in agricultural production alone cannot alleviate malnutrition, 18 but rather "a selective increase in the production of food products preferred by the people as registered by their attitudes". This selective approach must be coupled with an educational program to increase the public's acceptance and consumption of a wide range of foods. Food Habits of Native Indians In general there is a scarcity of studies on the food habits and nutritional status of Canadian Indians. Until the Nutrition Canada Survey in 1972, much of the information regarding native Indian dietary habits was based on studies carried out in Manitoba, Saskatchewan and Ontario several decades ago. (Moore et a l , 1946; Corrigan, 1946; Nicholls, 1946; Vivian et a l , 1948; Best et a l , 1958, 1961). These were primarily c l i n i c a l studies involving physical examinations, some dietary and biochemical evaluations and occasionally, anthropometric measurements. The majority of investigators gave only sketchy treatment to description of dietary patterns. In their study, Moore et al (1946) surveyed the dietary habits and nutritional status of more than 400 northern Manitoba "Bush" Indians. Food intake was investigated by studying trading posts records of food purchases. The authors determined that of the 1470 calories purchased daily per person, 857G were supplied by white flour, lard, sugar, and jam. Although diets were supplemented by fi s h and game (which provided additional protein, niacin and some calcium), 19 this contribution was considered minimal as the supply of these foods was becoming depleted. Assessment of the nutrient content of diets revealed pronounced deficiencies of Vitamins A, C, and riboflavin. C l i n i c a l examinations showed marked tissue changes in the majority of individuals, with the most marked changes being in the conjuctival, ocular limbic blood vessels, tongue or gums. The authors associated these symptoms and the high mortality and morbidity rates, among other factors, to the lack of proper foods. Vivian et a l , (1948) conducted a similar study of two populations in the James Bay area. Food purchase records indicated that, the bulk of food purchases from local stores included flour, fats, and sugar, with smaller amounts of milk,milk products, fruits and vegetables. Estimates of amounts of food obtained from hunting and fishing were made, and the nutrient intake from a l l sources was calculated. Intakes were considered adequate for a l l nutrients except for calcium, ascorbic acid and vitamin A. Cl i n i c a l findings and especially anthropometric measurements showed poor nutritional status among the 10 to 19 year age group, with one-third to two-thirds of the teenagers examined being 10 to 30 pounds underweight for height. In 1958, the nutritional status of children at Pine House and Pelican Narrows, Saskatchewan was investigated as a prelude to a demonstration nutrition project (Best and Gerrard, 1958). Dietary, anthropometric, and laboratory 20 data were collected. No frank deficiency diseases were encountered, but serum vitamin A and carotene and ascorbic acid levels were low. Hypoproteinaemia and anemia were common. Following the examinations the nutrition project began, with the introduction of a mid-day meal to the school children at Pine House, while Pelican Narrows served as a control. Reexamination of children in both settlements in 1960, showed improved serum vitamin A and carotene levels in those who had received the dietary supplements (Best et a l , 1961). Studies in British .Columbia include a comparison of nutrient intake of 61 Indian and non-Indian school children in Alert Bay. (Dong and Feeney, 1968). Dietary histories of the subjects revealed that intakes of ascorbic acid and calcium were significantly lower for Indian children than for non-Indian children. Both populations had intakes of vitamin A and calcium below the Canadian standard. A comprehensive study of the nutritional status of Indians in British Columbia, including evaluation of dietary, anthropometric, c l i n i c a l , laboratory and dental parameters was carried out by Lee et al in 1968. In that survey, comparisons were made between a coastal fishing reserve, Ahousat and an inland hunting reserve, Anaham. Dietary analysis revealed that a l l age groups consumed a diet high in protein (excess of CDS). At both reserves more than half of the children had calcium intakes less than 2/3 of the 21 standards, while 61 percent of teenage gir l s at Anaham did not meet 2/3 of the standards for iron. Vitamin A was the only other deficient nutrient, with 45 to 70 percent of the Anaham population having intakes below the 2/3 level. Intakes of vitamin E, thiamine, riboflavin, niacin and ascorbic acid were .adequate or in excess of standards. In their dietary investigations the authors observed that although traditional foods were s t i l l used, diets on both reserves also contained large amounts of processed and refined foods. Information regarding meal patterns, food costs, food storage, handling, preparation and preservation was also collected in that study. More recently Desai and Lee (1974) reported that among four Indian communities in British Columbia and the Yukon Territories, the number of subjects with plasma tocopherol levels in the deficient range varied from 1.3%, (Ahousat) to 35,8% (Anaham), with 26.0% at Upper Liard and 19.5% at Ross River. An examination of dietary intakes, as measured by the 24 - hour reca l l indicated that the pattern of daily intakes of Vitamin E corresponded closely to the pattern of plasma tocopherol levels. The authors suggested that the overall dietary status of the communities was a consequence of "socio-economic and cultural factors and the geographic locations, as well as the climatic conditions". 22 Other studies have examined oral health among native Indians and related these to dietary data (Myers and Lee, 1974; Lee, 1975). Myers and Lee (1974) noted significant differences in the incidence of dental caries and periodontal disease among four Indian communities in British Columbia and the Yukon Territories. Variations in findings were thoughtttoLbe the result of the availability of refined foods, as determined by cultural -and economic factors. The present day nutritional status of native Indians varies widely according to the relative importance of certain influences such as the b asic traditional economy, the settlement patterns, the availability of the white man's food and the impact of teaching (Smith, 1975). The dietary pattern of even very isolated Canadian Indians has been altered from a traditional high meat and low carbohydrate diet to one high in carbohydrate and low in meat and fish (Ellestad-Sayed and Haworth, 1977). Intensified hunting and fishing have greatly depleted these resources. Thus the use and knowledge of traditional foods is low and disappearing with the increasing consumption of store-bought foods (Peterson, 1971). In addition, white teaching had tended to undermine the Indian values, and many native people are ashamed of traditional foods (Smith, 1975). Food is not thought in terms of nutrient value, but has tended to be polarized into two groups, white man's food and native food. 23 New foods are brought into local stores with l i t t l e education on their nutritive value, relative cost or method of use. Increased availability of refined carbohydrate foods in local stores may contribute to suboptimal nutrition and high incidence of dental caries (Peterson, 1971; Goldthorpe, 1975). Native people tend to make poor food choices, so that native food items are being replaced by items of lower quality (Draper, 1975). 24 CHAPTER III MATERIALS AND METHODS Population and Sample A study was conducted, u t i l i z i n g descriptive and analytical survey research techniques to investigate the food habits of native Indian families on reserves in British Columbia. In order to identify differences in patterns of food intake and, possibly in nutritional status, reserves were selected on the basis of geographical isolation. They werecS-lassified as either isolated or non-isolated on the basis of: proximity to a center of 5,000 population, and access touitnedical and shopping f a c i l i t i e s . Four reserves considered representative of isolated reserves in British Columbia were chosen. These include Fort Ware, Nazko, Babine and Takla Lake. In each case the reserve was at least 50 miles from an urban centre, shopping f a c i l i t i e s were limited to one or two small general stores, and medical f a c i l i t i e s consisted of a monthly v i s i t from Medical Services personnel. Non-isolated reserves were located at or near large centres and had f u l l access to medical and shopping f a c i l i t i e s . They consisted of Nanaimo, Sechelt, and Necoslie reserves. (See Fig. 1 for locations). The fi n a l sample consisted of 52 families from nonisolated reserves and 40 families from isolated reserves. A summary of reserves 25 26 is presented in Table I, indicating the population size of each reserve, the number of families interviewed and 24 - hour recalls collected, as well as the state of 'isolation', linguistic group, and cultural area of each reserve. The reserves were selected with the help of Medical Services Branch (Pacific Region) of the Department of National Health and Welfare to maximize co-operation from the reserves. For a l l but one survey (Sechelt) preliminary arrangements were made with the Band Council or Chief of the reserve by personnel from Medical Services. At Sechelt, nutritionists from the School of Home Economics, University of British Columbia, met with the Indian Band Council to explain the purpose of the study and the procedures to be used. Home v i s i t s were made and interviews conducted with the female household heads. For the i n i t i a l contact with each family the interviewer was accompanied by the Public Health Nurse, Community Health Worker, or a female resident of the reserve. The study was explained an an appointment set up for a convenient time, usually the next day. Attmost of the reserves an attempt was made to approach a l l households. However, at Sechelt, Nanaimo, Necoslie and Nazko households were selected by the aide on a judgmental basis., i.e. only those families i t was f e l t would co-operate were approached. Thus an unbiased, random sample was not possible. TABLE I INDIAN RESERVES IN BRITISH COLUMBIA INVOLVED IN THE STUDY Reserve Linguistic Group Cultural Area State of Isolation Population Size* Sample 1.24-hour 2. Recalls Size Interviews Sechelt Salishan Pacific Coast Non-isolated 380 53 16 Fort Ware Athapaskan Mackenzie R. Isolated 165 32 12 Necoslie Athapaskan Plateau Non-Isolated 350 35 16 Nanaimo Salishan Pacific Coast Non-Isolated 415 56 20 Nazko Athapaskan Plateau Isolated 100 23 8 Lake Babine Athapaskan Plateau Isolated 115 21 7 Takla Lake Athapaskan Plateau Isolated 265 29 13 * Represents the number of status Indians presently living on the reserve. 28 Description of Reserves 1. Fort Ware The Sekani village of Fort Ware, located on the banks of the Finlay River about 275 miles north of Prince George, is one of British Columbia's most isolated communities. There is no road access to the reserve, and i t can be reached only by chartered aircraft or boat. The reserve i t s e l f consists of about 25 log-cabin homes, many of which were built by members of the band, with supplies being provided by the Department of Indian Affairs. There is also a community ha l l , health station, elementary school and a small general store on the reserve. Several diesel generators supply ele c t r i c i t y to the c l i n i c and the homes of teachers, missionaries, and the storekeeper. Native homes have no ele c t r i c i t y or indoor taps. Water is obtained from four wells and the nearby river. The 165 band members live mainly by trapping and hunting, and seasonal jobs such as guiding and fighting forest f i r e s . Local Initiative Programmes (LIP) provide some work around the reserve. Income from these activities is low and merely serves to supplement the welfare income on which almost the entire community reli e s . Trapping was once a more important source of 29 income but has declined with the lower price of pelts. The best trapper, for example, w i l l only earn up to $3,000 annually. Additional problems have been posed to wage earners by the formation of Williston Lake (created by the Bennett Dam) which hinders them from going south to Finlay Forks for summer jobs. Health care is provided by Medical Services. At the time of the survey (September, 1975) monthly v i s i t s lasting 2 to 3 days were being made to the reserve by a Doctor - Public Health Nurse team. The doctor holds medical c l i n i c , while the nurse is responsible for immunizations, child-health care, health education, etc. Since January, 1976, however, one of the Fransiscan Sisters stationed at the reserve, a registered nurse, has taken over the responsibilities of the public health nurse. Monthly v i s i t s are s t i l l being made by the doctor. Emergency patients are taken by chartered aircraft to either Mackenzie or Prince George. Yearly examinations for T.B. are conducted by a survey X-ray team. More recently these have been stepped up because of the increased, incidence of T.B. in the area. An annual dental service is also available, and includes the basic work of f i l l i n g s and extractions, centering mostly on the children. 30 The elementary school is operated by the Department of Indian Affairs and includes classes from Grades one through seven. A kindergarten is supported by band funds. The school is staffed by three Fransiscan Missionary Sisters of Mary. The diet for the most part consists of bannock and moose, supplemented by a small variety of goods available at the reserve store. Besides moose, the men hunt bear, beaver (in the spring and f a l l ) , goat and sheep (in the f a l l ) and occasionally deer, grouse, and ducks. Few families fish, chiefly because the catch in the Finlay River is poor. Rainbow and lake trout are more plentiful at Rainbow Lake, a 7-mile boat trip and 3-mile walk away. The distance poses problems for many individuals and consequently the community does not rely on fis h as an important food source. Huckleberries, cranberries, red currant and sopallalies are plentiful and gathered, generally only for summer eating. A few families make gam but no canning is done and only a l i t t l e preserving. There are no farms or home gardens. The only store on the reserve is a small trading post managed by a non-Indian and owned by a couple who live in Prince George. Food prices are substantially higher than those in Vancouver and the selection is 31 restricted to basic items such as flour, rice, sugar, powdered milk, etc and a variety of canned goods. During summer the stock is larger when a more varied supply of goods, including fresh fruits and vegetables are brought in from Prince George by barge. In winter prices increase further when the river freezes and food must be flown in by chartered plane at a cost of 30 cents a pound as compared to 10 cents a pound by barge. This poses an additional burden to the already impoverished inhabitants of Ware in obtaining an adequate diet. Regular reports in the press each winter speak of hunger and malnutrition in the-community. Emergency food supplies are brought in at such times, but the d i f f i c u l t i e s persist. 2. Nazko Nazko Reserve is a Carrier Indian community located sixty-five miles west of Quesnel. Until 1973, when a two-lane gravel road replaced the single lane dust t r a i l that linked i t to Quesnel, i t was very much removed from outside influences. Even now there are no telephones, except for a radiotelephone operated by the Band. Nazko is the largest of a group of small reserves that includes Baezeko, Trout Lake, Pelican Lake, Moses Lake and Kluskies, spread over 32 a 100 by 40 mile area. It has a population of about 100. Most of the 18 homes that make up the reserve have cold running water but no electricity. This is an impoverished area, with l i t t l e work for i t s inhabitants. Local Initiative Programmes have created some jobs on the reserve and in the f a l l during haying several families are employed by local white ranchers. Generally, however, most individuals are forced to rely on welfare. Although hunting, fishing and trapping are carried out, they do not seem to be a major source of livelihood. In the peak f a l l season the men hunt moose; last year the reserve averaged two moose per household. A few families trap beaver in the spring. Salmon is also caught in the summer, most from the Nazko River, although the Quesnel River is also a source. Blueberries are the only f r u i t gathered in any substantial amount, with quantities obtained varying with their availability. Very l i t t l e was found during the past year. When gathered, berries are dried for the winter; some are canned or frozen. In the summer of 1975, residents of the reserve planted a community garden that included beets, carrots, onions, lettuce and potatoes. Vegetables were taken as needed during the summer, but 33 none were stored or preserved. Thus later in the year, families purchased additional vegetables from ranchers. Individuals on the reserve have access to two small grocery stores. One is privately owned and serves both the white and Indian communities. The other, which is located on the reserve i t s e l f , is owned and operated by the Band. Both stores are similarly stocked, chiefly with canned goods and a small selection of fresh fruits and vegetables. Food prices are cheaper at the reserve store, probably because the Band have their own truck and are able to bring in most of their own freight from Quesnel. Where families shop varies with the selection available at the particular time and credit given. Families who are able to, do their bulk shopping in Quesnel where food is cheaper. Health f a c i l i t i e s are limited. A public health nurse employed by Medical Services in Prince George makes a monthly v i s i t to the area and remains for 3 to 5 days, serving the needs of both the Indian and non-Indian communities. Visits from a doctor are infrequent, and residents obtain routine medical care in Quesnel. There is a community health representative livi n g on the reserve. 34 There is no school on the reserve so children are bussed to a rearby provincial school which extends to Grade eight. Students who wish to continue their education do so at high schools in Quesnel, Prince George, or Williams Lake. 3. Takla Landing Takla Landing is a Carrier Indian community of about 265 people living on the edge of Takla Lake in north-western British Columbia. The village is accessible by water and r a i l from Ft. St. James, 192 miles to the south-east. It is about 30 miles north of Lake Babine and residents occasionally travel between the two centres, by foot in summer and skidoo in winter. Direct access to Smithers located 100 miles south is by chartered aircraft. There are a variety of sources of income. Some of the men are employed as fallers by any one of three logging companies in the area. These are located at Leo Creek, 20 miles south, Lovell Creek, 20 miles north and Driftwood, 40 miles north. Work is casual, for periods stretching from 3 days to 3 months. LIP and Work Opportunities Programmes (WOP) provide work around the community for a number of band members. Under the LIP projects for example, members of the band built the 35 band office, a community hal l , a hockey rink and one house, and repaired ten other houses. The WOP project was set up to provide services like house-cleaning, laundering, painting, collecting firewood, etc for needy band members. Fur trapping supplements the income of several families as well as handicrafts which are sold at the old Hudson's Bay store just outside the res Social assistance is s t i l l an important source of income. Takla Landing was the largest of the 'isolated' reserves visited. It consists of about 40 houses, a community h a l l , band office, Roman Catholic Church, pool ha l l , medical c l i n i c , store, and a two-room schoolhouse. Housing is also available for local teachers and v i s i t i n g priests. Few houses have elec t r i c i t y or indoor taps, most water being obtained from the river; wood and propane are used for heating and cooking. The school on the reserve, which has classes up to Grade 7 is operated by DIA. Again students who wish to attend high school are boarded outside the community, at Smithers, Prince George, or Ft. St. James. Residents of the reserve have access to two stores. One, located on the reserve i t s e l f and operated by a former chief, has a limited supply of goods. The owner was experiencing financial 36 d i f f i c u l t i e s at the time of the survey and there was a strong possibility that the store would soon close. Almost a l l residents shopped at the former Hudsons Bay Company trading post, now privately owned by a non-Indian couple. It is located just outside the reserve and had the largest stock of a l l 'isolated' reserves. Weekly supplies are brought in by r a i l from Fort St. James. In addition to food, shoes, clothing and local crafts (beaded moccasins and jackets) are also sold, the latter to tourists who come to the area to hunt and fish. Salmon and trout caught in Takla Lake in the summer, and moose hunted throughout the year are important food sources for the entire community. About one-quarter of the families at Takla trap either for fur (lynx, martin, beaver) or food (grouse, rabbit, groundhog). Much of the fish and meat is preserved by salting, smoking, drying or freezing in winter. The band council is encouraging gardening and about half of the residents had planted potato gardens during the past summer. Medical Services provides the same health care here as in Nazko. The public health nurse based 37 in Fort St. James v i s i t s the reserve twice a month, with v i s i t s from physicians being less frequent. A Community Health Representative lives on the reserve. 4. Babine Babine Reserve is a Carrier Indian Sommunity situated just 64 miles north of Smithers at the edge of Babine Lake. The 100 mile long lake is the site of an extensive a r t i f i c i a l spawning channel and is one of the province's leading producers of sockeye salmon. Two copper mines, Granisle and Noranda, as ^ e l l as a logging company, Northwood Pulp Ltd, operate in the area. Although Babine has a population of 115, this number is severely affected by seasonal employment. In the summer, jobs such as tree planting, road construction, work at the hatchery and LIP grants for housing, repairs provide employment for the reserve. During winter, when such work is temporarily halted, most families leave the community to seek work in the nearby towns of Burns Lake and Smithers. The 23 houses that make up the reserve have no running water and residents obtain water from a number of sources: the Babine River, Lake Babine, a seasonal creek and a single well. There is also 38 no elec t r i c i t y although the school and two families have private diesel generators. The only other buildings on the reserve are a small grocery store, church, and health station. The school operated by the Department of Indian Affairs and Northern Development and staffed by a non-Indian had an enrollment of 18 students, from Grades 1 through 7. Two students attending kindergarten were taught by a local resident employed as a teacher's aide. The small general store is owned and operated by the band. Selection is restricted to canned goods and a few fresh items i.e. apples, oranges and onions. Most residents buy their food i n Smithers and shop at the store only when necessary between trips to town. The store is most frequently patronized by the elderly, who find i t d i f f i c u l t to purchase their food in town and children, buying recess, lunch-time and after school "treats". Medical Services delivers health care to residents of the reserve. One of the public health nurses stationed at Fort St. James makes a 3 - day monthly v i s i t , providing the usual services. The position of the community health worker is currently vacant. Hunting and fishing are carried out extensively. The reserve averages from four to five moose per family annually. Generally when one is k i l l e d , i t is shared 39 among the community, lasting for approximately three weeks. Beaver is trapped from April to June at a time when its fur is at i t s best. Occasionally someone may catch a deer, cariboo, timber wolf, lynx, rabbit or porcupine. Game birds such as ptarmigans, grouse or ducks are also becoming scarcer. A variety of salmon including spring (August - late September), sockeye (mid-July) , pink (summer), cohoe and steelhead (late September) are obtained from the Babine River. Trout and char are also fished. Band members fish in family groups and divide the catch. Almost a l l the fish is smoked or dried; very l i t t l e canning is done. Some fish is salted in kegs. As in other communities described, very l i t t l e trapping is carried out. With the f a l l in the price of pelts, and fewer animals to hunt, trapping is no longer a worthwhile means of obtaining a living. Some of the elderly people tan moose hides which fetch $100 apiece, but this is a tedious and lengthy (2 weeks) procedure. 5. Necoslie The Carrier Indian community of Necoslie is located just outside Ft. St. James, on the banks of Stuart Lake. Lying almost at the geographical centre of the province, Ft. St. James is linked by 40 a paved road to Vanderhoof, 39 miles to the south. It is one of British Columbia's historical communities having been founded in 1806 by Simon Fraser as the main administrative centre for the region then called New Caledonia. Later i t became an important fur-trading post for the Hudson's Bay Company. Today Ft. St. James has a population of 5,000 and is the chief commercial centre for the north-central region. It is growing rapidly, with one secondary and two elementary schools, a 25-bed hospital, two supermarkets, a number of smaller grocery stores, hotels, restaurants, etc. F a c i l i t i e s in the town are used by the 350 residents of the reserve. Many of the men at the reserve are employed by local logging companies and sawmills. Recently, women are also being hired and several women from the reserve are thus employed. Wages are good. Other employment is provided by LIP projects, chiefly for the construction of new homes on the reserve. Housing on the reserve is generally poor. A survey carried out by Medical Services in 1976 judged 28 of the 63 existing homes as "unhealthy" (i.e. overcrowded, seriously deteriorating, no running water or proper sewage disposal). The situation is improving 41 slowly with new houses being constructed by the Band in collaboration with the Department of Indian Affairs. There is however presently, a four year waiting l i s t for a new home on the reserve, and many young families impatient with this delay are leaving the reserve and purchasing homes in town. Health services are provided by Medical Services. At the time of the survey one nurse, who was also responsible for six other nearby reserves, was stationed in Fort St. James. Her job has since been expanded (July 1976) to a two-nurse position. Similarly the CHR position has grown from half to three-quarter time. Residents of the reserve regularly consult with doctors at the hospital in Fort St. James or Vanderhoof. Sockeye salmon is the most important locally available food and is netted in Stuart Lake during late summer. Char (mid-September to late October), whitefish (October - November) and trout (year-round) are also caught. Some fish is eaten fresh in season, but most is smoked, frozen or dried for consumption throughout the year. Only a few families can fish. Hunting is done away from the reserve near Beaver Lake. Where there are men in the family a household w i l l average one to two moose annually. Beaver, 42 plentiful in the spring are trapped for both food and skin. Other game is rarer. A variety of berries (i.e. huckleberries, raspberries, soapberries and blueberries) are gathered by many families and dried or made into jam. 6. Nanaimo Nanaimo, a community of 415 Cowichan, people, is located on the east coast of Vancouver Island. It is made up of one larger main reserve located just outside of the city of Nanaimo, and four smaller river reserves on the Cedar Highway beside the Nanaimo River. The river reserves (numbered 2 to 5) are less developed and more thinly populated than the main reserve (reserve one). There are about 87 houses on the reserve, 68 of these on reserve one, six each on reserves 2 to 4 and one on reserve five. With a few exceptions a l l the houses on reserve one have electricity, telephone and water services available. The city of Nanaimo has a population of 42,000 and is one of the largest urban centres on Vancouver Island. As such i t has a hospital, a large supermarket (Safeway) together with a number of other smaller food and specialty stores and other amenities of small city l i f e . There is easy access by highway to Victoria, 70 miles south and i t is only a 2 - hour ferry ride away from Vancouver. The residents of Nanaimo reserve are thus 43 relatively urbanized. Medical Services and the provincial government share in providing health care. An energetic CHR on the reserve works with a Public Health nurse from the Central Vancouver Island Health unit in Nanaimo and Federal Public Health nurses from Victoria in holding bi-monthly baby c l i n i c s , child care programmes, immunizations etc. Residents of the reserve can also obtain routine medical and dental care in town. Fishing is s t i l l an important means of obtaining food. About half of the families set nets in the Nanaimo River every f a l l and the salmon caught are shared among members of the reserve. Many of the families also hunt for deer in the nearby Nanaimo Lakes area throughout the year. Some of the families gather berries and make jams There is no trapping done. 7. Sechelt Located on the 'Sunshine Coast' 30 miles north-west of Vancouver is the Salish reserve of Sechelt, adjoining . the Village of Sechelt. Access from Vancouver is by ferry from Horseshoe Bay across Howe Sound to the Langdale Terminal, then by road to Sechelt. Travel time is approximately one hour. Although the population of Sechelt Village i t s e l f is only 550, the total sub-area population of the region, known as the Powell River-Sechelt belt, is 32,000. There are 380 band members currently living on this reserve. 44 Fa c i l i t i e s for modern day living are quite complete. A l l homes have running water and electricity. There is an elementary school (Grades I to VII) in Sechelt Village, and a secondary school is located at the nearby community of Gibson's Landing. A 35-bed hospital was opened in 1964 on land donated by the reserve. Shopping f a c i l i t i e s are adequate, with a large supermarket (Shop Easy) and other smaller grocery and specialty stores. The major source of employment in the area is forestry and many of the men at the reserve work in local logging camps or sawmills. A small number of families make a living at commercial fishing in the Strait of Georgia, There is also seasonal employment for women at local f i s h packing houses. Fishing is also carried out as a means of obtaining food; clams are eagerly gathered. Some deer hunting is done, but no family reported trapping. As in Nanaimo, the responsibility for health, services is shared by the Provincial and Federal Governments. There is a CHR on the reserve. 45 Description of the Sample Population Univariate frequency tables were designed to describe how the isolated and non-isolated populations were distributed with respect to demographic characteristics. Age The age of women ranged from 17 to 72 years, with a mean age of 37.2 years in non-isolated areas and 37.9 years in isolated areas (Table II). Male heads of households living in isolated reserves were slightly older, on the average, than males in non-isolated reserves. The mean age for the populations was 41.1 years and 37.3 years, respectively. There were 321 children in the study population, equally distributed in number between the two groups. A larger percentage of children on isolated reserves however f e l l into the 12 years and under categories (82.0% as compared to 60.0% for non-isolated reserves). Household Characteristics As indicated by Table III, the size of households was large. The size of families ranged from 2 to 18 members, with a mean size of 6.80 family members in isolated areas, and 5.65 members in non-isolated areas. Isolated families had a larger number of children per household. The mean number of children in each family studied was 4.0 on isolated reserves and 3.0 on non-isolated reserves. There was no difference, however, TABLE II AGE DISTRIBUTION OF SAMPLE POPULATION Age Non--isolated Isolated No. • (%) No • (%) Female Household Head n = 52 n = 40 0 - 2 5 years 8 (15) 7 (17) 25 - 35 years 18 (35) 16 (40) 36 - 50 years 16 (31) 10 (25) 51+ years 10 (19) 7 (18) Male Household Head n = 37 n = 34 0 - 2 5 years 7 (19) 6 (18) 25 - 35 years 11 (30) 8 (23) 36 - 50 years 12 (32) 11 (32) 51+ years 7 (19) 9 (27) Children n = 158 n = 163 0 - 2 years 12 (8) 22 (13) 2 - .5 years 37 (23) 39 (24) 6 - 1 2 years 46 (29) 73 (45) 13 - 18 years 50 (32) 26 (16) 19 - 21 years 13 (8) 3 (2) 47 TABLE III HOUSEHOLD CHARACTERISTICS OF SAMPLE POPULATION Household Characteristic Non-isolated No. (%) Isolated No/ (7c) Household Size 0 - 3 members 4 - 6 members 7 - 10 members 10+ members 12 26 10 4 (23) (50) (29) (8) 2 15 21 2 (5) (38) (53) (5) No. Children/Household 0 1 - 3 4 - 6 7+ 6 28 16 2 (H) X54) (31) (4) 2 16 17 5 (5) (40) (43) (13) No. Adults/Household 1 2 3 3+ 4 27 14 7 (8) (52) (27) (13) 3 21 7 9 (8) (53) (18) (23) Household Type Nuclear Extended Single parent Other 28 13 6 5 (54) (25) (12) (10) 23 13 3 1 (58) (33) (8) (3) 48 in the mean number of adults per household in the two populations. Almost a l l "other" adults were parents, relatives, or older children of the male/female household heads. Table III also shows the different types of households, with the majority of households among a l l reserves classified as nuclear and extended. Education Table IV shows the level of education attained by people in each of the two populations. No woman on an isolated reserve had completed high school, whereas 157. of the women on non-isolated reserves had graduated from high school. The majority of women on isolated reserves (717o) had either no formal schooling or some grade school. On non-isolated reserves, 607. of the women had completed some high school. Similar findings were observed for the male household heads. While 467, of men on non-isolated reserves had completed some high school, only 217. on isolated reserves had reached that same level of education Occupation Since there was l i t t l e difference among job categories of working women interviewed, the work status i.e. whether or not a woman was employed, was used as a measure of occupation rather than the type of work i t s e l f . Distinct differences were observed between the two populations (Table V). Whereas an equal number of women on non-isolated reserves were either working or homemakers, the majority 49 TABLE IV EDUCATION LEVEL ATTAINED BY FAMILY HEADS OF HOUSEHOLD EDUCATION Non-isolated Isolated No. (%) No. (%) Female Head n = 52 n = 40 No Formal Schooling . 0 - 13 (33) Some Grade School . 6 (12) 15 (38) Completed Grade School 5 (10) 13 (8) Some High School 31 (60) 9 (23) Completed High School 8 (15) 0 -High School and Other Training 2 (4) 0 Male Head n = 37 n = 34 No Formal Schooling 2 (5) 11 (32) Some Grade School 6 (16) 9 (26) Completed Grade School 2 (5) 2 (6) Some High School 17 (46) 6 (18) Completed High School 6 (16) 1 (3) High School and Other Training 4 (H) 0 -Don11 know . 0 5 (15) (85%) of women on isolated reserves were homemakers. Although male household heads on a l l reserves were involved in similar types of occupations, a larger percentage of men on non-isolated reserves had jobs among the higher "strata" of job classification (i.e. tradesman, craftsman). 50 TABLE V OCCUPATION OF HOUSEHOLD HEADS OCCUPATION Non-isolated Isolated No. (%) No. (%) Work Status - Female Working full-time 19 (36) 2 (5) Working part-time 6 (12) 4 (10) Not working outside home 27 (52) 34 (85) icupation - Male Chief, Counsellor 2 (5) 1 (3) Tradesman, craftsman 6 (16) 0 -Sawmill, Forestry- 15 (39) 11 (32) Fisherman, Longshoreman 6 (16) 4 (12) Labourer, Trapper 5 (13) 12 (35) Unemployment, retired 4 ( ID 6 (18) Income Table VI shows that the distribution of income for the entire study population was low. Although results are broadly clustered into 5 categories, the majority of families reported a yearly income of just over $5,000.00. Differences are seen for the two areas, with a larger number of families on non-isolated reserves earning $5,000 or more annually. 51 TABLE VI DISTRIBUTION OF FAMILY INCOME INCOME Non-Isolated Isolated No. (%) No. (%) 0 - 2500 2 (4) 0 -2500 - 5000 7 (14) 12; (30) 5001 - 10,000 30 (58) 22 (55) 10,001 - 15,000 7 (14) 5 (13) 15,000+ 6 (12) 0 -No response 0 - 1 (3) Data Collection Three instruments were developed or adapted to gather data. 1• Questionnaire A questionnaire was developed to assess the food habits and shopping practices of native Indian women in British Columbia. Prior to the survey i t was pre-tested among a group of women from the Duncan Indian Band on Vancouver Island. In accordance with suggestions of the pre-test 52 subjects, the questionnaire was reduced in length and modified for the study.(Appendix A). The questionnaire was designed to measure separately, food beliefs, shopping habits, meal planning, and other food practices, as well as selected socio-economic and family variables. Attitudes of the women toward nutrition, termed food  beliefs, were measured by asking the women two questions: "What foods or types of food do you try to include in your family's diet each day?" and "Why do you think each of these foods is important." In the methods used to score the answers, credit was given for naming each basic food group or a food from each group, and for correctly providing the name of a nutrient or a function of a nutrient in the food group. As a measure of variety, the fr u i t and vege-table group was divided into two food groups. Each food group and nutrient and function named correctly scored one point, the maximum score possible being 10. On the food ideology data, women were asked to give their ideas on foods considered desirable and undesirable at certain stages of the life-cycle, i.e. during pregnancy, lactation, sickness, and for babies and younger children. Information concerning the women's opinions of diets in their area, and recent changes in native diets was also collected, but because much of this was incomplete,, i t was not included in the study report. 53 Food-buying habits were assessed in another section of the questionnaire composed of 12 questions dealing with shopping site and reason for patronage, shopping fre-quency, children's food requests, the use of recommended food-buying practices, food expenditures and method of payment, factors influencing choice of purchases and changes in food-buying patterns with rising food costs. The questionnaire also contained a number of questions designed to collect descriptive information indicative of other nutrition practices. These included meal planning and preparation, the use of nutrient supplements, sources of nutrition information, and use of traditional foods. Data concerning selected socio-economic and family characteristics such as age, education, family composition, occupation, household f a c i l i t i e s , etc., was also recorded because of indications in the literature that they are important in affecting nutritional status. A more complete description of the variables is given in the s t a t i s t i c a l analysis section of this chapter. 2. Food Practices After examining the various methods of collecting dietary intake data i t was decided that the 24-hour recall was the most feasible method to assess food practices. This method is the simplest and most direct method for collecting data on large groups of individuals, and data compares 54 favourably with that of the 3-day or 7-day record.(Young, et a l , 1952). It was recognized that results could only be interpreted in terms of groups, not individuals, and that foods consumed would not necessarily reflect seasonal or long-term patterns (Marr, 1971). When the female household head was interviewed, the dietary recall method was explained. She was asked to recall a l l foods consumed by her and one or two other family members during the 24 hours prior to the interview. When other family members were present, information was obtained from them directly. Subjects were asked to , mention the amount of food and drink consumed, using where necessary, glasses, measuring cups and cereal bowls as aids in estimating portion size. With the aid of the Nutritional Status Investigation Computer Programs of the School of Home Economics, University of British Columbia, the daily intake of 9 nutrients (calories, protein, calcium, iron, vitamin A, thiamin, riboflavin, niacin and ascorbic acid) was computed from the 24-hour recall of each individual. For both population groups, daily nutrients were grouped according to age and sex and the number of subjects with intakes below 2/3 of the Canadian Dietary Standard were noted. In a l l , a total of 249 recalls were obtained. In addition, in order to measure the criterion variable 'food practices' the information obtained from the 24-hour 55 dietary recalls of the 92 female heads of households were scored using the British Columbia Dairy Foundation's "Guide to Good Eating Everyday". Scores were assigned for each food group, according to the recommended number of daily servings of that group (Appendix B). The maximum score possible was 25. This numerical score represented a quantitative estimate of food practices. 3. Food Pricing and Food Availability Information on food prices and food availability was collected by the use of a food l i s t containing 66 items adopted from the 'food basket' of the Food Prices and Review Board, 1975 (Appendix C). Items of the same size and brand, where possible, were used. It was originally planned that the 66 food items would be used to develop a price index that would give some measure of food prices in each area relative to food prices in Vancouver. In the f i n a l analysis, because many of the items were not available on a number of the reserves i t was not possible to develop a food index. Instead, the cost of 30 food items which could be found in a l l reserves was compared to the cost of the same items in Vancouver. The 30 food items included the following: powdered skim milk, evaporated milk, apples, bananas, apple juice, canned peaches, oranges, raisins, potatoes, onions, turnips, canned peas, canned soup, dry cereal, rolled oats, flour, macaroni, cookies, canned tuna, 56 sardines, beans with pork, peanut butter, eggs, bacon, butter, margarine, shortening, sugar, jam, and tea. Data Analysis The data analyzed in the study were collected on native Indian reserves in British Columbia between the months of August 1975 and February 1976. A l l the variables (socio-economic, family and reserve) were viewed where possible in rank order, as this is required for the association tests demanding ordinal ranking. Variables were treated as follows: 1. Socio-economic Variables Education: was grouped according to the number of years completed in school, separately coded for the male and female head of the house. Occupation: was that of the male household head and was grouped according to the five categories; unemployed or retired, labourer or trapper, fisherman or longshoreman, sawmill worker or logger, tradesman or craftsman, and chief or councillor. Work status: of the female household head was dichotomized for 'yes' or 'no', according to whether she was involved in other than domestic work at home. 57 Income: represents the approximate yearly income of a l l adults in the household. It includes a l l money from work, trading, UIC and welfare. Per capita income: refers to the yearly income divided by the number of individuals dependent on that income. Household f a c i l i t i e s scale: was constructed using the presence or absence of the following items in the house-hold — electricity, stove, oven, running water, refriger-ator and freezer. 2. Family Characteristics Age: of the female'head of household is expressed in years. Household size: refers to the number of adults and children living in the household. Food beliefs: answers to this question were ranked as discussed in the text. Nutrition education: was again dichotomized and refers to whether or not the female household head had received any food or nutrition information in an education setting. 3. Reserve Variables Reserve: refers to one of the seven reserves. Isolation: refers to the geographical location of the reserve as previously described. 58 4. Food Practices Score As described earlier, the food practice score was obtained from a 24-hour food intake record of the female head of household of each family. After coding, data were key-punched on cards and treated s t a t i s t i c a l l y by computer analysis. The St a t i s t i c a l  Package for the Social Sciences (1963) was used as a ref-. erence for programming. The Kendall rank correlation coefficient, tau beta, was used to measure the degree of association between the food scores and a l l but one of the socio-economic variables. These parameters, as has been described, were a l l ranked in an ordinal manner. The Kendall rank correlation coefficient measures the degree of association or correla-tion between two sets of ranks (variables) ranging from -1 to +1. A +1 denotes a perfect identical ordering of the ranks and a -1 indicates a perfect opposite ordering. In determining whether or not there was any significant difference between reserves, a variable which had no ordinal property, and food practices, the analysis of variance was used. Although the major concern in this study was to investi-gate the relation between selected socio-economic, family, and reserve variables and the dependent variable, food practices, i t was thought that since relations between two variables may often be due to a third, i t would be useful 59 to look at r e l a t i o n s between a l l of the v a r i a b l e s . T h i s was done by means o f a mat r i x of K e n d a l l ' s t a u beta rank order c o r r e l a t i o n s . 60 CHAPTER IV RESULTS Food Patterns A. Analysis of nutrient intake data The average daily nutrient intakes by age and sex categories, of the isolated and non-isolated populations are shown in Tables VII-1 and VII-2, and illustrated in Figures 2 to 10. Tables VII-3 and VII-4 (Appendix D) show the mean daily nutrient intakes of the same age categories for the combined isolated and non-isolated populations (provincial) compared to median intakes of the Nutrition Canada Survey. The latter data are presented for general interest only and w i l l not be discussed. The percentage distribution of each nutrient derived from each of the 8 food groups, for the two populations is given in Table IV-1 and for each age and sex category in Tables IX-2 to IX-7 (Appendix D). 1. Calories The mean calorie intakes for a l l children up to 9 years for both populations were equal to or greater than the CDS. Adolescents of both sexes, regardless of reserve location had mean calorie intakes below the recommended Dietary Standards. Among teenage boys from non-isolated communities, TABLE VII-1 DAILY NUTRIENT INTAKES OF CHILDREN AND ADOLESCENTS FROM ISOLATED AND NON-ISOLATED RESERVES. MEANS AND STANDARD DEVIATIONS ARE GIVEN. FIGURES IN PARENTHESES ARE NUMBER OF INDIVIDUALS. 1 0-4 Years, , M & F 5-9 Years, M & F 10-19 Years, F 10-19 Years, M NI I NI I NI I NI I (12) (10) (17) (14) (10) (15) (14) ( I D Calories 1763+613 .. 1396+549 2082+879 1902+554 1875+342 1926+598 2235+744 2301+480 Proteins 65+22 56+22 78+41 69+18 73+16 82+23 82+34 70+16 Calcium 1029+500 1034+1096 1008+448 705+270 786+427 552+299 958+530 676+249 Iron 10.3+6.4 10.7+4.5 13.2+8.7 14.4+6.1 10.8+2.6 16.9+5.0 12.5+5.3 14.9+7.2 Vitamin A 3932+2278 3581+2192 3323+2272 3301+2282 3275+1715 2532+1302 4986+2618 2176+1305 Thiamin 1.02+0.37 1.04+0.36 1.66+1.13 1.15+0.32 1.22+0.45 1.33+0.28 1.49+0.46 1.20+0.39 Riboflavin 1.72+0.63 1.59+0.49 2.17+1.16 1.59+0.42 1.62+0.77 1.84+0.40 2.02+1.06 1.58+0.60 Niacin 13.9+10.6 10.8+5.1 16.8+10.5 16.6+8.1 17.4+6.9 21.6+6.3 19.5+8.3 17.0+5.3 Ascorbic 106+79 117+114 182+160 84+80 145+163 62+29 185+131 78+151 Acid 1 For this and other tables, units are Protein (gm), Vitamin A (International u n i t s ) , a l l others (mg). NI = Non-isolated I = isolated. TABLE VII-2 DAILY NUTRIENT INTAKES OF ADULTS FROM ISOLATED AND NON-ISOLATED RESERVES. MEANS AND STANDARD DEVIATIONS ARE GIVEN. FIGURE IN PARENTHESES ARE NUMBER OF INDIVIDUALS. 20 + Years, F 20 + Years, M Non-isolated Isolated Non-isolated Isolated (58) (43) (32) (13) Calories 1635 + 423 1594 + 485 2979 + 953 2127 + 618 Proteins 67 + 20 73 + 23 121 + 37 107 + 24 Calcium 554 + 305 548 + 547 848 + 468 573 + 241 Iron 10.8 + 4.2 14.9 + 5.6 18.7 + 7.3 23.5 + 8.1 Vitamin A 4018 + 2730 3608 + 2915 7234 + 4740 3825 + 3871 Thiamin 1.05 + 0.47 1.08 + 0.32 1.86 + 0.77 1.70 + 0.48 Riboflavin 1.36 + 0.67 1.65 + 0.61 2.08 + 0.85 2.18 + 0.82 Niacin 18.5 + 6.3 19.6 + 6.7 31.2 + 11.1 28.4 + 9.3 Ascorbic Acid 97 + 101 42 + 52 144 + 163 119 + 197 CTl TABLE VIII NUMBER OF INDIVIDUALS, BY AGE AND SEX, WITH DAILY NUTRIENT INTAKES LESS THAN TWO THIRDS OF THE CANADIAN DIETARY STANDARDS. FIGURES IN PARENTHESES ARE TOTAL NUMBERS OF INDIVIDUALS IN EACH GROUP. 0 - 4 Yrs. (M & F) NI I (12) (10) 5 - 9 Yrs. (M & F) NI I (17) (14) 10 -NI (10) 19 Yrs. (F) I (15) 10 -NI (14) 19 Yrs. (M) I (11) 20 + (F) NI (58) Yrs. I (43) 20 + (M) NI (32) Yrs I (i3: Calories 1 1 3 2 2 3 6 2 15 13 5 4 Proteins 1 0 0 0 0 0 0 0 0 1 0 0 Calcium 2 1 1 2 3 11 6 5 28 23 8 4 Iron 2 1 4 0 3 0 4 1 26 7 2 0 Vitamin A 1 1 0 1 3 4 1 4 9 11 5 4 Thiamin 0 1 5 0 2 0 1 1 13 2 4 0 Ribo f l a v i n 0 0 2 1 1 0 2 2 11 3 3 1 Niacin 2 1 3 1 0 0 2 2 2 3 1 2 Ascorbic Acid 1 1 3 3 1 5 2 7 7 15 2 4 NI = Non-isolated I = isolated TABLE IX-1 PERCENTAGE CONTRIBUTION OF FOOD GROUPS TO CALORIES AND NUTRIENTS (ALL AGES) Calories NI I Protein NI I Calcium NI I Iron NI I Vit. NI A I Thiamine NI I Ribofl. NI I Niacin NI I Ascorb. NI I 1. (Milk,milk products) 13 10 17 12 60 51 3 2 12 11 8 5 34 23 1 1 2 2 2. (Meat,fish poultry, eggs, legumes) 26 20 55 58 14 10 46 55 23 20 32 36 36 50 52 58 3 2 3. (Vegetables) 7 8 5 5 5 4 11 7 32 34 12 11 5 4 11 10 25 30 4. (Fruits) 8 5 2 1 6 3 9 3 15 10 14 8 5 2 6 3 70 65 5. (Grains, cereals) 25 34 20 24 14 30 29 28 1 3 32 39 16 18 21 22 1 6. (Fats,oils) 10 10 - - 1 1 -- - 17 22 - - - - - - -7. 8. (Sugars) .(Misc.) 8 1 14 - 1 1 2 2 5 - -2 1 2 1 1 9 6 - ~ >-< Q < y O < u 4000 3500 3000-2500^ 2000-I 500-1000-500 0-4 MF NO. NON-ISOL. 12 NO. I S O L A T E D 10 N O N - I S O L A T E D • I S O L A T E D • V. C D S LEVEL • 5-9 MF 17 14 10-19 F 10 15 10-19 M 14 I I 20 + F 58 43 20 + M 32 13 F I G U R E 2 . N O N - I S O L A T E D A N D I S O L A T E D M E A N I N T A K E S O F C A L O R I E S 66 in particular, a large percentage (48%) failed to achieve intakes equal to two-thirds of the CDS. The calorie intakes of adults, except males in non-isolated areas, were well below the CDS. The major food group source of dietary calories varied only slightly between children from the two populations, with 26-357, of calories being derived from grains and cereal products, 16-217o from meat, fish, poultry, and 11-237, from the milk group. A similar picture was obtained for adolescents, except for teenage boys in isolated areas where the contribution of sugars (207,) was f a i r l y high. In adult diets, grains and cereals and meats were s t i l l the largest source of calories, but significant amounts were derived from fats and oils and from sugars (8-137,). In general, for a l l groups, grains and cereals contributed more calories to diets on isolated reserves, while the meat and milk group supplied more calories to individuals on non-isolated reserves. 2. Protein Mean daily protein intakes for a l l age and sex groups, for both populations, exceeded the recommended standards, often by as much as 1007,. The number of individuals who failed to achieve two-thirds of the CDS was negligible. Protein intakes on non-isolated reserves were generally higher than on isolated reserves. Approximately one-half of a l l protein < o cc CL. 160 140 120 100 80 60 40 20 N O N - I S O L A T E D • I S O L A T E D • 2/ 3 C D S LEVEL • 0-4 MF 5-9 MF 10-19 F 10-19 M 20 + F 20 + M NO. NON-ISOL. 12 NO. I S O L A T E D 10 17 14 10 15 14 I I 58 43 32 13 F I G U R E 3 . N O N - I S O L A T E D A N D I S O L A T E D M E A N I N T A K E S O F P R O T E I N S 68 was derived from meat, fish, poultry, eggs and legumes, while grains and cereals and milk and milk products supplied the remainder. Among children up to 9 years, milk contrib-uted about 24-357o of the protein to diets in non-isolated areas and slightly less (17-267,) in isolated reserves. Milk supplied less protein in the 10-19 age bracket, but the proportion at non-isolated reserves was again greater, in this case almost double that at isolated reserves. Among adults, protein from meat sources was 60-697>v while milk and milk products supplied less protein compared with children and adolescents. 3. Calcium Up to the age of 9 years, calcium intakes were above the CDS and few children in either age category from either population obtained less than two-thirds of the recommended amount of calcium. In the 10-19 age bracket the mean intakes of calcium in non-isolated communities was slightly greater than in isolated areas, but for both groups diets did not meet the CDS. Approximately one-half of adolescent gir l s (307> on non-isolated reserves and 737, on isolated reserves) and adolescent boys (437, on non-isolated and 557, on isolated reserves) had calcium intakes below the two-thirds level. Mean calcium intakes for adults were also below the CDS, with a greater percentage of women (50-587,) than men (26-337.) f a i l i n g to obtain two-thirds of the recommended 1600-1 1400 1200 -1000 -800 600 400 -200 -0-4 MF NO. NON-ISOL. 12 NO. I S O L A T E D 10 N O N - I S O L A T E D • I S O L A T E D • 2A C D S LEVEL • 5-9 MF 17 14 10-19 F 10 15 10-19 M 14 20 + F 58 43 20 + M 32 13 F I G U R E 4. N O N I S O L A T E D A N D I S O L A T E D M E A N I N T A K E S O F C A L C I U M 70 amounts. In general, milk and milk products supplied 50-607o of the calcium in the diet. The proportion of calcium contributed by milk was highest among children and adolesc-ents (49-757.) and greater at reserves adjacent to urban centres than at isolated reserves. Significant amounts of calcium were also supplied by grains and cereals, with twice as large a proportion from this source at isolated reserves (21-377.) as compared to non-isolated reserves (11-177,). Meat was an additional calcium source, but in this case provided more calcium to non-isolated diets. 4. Iron Mean daily iron intakes for almost every group and both sexes were well above the recommended levels. There was, however, a wide range in individual intakes — from 2 mg to 40 mg daily, with intakes on isolated reserves consistently higher than on non-isolated reserves. Thus in some groups a considerable number of persons failed to obtain two-thirds of the recommended standards. Teenagers of both sexes, and adult females, had the highest percentage of individuals with intakes below the CDS. On non-isolated reserves, almost one-third of adolescent boys and g i r l s , and 507. of women, failed to obtain 2/3 of the recommended intakes. Among adult men at both reserves iron intakes were considerably in excess of recommendations, and the number of men f a i l i n g to meet 2/3 of the CDS was low. N O N - I S O L A T E D • I S O L A T E D • r a E < o 35-] 30 25-20-15-1 10-5-Yi C D S LEVEL NO. NON-ISOL. NO. I S O L A T E D 0-4 MF 12 10 5-9 MF 17 14 10-19 F 10 15 10-19 M 14 I I 20 + F 58 43 20 + M 32 13 F I G U R E 5 . N O N - I S O L A T E D A N D I S O L A T E D M E A N I N T A K E S O F I R O N 72 The primary food group sources of dietary iron for a l l individuals were meat, fish, poultry and legumes (Group II), contributing approximately half the dietary iron, and cereals and grains (Group V), supplying almost 30% of intake. Both dietary food groups made roughly similar con-tributions to the diets of the two population groups. Some difference was observed, however, between the contribution of fruits and vegetables to the iron intake. While vege-tables were a better source of iron to diets on non-isolated reserves, the reverse was true for fruits. 5. Vitamin A A l l age groups had mean vitamin A intakes greatly in excess of standards. Individual daily intakes of this nutrient, however, were extremely variable — from a low of zero to a high of 18,050 iu. Except for age groups 0-9, about 207o of diets of a l l other groups were deficient in vitamin A when compared with 2/3 of the CDS. Adolescent girl s had poorest intakes, with 287, f a i l i n g to achieve 2/3 recommended levels. The mean vitamin A intakes on non-isolated reserves were generally higher than those on isolated reserves, and a larger proportion of individuals from isolated reserves failed to meet requirements. The contribution of the various food groups to the diets of children was variable. Vegetables (Group III), the largest single contributor, supplied approximately 1/3 of ro -o < I-< z z < > 8000 7000 6000 5000 4000 3000 2000 1000 i 0-4 MF NO. NON-ISOL. 12 NO. I S O L A T E D 10 5-9 MF 17 14 N O N - I S O L A T E D • I S O L A T E D • 2/ 3 C D S LEVEL • 10-19 F 10 15 10-19 M 14 II 20 + F 58 43 20 + M 32 13 (jO F I G U R E 6 . N O N - I S O L A T E D A N D I S O L A T E D M E A N I N T A K E S O F V I T A M I N A -7 4 the vitamin A, regardless of reserve. But milk was a better source in urban reserves, while both the meat (Group II) and fats and oils (Group VI) supplied more vitamin A on isolated reserves. Among teenagers in non-isolated communities, fruits supplied the most vitamin A (26-337.) . Fats and oils (16-327.) , milk and milk products (16-227.) , and the meat group (10-227.) made similar contribu-tions to adolescent diets. Vegetables were an important contributor of vitamin A to adult diets (28-447.) , followed by meats (20-347.) , and fats and oils (14-21%). 6. Thiamin and Riboflavin Mean thiamin and riboflavin intakes were in excess of the recommended standards for every group with the exception of adolescent males on isolated reserves. Intakes of thiamin were similar for both population groups, except for 5-9 year olds, and adolescent and adult males, where intakes were greater in non-isolated areas. Intakes of riboflavin were also generally higher on non-isolated reserves, except for teenage gir l s and adult groups. At the same time the variance of intake of both nutrients on non-isolated reserves was larger than on isolated reserves, so that more individuals on non-isolated reserves failed to meet the 2/3 CDS. Thus 29% of children in the 5-9 year old category, 20% of adolescent females, and 23% of adult women in non-isolated communities did not reach the 2/3 level. With respect to ra < H Z < I-2.4-7 2.1 1.5 1.2 H .9 -• 6H .3 - i 0-4 MF N O N - I S O L A T E D I S O L A T E D • 2/ 3 C D S LEVEL • 5-9 MF 10-19 F 10-19 M 20 + F 20 + M NO. NON-ISOL. 12 NO. I S O L A T E D 10 17 14 10 15 14 I I 58 43 32 13 F I G U R E 7 . N O N - I S O L A T E D A N D I S O L A T E D M E A N I N T A K E S O F T H I A M I N 4.0 3.5 3.0 2.5 2.0 N O N - I S O L A T E D • I S O L A T E D • 2/ 3 C D S LEVEL ^ 1.5 I.OH .5-1 0-4 MF NO. NON-ISOL. 12 NO. I S O L A T E D 10 5-9 MF 17 14 10-19 F 10 15 10-19 M 14 I I 20 + F 58 43 20 + M 32 13 F I G U R E 8. N O N - I S O L A T E D A N D I S O L A T E D M E A N I N T A K E S O F R I B O F L A V I N 77 riboflavin, only adult women in non-isolated areas failed to ingest amounts equal to 2/3 of the CDS in significant numbers (30%). The contribution of the various food groups to thiamin intake were roughly similar for both population groups, with grains and cereals (Group V) contributing 29-55% of the thiamin, and meat, fish, poultry and legumes (Group II) contributing the second largest amounts. Fruits, particularly in urban areas, contributed significant amounts of thiamin to the diets of children (7-23%), while both the f r u i t and vegetable groups provided thiamin to adult diets (4-18%). Among the population under 9, milk and milk products contributed the largest amount of riboflavin, approximately 567o in the 0-4 age group, and 35-47% in 5-9 year old child-ren. In the case of adolescents in urban areas milk con-tributed 45% of the riboflavin, while meat (Group II) supplied similar quantities of riboflavin to diets of adolescents in isolated communities. Among adults, meat contributed the largest amount of riboflavin, with the largest proportion in diets of isolated residents. For a l l groups, most of the remaining riboflavin came from grains and cereals.(14-25%). 7. Niacin Average intakes of niacin were considerably greater than the recommended standards for every group. On isolated 40 35 30 25 H 20 15 io H N O N - I S O L A T E D U I S O L A T E D • Vi C D S LEVEL • 0-4 MF 5-9 MF 10-19 F 10-19 M 20 + F 20 + M N O . NON-ISOL. 12 NO. I S O L A T E D 10 17 14 10 15 14 I I 58 43 32 13 F I G U R E 9. N O N - I S O L A T E D A N D I S O L A T E D M E A N I N T A K E S O F N I A C I N 7 9 reserves, 0-4 year olds, adolescent and adult males had lower mean niacin intakes than did the corresponding groups on non-isolated reserves. In a l l other groups intakes in non-isolated areas were equal to or greater than those in reserves adjacent to urban centres. The number of individuals with intakes below 2/3 of the CDS was negligible, with not more than one to three persons in any age group from either population in that category. In a l l groups meat, poultry and legumes (Group II) were the major contributor to dietary niacin, with residents from non-isolated areas obtaining slightly less niacin (43-567o) from that source, than isolated residents (43-667,). The second important contributor was the cereal and grain groups (about 257,) , followed by vegetables (7-157.) , both equally distributed between reserves. 8. Ascorbic Acid Mean intakes of ascorbic acid were in excess of the Canadian Dietary Standards in every age category for both populations, with intakes on non-isolated reserves being considerably greater than those on isolated reserves (except 0-4 year olds, where the two were similar). However, because of the large variance, 9-367, of persons in most age groups failed to take in sufficient ascorbic acid to meet two-thirds of the CDS. Among adolescent boys, for example, 647, of those from isolated areas failed to achieve 240 - i 210 H N O N - I S O L A T E D • I S O L A T E D • V3 C D S LEVEL • 180 A 150 120 90 H 60 30 0-4 MF NO. NON-ISOL. 12 NO. I S O L A T E D 10 5-9 MF 17 14 10-19 F 10 15 10-19 M 14 I I 20 + F 58 43 20 + M 32 13 F I G U R E 1 0 . N O N - I S O L A T E D A N D I S O L A T E D M E A N I N T A K E S O F V I T A M I N C 81 that level of intake. The primary source of ascorbic acid intake among children and adolescents was the f r u i t group, with individ-uals on non-isolated reserves receiving more vitamin C from that source (81-897o) than those on isolated reserves (66-817.) . Vegetables also contributed a large percentage of ascorbic acid, but more at isolated reserves (15-297.) than on non-isolated ones (8-157.) . Among adults, the pattern of intake was related more to the sex of the individuals than to isolation. Whereas vegetables (Group III) contributed just over one-half of the vitamin C to diets of women, fruits (Group IV) provided males with that same amount. B. Food Frequencies The frequencies with which individual foods were consumed by respondents are given in Table X. Data for this table was obtained from the 249 24-hour recalls collected and may not be representative of the total diet of any one individ-ual over time. Foods used most extensively include bread, potatoes, tea and coffee, as well as a variety of meats, particularly game. Although the quantity of meat consumed was similar for the two populations, the pattern of consumption varied. 32 TABLE X FREQUENCY OF CONSUMPTION OF SPECIFIC FOOD ITEMS BY ISOLATION* Foods % Urban 7oIsolated Meats Fish 31! 7 Poultry 13 . 7 Luncheon meats 31 19 Hamburger/stew 37 10 Game 11 69 "Other"meats 16 3 Eggs 43 40 Peanut butter/beans 17 9 Bacon 20 17 Fruits and Vegetables Apples/bananas 26 15 Citrus fruits/juice 25 -5 Peaches/apricots 14 11 "Other" fruits 14 6 Celery/cucumber 21 0 Vegetable soup (pkg) 8 18 Potato 64 62 Onion 31 17 Leafy green vegetables 39 '3 Tomato/juice/sauce 29 11 Peas/green beans 23 10 Carrots/beets 32 10 Corn/turnips 22 18 Bread & Cereals Bread 83 88 Rice 31 58 Breakfast cereal 11 11 Hot cereal 14 25 Macaroni/spaghetti " 17 25 Pancakes 5 23 Biscuits/crackers 5 12 * Calculated from 24-hour recalls and based on the number of individuals who listed the specific food in their recall. 83 Foods % Urban % Isolated Milk and Milk Products Evaporated milk 38 52 Powdered milk 7 20 Fresh milk 42 7 Cheese 20 9 Other milk products 22 6 Sugars Sugar/honey 68 82 Jam/jelly 31 52 Cookies/cakes 29 36 Cheesies/chips, etc. 18 19 Fats and Oils Margarine 52 48 Butter 25 26 Miscellaneous Pickles/relish, etc. 30 10 Tea/coffee 71 79 Tang 31 21 Pop/Kool Aid 25 19 Meal Frequency Breakfast 80 88 Lunch 87 97 Dinner 99 95 Snacks 79 69 84 Whereas game meat, namely moose, was the main p r o t e i n source f o r r e s i d e n t s i n i s o l a t e d r e s e r v e s , i t s consumption being r e p o r t e d by almost 70% o f those respondents, i n d i v i d u a l s i n n o n - i s o l a t e d r e s e r v e s g e n e r a l l y ate a g r e a t e r v a r i e t y o f meats. These i n c l u d e d luncheon meats, p o u l t r y , hamburger and stew meats, and " o t h e r " meats. I n d i v i d u a l s on n o n - i s o l a t e d r e s e r v e s a l s o consumed more f i s h , t h i s being l a r g e l y a f u n c t i o n o f g e o g r a p h i c a l l o c a t i o n as a l l three "urban" r e s e r v e s were s i t u a t e d near f i s h i n g areas. Egg consumption was h i g h f o r both p o p u l a t i o n s , i t s frequency o f use being about 40%,. Peanut b u t t e r was the only ve g e t a b l e p r o t e i n eaten i n a p p r e c i a b l e q u a n t i t i e s , w i t h h i g h e s t i n t a k e s i n n o n - i s o l a t e d areas. M i l k i n t a k e was g e n e r a l l y low, w i t h many respondents i n d i c a t i n g g a s t r o - i n t e s t i n a l d i s t u r b a n c e s w i t h i t s i n g e s t i o n . Evaporated m i l k was the m i l k used most f r e q u e n t l y , p a r t i c u -l a r l y i n i s o l a t e d communities where i t was consumed by 52% of respondents. I t was r a r e l y drunk as a beverage, but was added to c o f f e e , t e a or c e r e a l . Powdered m i l k was a l s o used more f r e q u e n t l y on i s o l a t e d r e s e r v e s . T h i s would be expected because of l a c k o f r e f r i g e r a t i o n , c o s t of milk, and d i f f i -c u l t y i n o b t a i n i n g f r e s h m i l k and other d a i r y products. The use o f f r e s h m i l k , cheese, and other d a i r y products was h i g h e s t on r e s e r v e s adjacent to urban ce n t r e s , where access to supermarkets and thus a l a r g e r v a r i e t y o f m i l k products was g r e a t e r . 85 Consumption of foods from the cereal group was high, with bread (including bannock) being the most popular item, included in over 80% of a l l diets. Nutrition Canada (1977) also found that for a l l age groups the mean consumption of bread and r o l l s , as well as the mean consumption of.cereals in general was higher for the native Indian population than the general population. For almost a l l groups, in fact, cereals were a primary source of calories. Similar results were documented by Lee et al (1970). In the present study, cereals provided more calories to diets of individuals on isolated reserves than on non-isolated reserves. This is reflected in the greater frequency of consumption of "other" foods from the cereal group by isolated respondents. These include rice, which was eaten by almost twice as many residents — 607. on isolated reserves — as well as hot cereal, macaroni and spaghetti, pancakes, biscuits and crackers. Fruit and vegetable intake was low as has been described in other studies (Lee et al, 1970; Nutrition Canada, 1977). Smith (1975) reported that when available, potatoes are often eaten, while other vegetables are usually thought to be too expensive to purchase. In the present study, pota-toes were a staple of the diet. They were, in fact, the only vegetable mentioned by almost 2/3 of respondents, regardless of geographical location. The most common method of preparation was by frying. 86 Vegetables most frequently eaten included onions, tomatoes, carrots, peas, corn and turnips which were generally included in popular one-pot dishes such as meat and vegetable stews or soups. A surprising finding was the relatively high consumption (39%) of leafy green vegetables reported by urban respondents. These were, again, mostly eaten as part of a combination food — either in sandwiches or hamburgers — and not as a distinct vegetable dish, i.e. salads. Intake of fruits, as well as vegetables was lower on isolated reserves than on non-isolated reserves. Fruits such as apples, bananas or canned peaches and apricots — which are more easily purchased on isolated reserves — were reported most frequently, but the number of individuals doing so was low. Citrus fruits were almost completely absent from the diets of isolated residents, and this was reflected in their lower vitamin C status. No native fruits and vegetables were mentioned except for several types of berries. One reason for this may be because of the time of the year the study was conducted, i.e. f a l l and winter when store supplies are also low. It has frequently been reported that native diets are high in "empty calorie" items. (Schaeffer, 1977; Ellested-Sayed, 1977). Smith (1975) noted that sweet (and greasy) foods have a great appeal; young children are often given bottles f i l l e d with sugar water or pop; cookies, candies 87 and soft drinks are popular snack items for both young children and adolescents. Nutrition Canada (1977), however, found that the percentage contribution of sugars, beverages and soft drinks to the caloric intake of native diets was similar to that of the general population. Here, the food items most frequently consumed in this category were sugars added to coffee and tea, or jams, j e l l i e s and syrup, most often eaten with bannock, bread or pancakes. In both cases consumption was higher in isolated communities where, in fact, foods from this group provided almost twice as many calories to diets (Table IX-1). Cookies and cakes were also eaten by about 307. of respondents from non-isolated reserves and 367. from isolated reserves. Other foods also classified as "empty calorie" such as cheesies, chips, carbonated beverages and Kool Aid were also consumed by both groups, but to a lesser extent. A high percentage of the population, 717. on non-isolated reserves and 797. on isolated reserves, consumed large quant-ities' of tea or coffee. Margarine was used more frequently than butter, possibly because of availability and cost. Tables XI-1 and XI-2 show some randomly selected but representative meal patterns. In almost a l l cases three meals a day were eaten. Breakfast was the meal most commonly missed, by 207. of respondents on non-isolated reserves and 127. on isolated reserves. Almost a l l recalls included an evening meal. The frequency of snack consumption was high, indicated by almost three-quarters of a l l respondents. 88 TABLE XI-1 SAMPLE DAILY MENUS, TAKEN FROM DIETARY RECALL FORMS COLLECTED ON "ISOLATED" RESERVES. Early Morn 2 white toast with marg. and jam. Small bowl of oatmeal with sugar and evap. milk. Coffee with sugar and evap. milk 2 cups coffee with sugar and evaporated milk Mid Morn Coffee with sugar and evap. milk; 2-3 cookies Noon 3-4 oz. moose, % cup mashed potatoes with marg. and evap. milk; 1 piece bread with marg. and jam. Tea with evap. milk and sugar 1 cup tomato soup (pkg). 6 oz. moose steak, % cup rice, potato Mid-afternoon Coffee with sugar and milk. Bread with marg. and jam. 1 cup tea with sugar Evening Moose meat. % cup rice. Tea with sugar and milk Moose stew with noodles. Potatoes and rice. Bannock with marg. Tea with sugar Late evening Coffee with sugar and milk 1 - 2 cups coffee bread with marg. and jam with sugar and milk 89 TABLE XI-2 SAMPLE DAILY MENUS, TAKEN FROM DIETARY RECALL FORMS COLLECTED ON "NON-ISOLATED" RESERVES. Early Morn 1 small pancake with marg. and jam. Coffee 2 toast (white) with marg. Coffee with sugar and evap. milk Mid Morn Coffee 4 cups coffee with sugar and milk Noon Macaroni and cheese 2 toast (white) with marg. and applesauce 1 cup rice; 1 thick slice (%") fried balogne. Tea with sugar and milk (2-3 cups tea) Evening Fried chicken Breast 1 baked potato with marg. and gravy % cup canned corn. 8 oz. Tang Beef stew with spaghetti and onions 1 cup tea with sugar and milk Late Evening 1 sandwich with meat- 4 cups tea with spread, mayonnaise, sugar and milk and marg. 1 pop 90 Food Ideology A. Food b e l i e f s of homemakers Table XII gives the measured food a t t i t u d e s of respondents. With the e x c e p t i o n o f the c e r e a l group, women i n n o n - I s o l a -ted areas were more able than those on i s o l a t e d r e s e r v e s to l i s t foods which should be i n c l u d e d i n t h e i r d a i l y d i e t . In n o n - i s o l a t e d areas women most f r e q u e n t l y mentioned meat (1007,), vegetables (887.) and the m i l k group (737,) as the foods most important to t h e i r f a m i l i e s , w h i l e those from i s o l a t e d areas l i s t e d meat (.907,) , c e r e a l s (857.) and vege-t a b l e s (707,) . I t i s i n t e r e s t i n g to note that w h i l e many of the respondents l i s t e d the v e g e t a b l e group, 527, of these named the potato s p e c i f i c a l l y . Women from n o n - i s o l a t e d r e s e r v e s were a l s o more l i k e l y to pro v i d e v a l i d n u t r i t i o n a l reasons f o r i n c l u d i n g s p e c i f i c foods i n t h e i r d i e t . Whereas 697, of women c o u l d g i v e a v a l i d n u t r i t i o n a l reason f o r i n c l u d i n g v e g e t a b l e s i n t h e i r d i e t , o n l y 107, of those on i s o l a t e d r e s e r v e s c o u l d g i v e s i m i l a r answers. Knowledge was poores t w i t h r e s p e c t to the c e r e a l group, and o n l y about 107, of respondents from e i t h e r l o c a t i o n c o u l d p r o v i d e a v a l i d reason f o r the importance o f t h i s group. 91 TABLE XII NUMBER OF WOMEN WHO LISTED A FOOD GROUP AS IMPORTANT IN THE DIET AND GAVE A VALID NUTRITIONAL REASON FOR ITS IMPORTANCE. FOOD GROUP ISOLATED (52) NON-ISOLATED (39) No. (%) No. (7o) 1. Milk group a. Listed b. Valid Reason 2. Meat group a. Listed b. Valid Reason 38 34 52 24 (73) (65) (100) (46) 19 6 35 11 (49) (21) (90) (28) 3. Fruits a. Listed b. Valid Reason 4. Vegetables a. Listed b. Valid Reason 5. Cereal group a. Listed b. Valid Reason 37 22 46 36 34 6 (71) (42) (88) (69) (65) (12) 15 3 27 4 33 4 (39) (8) (70) (10) (85) (10) 92 B. Food beliefs as related to pregnancy, lactation,  infancy and illness Tables XIII to XVI l i s t some of the most common foods considered beneficial or harmful at certain stages of the l i f e cycle. General statements made by respondents indi-cating why foods were so classified, together with certain traditional food beliefs are also presented. Respondents listed few dietary alterations that occur during pregnancy, and for the most part stressed the con-sumption of a regular diet (Table XIII). Foods from the milk and vegetable groups were mentioned most frequently as foods important to the pregnant woman. Few foods were considered taboo. Avoidances of specific foods appear to be more closely related to restriction of weight gain than any widely held folk-belief. Opinions related to maternal nutrition diring lactation are presented in Table XIV. Many of the women related that they had not breastfed their infants and were thus unsure of the best diet at this time. Foods most frequently .. classed as "beneficial" to lactation were fluids, as either milk (.36%), tea, coffee, or soup (13%). Certain vegetables and fruits, and chocolates were considered as "harmful" by a small percentage of women (9-12%) because they were thought to cause diarrhea and cramps in infants. Table XV shows that respondents were more lik e l y to 93 TABLE XIII PERCENTAGE OF WOMEN INDICATING SPECIFIC FOODS AS BENEFICIAL OR HARMFUL DURING PREGNANCY BENEFICIAL FOODS (%) HARMFUL FOODS (%) Milk 42 Greasy/s tarchy 14 Vegetables 33 Meat 12 Regular diet 28 Fruits/vegetables 8 Fruits 26 Empty calories 7 Meat 23 Alcohol 6 Cereal 8 Salt 6 Soup 6 Milk 4 Vitamins 5 N=86 General statements: Bananas and potatoes are too starchy. Not too much starches — gain too much weight. Don't eat potato — baby w i l l get too big. No sugar, baby w i l l be too big. Not too much meat — baby might grow too big. Don't eat double or baby w i l l get too big. Green apples and coconut are bad for baby. Baby w i l l be healthy i f you eat grouse and rabbit. My mother-in-law told me not to eat onions. Traditional beliefs: Certain seaweed w i l l darken baby's hair (or skin). Fish heads (or eggs) w i l l produce a bald-headed baby. Eating beaver or pig's feet w i l l deform feet of baby. No berries (huckle/blue) or baby w i l l have spots. Eating fish eggs w i l l cause scars on child's face. No fish t a i l s — baby w i l l be breach. 94 TABLE XIV PERCENTAGE OF WOMEN INDICATING SPECIFIC FOODS AS BENEFICIAL OR HARMFUL DURING LACTATION BENEFICIAL FOOD (%) HARMFUL FOOD (%) Milk (.36) Vegetables (12) Tea (13) Chocolates/pop (10) Soup (13) Fruits (9) Coffee/other fluids (13) Fatty foods (6) Fruits (12) Meat (5) Regular diet (12) Spicy foods (3) Vegetables (10) N=86 General Comments: Fruits give baby gas pains and diarrhea. Turnips and cabbage w i l l upset the child with gas. Orange stops the milk flow (also causes diarrhea). Onions w i l l make baby smell. The mother cannot eat meat for 40 days because her stomach is weak and cannot grind i t . Gum, chocolates and sweets w i l l give baby cramps. TABLE XV PERCENTAGE OF WOMEN INDICATING SPECIFIC FOODS AS BENEFICIAL OR HARMFUL DURING INFANCY BENEFICIAL FOODS (%) HARMFUL FOODS (%) Milk 74 Empty calories 23 Canned baby foods '52" Solids '7 Fruits 51 Cereal 5 Vegetables 48 Meat '4 Meats 43 Canned baby foods 4 Cereal 42 Juice 21 Regular (mashed) 14 Soups 7 N=86 General Comments: Almost everything we eat, ground up. Not too much meat. If so, should be well done. Cabbage and cauliflower are too gassy.. No strong foods such as meat and fish. No bannock or dried meat, baby might choke. 96 TABLE XVI PERCENTAGE OF WOMEN INDICATING SPECIFIC FOODS AS BENEFICIAL OR HARMFUL DURING ILLNESS BENEFICIAL FOODS (%) HARMFUL FOODS (%) Soup 57 Solids 20 Fruit juices 55 Meat 6 Liquids 26 Usual meals 5 Soft drinks 13 Fried foods 5 Tea 12 Cereal 4 Meat 12 Vegetables 4 Milk 9 N=86 General Comments: Soup is easier to take. Can't eat when you are sick. Don't eat most foods. Avoid heavy starchy foods that w i l l lay heavy in stomach. 97 provide opinions regarding diets of infants. Milk was mentioned by 74% of women as an important food for infants, while over 50% lis t e d fruits, vegetables, and canned baby foods. Almost no foods were considered harmful during this period, although almost 25% of respondents emphasized that "empty calorie" foods should be avoided. During illness, some alterations in food intake occur, as indicated in Table XVI. Many respondents indicated that consumption of liquid foods, notable soups and f r u i t juices when i l l . Twenty percent of respondents mentioned with-drawal of solids and other "heavy" foods from their diet. Shopping Practices Table XVII shows that supermarkets were the most popular type of store selected for food purchasing by women on non-isolated reserves. Isolated homemakers, in contrast, shopped at small grocery or general stores. Where access was possible, 23% of isolated families travelled to larger centres and purchased their food in supermarkets. Better, selection, convenience, and the availability of credit were the principal reasons given by women on non-isolated reserves for selecting stores (Table XVIII). On many isolated reserves families were restricted to one grocery outlet. In those isolated areas with more than 98 TABLE XVII TYPE OF STORE WHERE MAJORITY OF FOOD SHOPPING IS DONE STORE NON- ISOLATED ISOLATED No. (7.) No. Supermarket 36 (69) 9 (23) Small supermarket 12 (23) - - • Convenience store 3 (6) - -General/Grocery store - - 31 (78) Co-op 1 (2) - -one store, purchasing decisions were based on better selection and the availability of credit. Cost was given equal consideration by the two populations. Frequency of shopping for major and minor, or " f i l l i n" food purchases are reported in Table XIX. A small number of respondents expressed d i f f i c u l t y in categorizing shopping trips, and this problem may be reflected in the results. The majority of homemakers shopped once weekly or every two weeks for their major grocery supplies. Among the isolated group, one-third of the families, including many of those who sought alternative grocery outlets outside their communities, did a large monthly shopping. Minor purchases were frequent and the majority of families from both areas shopped two or more times a week. TABLE XVIII REASONS FOR SELECTING STORE Reason Non- Isolated Isolated No. (%) No. (%) Better selection 21 (40) 11 (28) Cheaper 6 (12) 5 (13) Convenient 8 (15) 0 Credit 9 (17) 1 (3) Selection & price 3 (8) 1 (3) No choice 0 15 (38) Service 3 (8) 0 Location 2 (4) 4 (10) Patronage 0 3 (8) TABLE XIX FREQUENCY OF SHOPPING FOR MAJOR AND MINOR FOOD PURCHASES Frequency Non-•Isolated Isolated No. (%) No. (%) Major shopping Daily 1 (2) 5 (13) Weekly 12 (23) 9 (23) .Bi-weekly 31 (60) 11 (28) Monthly 8 (15) 13 (33) Other 0 (10) 2 (5) Minor shopping 6 - 7x/week 15 (29) 5 (13) 4 - 5x/week 7 (14) 8 (20) 2 - 3x/week 20 (39) 20 (50) Weekly 7 (14) 4 (10) Don't do 3 (6) 3 (8) 100 The responsibility for purchasing food for the household differed with isolation (Table XX). Whereas on non-isolated reserves the female head of household was by far the principal food shopper (857,) , on isolated reserves this task was almost equally distributed between the woman and other family members. The majority of women (767o) did not shop alone, and were accompanied to stores by family members, most frequently, children. The types of foods children encourage mothers to purchase while shopping were classified into the food groups and are presented in Table XXI. Snacks and empty calorie foods such as pop, sweets, potato chips, etc. were the most popular items requested, particularly on isolated reserves. Foods from the milk group (notably ice cream), fruits, and cereals were also liked by children. The use of several recommended food - buying practices was assessed, as illustrated by Table XXII. While respondents on non-isolated reserves were more likely to budget and pay cash for food purchases, an equal percentage of women from both groups used shopping l i s t s . Monthly food expenditure ranged from $84.00 to $630.00 with a mean of $252.16 on non-isolated reserves, and $302.43 on isolated reserves. (Table XXIII). A larger percentage of families on isolated reserves reported expenditure of three hundred dollars and more. (537, as compared to 297, for non-isolated reserves) . 101 TABLE XX PERSON WHO DOES MAJORITY OF FOOD SHOPPING Shopper Non-Isolated Isolated No. (%) No. (%) Female head of household 44' (85) 18 (45) Male head of household - - 6 (15) Female head of household & other family member 7 (13) 11 (28) Children/other adult 3 (6) 5 (8) Person accompanying Food Shopper Husband .8 (20) 5 (16) Children 25 (61) 20 (65) Friends/relatives .3 (7) 4 (13) Entire family . 5 (12) 2 (7) TABLE XXI FOOD SHOPPING REQUESTS OF CHILDREN Food Group Non-Isolated Isolated No. (7.) No. (7o) Milk 10 (31) 7 (29) Meat 4 (13) 1 (4) Fruits 13 (41) 4 (17) Vegetables 2 (6) 0 -Cereals 7 (22) 3 (13) Empty calories 18 (56) 23 (96) Other 5 (16) 0 102 TABLE XXII FREQUENCY OF SELECTED SHOPPING PRACTICES P r a c t i c e Use of Lis t Payment Cash Charge Cash & charge Charge & trade Non-Isolated(52) Isolated(39) No. (%) No. (%) (56) 19 (49) (44) 20 (51) (56), 7 (17) (44) :• 32 (82) 36 (69) 6 (15) 13 (25) 25 (64) 3 (6) 7 (18) 0 1 (3) Makes List 29 Doesn't make List 23 Budget Budgets for food 29 Doesn't budget 23 To assess the effect, i f any, of using food costs on the purchasing patterns of families, women were asked whether they now buy more, less, or the same amounts of certain foods. As illustrated in Table XXIV, 5370 of women named meat as the food most affected. Many of these same respondents also indicated that they were now relying more on meat from hunting and fishing. Snack foods, fruits and vegetables were other food groups affected. Increased purchases were most apparent in the bread and cereal group, with almost 207o of families indicating that they were recently 103 buying more of these foods. TABLE XXIII DISTRIBUTION OF MONTHLY FOOD EXPENDITURE Food Expenditure Non-Isolated Isolated ($ per month) No. (%) No. (%) Less than 100 1: :'(2) ; o 100 - 199 13 (25) 5 (13) 200 - 299 20 (39) 11 (28) 300 - 399 10 (19) 12 (30) 400 + 5 (10) 9 (23) No response 3 (6) 3 (8) The degree to which various factors influence food purchases and thus food consumption was also investigated, with the consideration that these attitudinal data could be used to increase the effectiveness of nutrition education programme. Homemakers were asked to indicate whether each factor listed was very important, or/vnot important in influencing food selection (Table XXV). "What the children l i k e " was chosen most often as an influential factor. "Cost", "what is good for you", and "requests made by husbands" were also mentioned frequently. The woman's own food preferences was the main factor in the 'important' category, while ease of preparation was the least influential factor. 104 TABLE XXIV CHANGES IN FOOD BUYING WITH INCREASING FOOD PRICES Food Group Buy less Buy more Same No. (%) No. (%) No. (%) Milk 9 (15) .6 (10) 45 (75) Meat 32 (53) •2 (3) 26 (44) Fruits 12 (20) 2 (3) 46 (77) Vegetables 11 (18) .3 (5) 46 (77) Cereals/bread 5 (8) 11 (18) 44 (74) Snack foods 22 (37) 2 (3) 36 (60) N = 60 Meal Planning and Preparation Table XXVI shows that the chief individual responsible for the preparation of family meals, regardless of isolation was the female head of household. Males play l i t t l e , i f any, role in the actual cooking of food. Whether or not meals were planned ahead, and how far in advance was also assessed, as. illustrated in Table XXVII. Although few women used meal plans, a larger percentage of those in non-isolated reserves were more li k e l y to do so. TABLE XXV FACTORS IDENTIFIED BY RESPONDENTS AS INFLUENCING FOODS PURCHASED. Factor Very Important Important Not Important No. (7.) No. (%) No. (To) What the homemaker 14 (22) 45 (70) 5 (8) likes What husband likes 21 (34) 28 (46) . 4 (7) What children like 34 (53) 25 (39) .3 (5) Easy to prepare 6 (10) 22 (34) 36 (56) Cost of Food 27 (42) 22 (34) 15 (23) What is "good" for 26 (40) 35 (55) 3 i(5) N = 64 1 0 6 TABLE XXVI PERSON WHO DOES MAJORITY OF COOKING Cook Non-Isolated No. (%) Isolated No. (%) Female head of household Male head of household Other adult FHH and other adult FHH and daughter FHH and MHH Shared by a l l Children 35 0 3 3 5 1 3 0 (6) (6) (10) (2) (6) (70) 25 1 1 3 4 3 2 1 (2) (2) (8) (10) (63) (8) (5) (2) There was a significant difference in household f a c i l i t i e s available to individuals living in the two areas (Table XXVIII). Whereas almost a l l families in non-isolated reserves had running water, electricity, refrigerators, stoves and ovens, these were reported by a much smaller percentage of families in isolated areas. Freezers were an appliance least available to a l l respondents. Homemakers were asked whether they had ever "studied about what to eat" and where they had studied. There was a large differnce between the two populations, with 657, of women on non-isolated reserves having received some training, but only 257, of those on isolated reserves having food education (Table XXIX). Formal schooling was 107 indicated' ;" by the majority of respondents from both areas as the source of teaching. Women were also in agreement that the food or cooking information they had received was of benefit to them. TABLE XXVII USE OF, AND FREQUENCY OF MEAL PLANS Plan Non -isolated Isolated No. (%) No. (%) For one week 4 ((8) 0 For a few days 4 1(8) 1 .(3) Day before 8 (15) 2 '(5) Day-to-day 36 (69) 37 (93) TABLE XXVIII HOUSEHOLD FACILITIES Fa c i l i t y Non -isolated Isolated No. (%) No. (%) Running water 5i: . (98) H (21) Elec t r i c i t y 51 (98) 13 (33) Freezer 26 (50) 4 (10) Refrigerator 52 (100) 2 ..(5) Stove 52 (100) 39 (98) Oven 5.2 (100) 32 (80) 108 TABLE XXIX FOOD AND COOKING EDUCATION OF RESPONDENTS Education Non-•Isolated Isolated No. (%) No. (%) Received training 34 (65) 10 (25) Did not receive training 18 (35) 30 (75) Source of teaching Grade school 1 (3) 1 (10) High school 24 (71) 5 (50) Vocational school/ 3 (9) 2 (20) other training High school & other 5 (14) 1 (10) Evening classes 1 (3) 1 (10) Value of information Helpful 26 (79) 9 (90) Not helpful 7 (21) 1 (10) Sources of nutrition information identified by respondents are illustrated in Table XXX. The primary source of information listed by respondents was their mother, while family members and other relatives were indicated by almost 40% of women. Of the non-human sources, cookbooks and other books received a high response from the population. Newspapers and magazines were cited by 507o of women on non-isolated reserves, but not mentioned by women on isolated reserves. Nutritionists, dieticians, physicians, or nurses were mentioned infrequently. TABLE XXX SOURCES OF NUTRITION INFORMATION IDENTIFIED BY RESPONDENTS Source Non-isolated (52) No. (%) Isolated (40) No. (%) Total (92) No. (7o)* 1. Physicians, nurses 6 dentists 2. Nutritionists, dieticians 3 3. Mother 26 4. Family member/other 20 relatives 5. Friends 13 6. Newspapers, magazines 29 7. Cookbooks, other books 26 8. T.V./Radio 9 9. Past experience 13 (12) (6) (50) (38) (25) (56) (50) (17) (25) 0 25 15 1 0 18 0 9 (5) (63) (38) (3) (45) (23) 8 3 51 35 14 29 44 9 22 (9) (3) (55) (38) (15) (32) (48) (10) (24) * expressed as % of a l l women 110 A large percentage of respondents, 737, on non-isolated reserves and 78% on isolated reserves indicated use of vitamin and mineral supplements (Table XXXI). Less than half of these,however, mentioned that supplements were used regularly. Different patterns of use were apparent. Whereas on isolated reserves the majority of users (80%) were children, on non-isolated reserves, children, the female head of household and the entire family were taking supplements. The type of supplement being taken also varied with location with 1Tri-Vi-Flor/Adeflor' (issued by Medical Services) being the most frequently mentioned supplement on isolated reserves, and 'Multivitamins' on non-isolated reserves. In order to assess the role of alternate food ~ sources to families, respondents were asked to rank the importance of fishing, hunting, trapping, gardening, and gathering as a food source to them (Table XXXII). In almost every case, subjects in isolated areas were more li k e l y than those in non-isolated areas to rate food from the land as being a more important means of obtaining food. The most notable differences were in hunting and fishing; whereas 100 percent of respondents in isolated communities indicated that hunting was either very important or important to them, only 567. of those on non-isolated reserves did likewise. Similarly trapping TABLE XXXI USE OF VITAMIN AND MINERAL SUPPLEMENTS Variable Non-Isolated Isolated No. (%) No. (%) Practice Take supplements So not take supplements Frequency Regular Irregular Winter only Family member Child/children Female head of household Male head of household Other family members A l l or most of family Type of supplement Multiple Adeflor/Tri-vi-flor Calcium Iron Iron + vitamins Cod liver o i l Combination of types Don't know 38 (73) 31 (78) 14 (27) 9 (23) 18 (47) 13 (42) 15 (40) 18 (58) 5 (13) 0 10 (26) 24 (80) 13 (34) 3 (10) 1 (3) 1 (3) 1 (3) 0 13 (34) 2 (7) 21 (55) 5 (13) 30 (100) 1 (3) 2 (5) 5 (13) 1 (3) 2 (5) 1 (3) TABLE XXXII TRADITIONAL FOOD PATTERNS Practice NON-ISOLATED(52) ISOLATED(40) Very Impt. Impt. Not Impt. Very Impt. Impt. Not Impt. Fishing 30 (50)* 14 (27) 8 (15) 28 (70) 9 (23) 3 (8) Hunting 15 (29) 14 (27) 23 (44) 37 (93) 3 (8) 0 Trapping 1 (2) 5 (10) 46 (88) 8 (20) 12 (30) 20 (50) Gardening 8 (15) 7 (14) 3? (71) 6 (15) 10 (25) 24 (60) Gathering 6 (12) 2 (40) 25 (48) 7 (18) 22 (55) 11 (28) * Figures in parentheses indicate percentage of isolation type PRESERVATION PRACTICES Non-isolated Isolated No. (%) No. (7o) Preserves Food 37 (71) 29 (73) 113 was stressed by 507, of isolated residents, but only 127, of non-isolated families. Gardening appeared to be least important to a l l respondents, while fishing was most important. The practice of food preservation was not affected by isolation and almost three-quarters of a l l families preserved food (Table XXXII). Food Practices of Homemakers A. Food Scores Food practices were measured by a score based on a 24 - hour reca l l of the intake of the female household head. As an indication of dietary adequacy, the assumption of Au Coin et al (1972) was adopted: "In recognition of the fact that i t is quite possible to obtain a satisfactory nutrient intake in terms of Canadian Dietary Standards yet not meet a l l of the recommendations of Canada's Food Guide (McClinton et a l , 1971; Milne et a l , 1963) for the purpose of this study, a score of 70 or more out of a possible 100 was considered to be adequate (p.147)." Table XXXIII shows that scores for food practices varied widely, with a range of 10 to 25 points and a mean of 18.3 for the entire population. Satisfactory intake was obtained by only 577, of the women, as indicated by scores of 18.5 (707,) or greater. Significant differences were observed between the scores of the two populations, with 114 TABLE XXXIII FOOD PRACTICE SCORES ACHIEVED BY RESPONDENTS Score Non-isolated (52) Isolated (40) No. (%) No. ^ (%) 10 0 1 (2.5) 11 0 1 (2.5) 12 2 (3.8) 1 (2.5) 13 1 (1.9) 3 (7.5) 14 1 (1.9) 4 (10.0) 15 3 (5.8) 2 (5.0) 16 1 (1.9) 3 (7.5) 17 6 (H.5) 3 (7.5) 18 3 ..^5^81 5 {12.51* 19 6 (11.5) 7 (17.5) 20 10 (19.2) 5 (12.5) 21 8 (15.4) 4 (10.0) 22 4 (7.7) 1 (2.5) 23 4 (7.7) 0 24 2 (3.8) 0 25 1 (1.9) 0 mean = 19.3 mean = 17.2 * level of dietary adequacy women.' on non-isolated reserves scoring higher. In non-isolated areas, 677, of respondents had adequate ;diets, while only 437. of respondents on isolated areas did so. Food practice scores were also broken down into major food groups (Table XXXIV). 115 TABLE XXXIV. FOOD SCORES OF RESPONDENTS BASED ON MAJOR FOOD GROUPS Food Group Score Non-isolated.(52) I s o l a t e d (40) No. (%) No. (%) MILK 0 8 (15) 3 (8) 1 3 (6) 5 (13) 2 8 (15) 9 (23) 3 3 (6) 11 (28) 4 13 (25) 6 (15) 5 2 (4) 1 (2) 6 15 (27) 5 (13) mean = 3.5 mean = 2.9 FRUIT AND 0 3 (6) 8 (20) VEGETABLES 2 3 (6) 3 (8) 3 2 (4) 8 (20) •4 4 (8) 9 (23) 5 18 (35) 6 (15) 6 4 (8) 4 (10) 7 18 (35) 2 (5) mean = 5/2 mean = 3.4 MEAT 1 1 (2) 0 (0) 3 3 (6) 1 (3) 4 3 (6) 4 (10) 5 10 (19) 6 (15) 6 35 (68) 29 (72) mean = 5.4 mean = 5.6 BREAD AND CEREAL 0 1 (2) 2 (5) 2 3 (6) 2 (5) 3 1 (2) 0 (0) 4 7 (14) 3 (8) 5 4 (8) 0 (0) 6 36 (69) 33 (83) mean = 5.3 mean = 5.4 116 Meat and cereal were the most adequate groups in the women's diets. Ninety-five percent of the respondents consumed the recommended daily intake of meat or meat products, as demonstrated by a score of 4 or greater. Only one woman had no foods from this group. No significant differences were found between the two populations for meat consumption. For the cereal food group, 697> of women on non-isolated reserves, and 837. of women on isolated reserves consumed 3 servings, thus achieving a maximum score of 6 points. A total of 87% of respondents had an adequate intake of foods from this group (adequate being taken as a score of 4 plus). Milk and milk products was the group consumed in the least adequate amounts. Foods from this group were eaten by only 22% of the women in the recommended 1% servings, When a score of 4 is taken as a basis for dietary adequacy, 447> of the surveyed population had an adequate intake of foods from this group. Although intakes were lower in isolated areas, this difference was not significant. A significant difference between the two populations was observed, however, in the intake of fruits and vegetables. Only 307. of women on isolated reserves had adequate intakes of foods from this group (indicated by a score of 5 plus), as compared to 787. of women on non-isolated reserves. Forty-eight percent of isolated respondents had one or no serving of fruits and vegetables. 117 TABLE XXXV INTER-RELATIONSHIP BETWEEN FOOD GROUPS AND FOOD PRACTICES Milk 1 Fr Veg 2 -0 .015 Meat 3 -0 .134 Cereal 4 0 .128 Practices 5 0 .499,c 0.002. •0.207° 0.051 0.437c 0.142a 0.250b 1.000 P < .01 cp < .001 Tnter-correlation of mean scores in the four food groups showed only asstrong negative correlation (p < 0.01) between scores for the cereal and the fruits and vegetables groups (Table XXXV). Mean scores of each of the four food groups were positively correlated with the total food practice mean scores. Milk, and fr u i t and vegetable group mean scores were found to correlate most strongly (p < .001), while cereal (p < .01) and meat (p < .05) group mean scores related less strongly to total food practice mean scores. B. Relationship between food practices and selected  variables Analysis of variance indicated that the location of the reserve did influence the food practice scores of respondents (Table XXXVI). The mean food practice scores 118 TABLE XXXVI MULTIPLE RANGE TEST OF MEAN SCORES FOR FOOD PRACTICES, WITH RESPECT TO RESERVE Reserve N Mean Score 1. Sechelt 16 19.00b * 2. Fort Ware 12 16.08 a b 3. Necoslie 16 19.81 b c 4. Nanaimo 20 19.10b 5. Nazko 8 18.50b 6. Babine 7 19.14b 7. Takla 13 16.23 a b * Means not sharing the same subscript under each variable are significantly different at p < 0.05. of women from Necoslie did not differ significantly from the mean scores of women at Sechelt, Nanaimo, Nazko or Babine, but were significantly different from the mean scores of those at Fort Ware or Takla. Results of Scheffe's Test for food practice scores in terms of reserves: 3 1 4 5 6 1 4 5 6 7 2 For reserves underlined by the same line, differences in mean practice scores were not significant. 119 TABLE XXXVII RELATIONSHIP OF DEPENDENT VARIABLES AND FOOD PRACTICE SCORES (KENDALL'S CORRELATION COEFFICIENT) Variable Food Score Isolation - 0.286c Age - female 0.040 Household size - 0.136a Education-female 0.179a Education-male 0.155 Nutrition Education 0.137 Beliefs 0.229b Family Income - 0.079 Per Capita Income 0.083 Work Status-female 0.021 Occupation-Male 0.144 Household f a c i l i t i e s 0.238b ap < .05 bp < .01 Cp < .001 Rank correlation indicated that a number of variates were significantly related to nutrition practice scores (Table XXXVII). 120 The most significant factor relating to food consumption was isolation (p < .001). Isolation was also significantly correlated with different independent variables (Table XXXVIII) . Reserves intrmore urbanized areas were associated with increased levels in the general way of l i f e , i.e. more education, higher occupational status, increased income and level of living and better nutritional attitudes. A significant negative correlation was observed between the women's food scores and total household size. In this study, families with large households tended to be located in isolated areas, had lower incomes, and less formal education. Education of respondents was also significantly related to nutrition practice scores (p < .05). Women who had a higher educational level tended to live in urban areas, had smaller families, a higher income, and a better attitude toward nutrition. The women's attitudes toward nutrition, as expressed in their food beliefs, had a significant effect on their food practices (p < .01). Beliefs were also significantly related to other variables influencing dietary practices -i.e., education, household f a c i l i t i e s and isolation. There was a significant correlation between the level reached on the household f a c i l i t i e s scale and nutrition adequacy (p < .01). TABLE XXXVIII INTER-RELATIONSHIP BETWEEN VARIABLES 1 2 3 .4 5 6 • 7 8 , '9 :L" 10 ISOLATION 1 1 F AGE 2 .012 BELIEFS 3 --.387° • -.085 HSHLDSIZE 4 .251b .171a -.062 INCOME 5 --.184a • -.044 , .128 .135 INC/FAMSIZE 6 --.318c -.118 .127a -.527° .485° F EDUC 7 --.581° -.350° .477c -.244b .152a .272° M EDUC 8 --.460° .450° .299° -.382c .178a .395° .560° F WORK 9 • -.347° -.092 .231 - .067 .172a .150a .418° .226a NUTR EDUC 10 --.401c -.371° .397c -.233b .219a .323c .623c .522° .238a HSHL'D FACIL 11 • -.788c .119 -.344c -.081 .250b .257° .382° .291b .256b .272b M "'OCCUP 12 --.291b -.139 .156a -.103 .321° .271° .185a .356c .086 .236a ap < .05; bp < .01; Cp < .001 122 Cross-tabulation of the age of the female household head with scores on food practices revealed no significant relationship between the two variables. No significant relationship was observed between the educational level of the male head of household and the diet of respondents. Correlation of the nutrition education of the respondents with scores on food practices showed that food practice scores increased with nutrition education, but the relationship was not significant. Whether or not female household heads were employed did not significantly affect their food practice scores. Neither was there a significant relationship between food practice scores of homemakers and the occupation level of husbands. Although there was a trend toward a more adequate diet with increased income, no significant relationship was observed between family income and dietary practices. Similarly when family income was expressed as per capita income and cross tabulated with the women's food practice scores, no significant effect was indicated. 123 Food Pricing and Food Availability The availability of the 66 food items contained in the 'food basket' in the selected reserves is shown in Table XXXIX. Overall select ion was poorest in isolated reserves, notably Babine and Fort Ware. Distinct differences were also observed in the availability of certain categories of foods between isolated and non-isolated reserves. The items most often in short supply were dairy products, fresh meats, and fresh fruits and vegetables. The cost of 30 food items selected from the 'food basket' on the different reserves relative to Vancouver prices is shown in Table XL. Because so few food items were available in the small grocery store at Babine and most residents there shopped at Smithers, food costs for Babine residents were calculated from the supermarkets at Smithers rather than Babine i t s e l f . As indicated in Table XL, food costs were highest in the most isolated reserves (Fort Ware and Takla), where transportation costs were also expensive. Prices in more urbanized areas varied from 5% (Nanaimo) to 15% (Fort St. James) higher than Vancouver. 124 TABLE XXXIX FOOD AVAILABILITY CATEGORY NO. ITEMS COMMUNITIES LISTED CO cu r-l 4-> 0 CU CU CO -rH & ~C cd 4-> O - C - H CL) 4-J Cd 0 CO |Jq |3 CO cu CO r-l Q U cd cu c cd O •H rH r * 4-1 X> N U cd cd cd o PQ H 3 Dairy products 7 7 7 7 7 2 2 6 3 Fruits/vegetables: Fresh 12 12 11 11 12 4 9 8 6 Processed 13 13 13 13 13 5 9 11 9 Breads and cereals 8 8 8 8 8 6 8 8 6 Meat: Fresh 9 9 9 9 9 0 7 5 0 Processed 8 7 8 7 8 2 8 8 6 Fats and oils 5 5 5 5 5 0 5 5 3 Miscellaneous 4 4 4 4 4 4 4 4 4 Total 66 65 65 64 66 23 52 55 37 125 TABLE XL COST OF 30 FOOD ITEMS IN SELECTED COMMUNITIES RELATIVE TO THE COST OF THESE ITEMS IN VANCOUVER Community Cost °L Higher Than Vancouver Vancouver $29. .86 Sechelt 33. .35 12 Fort St. James 34. ,24 15 Nanaimo 31. .24 5 Smithers 31. .51 6 Takla 40. ,59 36 Babine Nazko 36. ,50 22 Fort Ware 54. ,37 82 126 CHAPTER V DISCUSSION AND IMPLICATIONS A. Analysis of nutrient intake data In the present study, low nutrient intakes (defined as less than two-thirds of the Canadian Dietary Standard) were frequent for, calcium, iron, Vitamin C and calories. Among native Indianspopulations, calcium intakes have frequently been reported to be poor. (Heller, 1964; Lee, 1970; Dil l i n g et a l , 1978). Nutrition Canada (1975) reported inadequate intakes among teenage gir l s and pregnant women, marginal intakes among children 5 to 9 years of age, a l l adult women and elderly men. In the study described here, calcium intakes were lowest for adolescents of both sexes, particularly on isolated reserves. This difference in regional adequacy is reflected in food frequency consumption as indicated in Table X. Milk and milk products which supplied about one half of the calcium intake, were consumed more frequently at non-isolated reserves. Intakes of a l l adults, particularly women were also inadequate. Concern is expressed for the low calcium intakes among adolescents and women, particularly those of child-bearing age who have increased dietary demands for calcium. On the evidence of bone density studies Fraser (1975) has suggested that low calcium intakes may predispose adults over 40 years to a higher incidence of osteoporosis. 127 Calcium is a nutrient that requires careful consideration, particularly with recent reports of lactose intolerance among native groups (Leichter and Lee, 1971; Ellestad -Sayed and Haworth, 1977). Leichter observed a high incidence of lactose intolerance among adolescent B.C. Indians, however test doses given to subjects were very high. There appears to be less intolerance when lactose is given as a whole milk in small quantities (Garza and Scrimshaw, 1976) or milk taken with other foods or as part of a food recipe (Leichter, 1977). It would be advisable then for nutrition education programmes to encourage incorporation of milk and milk products into other food dishes i.e. cooked cereal, ground meat, mashed potato, cream soup, cocoa, etc. Iron intakes followed the trend noted in other studies, with a high percentage of adolescents and adult women below the two-thirds level (Lee, 1970; Nutrition Canada, 1975). Those individuals on non-isolated reserves exhibited the poorest iron status. This is very likely due to differences in the consumption pattern of meat which contributed less iron to diets of non-isolated than isolated residents (Table IX-1). The type of meat consumed may be an additional factor. Diets on isolated reserves contained more meats with a high iron content (i.e. moose) than those on non-isolated reserves where fish, luncheon meats, and poultry were more commonly eaten (Table X). 128 Among adolescents, poor dietary practices often contribute to low iron intake (Schorr et a l , 1972; Singleton et a l , 1976). Adolescent g i r l s in particular may restrict caloric intake or subscribe to fad diets in order to lose weight (Singleton et a l , 1976). The low caloric intake of adult women in this study no doubt contributed to their low iron status, as any reduction of calories is likely to reduce iron intake (Clements, 1975). The low dietary intake of iron, like calcium, among women of child-bearing age is of concern because of increased demands at this time. The geographical pattern of lower Vitamin C intakes among native Indians in remote areas as compared to those living nearer to urban centres, identified by Nutrition Canada (1975) was also observed in this study. Vitamin C intakes on isolated reserves, particularly among adolescent boys, were considerably lower than on non-isolated reserves. Of interest to note also, was the changing pattern of the source of ascorbic acid in diets. Whereas Lee (1970) noted that residents of the Anaham and Ahousat reserves were dependent on evaporated milk for their Vitamin C, individuals in this study obtained most of their supply from fruits (about 70%). Foods from the milk group contributed a negligible 2% of the ascorbic acid intake. One explanation for this may be increased consumption of the orange drink Tang on both isolated and non-isolated reserves (Table X) ., Tang, which is cheap, convenient, easy to store and 129 widely available has been readily accepted as a " f r u i t " drink in native diets (Peterson, 1974). Among the national native population, as well as the general population, vegetables as well as fruits are a primary source of Vitamin C (Nutrition Canada, 1977). Low caloric intakes were observed for a l l adolescents, particularly boys, and for most adults, regardless of reserve location. That diets of adolescent gir l s were more favourable than those of adolescent boys was of interest. Generally studies show that nutritional status of adolescent boys is superior to that of adolescent g i r l s , chiefly because boys eat more food than g i r l s and thus have a better chance of obtaining adequate intakes (Schorr et a l , 1972). One reason for our results may be the uneven distribution of girls in the 10 to 19 years category, many of whom were under 13 years, in the age range where intakes are more favourable (Au Coin et al, 1972; Haley et al, 1977). One paradox that was apparent here, and described in other studies (Prothro et a l , 1976; Nutrition Canada, 1975), was that although caloric intake of adults, particularly women, was not excessive, many of the women appeared to be overweight. It has been suggested that factors such as past nutritional history, omission of food items in recalls, and a sedentary l i f e s t y l e may explain this inconsistancy (Nutrition Canada, 1975). 130 B. Relationship between food practices and selected  variates The location of the reserve (rural vs. urban) may through physical availability — i.e., food production, preservation, distribution — affect food habits. In the present study, the most significant factor related to food consumption was isolation, with diets in urban areas being more adequate than those in isolated areas. Other studies which have examined the influence of location, have tended to focus on differences between city and farm diets (Dean et al, 1954; Hendel et a l , 1965) . In their investigation Dean et al (1954) found that Intakes of city children were better than those of children living in nearby rural areas. The 1955 USDA survey studied/closely he effect of residence arid found that farm diets tended to be lower in.vitamins A and'C than city-diets. Contradictory results were obtained in the 1965 USDA survey, and i t was concluded that other factors besides residential differences were exerting an effect on dietary adequacy. Similarly, results of the Nutrition Canada Survey indicated that the "type of food consumed was l i t t l e i n f l u -enced by region or season...." (Educational Services, 1978). Several investigations have found a direct relation-ship between the homemaker's age and dietary adequacy. Young (1955) reported better nutritional practices among young 131 homemakers (under 40 years) than middle aged or older homemakers. As age increased, use of milk products and citrus fruits decreased. In Jolso's study (1965) increasing age was positively associated with increasing r i g i d i t y and with decreasing nutritional practice scores. Bowering et al (1976) found that among,? 119 low-income women attending an obstetrics c l i n i c in New York, age was associated with dietary indices. Older women tended to have poorer diets. In this study, although there was a wide distribution in ages among respondents, age had no effect on dietary practices, although older women tended to have less education and larger families. Age was however not related to isolation or level of living, two variables which exerted the strongest influence on food practices. Household size may exert a negative influence on nutritional status. It has been hypothesized that as family size increases, there is a decrease in the amount of money spent for food per person (Davis, 1969). Studies among preschoolers of various cultural backgrounds have yielded conflicting results. While Sanjur and Scoma (1972) and Caliendo et al (1976) found that nutrient intake was not dependent on family size, Sims and Morris (1974), Cook et al (1973) and Hendel et al (1965) did observe some effect. Examinations of the dietary habits of teenagers have shown no relationship between these two variables (Thompson, 1975; 132 Schorr et a l , 1972; Duyff et a l , 1975). Similarly in a study of 483 expectant Negro women, Crump et al (1959) found no relationship between size of the family unit and prenatal nutrition of subjects. Boek (1956) however, reported that dietary intake of calcium as well as dietary diversity of Michigan farmers were inversely related to family size. Results of the present study were in agreement with the findings of Boek in that a significant negative correlation was observed between food scores and household size. A direct relationship has also frequently been reported between educational attainment and nutritional adequacy of different population groups. (Eppright, 1970; Payton, 1960; Cliendo et al, 1977; Haley et a l , 1977). Both Futtrell (1971) and Eppright (1970) stressed that the education of the woman was a more significant factor than income in determining dietary quality. Murphy and Wertz (1954) found that the dietary adequacy of 65 pregnant women increased with their educational level. While 42% of women with the highest education ate an adequate diet, only 207, of those with lesser education were in this group. The present study supported these studies. Dietary practices were significantly related to the educational level of respondents. The importance of the educational level of the male household head has been discussed by a number of 133 investigators. It is generally considered that with increased education, the socio-economic level increases, providing individuals with higher incomes for purchasing food (Davis et a l , 1969). Many studies have examined the relationship between the educational level of the male parent and the dietary adequacy of children from varying backgrounds, with inconsistent results. While Au Coin (1971), Haley (1977) and Hinton (1963) reported that the father's educational achievements exerted a strong influence on dietary practices of their school children, Caliendo et a l , 1976 and Walter (1974) failed to obtain a similar significant relationship in their studies. The present investigation was in agreement with the latter two studies in that no significant correlation was observed between the educational level of the male head and the dietary practices of homemakers. One reason for this finding may be the general lack of employment on reserves, regardless of education. Most jobs available don.not require specialized training, and can be occupied by anyone, regardless of education. A large number of investigators have documented the positive relationship between nutrition education and dietary practices (Coale, 1972; Hunt, 1976; Bowering et a l , 1976). Walter(1974) found that Indian youths having educational dietary programs available to themhhad a better 134 Food Quality Index (FQI), while Hunt (1976) recently reported that low-income pregnant women participating in nutrition education programs significantly increased their mean intakes of protein, ascorbic acid, niacin, riboflavin and thiamine. Results of the present study, however, showed that women who had received "food or nutrition information" did not achieve significantly higher food scores. The majority of women reported formal schooling as the source of their food information, with only a small percentage indicating other sources of learning. This finding suggests that among the study subjects, food or nutrition education received in Home Economics classes did not significantly alter dietary practices. Schwartz (1975, 1976) also found no relationship between enrollment in Home Economics classes and the nutrition practice scores of 313 Ohio high school graduates, and again amoung 352 Canadian public health nurses. Results of the present study indicate that the food beliefs or attitudes of the women affected their dietary practices. A highly significant positive correlation (p < .001) was found between food beliefs and practices of respondents. These findings support the work of Schwartz (1975, 1975), J a l s o et al (1965) and Dickins (1962), who have documented similar positive relationships between 135 nutrition attitudes and practices. Income is considered to have a direct effect on nutrition practices with the quality of the diet generally improving with an increase in the income level. (Delgado et a l , 1961; Hendel et a l , 1965; Dickins, 1965; Payton et a l , 1960). Although a recent report based on data from the Nutrition Canada Survey concluded that for most physiological groups income does not affect nutritional status, native Indians * were not included in the study population (Health and Welfare Canada, 1975). No relationship was observed between income and dietary practices in the present study. The study of Walter (1974) among American Indian youths also found no significant relationship between these two variables. In his discussion of this finding Walter distinguishes between the effects of two kinds of poverty: internal and external poverty. Internal poverty is described as a poverty one is born into, the "culture of poverty". Under conditions of an impossible environment, the poor develop a sense of living in the present, with an immediate approach to l i f e . External poverty lies outside the culture of poverty and is the result of different factors i.e. a decline in economic activity resulting in unemployment and loss of income. Walter concludes that the relationship between income and diet exists in the 136 external poverty sense, but not to those subject to internal poverty.. It may be that the population group in the study were similarly a part of the internal poverty and factors other than income affected the way they eat. No significant differences were found between dietary practices of employed and non-employed respondents, confirming the reports of Robson (1971), Au Coin et a l , (1972) and Doyle et al (1953). Other studies have concluded that families of employed women show better diets (Schorr et a l , 1972; Dickins, 1961; Sanjur and Scoma, 1972; Coale, 1971). The difference in findings may be caused by the similarity of occupations in which homemakers were employed. The effect of the occupational status of the male head of household on family food practices has been studied among adolescents (Schorr, 1972)', children (Sims, 1974), and adult women (Murphy and Wertz, 1954), with positive results. Duyff (1975) however, found that among a sample of Puerto Rican teengagers a higher level in the occupational scale of the parents was associated with frequent consumption of soft drinks, perhaps indicating that more money was avaiable. Walter (1974) similarly noted that the occupation of the family head had no 137 influence on the food practices of 35 Indian youths. The findings of the present study support the last study in that there was no significant relationship between food practice scores of homemakers and the occupational level of male heads. This may be because here, as in Walter's study, differences in occupational categories were minimal, and many of the men were employed in similar types of work. The typesof public services and materials available -water, electricity, equipment and f a c i l i t i e s for food preparation and eating - a l l influence food patterns. There is generally, a lack of these services and f a c i l i t i e s on Indian reserves, resulting in a high incidence of various diseases (Simpson, 1974; Smith, 1975). Among the study group, respondents with higher household f a c i l i t e s scale exhibited better dietary practices. This is consistent with other reports. Boek (1956) showed a significant positive correlation between calories and ascorbic acid and level of living among a group of Michigan farmers. Walter (1974) found that Indian youths living in homes with el e c t r i c i t y tended to have better FQI than those not having this benefit. Level of livi n g was also significantly related (p < .01) to the family food scale in each area studied in the Caribbean Island survey of Beaudry - Dariame et al (1971). 138 C. General Discussion The most significant factor related to food consumption is isolation. Diets of families living in non-isolated communities are more adequate than those in rural areas. Changes in the way of living that are affecting native Canadians are having in some ways a more profound effect on the nutritional status of those native peoples in isolated reserves. Traditional dependence on local food resources, although s t i l l in evidence is declining, the local community store becoming a more important food source for many families. Many of the foods brought into these stores are nutritionally inferior to native foods (Schaefer, 1977). As a result, the traditional native diet, rich in protein, is being replaced by low-quality carbohydrate foods, i.e. "luxury sugars", with disastrous consequences to native health (Schaefer, 1977; Ellestad-Sayed and Haworth, 1977). A comparison of food prices among the reserves reveals that costs are greatest in isolated communities, notably Fort Ware, Takla Landing and Nazko. Although the relation-ship between food costs and reserve location was not stat-i s t i c a l l y explored, i t is of interest to note that food practice scores of women are also lowest at these three reserves. Food practice scores are highest at Necoslie and the fourth isolated reserve, Lake Babine. These two commun-itie s s t i l l relied strongly on 'food from the land', yet had access to a well-stocked, reasonably-priced food outlet (in 139 the case of Babine, the supermarket at Smithers, 64 miles south). It may be that access to both modern and traditional methods of food procurement, available to these two reserves, is one of the ways through which reserve location affects food practices. Variety for selection is also poorest on isolated reserves, particularly with respect to dairy products, frozen and fresh meats, and fresh fruits and vegetables. Lack of fresh meats is most probably due to harvesting of fish and game from the land. The absence or limited supply of dairy products and fresh fruits and vegetables, reflected in dietary recalls, may pose nutritional problems. The problems of obtaining food on isolated reserves is intensified by lack of employment, hence inadequate income to purchase these expensive foods. Thirty percent of respondents on isolated reserves indicate yearly incomes of $5,000 or less, as opposed to 18% on non-isolated reserves. At the same time families on non-isolated reserves report mean monthly food expenditures of $252.16, while those on isolated reserves spent $302.43 monthly. Thus those families with the least money to spend on food, and the most restricted choices, are forced to spend more money. Housing, public services and household f a c i l i t i e s on isolated reserves are inadequate, compounding d i f f i c u l t i e s further. 140 " We forget that modern cooking requires a great deal of equipment, appliances, a source of electricity, pans, dishes, running water, and storage areas and these are not always available to native peoples" (Smith, 1975) While dependence on store-bought foods has increased, information regarding use of these new foods has not been passed on. Few women on isolated reserves have received any food, nutrition, or cooking education. Until recently the majority of Indian children received their education at residential schools where homemaking s k i l l s were not taught. They did not purchase or prepare foods. Children at the schools often ate only with each other and not with adults. With no adult model around to watch i t is d i f f i c u l t to teach children to accept new foods (Smith, 1975) . The majority of respondents l i s t mothers (63%) and other family members or relative (38%) as their primary 'human' sources of nutrition and food information. Other investigators have also found homemakers to be strongly influenced by the experience of their mothers (Schwartz, 1975; Young et al, 1956; Coale, 1971). Although 45% of women on isolated reserves indicate cookbooks and other books as a source, individuals on non-isolated reserves are more lik e l y to use mass media as a source of nutrition/ food information. When compared with other studies, however 141 the use of printed material and television as a source of nutrition information is much lower; printed material appears to have more influence among population groups with higher income levels (Sanjur, 1972; Coale, 1971; Young et a l , 1956; Jalso, 1965; Schwartz, 1975). Similarly, professional persons are mentioned less frequently as nutrition information sources than has been documented in the studies of Coale (1971), Lund and Burke (1969), Eppright et al,(1970), or Fox et al (1970). When shopping, homemakers are strongly influenced by the "likes and dislikes" of their children who often accompany them to stores. "Cost", "what is good for you", and "requests made by husbands" are also influential factors. Similar findings were reported by Young et al (1956) who also found foods "good" for the family, preferences, and cost to have significant influence on meal planning. In another study among low-income homemakers in New York Sanjur et al (1972) also reported taste as the predominant element influencing food shopping, followed by cost, familiarity with food, and nutritive value. Preparation time, the least influential factor in the present study has similarly been found not to be a major consideration in other studies (Shapiro, 1962; Young et a l , 1956; Coale, 1971). There is l i t t l e evidence of budgeting and meal planning. According to Goldthorpe (1975) planning ahead 142 does not f i t into the Indian way of l i f e : "the Indian culture is not to plan or save but to share and live f u l l y for today, so that within months of a successful return from the trapline, there may have to be a welfare cheque." Smith (1975) claims that native people do not s i t down and work out a budget or determine where the best bargains are. Shopping is a social activity, a way of meeting with friends and neighbours, thus they prefer to shop daily. Results of the study indicate that this is true more for residents' of isolated than non-isolated reserves. Almost 70% of urban respondents shop at supermarkets, a figure comparable to that found in the studies of Leichter et al (1978), Metheny et al (1962) and Stubbs (1961). Better selection is the most important reason given in their selection of the supermarket. That 23% of families on isolated reserves travelled to larger centres and purchased food in supermarkets where 'costs are cheaper' and 'selection is greater' is also an indication of their increasing awareness of shopping s k i l l s . Food practices on non-isolated reserves are more adequate than those in isolated reserves. Although families in urban communities rely even less on food from the land than those in rural areas, they have greater access to supermarkets and a larger selection of store foods. Increased 143 availability of milk and milk products, for example, has resulted in greater consumption of these foods. At the same time, a larger selection of foods does not necessarily mean that individuals w i l l necessarily make the best choices. Consumption of fruits and vegetables among urban families is s t i l l inadequate. Tang, although f o r t i f i e d with Vitamin C, is a poor substitute for f r u i t juices. In the U.S., food consumption studies have shown that with increased urbanization, there has been a concurrent decline in two particular nutrients, vitamins A and C. According to Parrish (1971) this decline is a reflection of change from "wide-variety to limited-variety food habits" combined with consumer preference for fast foods (low in A and C) and neglect of fresh fruits and vegetables (high in A and C). Of interest to note is the frequency with which respondents and theirffamilies take vitamin/mineral supplements. Following the results of the Nutrition Canada Survey, Butler (1975) reported that "action is being intensified...in the provision of vitamin and iron supplements to risk groups." Smith (1975) claims that nurses tend to overestimate the use of vitamins because they base i t on the amount distributed, while in fact actual use is much lower. Results of the study indicate that 144 while a very high percentage of family members take supplements (73 to 78%) less than 50% of these do so regularly. Frequency of use of supplements is nevertheless higher than has been found among other population groups. Figures obtained in other surveys include: 27% among a group of 383 elementary schoolchildren in Winnipeg (Ellestad -Sayed and Haworth, 1977), 31%, of a group of adolescent gi r l s (Huenemann et al, 1968), 20% of 2839 adults surveyed in a country-wide U.S. study (Pearson, 1972) and from 15% (Leichter et al , 1978) to 24% (Read and Miles, 1977) of elderly Canadian citizens. Supplements are most often taken by children on isolated reserves and by homemakers, children and the entire family on non-isolated reserves. Two areas of concern are identified. That few women on isolated reserves reported use of supplements indicates that few pregnant women, an identified risk group, are also taking supplements. It is recommended that judicious use of supplements be combined with nutrition counselling of risk groups and intensified efforts to improve availability and selection of foods. Implications Results of the study indicate the need for nutrition education programs designed to improve the quality of native diets. An understanding of those factors which 145 influence food habits is basic to any such programme. Nutrition education programs which consider those factors affecting food choices can better improve dietary practices. Nutrition educators working with native peoples ought to encourage those strong aspects of food practices such as one pot meat-vegetable stews and soups, oatmeal cereals, and use of traditional foods. Emphasis might be given to increase intake of vegetables, dairy products and foods high in iron. One logical place from which nutrition education programs could be provided is the school, where there is presently no formal program of nutrition education. In some areas, vitaminized biscuits, developed by the Department of National Health and Welfare specifically for native Indian children, are distributed by teachers. Distribution is not combined with any nutrition education programs(Smith, 1975). Children exert strong influences on family food practices through demands for mothers admitted, as has been discussed, that "what the children l i k e " was a very important influence on what she bought. Nutrition information learned by the children would hopefully be "passed on" through discussion and sharing of materials with other family members. Nutrition education programmes aimed at the homemaker herself are suggested. In the majority of households i t is the female head herself who purchases and prepares the food, 146 and thus determines what her family eats. Food beliefs may indicate the basis of decision-making processes, which ultimately affect food selection (Sanjur, 1972). Examination of food beliefs of respondents reveals that many of the beliefs held by women have their basis in non-Indian teaching rather than traditional native culture. Certain attitudes expressed by women indicate those areas which are amenable to nutrition education. During pregnancy many women are concerned with restricting weight gain, a practice which is contrary to the recommendations of the Committee of Maternal Nutrition, Food and Nutrition Board in the U.S.A. (1970) and the British Columbia Medical Association as endorsed in the position paper established by the Nutrition in Pregnancy Committee of the Health Planning Council of British Columbia (1973) that recommends an average weight gain of 24 pounds. Although the majority of women indicate that 'breastfeeding is best for baby', the practice is not widespread among the study population. Smith (1975) attributes the decline in breastfeeding to giving birth in a hospital where women receive l i t t l e encouragement and support to breastfeed. Present policy of Medical Services is to strongly advocate breastfeeding. Sound dietary advice as part of the breastfeeding education programme may help to alleviate some 147 of the ' d i f f i c u l t i e s ' (i.e. drying up) experienced by nursing mothers. For women who choose not to breastfeed, education .is needed in the preparation of formulas. Over 507o of respondents l i s t canned baby foods as a food beneficialtto infants. If in fact, a large number of families are buying prepared foods, information regarding careful selection of these products ought "to be included in education programmes. Where conditions permit, home preparation of infant foods is also to be encouraged. Nutrition education programmes, however, cannot replace food, and before they can be effective there must be adequate food supplies. Funds ought to be made available to subsidize transportation costs of certain foods i.e. fruits and vegetables to isolated areas. Dialogue with local shopkeepers to encourage stocking of more nutritious foods, replacing low-quality high sugar foods is also suggested. Where possible use of traditional foods ought to be encouraged. Perhaps the most important factor in considering improved nutritional status is motivation. Individuals w i l l not improve dietary practices unless motivated to do so: "No matter how much money one has, or how much food (enriched or not) is available, and regardless of the cultural situation or nutrition education level, people must have proper motivation to eat well. This is partially a matter of nutrition education but much more is involved" (Briggs, 1970) 148 Many of the health problems of native Indians are associated with their l i f e s t y l e and environment and alleviation of these problems requires the support of the people themselves as well as the agencies responsible for environmental services (Butler, 1975). While Indian Band Councils are becoming increasingly autonomous and often manage their own funds, health related projects are not always given top priority (Simpson and Dormaar, 1974; Butler, 1975). If motivation to improve food practices is to be increased, i t is necessary also to increase the awareness of native peoples of nutrition problems and encourage their participation in education programmes. 149 CHAPTER VI SUMMARY AND CONCLUSIONS This study was conducted to investigate the food habits of native Indian families in British Columbia. By use of a 24 - hour r e c a l l , the nutrient content of diets of 144 individuals living on non-isolated reserves was compared with diets of 105 individuals living on isolated reserves. A secondary purpose was to examine the relationship between the food practices of the female head of household and certain socio-cultural characteristics of the family. Ninety-two women from seven reserves were interviewed. In addition, information on food prices and foods available in local stores was collected. Rank correlation coefficients using Kendall's tau beta demonstrated that several independent variables (socio-economic, family and reserve characteristics) were related to the dependent variable, food practices. Independent variables which were significantly and positively related to food practices included the location of the reserve, education of respondents, the women's attitudes toward nutrition, and the level reached on the household f a c i l i t i e s scale. The size of the household was negatively correlated to the adequacy of the woman's diet. The most significant factor related to food consumption was isolation, with diets in urban areas being more adequate than those in rural areas. Family income and 150 whether or not the woman had received food or nutrition education were not significantly related to food intake, although there was a trend towards improved diets. Analysis of nutrient intake data showed that low intakes (defined as less than two-thirds of the Canadian Dietary Standard) were frequent for calories, calcium, iron and vitamin C. Calcium intakes were lowest for adolescents of both sexes, particularly on isolated reserves. Calcium intakes of a l l adults, particularly women, were also inadequate. A high percentage of adolescents and adult women exhibited poor iron intakes, particularly on non-isolated reserves. Vitamin C intake's on isolated reserves, particularly among adolescent boys, were considerably lower than on non-isolated reserves. Low cal-oric intakes were observed for a l l adolescents, particularly boys, and most adults, regardless of reserve location. Mean daily protein intakes at a l l age and sex levels for both population groups exceeded the recommended standards. Food frequency studies revealed that bread, potatoes, tea and coffee, as well as a variety of meats, particularly game, were the foods used most extensively. Game meat, namely moose, was the main protein source in isolated areas, while individuals in non-isolated reserves consumed a greater variety of store-bought meats. Milk intake was generally low, and many respondents indicated gastro-intestinal disturbances with ingestion. Consumption of foods from the 151 cereal group was high, particularly on isolated reserves. Potatoes were the main vegetable eaten. Generally intake of fruits and vegetables was highest in non-isolated communities. Sugar was the "empty calorie" food consumed most frequently (in coffee or tea) together with jams, j e l l i e s and syrup eaten with bannock, bread or pancakes. Generally three meals a day were eaten; breakfast was the meal most commonly missed, while most respondents reported eating an evening meal. Snacks were frequent. Information regarding food beliefs of respondents was collected. With the exception of the cereal group, women in non-isolated areas were more able than those on isolated reserves to l i s t foods that should be included in their daily diet. They were also more lik e l y to provide valid nutritional reasons for including specific foods in their diet. During pregnancy, respondents listed few dietary alterations and for the most part stressed the consumption of a regular diet. Few women mentioned specific beliefs regarding nutrition during lactation, as few had breastfed their infants, and were thus unsure of the best diet at this time. Respondents were more likely to provide opinions regarding diets of infants, l i s t i n g milk, fruits, vegetables and canned baby foods as important foods for infants. Liquid foods, notably soups and fru i t juices were foods most frequently consumed during most types of illnesses. 152 Investigation of shopping habits revealed that on non-isolated reserves women most frequently shopped in supermarkets because of better selection and convenience. Families in many of the isolated communities were restricted to one grocery outlet. The majority of homemakers shopped once weekly or every two weeks for their major grocery supplies, while minor purchases were more frequent. Responsibility for purchasing food rested with the female household head in non-isolated reserves, but was shared among family members in isolated reserves. Children frequently accompanied mothers to stores, requesting them to purchase empty calorie foods, ice-cream, fruits and cereals. Respondents on non-isolated reserves were more lik e l y to budget and pay cash for food purchases while an equal percentage of women from both groups used shopping l i s t s . Monthly food expenditure ranged from $84 to $630, with a mean of $252.16 on non-isolated reserves, and $302.43 on isolated reserves. Rising food costs had altered the purchasing patterns of families. Over 50% of families were buying less meat and relying more heavily on meat from hunting and fishing, Of the factors which the homemaker perceived as influencing buying, "what the children l i k e " was most often selected. "Cost", "what is good for you" and "requests made by husband" were also mentioned frequently. The female head of household was the chief individual responsible for the preparation of 153 family meals, regardless of degree of isolation. Few women used meal plans. There was a significant difference in household f a c i l i t i e s available to the two areas, with a larger percentage of homes in non-isolated having access to running water, electricity, refrigerators, stoves, ovens and freezers. Women on non-isolated reserves were also more like l y to have "studied about what to eat." The primary nutrition/food information source identified by respondents was their mother, followed by family members and other relatives. Homemakers in urban communities also cited newspapers and magazines. Although a large percentage of respondents indicated use of vitamin and mineral supplements, (73% on non-isolated reserves, 787c on isolated reserves) less than half of these mentioned that these were used regularly. Subjects in isolated areas were more likely than those in non-isolated areas to rate food from the land as being an important means of obtaining food. Overall food selection was poorest in isolated reserves, notably Babine and Ft. Ware. Distinct differences were also observed in the availability of certain categories of foods between isolated and non-isolated reserves. The items most often in short supply were dairy products, fresh meats, and fresh fruits and vegetables. 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Metheny, N.Y., Hunt, F.E., Patton, M.B. andHeye, H. The Diets of preschool children 2. Factors in food acceptance. J. Home Econ. 54:303-308, 1962. 161 Meyers, T. The extra cost of being poor. J. Home Econ. 62:379-382, 1970. Milne, H., Kerr, C, Trenholme, M., and Beaton, G.H. Studies of teenage eating in Ontario. II. Evaluation of a diet scoring method. Can. J. Publ. Health. 54:463-470, 1963. Mize, J.J. Determinant factors and motivations in meat choices for household use. Georgia Agr. Exp. Sta.  Bull. No. 97, 27p, 1962. Moore, P.E., Kruse, H.O., Tisdall, F.F. and Corrigan, R.S.C. Medical survey of nutrition among the Northern Manitoba Indians. Can. Med. Assoc. J. 54:223-228, 1946. Myers, G.S. and Lee, M. Comparison of Oral Health in Four Canadian Indian communities. J. Dental Ros. 53:385-392, 1974. Nicholls, J.V.V. A survey of the ophthalmic status of the Cree Indians of Norway House, Manitoba. Can: Med.  Assoc. J. 54:344-348, 1946. Nie, N. and Bent, D. 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Walter, J.P., Two Poverties Equal Many Hungry Indians: An Economic and Social Study of Nutrition, A Working Paper for the Select Committee on Nutrition and Human Needs of the U.S. Senate pp. 95-106, Washington, D.C. 19 74. Wilhelmy, 0., Young, C. and Pilcher, H. Nutritional Status Survey, Groton Township, New York. III. Nutrient Usage as Related to Certain Social and Economic Factors. J. Amer. Diet. Assoc. 26:868-873, 1950. Williams, S.W. Food buying practises of selected low- and middle-income families in Americus, Georgia. Unpublished Masters Thesis, University of Alabama, 1972. Young, CM., Hagan, G.C, Tucker, R.E. and Foster, W.D. A comparison of dietary study methods: 2. Dietary history vs. seven-day record U.S. 24-hr. r e c a l l . -J. Amer. Diet. Assoc. 28:218-221, 1952. Young, CM., Waldner, B.G. and Berresford, K. "What the homemaker knows about nutrition. II Levels of nutrition knowledge." J. Amer. Diet. Assoc. 32:218-222, 1956. Young, CM., Waldner, B.G. and Berresford, K. What the homemaker knows about nutrition. IV. Her food problems, shopping habits and sources of information. J. Amer. Diet. Assoc. 32:429-434, 1956. Young, F.W. and Young, R.C. The differentiation of family structure in rural Mexico. J. Marriage and Family 30:154-161, 1968. APPENDIX A QUESTIONNAIRE Family No Band No -Town DEMOGRAPHIC DATA 1. Population of reserve 2. Isolation (no. of miles from urban centre of 5,000 pop.) 3. Health services available to the community: 4. Shopping facilities: 5. Price of food: 6. a. How many people live and eat in your home? b. Number of children c. Number of adults d. Relationship of adult(s) to female head of household: mother/mother-in-law father/father-in-law relative friend 7. a. Age of female head of household b. Age of male head of household— c. Age of child/children _ _ _ _ _ _ No. that are: less than 2 years 2 — 5 years 6—12 years 13—18 years more than 18 years 1 167 8. Type of household: nuclear single parent |37. extended communal 9. a. Occupationofmaleheadofhousehold: 38. b. Occupation of female head of household 39. If housewife, have you ever worked in the past? yes no |40. If yes, how long ago? less than 1 year 5—lOyears |41. 1—4years more than 10years 10. a. What was the last grade you completed at school? some grade school completed grade school some high school completed high school |42. completed high school and also other training, but not college some college |43 . completed college some graduate work graduate degree none other b. What was the last grade your husband completed? 44. '. : 45. 11. Social Class 46. 12. What is your approximate family income? less than $2,500 $10,001-$15,000 |47_ $2,501—$5,000 more than $15,000 $5,001-$10,000 FOOD BELIEFS 1. What foods or types of foods do you try to include in your family 'sdieteachday?Whydo you think each of these foods is important? 1. nutritional reason 2. non-nutritional reason 3. no reason given 2 168 milk group-Reason meat group_ Reason fruits. Reason. vegetables _ Reason cereal group. Reason. empty calories. Reason. other. Reason. 2. Are there any foods you think should/shouldn't be eaten during pregnancy? yes no If yes, what foods should be eaten? milk group — — — — meat group fruits vegetables cereal group — empty calories -other What foods shouldn't be eaten? milk group meat group, fruits vegetables. cereal group. empty calories, other ;  3. Are there any foods you think should/shouldn't be eaten while breastfeeding? 3 169 yes no If yes, what foods should be eaten? milk group meat group — fruits — vegetables _ cereal group-empty calories _ other What foods shouldn't be eaten? milk group ; meat group : fruits -vegetables cereal group. empty calories _ other 4. What do you think is best for babies—bottle-feeding or breast-feeding? bottle-feeding both the same breast-feeding don't know 5. Are there any foods you think should/shouldn't be eaten by babies and younger children? yes no If yes, what foods should be eaten? milk group meat group, fruits vegetables cereal group. empty calories, other What foods shouldn't be eaten? milk group 70 71 72 73 74 75 76 77 78 79 80 No— Card. 10_ 11_ 12 _ 13 _ 14_ 15. 16_ 17. 18. 4 170 meat group-fruits vegetables — cereal group. empty calories . other 6. Are there any foods you think should/shouldn't be eaten by sick persons? yes no If yes, what foods should be eaten? milk group . meat group . _ fruits ; vegetables cereal group_ empty calories, other What foods shouldn't be eaten? milk group meat group fruits vegetables cereal group. empty calories _ other 7. a. How would you describe the diet of the Indian people in your area? excellent poor good don't know fair other b. Why do you think it is. c. Do you think it has changed in your lifetime? yes no If yes, how do you think it has changed?-19-20-21. 22-23. 24. 25 _ 26 _ 27 _ 28 _ 29 _ 30 _ 31_ 32 _ 33. 34_ 35_ 36, 37. 38. 39, 40. 41-42. 43. 5 SHOPPING HABITS 1. Where do you do most of your shopping? supermarket _! convenience store food co-op — i general store 2. Why do you shop there? cheaper better selection/quality location credit given service .specialty store . health food store .other . no choice . convenience . patronage . other 3. How often do you shop for groceries? a. major trips .daily .weekly b. minor trips -daily . weekly .bi-weekly .monthly . bi-weekly . monthly .other -other 4. How do you get to and from the store? w a lk bus boat animal car/truck taxi bicycle other 5. Who usually does the shopping? female head of household male head of household other female adult family member other male adult family member daughter Does anyone go with that person? yes no If yes, who? female head of household mother male head of household friends/relatives children other If family member, does she/he request certain foods? yes no son relatives/friends other children other 6 If yes, what foods? milk group meat group fruits vegetables cereal group empty calories. other 6. Do you use a shopping list? yes no If no, when do you decide to buy? before going to store at the store .both .other 7. How do you feel about: a. The number of grocery shops in your area too many too few . enough . don't know b. The variety of foods in the shops excellent fair don't know good poor c. The prices charged reasonable too low toohigh don'tknow d. The quality of the food 1. good 2. fair 3. poor 4. don'tknow meat fruits vegetables dairy products bread 8. Do you set aside a certain amount of money every week, month, or twice a month for buying food? yes no 9. How much money do you usually spend on food every month?_ 10. How do you pay for your food? cash trade .charge .food voucher .other 7 1 11. How important are the following in helping you to decide what to buy? 1. very important 2. important what you like what your husband likes what your children like what is easy to prepare cost of the food . what is good for you 3. not important 76. 77. 78. 79. 80. No. Card 12. Rising food costs have forced many people to make changes in their shopping habits. Do you find that you now buy more, less or the same amounts of the following foods? 1. buy less 2. buy more 3. same 4. don't know . milk/dairy products . meat . fruits . vegetables . cereals/bread . snack foods 6. 7. 8. 9. 110. 11-MEAL PLANNING AND PREPARATION 1. Who usually does the cooking in your home? female head of household daughter male head of household son other female adult household member shared other male adult household member other 12. 13. 2. Does your family eat together? yes no If yes, when? How many times per week? morning mid-moming mid-day 1. 6-7 times a week 3. 2-3 times a week 5. once every two weeks afternoon early evening late evening 2. 4-5 times a week 4. once a week 6. other 14-15. 16. 17. 18. 19. 20. 3. How far ahead do you plan your meals? for the entire month day-to-day for two weeks no plan for one week other for a few days 21. 8 4. Do you have: running water electricity a freezer refrigerator stove oven other storage facilities FOOD PRACTISES A. Factors affecting food practises 1. Have you ever taken cooking classes or studied about foods? yes no If yes, where? Do you think what you learned has been helpful to you? yes no 2. Has anyone else ever taught you about food or nutrition? _yes no If yes, who? nurse doctor dentist _ _ friends relatives family member pharmacist dietician/ nutritionist mother health food personnel shopkeepers other 9 3. Have you obtained food or nutrition information from anywhere else? yes no If yes, where? newspapers magazines —T.V: radio talks/lectures cookbook other books past experience other B. Actual practises 1. Do you or your family take vitamins? yes no If yes, what kind? How often? regularly irregularly Who advised you to take them? nurse doctor dentist friends family relatives .dietician/nutritionist .mother .husband .pharmacist .health food personnel .other 2. How important are the following as a food source for your family? 1. very important 2. important 3. not important fishing hunting trapping home gardening gathering 3. Do you can, freeze, dry, smoke or otherwise preserve any foods? yes no 10 APPENDIX B SYSTEM USED FOR SCORING FOOD PRACTICES (24-HOUR RECALLS) 177 SCORING SYSTEM FOR FOOD PRACTICES FOOD GROUP RECOMMENDED SERVINGS (1974) POINTS PER SERVING MAXIMUM POINTS Milk and Milk products Fruits and vegetables 1% Vitamin C source %.... 2 points 1. 1. .2 points .1 point 6 1 Meat and alternates 3 points Cereals, bread and pastas 2 points Maximum score 25 Source: B.C. Dairy Foundation, Guide to Good Eating Every Day. APPENDIX C FOOD LIST USED FOR FOOD PRICING AND FOOD AVAILABILITY STUDY 179 FOOD JNIT BRAND PRICES AVERAGE Store 1 Store 2 DAILY PRODUCTS pwd. skim milk J3 lb Pacific evaporated milk Pacific fresh, while qt. "local" fresh, 27c qt. "local" Cheddar cheese 1 lb "local" processed cheese 2 lb "local" ice cream 3 pts BREAD & CEREALS bread (whole • 16 oz "local" wheat) bread (white) 16 oz "local" ready-to-eat 12 oz Kelloggs cereal rolled oats 5 lb Quaker flour,enriched 10 lb Five Roses rice 2 lb Delta macaroni,enriched 2 lb Cat e l l i cookies 4 lb Dad's FRESH FRUIT AND VEGETABLES potatoes lb "local" lettuce head "local" carrots lb "local" onions, cooking lb "local" cabbage lb "local" corn cobs "local" turnips lb "local" beets lb "local" apples lb "local" bananas lb "local" tomato lb "local" oranges lb "local" 180 FOOD BRAND PRICES Store 1 i Store 2 AVERAGE PROCESSED  MEAT/MEAT  ALTERNATES canned tuna canned sardine bologna weiners(bulk) bacon beans with pork peanut butter eggs, large A FATS AND OILS butter margarine shortening salad/cooking o i l salad dressing MISCELLANEOUS Sugar jam coffee tea 6%oz 3%oz lb lb lb 28oz 16oz doz lb 31b lb 32oz 24oz 51b 24oz lb lb Cloverleaf Brunswick Canadian "local" "local" "local" Libby's McColls "local" B.C. Empress Crisco Mazola Mayonnaise B.C. Nabob Nabob Lipton 181 FOOD UNIT BRAND PRICES AVERAGE Store 1 Store 2 PROCESSED FRUITS -AND VEGETABLES apple juice= 48oz Sun-Rype (vitam) tomato juice 48oz Town House canned tomatoes 28oz Royal City applesauce 14oz Town House canned peaches 14oz Town House orange juice 12oz Bel Air raisins 15oz Golden Harvest prunes 16oz -canned peas 14oz Town House canned corn 14oz Town House frozen vegets. ,,21b Green Giant canned soup (veg) KOoz Campbell's dry soup (split 16oz Avion pea) FRESH AND FROZEN MEAT beef liver lb "local" beef roast (blade lb "local" or chuck) beef,hamburger lb "local" beef, stewing lb "local" chicken lb "local" turkey lb "local" pork chops lb "local" ham, butt end lb Vlocal" fish, cod lb "local" APPENDIXXD TABLES VII-3 and VII-4: Daily nutrient intakes of a l l children, adolescents and adults compared to median intakes of the Nutrition Canada Survey. TABLES IX-2 to IX-7: Percentage contribut of food groups to calories and nutrients for each age and sex category. TABLE VII-3 DAILY NUTRIENT INTAKES OF ALL CHILDREN AND ADOLESCENTS. MEAN AND STANDARD DEVIATIONS ARE GIVEN. MEAN PROVINCIAL INTAKES ARE COMPARED TO MEDIAN INTAKES OF THE NUTRITION CANADA SURVEY. FIGURES IN PARENTHESES ARE NUMBER OF INDIVIDUALS. 0-4 Years, M & F 5-9 Years, M & F 10-19 Years , F 10-19 Years, , M Province N.C.* Province N.C. Province N.C. Province N.C. (22) (31) (25) (25) Calories 1596+ 601 1678 2001+ 744 2025 2250+ 503 2129 2264+ 630 2584 Proteins 61+ 22 60 74+ 33 67 78+ 20 69 77+ 28 89 Calcium 1031+ 804 881 871+ 403 798 645+ 366 661 834+ 446 791 Iron 10.5+ 5.5 10 13.7+ 7.5 11 14.5+ 5.1 12 13.5+ 6.2 16 Vitamin A 3772+2193 703(R.E) 3313+2239 784 2829+1493 724 3750+2540 971 Thiamine 1.03+0.36 1.00 1.43+0.89 1.13 1.29+0.35 1.12 1.36+0.45 1.53 Riboflavin 1.66+0.56 1.72 1.91+0.93 1.71 1.75+0.58 1.57 1.82+0.90 2.04 Niacin 12.5+8.5 21 16.7+9.3 25 19.9+6.7 27 18.447.1 35 Ascorbic 119+ 94 81 138+ 138 71 95+ 121 83 138+ 147 70 Acid * N.C. = Nutrition Canada Survey TABLE VII-4 DAILY NUTRIENT INTAKES OF ALL ADULTS. MEANS AND STANDARD DEVIATIONS ARE GIVEN. MEAN PROVINCIAL INTAKES ARE COMPARED TO MEDIAN INTAKES OF THE NUTRITION CANADA SURVEY. FIGURES IN PARENTHESES ARE NUMBER OF INDIVIDUALS. 20-39 Years Province (62) N.C. 20-39 Years, Province (27) M N.C. 40 + F Province (39) N.C. 40 + M Province (18) N.C Calories 1674+ 500 1970 2780+ 817 2893 1527+ 338 1577 2661+1135 2174 Proteins 71+ 23 72 119+ 33 105 67+ 19 60 114+ 37 85 Calcium 594+ 504 631 804+ 417 733 484+ 232 536 715+ 459 606 Iron 13.1+ 5.3 13 20.1+ 8.1 18 11.7+ 5.2 10 18.7+ 7.3 14 Vitamin A 3793+2880 684(R.E) 5848+4761 1173 3923+2711 959 6850+4750 1011 Thiamine 1.12+0.47 1.14 1.96+0.71 1.54 0.96+0.27 .84 1.61+0.63 1.21 Riboflavin 1.52+0.74 1.46 2.16+0.89 2.17 1.42+0.50 1.37 2.03+0.76 1.26 Niacin 19.0+6.8 30 30.5+12.2 41 18.4+6.1 23 30.5+8.1 34 Ascorbic 83+ 104 68 156+ 210 82 59+ 52 55 109+ 86 59 Acid TABLE IX-2 PERCENTAGE CONTRIBUTION OF FOOD GROUPS TO CALORIES AND NUTRIENTS (5 - 9 Years M & F) Calories NI I Protein NI I Calcium NI I Iron NI I Vit NI .A I Thiamine NI I Ribofl. NI I Niacin NI I Ascorbic NI I FOOD GROUPS I. (Milk, Milk products) 18 11 28 17 73 63 2 2 21 12 13 8 48 35 2 2 3 3 II. (Meat,fish, poultry, eggs, legumes) 18 16 41 47 3 7 38 41 6 15 28 25 28 37 51 51 III. (Vegetables) 4 7 3 5 1 3 5 7 73 31 5 11 2 4 7 12 8 22 IV.(Fruits 14 8 4 2 9 4 13 7 29 12 22 13 7 4 11 4 89 75 V. (Grains, cereals) 31 35 23 28 12 21 38 36 1 3 33 43 14 19 29 29 - -VI. (Fats,oils) 7 11 - - - 1 - - 19 27 VII.(Sugars ) 8 12 1 1 1 2 4 7 - - - - 1 1 - - -VIII.(Misc.) TABLE IX-3 PERCENTAGE CONTRIBUTION OF FOOD GROUPS TO CALORIES AND NUTRIENTS (0-4 Years M & F) Calories Protein Calcium Iron Vitam A Thiamine Ribof. Niacin Ascorb. NI I NI I NI I NI I NI I NI I NI I NI I NI I FOOD GROUPS I. (Milk, milk products) 23 19 35 26 72 53 5 3 21 15 18 11 57 45 3 4 4 3 II.(Meat,fish, poultry, eggs, legumes) 21 16 38 42 6 4 28 44 12 23 25 27 20 30 54 47 1 III.(Vegetables) 7 5 5 4 3 1 9 7 43 28 11 8 4 3 12 12 18 11 IV.(Fruits) 9 11 2 4 4 3 10 8 8 19 16 19 4 5 6 12 78 84 V. (Grains, cereals) 26 29 20 22 14 37 41 35 2 1 29 36 14 16 25 24 — 1 VI. (Fats,oils) 8 9 - - - - - - 15 14 - - - - - - - -VII.(Sugars) 7 11 - 2 1 1 7 4 - - - - - 1 - - • - -VIII.(Misc) TABLE IX-4 PERCENTAGE CONTRIBUTION OF FOOD GROUPS TO CALORIES AND NUTRIENTS (10 - 19 F) Calories NI I Protein NI I Calcium NI I Iron NI I Vit NI A I Thiamine NI I Ribof. NI I Niacin NI I Ascorb NI I FOOD CROUPS I.(Milk, milk products) 15 9 22 10 68 49 3 2 17 16 11 4 42 18 2 1 2 2 II.(Meat, f i s h , poultry, eggs, legumes) 22 19 45 60 8 16 39 56 17 17 16 34 21 51 50 62 1 1 III.(Vegetables) 5 6 3 3 3 3 7 4 7 16 9 8 4 3 8 7 12 29 IV. (Fruits) 14 5 5 1 6 3 16 3 33 22 23 6 9 2 11 2 85 66 V.(Grains cereals) 28 37 25 26 14 25 34 29 - 3 41 47 24 24 26 23 2 VI.(Fats,oils) 11 10 - - 1 - - - 26 26 - - - - - -VII.(Sugars) 11 13 - - - 3 - 5 - - - - 1 - - -VIII. (Misc.) TABLE IX-5 PERCENTAGE CONTRIBUTION OF FOOD GROUPS TO CALORIES AND NUTRIENTS (10 - 19 Years,M) Calories Protein Calcium Iron V i t . A Thiamine Ribof. Niacin Ascorb NI I NI I NI I NI I NI I NI I NI I NI I NI I FOOD GROUPS I.(Milk,milk products) 23 9 27 16 75 56 4 2 21 22 13 6 48 28 2 2 3 2 II.(Meat,fish poultry, eggs,. legumes) 18 12 41 40 4 5 37 34 23 10 15 18 25 36 43 43 3 III.(Vegetables) 7 8 5 4 2 3 10 6 13 16 11 9 4 4 12 12 13 23 IV.(Fruits) 13 5 5 1 6 4 17 5 26 13 21 11 8 3 12 3 82 74 V. (Grains, cereals) 26 38 23 38 11 26 31 45 1 7 39 55 14 25 29 36 - 1 VI.(Fats,oils) 8 8 - - 1 1 - - 16 32 - - - - - - - -VII.(Sugars) 5 20 - 1 1 5 2 8 - - - 1 1 3 - 1 - -VIII.(Misc.) - - - - - - - - - - - 1 - 1 2 4 - -TABLE IX-6 PERCENTAGE CONTRIBUTION OF FOOD GROUPS TO CALORIES AND NUTRIENTS (20 + FEMALES) Calories Protein Calcium Iron Vit.A Thiamine Ribof. Niacin Ascorb NI I NI I NI I NI I NI I NI I NI I NI I NI I FOOD GROUPS I.(Milk, milk products) 11 9 14 9 57 46 2 1 10 9 7 5 30 20 1 1 2 3 II.(Meat,fish poultry, eggs, legumes) 28 23 60 63 16 12 50 63 21 20 33 42 41 56 51 60 4 4 III.(Vegetables) 8 9 6 5 7 5 13 8 44 44 15 13 7 4 11 10 34 50 IV.(Fruits) 6 3 2 1 4 1 6 1 10 5 11 3 4 1 4 1 60 41 V.(Grains, cereals) 23 32 17 21 13 34 26 24 1 3 31 35 15 17 18 19 — 1 VI.(Fats,oils) 10 12 - - 1 1 - - 14 21 - - - - - - - -VII.(Sugars) 11 14 - - 1 1 2 4 VIII.(Misc.) 3 - - - 1 - - - - - 3 2 3 2 15 9 - -TABLE IX-7 PERCENTAGE CONTRIBUTION OF FOOD GROUPS TO CALORIES AND NUTRIENTS (20 + MALES) Calories Protein Calcium Iron Vit. A Thiamine Ribofl. Niacin Ascorb NI I NI I NI I NI I NI I NI I NI I NI I NI I FOOD GROUPS I. (Milk,milk products) 8 5 8 6 38 40 2 - 8 5 3 3 17 15 1 1 1 1 II.(Meat,fish, poultry, eggs, legumes) 32 30 65 69 30 17 54 61 34 30 42 46 49 61 56 64 6 4 III.(Vegetables) 8 9 6 5 6 6 12 8 28 33 14 13 7 6 11 11 36 32 IV.(Fruits) 5 6 2 1 6 4 6 4 12 10 10 8 4 3 4 2 57 64 V.(Grains, cereals) 25 30 19 19 17 30 24 21 1 3 29 28 19 14 19 15 - -VI.(Fats,oils) 12 9 - - 1 1 - - 18 19 - - - - - - - -VII.(Sugars) 8 11 - - 1 2 1 4 - - - - - - - - - -VIII.(Misc.) 2 - - - 1 - - - - - 2 1 3 1 9 7 - -LEGEND TO APPENDIX E Variable Code Isolation l=Non-Isolated Reserve 2=Isolated Reserve APPENDIX E Raw Data — Individual Nutrient Values Calculated From 24-Hour Dietary-Recalls For Subjects From The Eight* Reserves. Units are protein, total fat, carbohydrate (gm) , Vitamins A and E (International Units), a l l others in mg. Data from Fort Ware and Injenika were later poole under Fort Ware, making a total of seven reserves CODE AGE ISO RE SEX CALO PROT CALCIUM IRON HUM LAT SER RIES EIN ION VE A. SECHELT 11 41 1 1 F 1549 58 614 4.6 13 12 1 1 F 1516 71 771 8.8 14 14 1 1 M 2115 91 1456 8.7 15 15 1 1 M 26 50 106 1707 11. 4 21 42 1 1 F 12 05 64 337 8.3 22 52 1 1 M 1288 88 398 10.4 23 15 1 1 M 1702 63 1390 6. 2 31 66 1 1 F 1457 63 608 8. 8 33 16 1 1 M 1963 96 962 11-2 34 28 1 1 M 2515 119 657 17.2 41 2 7 1 1 F 1624 98 797 14.0 43 4 1 1 M 1940 106 1623 26. 9 44 5 1 1 F 1303 75 959 8.6 51 26 1 1 F 1387 46 172 7. 8 53 7 1 1 F 1365 24 401 4.4 54 6 1 1 M 1671 34 474 4.9 61 25 1 1 F 965 59 228 7.2 62 29 1 1 M 2546 161 777 17. 5 63 6 1 1 F 1445 49 461 8.2 64 5 1 1 M 1026 34 400 5. 7 71 22 1 1 F 1548 82 910 7.2 72 25 1 1 M 2600 127 796 16.8 81 55 1 1 F 2019 74 369 17. 0 82 19 1 1 F 1650 55 167 13.3 91 44 1 1 F 1444 42 203 8. 1 92 48 1 1 M 1407 52 239 10.1 93 10 1 1 M 1554 40 522 9.6 94 .5 1 1 F 890 22 382 4.7 95 13 1 1 M 1718 76 375 14.7 96 15 1 1 M 1780 60 286 11.8 97 16 1 1 F 1813 65 284 12.2 98 21 1 1 F 728 36 125 6.9 103 16 1 1 F 2533 81 1349 11.9 104 18 1 1 F 1987 71 464 12. 5 105 12 1 1 M 770 28 180 5.5 106 13 1 1 M 2159 47 699 8.0 111 45 1 1 F 1429 47 743 9.3 112 44 1 1 M 4189 153 1434 25.1 113 18 1 1 M 3702 124 1584 19. 5 114 8 1 1 M 2444 86 1466 12.4 121 19 1 1 F 1476 107 747 8.6 123 2 1 1 M 1691 41 317 11.5 124 1 1 1 F 850 44 1227 2.1 131 34 1 1 F 1245 51 139 11.0 133 11 1 1 M 2630 77 1516 12. 6 134 12 1 1 M 2578 75 973 13.9 135 5 1 1 F 1671 69 1154 7.9 193 VITAMIN VITAMIN A E 1000 201.8 3080 128.4 3846 289.5 3590 517.3 913 2 49.4 12975 62.3 3699 44.6 2050 113.6 2867 179.7 5433 269.4 2308 148.1 1891 131.1 1720 74.4 2027 280.0 2120 280.6 19 70 307.9 1770 201.5 3087 398.4 2406 279.0 1696 166.1 1905 81.9 2131 210.4 2701 65.2 1575 169.1 4600 190.5 5605 108.5 526 0 120.9 3000 87.9 8482 97.9 7480 66.5 6940 61.2 4115 51.9 4066 339.8 1950 94.5 865 33.6 2502 99.1 4779 145.0 15196 633.8 93 63 250.0 10173 2 77.6 1556 189.2 33 05 263.6 1322 44.8 5251 167.5 8675 438.2 584 0 239.2 3690 74.5 CODE AGE ISO RE SEX NUM LAT SER ION VE 141 18 1 1 F 142 2 0 1 1 M 151 3 5 1 1 F 161 22 1 1 F 162 21 1 1 M 163 0 1 1 F 8. FORT WARE 171 61 2 2 F 172 69 2 2 M 173 18 2 2 F 181 33 2 2 F 182 48 2 2 M 183 7 2 2 F 184 4 2 2 F 211 86 2 2 F 213 3 2 2 F 214 5 2 2 F 215 21 2 2 F 221 32 2 2 F 223 8 2 2 F 231 22 2 2 F 233 1 2 2 F 234 2 2 2 M 241 31 2 2 F 251 50 2 2 F 261 31 2 2 F 263 8 2 2 M 264 10 2 2 M 265 14 2 2 F 271 22 2 2 F 27 2 25 2 2 M 273 5 •> 2 F 281 33 2 2 F C. INJENIKA 191 21 2 3 F 192 30 2 3 M 193 2 2 3 F 201 23 2 3 F 202 28 2 3 M 203 3 2 3 F D. NE COSLIE 291 30 1 4 F 293 7 1 4 F CALO PROT CALCIUM RIES EIN 1736 82 1008 2400 101 745 1822 77 927 1454 62 835 4084 148 1063 641 31 1549 870 129 241 870 129 241 1976 105 3 62 553 42 118 1856 103 334 892 63 990 544 3 0 923 958 48 193 1007 54 458 1711 72 947 1433 83 840 989 32 184 1709 52 474 172 8 89 336 1242 48 4091 2270 100 1021 818 24 272 1273 47 449 2102 117 6 95 2110 67 891 3304 97 1110 3400 125 1413 1326 50 445 1929 120 356 1228 43 415 2038 72 565 1647 76 605 1670 77 413 1073 39 578 1979 81 3762 2267 93 556 1103 37 294 1800 59 723 2813 89 995 194 IRON VITAMIN VITAMIN A E 15.1 4009 212.5 24.4 12460 367.4 14. 5 9596 126.6 7.7 3554 190.7 28.5 13244 565.7 2. 8 2010 11.3 30. 1 160 11.5 30. 1 160 35.5 25. 7 4480 227.3 9. 6 0 14.5 20.3 3280 194.9 9. 2 935 25.9 1.9 50 10.5 10. 8 464 83.6 10.6 2060 70.8 13.7 3540 176.8 17.5 1312 182.4 5.0 390 44.8 10.4 1507 120.6 18.3 4820 150.4 15.9 4560 70.5 15.0 5293 135.9 4.2 2490 179.9 8.7 3370 199.1 24.9 2860 201.2 11. 7 3140 204.8 17.4 4390 299.2 26. 2 4315 153.5 9.1 1630 56.8 14.6 125 69.4 8.3 1465 50.8 9.3 2525 217.1 17.8 9056 157.0 21.0 1395 4 100.0 8.7 7391 80.5 25.1 2555 98.0 17.0 2655 214.7 6.9 2820 72.7 8.3 2523 136.7 13. 8 4210 179.2 • ODE AGE ISO RE SEX CALO PROT NUM LAT SER R i e s EIN ION VE 294 8 1 4 M 4416 144 301 21 1 4 F 1823 65 302 26 1 4 M 2750 95 311 25 1 4 F 1828 69 312 3 7 1 4 M 3667 148 313 2 1 4 F 1687 65 321 21 1 4 F 1289 44 322 36 1 4 M 1315 71 323 4 1 4 F 1870 54 331 61 1 4 F 1163 69 341 44 1 4 F 1887 85 342 44 1 4 M 3417 161 351 27 1 4 F 1666 72 352 36 1 4 M 3639 113 353 8 1 4 F 2130 74 361 51 1 4 F 1751 91 371 24 1 4 F 2734 123 373 2 1 4 F 1475 62 374 4 1 4 F 193 7 70 381 3 9 1 4 F 1316 74 382 38 1 4 M 3781 158 383 5 1 4 M 2888 164 391 27 1 4 F 1159 51 393 6 1 4 M 1601 56 401 54 1 4 F 1955 96 403 20 1 4 F 1179 37 411 52 1 4 F 1803 70 421 37 1 4 F 233 7 69 423 74 1 4 F 1096 72 424 9 1 4 F 2799 110 431 26 1 4 F 2545 90 441 42 1 4 F 1914 58 442 46 1 4 M 2867 107 E. NANAIMO 451 28 1 5 F 2426 102 452 31 1 5 M 2292 94 453 3 1 5 M 2601 72 461 33 1 5 F 1773 95 462 38 1 5 M 2498 154 463 10 1 5 M 2922 141 464 8 1 5 M 2263 129 471 46 1 5 F 1175 55 481 25 1 5 F 2447 61 482 24 1 5 M 4479 129 483 24 1 5 :F 2129 60 491 46 1 5 F 1956 91 493 25 1 5 F 2055 91 CALCIUM IRON VITAMIN VITAMIN A E 1364 24.4 5520 279.5 625 10.3 2965 225.3 577 16.4 3055 382.0 581 14.0 10437 95.6 562 25. 5 15562 289.5 13 54 5.9 4490 86.2 408 9.2 872 148.3 366 15.6 1496 •125.1 220 10. 2 1759 335.0 867 6. 1 6323 70.4 680 12. 7 5420 158.5 755 25.8 11345 334.4 922 7.4 2953 218.7 800 17.9 3305 617.3 1518 23.7 2155 184.1 450 17. 9 1512 120.5 1572 15.0 11364 195.4 1003 8.2 8635 57.9 889 11.0 6183 107.0 108 18.2 1120 114.8 780 36. 7 6450 182.3 918 35.3 2513 110.9 719 8.5 2931 56.2 964 6. 6 1650 48.2 470 13.5 10312 303.9 210 7.0 1179 200.1 518 9.4 2470 97.3 586 14.7 2373 191.4 150 17.4 993 59.0 1311 18.0 2795 275.0 1256 14. 1 30 96 447.3 237 10.6 4988 144.5 726 16.9 7710 262.4 727 10.4 4042 359.6 472 11.6 4460 463.5 1348 9.5 523 5 241.1 566 18.8 2581 336.4 5 97 31.4 18050 369.2 1270 24.5 4399 559.8 1126 20.6 2037 211.8 674 7. 0 1330 98.6 687 14.1 2610 199.9 1423 27.3 4010 431.8 208 12.0 6370 199.7 1345 9.2 3461 292.1 655 12.2 2487 274.7 C O D E A G E I S O R E S E X N U M L A T S E R I O N V E 501 40 1 5 F 502 42 1 5 M 503 18 1 5 F 504 13 1 5 F 511 42 1 5 F 512 44 ' 1 5 M 513 3 1 5 F 514 5 1 5 F 521 60 1 5 F 522 64 1 5 M 5 23 17 1 5 F 531 84 1 5 F 533 46 1 5 M 541 61 1 5 F 551 48 1 5 F 552 50 1 5 M 553 24 1 5 M 561 38 1 5 F 562 40 1 5 M 563 17 1 5 M 571 57 1 5 F 573 85 1 5 F 581 29 1 5 F 582 29 1 5 M 583 25 1 5 F 5 84 24 1 5 M 591 56 1 5 F 592 63 1 5 M 593 29 1 5 M 601 27 1 5 F 602 24 1 5 M 611 26 1 5 F 613 24 1 5 F 614 4 1 5 F 615 2 1 5 M 621 41 1 5 F 622 41 1 5 M 631 28 1 5 F 641 27 1 5 F 643 6 1 5 M 651 2 3 1 5 F 6 52 23 1 5 M F . N A Z K O 661 3 6 2 6 F 662 41 2 6 M 671 26 2 6 F 673 4 2 6 F 196 C A L O P R O T C A L C I U M I R O N V I T A M I N V I T A M I N R I E S 6 I N A E 1618 41 501 4. 7 1805 216.1 1495 39 284 5.7 1450 101.3 1918 57 704 9. 3 4650 258.0 2354 57 855 9.7 3179 272.4 1470 43 205 9.4 2078 240.6 3941 142 849 26. 5 12869 668.0 2505 84 1603 13.0 274 5 151.2 1962 81 1603 10.9 2040 117.7 172 8 55 6 54 6.4 2008 518.4 1975 88 1034 5.6 1410 593.8 1767 80 1508 6. 8 1748 325.9 1406 33 511 5.2 7665 46 .3 4302 187 2080 19.0 9750 268.4 1459 71 603 9.4 7025 232.3 1961 60 780 8.7 3711 433 .4 3861 122 712 20.6 5561 880.2 1548 51 491 7. 0 1980 387.2 1845 88 206 14.4 2135 224.8 2586 148 608 19. 9 3633 345.7 3051 130 496 17.5 2939 438.8 1113 58 439 11.8 2210 78.9 1044 57 387 6.2 2055 132.6 1520 43 490 3 .9 1314 3 56.5 388 5 190 2128 15.9 4470 530 . 0 2296 121 879 17. 1 3804 314.6 2615 124 742 19.2 5433 421.6 1438 63 396 8.0 4816 115.8 3490 109 703 13. 0 5046 527.9 3 047 150 1374 17.6 8377 375.3 1613 66 759 23. 2 5716 173.2 3466 116 1674 13.9 6337 189.9 1936 62 488 12.4 8505 543.9 1216 45 32 5 8.6 5742 330.2 1462 56 659 7.9 323 2 223.9 2493 96 551 14. 0 6321 736.9 1895 86 51.1 12. 9 8110 251.1 4120 120 547 20.9 12944 686.7 1420 72 297 13.3 3485 111.7 1653 64 521 8.5 1514 269.2 27 13 89 1644 14.2 6804 266.2 1105 47 2 34 8.0 7858 125,9 3269 103 734 17.7 6660 437.6 1633 85 719 16.9 2220 197.1 2234 104 872 21.9 2820 273.4 2443 93 808 24. 2 11971 302.0 1346 49 763 8.2 172 0 159.1 C O D E A G E I S O R E N U M L A T S E R I O N V E 6 7 4 1 2 2 6 6 8 1 2 0 2 6 6 8 3 2 2 6 6 9 1 2 9 2 6 6 9 3 1 1 2 6 7 0 1 4 4 2 6 7 0 3 8 2 6 711 5 1 2 6 713 1 7 2 6 7 1 4 1 3 2 6 7 1 5 1 1 2 6 7 1 6 1 4 2 6 7 1 7 1 1 2 6 7 1 8 1 1 2 6 7 1 9 1 6 2 6 7 2 3 1 4 2 6 7 2 4 1 1 2 6 7 3 1 3 3 2 6 7 3 3 7 2 6 G . L A K E B A B I N E 7 4 1 3 2 2 7 7 4 2 3 5 2 7 7 4 3 1 0 2 7 7 4 4 8 2 7 7 5 1 5 9 2 7 7 5 3 2 0 2 7 7 5 4 1 0 2 7 7 6 1 7 1 2 7 7 6 3 2 7 2 7 7 6 4 2 0 2 7 7 6 5 2 2 2 7 7 6 6 2 8 2 7 7 7 1 4 2 2 7 7 7 3 1 4 2 7 7 8 1 1 7 2 7 7 8 3 9 2 7 7 8 4 1 4 2 7 7 9 1 3 5 2 7 8 0 1 4 0 2 7 8 0 3 2 2 7 8 0 4 9 2 7 H . T A K L A L A K E 8 1 1 4 5 2 8 8 1 3 2 0 2 8 8 2 1 3 3 2 8 , EX C A L O P R O T C A L C I U M R I E S E I N F 1 2 3 4 5 2 4 6 4 F 2 3 3 2 1 2 0 8 1 4 M 1 4 4 3 5 3 6 0 2 F 1 6 7 9 6 5 6 5 4 F 2 3 5 9 8 9 3 8 8 F 1 4 1 0 6 3 6 6 0 F 2 7 6 9 9 8 1 2 0 0 F 1 0 4 6 6 5 2 5 4 M 2 6 2 7 8 3 8 0 6 M 1 6 5 8 6 7 4 4 7 F 1 6 2 1 6 3 3 2 4 F 1 5 9 2 6 0 4 2 9 M 2 4 8 3 7 7 8 2 4 M 2 0 6 7 7 8 6 6 7 M 2 6 4 0 7 2 4 7 8 M 1 8 0 0 4 1 7 2 0 M 1 8 5 0 4 3 3 8 0 F 1 9 4 5 7 6 6 2 2 M 2 5 5 7 7 8 5 5 7 F 1 7 7 7 7 1 4 2 9 M 2 3 0 5 1 0 1 5 5 3 M 2 4 1 2 7 7 1 0 3 5 F 1 7 0 2 6 4 8 9 6 F 1 8 0 9 6 2 6 7 2 F 1 9 2 4 7 6 6 3 5 F 1 6 4 1 6 0 5 5 0 F 1 2 3 6 7 0 3 6 7 M 1 6 1 6 7 5 6 6 9 M 2 8 8 8 1 4 7 5 0 7 M 2 9 1 1 1 4 6 1 0 4 1 M 3 0 9 7 9 8 8 5 1 F 1 4 6 4 6 4 3 9 7 F 2 0 9 8 6 8 6 6 3 F 2 1 4 3 8 6 3 6 7 F 2 4 0 6 7 1 6 7 0 F 1 0 2 5 7 9 3 1 4 F 2 0 9 0 8 3 7 0 6 F 1 6 1 2 7 4 3 2 4 F 1 6 4 7 6 5 8 7 3 M 2 2 8 9 1 1 1 3 5 4 F 1 6 7 3 5 7 1 9 8 F 1 6 1 8 6 7 2 6 4 F 1 2 3 4 4 9 4 4 0 197 I R O N V I T A M I N V I T A M I N A E 1 1 . 0 4 0 0 2 7 3 . 5 1 9 . 4 6 9 1 0 3 3 9 . 2 1 0 . 7 3 4 6 7 1 1 0 . 2 1 1 . 2 9 4 6 2 1 0 7 . 9 1 9 . 3 3 8 9 0 1 3 7 . 8 8 . 3 2 9 5 8 1 6 6 . 4 1 2 . 8 3 1 6 8 2 2 7 . 4 1 1 . 0 4 4 0 8 3 9 . 5 1 4 . 7 2 6 3 0 2 4 8 . 7 1 0 . 5 • 2 1 2 0 4 4 - 3 1 0 . 5 1 4 7 2 1 1 5 . 7 1 3 . 4 1 2 9 0 1 5 0 . 9 1 1 . 8 2 5 3 9 1 3 9 . 8 1 3 . 9 6 0 0 2 9 5 . 0 1 7 . 7 2 1 5 5 4 2 3 . 1 5 . 5 1 4 9 0 7 9 . 6 7 . 3 7 3 0 3 4 3 . 5 8 . 8 3 4 4 5 2 9 0 . 6 1 1 . 1 5 5 5 1 4 6 7 . 0 1 5 . 4 2 3 1 7 2 6 8 . 8 4 0 . 3 1 8 9 0 2 8 9 . 3 3 2 . 8 3 6 6 1 1 0 0 . 2 2 7 . 8 2 5 9 1 8 5 . 2 1 4 . 1 4 1 4 2 2 2 3 . 2 1 7 . 3 4 1 7 2 1 5 8 . 7 1 1 . 2 3 3 0 2 8 6 . 3 1 2 . 1 1 6 3 0 1 6 0 . 3 1 1 . 5 1 8 3 9 7 9 . 9 3 1 . 4 2 3 2 9 1 7 4 . 1 3 1 . 6 2 6 6 3 2 4 0 . 7 1 9 . 7 6 4 1 0 3 3 3 . 0 1 3 . 6 8 6 3 0 1 6 9 . 6 1 5 . 0 3 0 3 0 2 0 5 . 4 2 0 . 9 3 6 2 4 1 0 9 . 0 1 8 . 3 3 3 4 0 2 6 1 . 4 1 5 . 0 3 1 1 1 3 2 . 9 1 7 . 4 2 1 7 0 3 3 5 . 2 1 7 . 2 2 2 6 0 2 0 6 . 0 1 2 . 6 2 6 2 0 1 8 0 . 9 2 6 . 7 1 6 1 0 2 8 6 . 4 1 3 . 8 1 5 3 0 2 3 7 - 7 1 6 . 7 1 6 2 0 2 3 1 . 5 9 . 9 6 1 9 5 5 9 . 0 198 ODE AGE ISO RE SEX CALO PROT CALCIUM IRON VITAMIN VITAMIN NUM LAT SER RIES E IN A E ION VE 323 6 2 8 F 1615 48 722 10. 8 5090 72.0 824 12 2 8 F 1839 78 614 14.3 2611 95.1 831 56 2 8 F 1667 86 555 1 9 . 2 9825 37.6 833 15 2 8 F 1215 71 242 16. 0 1840 50.2 841 27 2 8 F 1103 36 240 4. 9 5730 114.2 843 7 2 8 F 2493 78 780 11.2 9715 181.9 851 35 2 8 F 1377 85 318 19. 2 1898 143.6 853 1 1 2 8 F 2027 65 803 14. 1 2818 176.2 854 14 2 8 M 2009 70 419 18 . 1 3270 169.6 861 3 6 2 8 F 772 52 168 12. 1 1040 52.2 863 9 2 8 F 1321 62 258 16.3 173 2 43.2 871 46 2 8 F 2194 86 628 19. 2 2662 79.8 872 60 2 8 M 2311 120 689 27.6 246 0 81.4 873 6 2 8 F 1820 63 709 13.0 2830 49.0 831 23 2 8 F 2627 84 860 15.6 8310 255.8 883 3 2 8 F 2287 82 735 16.6 5833 246.5 884 28 2 8 F 1488 88 467 19.3 2100 147.2 891 50 2 8 F 1439 63 307 14.0 5607 116.7 892 52 2 8 M 1697 81 362 18.4 9100 89.6 901 28 2 8 F 1092 58 101 14.5 135 74.1 911 35 2 8 F 1827 118 6 87 22.0 1694 171.7 913 12 2 8 F 2136 119 869 20.3 2480 227.3 921 26 2 8 F 1983 74 451 13.3 2140 47.7 931 20 2 8 F 2358 87 714 14.6 3014 127.4 933 13 2 8 F 2579 105 473 20. 5 2110 98.1 934 53 2 8 F 1990 93 394 15.6 2800 73.6 93 5 10 2 8 M 2457 68 550 13.6 346 68.6 199 CODE AGE ISO RES SEX NUM LAT ER ION VE A. SECHELT 11 41 1 1 F 13 1 2 1 1 F 14 14 1 1 M 15 15 1 1 M 21 42 1 1 F 22 52 1 1 M 23 15 1 1 M 31 66 1 1 F 33 16 1 1 M 34 28 1 1 M 41 27 1 1 F 43 4 1 1 M 44 5 1 1 F 51 26 1 1 F 5 3 7 1 1 F 54 6 1 1 M 61 25 1 1 F 62 29 1 1 M 63 6 1 1 F 64 5 1 1 M 71 22 1 1 F 72 25 1 1 M 81 55 1 1 F 82 19 1 1 F 91 44 1 1 F 92 48 1 1 M 93 10 1 1 M 94 5 1 1 F 95 13 1 1 M 96 15 1 1 M 97 16 1 1 F 98 21 1 1 F 103 16 1 1 F 104 18 1 1 F 10 5 12 1 1 M 106 13 1 1 M 111 45 1 1 F 112 44 1 1 M 1 1 3 18 1 1 M 114 8 1 1 M 121 19 1 1 F 123 2 1 1 M 124 1 1 1 F 1 3 1 34 1 1 F 133 11 1 1 M 134 12 1 1 M 135 5 1 1 F THIA RIBO NIACIN MINE FLAVIN (MG) {MGJ (MG) 0.50 1.12 18.4 1.05 1.53 11.3 1.67 2.44 19.5 1.44 3.03 25-2 0.55 0.95 11.9 0.75 1 . 12 16.8 1.86 1.68 15.4 0.83 1.45 11.1 1 . 50 2.53 17.1 1.56 1.98 27.2 1.24 2.00 21.6 1.05 2.50 16.8 0.61 2.02 9.8 0.61 0.61 14.8 0.48 0.60 4.8 0. 63 0.67 1 1 . 7 0.87 0.47 12.6 1.60 1.45 33.8 1.29 0.82 1 1 . 9 0.97 0.68 8.2 0.62 1.27 11.9 1-69 1. 48 20.6 0.55 1.03 20.1 0.38 0.65 15.3 1.10 0.72 15. 0 1.32 0.89 17.5 1.35 1.09 12.7 0.68 0.65 6.2 1.44 1.55 13.0 1.47 0.92 19.0 1.48 1.13 17.0 0.69 0,64 8.6 1.02 2.39 12.5 1.54 1.11 14.8 0.47 0, 52 7.1 1.00 1.20 10.9 0.86 1.46 10.9 2.14 3.00 27.6 2. 18 3.11 23.0 1. 57 2.60 14,4 0.71 1.70 35.9 0.85 1.09 10.3 0.5 7 1.97 1.5 0.53 0.74 16.4 0.99 2.45 15.4 1.63 1.68 27.9 0.70 1.97 12.7 ASCOR TOTAL CARBO BIC FAT HYD AC 19 RATE 7 42 158 67 60 174 190 72 279 41 87 377 61 46 81 83 61 90 328 57 242 60 58 174 73 103 178 246 117 248 9 70 170 24 89 193 5 66 106 34 76 135 2 57 202 72 69 245 139 31 113 157 105 244 316 37 243 258 21 183 45 5 2 190 40 95 324 92 100 215 8 95 153 255 43 231 323 43 210 422 29 301 214 23 159 312 75 190 340 66 248 232 78 218 174 29 80 52 93 368 24 79 274 0 31 101 11 69 362 62 62 188 116 154 569 183 105 599 122 83 358 24 59 127 152 73 2 28 14 33 104 92 5 5 134 123 107 354 136 132 276 52 64 205 200 CODE AGE ISO RES SEX NUM LAT ER ION VE 141 18 1 1 F 142 20 1 1 M 151 35 1 1 F 161 22 1 1 F 162 21 1 1 M 163 0 1 1 F >. FORT WARE 171 61 2 2 F 172 69 2 2 M 173 18 2 2 F 181 33 2 2 F 182 48 2 2 M 183 7 2 2 F 184 4 2 2 F 211 86 2 2 F 213 3 2 2 F 214 5 2 2 F 2 15 21 2 2 F 221 32 2 2 F 223 8 2 2 F 231 22 2 2 F 233 1 2 2 F 234 2 2 2 M 241 31 2 2 F 251 50 2 2 F 261 31 2 2 F 263 8 2 2 M 264 10 2 2 M 265 14 2 2 F 271 22 2 2 F 272 25 2 2 M 273 5 2 2 F 281 33 2 2 F INJENIKA 191 21 2 3 F 192 30 2 3 M 193 2 2 3 F 201 23 2 3 F 202 28 2 3 M 203 3 2 3 F D . NECOSLIE 291 30 1 4 F 293 7 1 4 F THIA RI BO NIACIN MINE FLAVIN (MG) IMG) (MG) 1-51 3.26 16.8 1-92 2.50 3 7.7 1-80 1.70 18.2 0.79 1.32 12.5 3.31 2.72 33. 2 0-35 1.55 1.9 1.40 3.08 3 8.5 1.43 3.05 3 9.7 1.43 2.47 3.1.5 0.75 0.98 15.2 1.66 2.16 24.7 0.94 2.10 10.9 0.51 1.35 3.0 0.78 1.05 14.1 0.85 1.39 10.9 1.11 1.98 12.1 1.23 2.28 17.5 0.73 0.55 7.2 1.00 0.75 9.8 1.73 1.77 21.8 1.00 1.87 5.7 1.87 2.20 17.9 0. 44 0.66 5.1 0.84 1.21 5.4 1.56 2.88 28.9 1.07 1.79 10.9 1.62 2.40 16.3 1-57 2.58 24.1 0.80 1.16 9.8 1.54 1. 17 24.0 0.77 1.06 7.6 0.87 0.92 14.1 1.23 1.88 2.1.1 1.37 1.68 24.2 0.78 1. 11 7.8 1.93 1.61 15.1 1.89 1. 74 14.8 0.98 0.78 8.6 2.20 1.41 17.8 3.07 1.94 17.6 ASCOR TOTAL CARBO BIG FAT HYD ACID RATE 40 59 225 146 117 263 565 50 275 58 67 158 911 161 535 8 36 48 1 28 17 1 28 17 5 87 198 60 11 69 80 96 142 47 20 106 27 5 89 1 35 114 70 39 107 112 71 186 34 48 158 24 37 139 26 50 260 214 64 209 26 46 158 381 83 278 56 45 78 47 55 150 3 80 224 4 82 278 5 126 453 30 126 424 2 43 194 6 73 210 1 33 189 33 69 2 83 49 56 203 75 43 234 111 33 148 158 87 224 152 95 262 232 40 154 285 70 238 521 104 384 201 CODE AGE ISO RES SEX NUM LAT ER I ON VE 294 8 1 4 M 301 21 1 4 F 302 26 1 4 M 311 25 1 4 F 312 37 1 4 M 313 2 1 4 F 321 21 1 4 F 322 36 1 4 M 323 4 1 4 F 331 61 1 4 F 341 44 1 4 F 342 44 1 4 M 351 27 1 4 F 352 36 1 4 M 3 53 8 1 4 F 361 51 1 4 F 3 71 24 1 4 F 373 2 1 4 F 3 74 4 1 4 F 381 39 1 4 F 382 38 1 4 M 383 5 1 4 M 391 27 1 4 F 393 6 1 4 M 401 54 1 4 F 403 20 1 4 F 411 52 1 4 F 421 37 . 1 4 F 423 74 1 4 F 4 24 9 1 4 F 431 26 1 4 F 441 42 1 4 F 442 46 1 4 M E. NANAIMO 451 28 1 5 F 452 31 1 5 M 453 3 1 5 M 461 33 1 5 F 462 3 8 1 5 M 463 10 1 5 M 464 8 1 5 M 471 46 1 5 F 481 25 1 5 F 482 24 1 5 M 483 24 1 5 F 491 46 1 5 F 493 25 1 5 F THIA RIBO NIACIN MINE FLAVIN {MG.) (MG) {MG) 5.09 2.88 30.9 0. 73 1.26 13.2 1. 56 1.5 8 24.9 1-71 1.38 16.5 3.89 2.07 34.8 1.20 2.24 8.2 0.85 1.38 16.6 1.2 7 2.02 22.1 0.98 0.86 18.9 0.64 1.40 19.1 1.24 1.61 25.5 2.31 2.72 38.6 0.84 1.69 15.9 1.48 1.67 40.1 1.49 2* 25 15.1 1.42 1.89 30.2 2.00 3.11 34.9 1.03 1.94 11.8 1.27 1.79 18.2 1.06 1.43 26.6 2.71 3.15 42.6 2. 20 3.75 45.4 1.92 3.94 17.0 1.90 3.47 14.8 1.56 2.40 24.2 0.60 0.60 11.2 0.94 1.31 19.0 1.40 1.60 17.1 0.93 1.64 21.9 2.20 2.65 22.8 1.39 2.03 24.9 0.66 0.82 17.1 1.99 1.90 28.1 1.46 1.47 34.0 1.80 1.81 26.8 1.04 1.68 11.5 1.63 2.46 22.1 2.13 5.07 35.6 2.20 4.51 30.1 T.72 4.12 31.2 0.98 1.35 11.4 0.74 0.94 8.3 1.77 1.83 28.9 1.22 0.76 25.5 1.10 2.23 19.3 1.02 1.30 23.4 ASCOR TOTAL CARBO BIC FAT HYD ACID RATE 504 173 578 9 96 180 19 132 306 34 85 201 73 199 339 134 84 174 5 33 207 6 41 158 82 77 244 58 50 109 56 77 218 114 171 315 67 60 215 125 175 432 277 58 346 160 50 238 324 80 3 87 166 47 2 02 158 61 283 11 28 195 46 135 505 43 95 340 25 29 178 12 52 215 29 89 196 42 56 132 48 76 216 25 77 341 20 26 143 94 103 360 84 97 337 56 69 137 176 105 2 85 244 99 291 213 10 9 251 2 86 107 343 167 64 207 36 90 272 239 114 343 188 71 293 60 50 132 7 77 374 21 168 5 89 246 58 352 46 99 183 190 95 163 202 CODE AGE ISO RES SEX NUM LAT ER ION VE 501 40 1 5 F 502 42 1 5 M 503 18 1 5 F 504 13 1 5 F 511 42 1 5 F 512 44 1 5 M 513 3 1 5 F 514 5 1 5 F 521 60 1 5 F 522 64 1 5 M 523 17 1 5 F 531 84 1 5 F 533 46 1 5 M 541 61 1 5 F 551 48 1 5 F 552 5 0 1 5 M 5 53 24 I 5 M 561 38 1 5 F 562 40 1 5 M 563 17 1 5 M 571 57 1 5 F 573 85 1 5 F 581 29 1 5 F 582 29 1 5 M 5 83 25 1 5 F 584 24 1 5 M 591 56 1 5 F 592 63 1 5 M 593 29 1 5 M 601 27 1 5 F 602 24 1 5 M 611 26 1 5 F 613 24 1 5 F 614 4 1 5 F 615 2 1 5 M 621 41 1 5 F 622 41 1 5 M 631 28 1 5 F 641 27 1 5 F 643 6 1 5 M 651 23 1 5 F 652 23 1 5 M F. NAZKO 661 36 2 6 F 662 41 2 6 M 671 26 2 6 F 673 4 2 6 F THIA RIBO NIACIN MINE FL A V I N (MG) (MG) (MG) 0.71 1.14 22.7 0.79 0.92 20.6 1.53 1.15 17.4 1.86 1.17 14.5 1.39 0.86 10.8 3.22 2.57 32.5 1.83 2.87 11.2 1.67 2.55 10.6 0.68 0.96 20.8 0.57 1.30 34.2 1.11 2.10 18.1 0.60 0.81 8.8 1.93 3.29 45.3 0.94 1.12 25.1 0.74 1.41 14.2 1.8.1 1.75 27.1 0.56 0.84 12.4 1.08 1.00 26.9 1.32 2.02 35.1 1.65 1.54 37.1 1.01 1.24 21.2 0.94 1.16 16.1 0.43 0.5 7 17.1 1.81 2.59 72.9 2.81 3.17 32.7 2.43 2.10 29.2 1.39 1.19 16.6 1.85 1. 78 39.7 3.06 2.76 38.8 1.01 1.56 16.4 1.54 2.42 21.5 1.10 1.09 17.2 0.76 0.62 11.9 0.83 1.11 13.7 1.28 1.00 42.5 1.00 1.38 23.7 1.77 1.71 35.3 0.92 1.02 23.8 0.73 0.82 16.5 1.96 3.23 17.4 0.65 0.70 11.1 1.82 1.46 21.0 1.28 2.18 21.0 1.61 2.60 26.5 1.63 2.99 27.2 1.12 1.63 8.9 ASCOR TOTAL CARBO BIC FAT HYD ACID RATE 96 49 172 161 40 163 449 78 2 62 401 95 329 13 94 116 285 206 402 92 87 336 155 73 261 43 71 227 64 77 233 151 53 247 37 37 254 91 219 404 168 49 184 47 97 214 70 204 405 48 79 159 206 100 145 35 141 185 197 134 340 100 37 136 49 43 107 27 64 191 230 130 486 249 96 243 128 118 266 48 66 106 53 156 340 270 150 2 86 72 72 192 120 168 378 127 99 217 38 51 160 97 62 186 64 143 240 48 85 204 118 180 519 120 26 204 32 67 216 255 100 378 176 58 103 98 138 415 26 46 203 42 62 288 8 99 306 4 50 177 203 CODE AGE ISO RES SEX NUM LAT ER ION VE 6 74 12 2 6 F 681 20 2 6 F 683 2 2 6 M 691 29 2 6 F 693 11 2 6 F 701 44 2 6 F 703 8 2 6 F 711 51 2 6 F 713 17 2 6 M 714 13 2 6 M 715 11 2 6 F 716 14 2 6 F 717 11 2 6 M 718 11 2 6 M 719 16 2 6 M 723 14 2 6 M 724 11 2 6 M 731 33 2 6 F 733 7 2 6 M G. LAKE BABINE 741 32 2 7 F 742 35 2 7 M 743 10 2 7 M 744 8 2 7 F 751 59 2 7 F 753 20 2 7 F 754 10 2 7 F 761 71 2 7 F 763 27 2 7 M 764 20 2 7 M 765 22 2 7 M 766 28 2 7 M 771 42 2 7 F 773 14 2 7 F 781 17 2 7 F 783 9 2 7 F 784 14 2 7 F 791 35 2 7 F 801 40 2 7 F 803 2 2 7 F 804 9 2 7 M H. TAKLA LAKE 811 45 2 8 F 813 20 2 8 F 821 33 2 8 F THIA RIBO NIACIN MINE FLAVIN (MG) {MG) IMG) 1.50 1.49 11.9 1.46 2.19 28.9 0.95 1.30 11.7 0.89 1.36 18.6 1.66 1.91 22.6 0.67 1.12 16.3 1.33 1.88 26.7 0.84 1.75 18.0 1.31 2.60 18.9 0.91 1.88 15.6 1.05 1.64 18.4 1.21 1.28 18.2 0.87 1.19 15.6 1.39 1.58 25.1 1.46 1.57 22.0 0.60 0.77 7.1 0.86 0.81 9.3 0.76 1.39 16.2 1.16 1.25 22.0 1.2 7 1.56 22.7 1.43 2.16 31.1 1.94 1.99 2 1 . 3 1.29 1.65 15.6 1.30 2.33 2 0.3 1.15 2.20 21.5 0. 83 1 . 6 7 14.9 0.93 1.43 20.9 1.47 1.27 15.7 2.08 3.06 44.4 2.45 3.86 41.0 2.74 1.80 24.0 1 . 0 1 1.42 17.6 1.40 1.67 17.5 1.81 2.45 24.9 1.43 1.96 19.5 1.09 1.43 27.9 1.36 2.12 23.3 1.20 1.71 21.5 1.03 1.95 14.5 2.02 2.14 37.7 0.97 1.21 19.3 0.95 1.40 19.7 0.79 1.23 16.4 ASCOR TOTAL CAR BO BIC FAT HYD ACID RATE 2 22 212 33 110 221 143 44 215 37 62 215 213 104 274 30 58 162 162 94 378 154 30 127 262 93 354 44 58 218 64 57 210 6 44 244 7 101 303 12 74 284 15 84 400 7 68 260 7 62 280 3 7 95 203 41 110 326 172 63 240 61 77 294 471 56 421 219 54 256 36 56 259 40 54 265 28 49 246 45 40 146 14 74 167 67 99 353 150 73 430 751 84 492 21 53 185 33 66 306 192 53 333 132 76 353 40 24 120 12 75 274 21 49 219 84 60 206 41 63 316 40 51 249 0 53 213 16 42 170 204 CODE AGE ISO RES SEX NUM LAT ER ION VE 823 6 2 8 F 824 12 2 8 F 831 56 2 8 F 833 15 2 8 F 841 27 2 8 F 8 43 7 2 8 F 851 35 2 8 F 853 11 2 8 F 854 14 2 8 M 861 36 2 8 F 863 9 2 8 F 871 46 2 8 F 872 60 2 8 M 873 6 2 8 F 881 23 2 8 F 883 3 2 8 F 884 28 2 8 F 891 50 2 8 F 892 52 2 8 M 901 28 2 8 F 911 35 2 8 F 913 12 2 8 F 921 26 2 8 F 931 20 2 8 F 933 13 2 8 F 934 53 2 8 F 935 10 2 8 M THIA RI80 NIACIN MINE FLAVIN IMG) (MG) (MG) 0.91 1.35 11.9 1.28 1.74 18.4 I. 21 1.94 23.1 1.24 1.54 20.1 0.58 0.63 11.1 1.32 1.64 12.3 1.24 1.92 27.0 1.00 1.70 15.2 1.06 1.42 19.1 0.79 1.17 15.2 0.87 1.26 19.2 1.13 1.92 25.9 1.44 2.63 35.0 0.86 1.47 16.5 1.24 2.20 24.0 1.31 2.32 18.6 1.21 2.08 23.2 0.84 0.95 18.1 0.99 1.19 23.8 0.82 1.13 19.6 1.57 2.26 34.1 1.64 2.16 34.0 1.09 1. 52 19.8 0.97 1.84 18.7 1. 26 1.94 24.2 1.09 1.60 21.1 1.23 1.14 17.0 ASCOR TOTAL CARBO BIC FAT HYD ACID RATE 125 53 229 14 86 195 31 54 202 108 39 146 27 39 160 233 84 351 22 41 164 28 67 285 24 61 2 83 9 25 82 18 39 170 29 85 264 8 81 262 12 67 235 10 90 3 83 88 87 302 2 49 172 119 43 197 146 58 211 0 30 144 152 53 217 165 63 2 72 2 87 235 3 104 260 1 86 347 1 95 195 2 44 449 

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