The relationship between dietary exposure to persistent organic pollutants from fish consumption and type 2 diabetes among First Nations in Canada

Lesya Marushka,Tonio Sadik,Malek Batal,Hing Man Chan,Amy Ing,Karen Fediuk,Xuefeng Hu,Harold Schwartz,Constantine Tikhonov

doi:10.17269/s41997-021-00484-w

Abstract

ObjectiveWe previously examined the associations between dietary dichlorodiphenyldichloroethylene (DDE) and polychlorinated biphenyls (PCBs) intake from fish consumption and type 2 diabetes (T2D) prevalence in Ontario and Manitoba. This study aims to further explore the relationship in a regionally representative sample of First Nations adults living on-reserve across Canada.MethodsDietary, health and lifestyle data collected by the cross-sectional First Nations Food, Nutrition and Environment Study (2008–2018) were analyzed. This participatory study included 6091 First Nations adult participants who answered questions on T2D. The consumption of locally caught fish was estimated with a food frequency questionnaire. A total of 551 samples from 96 fish species were collected and analyzed for the presence of DDE and PCBs. The associations between fish and dietary DDE/PCBs intake with self-reported T2D were investigated using multiple logistic regression models adjusted for confounders.ResultsDietary exposure to DDE (>2.11 ng/kg/bw) and PCBs (>1.47 ng/kg/bw) vs no exposure was positively associated with T2D with ORs of 2.33 (95% CI: 1.24–4.35) for DDE and 1.43 (95% CI: 1.01–3.59) for PCBs. The associations were stronger among females (DDE OR = 3.11 (1.41–6.88); PCBs OR = 1.76 (1.10–3.65)) and older individuals (DDE OR = 2.64 (1.12–6.20); PCBs OR = 1.44 (1.01–3.91)) as compared with males and younger participants. Also, significant dose-response relationships were found for fish consumption in females only.ConclusionThis study confirms our previous findings that dietary DDE/PCBs exposure may increase the risk of T2D. The effect of DDE/PCBs from fish consumption is driven by geographical differences in DDE/PCBs concentrations in fish and by the amount of fish consumed, and is more prominent in females than in males.

Highlights

Type 2 diabetes (T2D) has become increasingly prevalent among Indigenous populations (Acton et al 2002; Crowshoe et al 2018; Young et al 2000)
We previously investigated the associations among fish consumption, dietary eicosapentaenoic acid (EPA)-docosahexaenoic acid (DHA) intake, and DDE and polychlorinated biphenyls (PCBs) exposure with the prevalence of T2D in First Nations living on reserves in Manitoba and Ontario (Marushka et al 2018; Marushka et al 2017a; Marushka et al 2017b)
We found that dietary DDE/PCBs intake was positively associated with the prevalence of T2D, whereas fish (EPA-DHA) consumption showed protective associations with T2D

Summary

Introduction

Type 2 diabetes (T2D) has become increasingly prevalent among Indigenous populations (Acton et al 2002; Crowshoe et al 2018; Young et al 2000). The diet of First Nations was based on traditional foods harvested from the local environment and consisted of wild game, fish, plants and berries This food contributes to both nutrient intake and physical fitness (Kuhnlein et al 2004). First Nations have been undergoing rapid lifestyle and dietary transitions, moving from a traditional highnutrient diet toward store-bought food, which is high in energy, fat and sugar (Kuhnlein et al 2004) This dietary transition has been concomitant with a sedentary lifestyle, contributing to the high rates of obesity and T2D in the First Nations population (Batal and Decelles 2019; Young et al 2000; JohnsonDown et al 2015; Reeds et al 2016)

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