Nenets Autonomous Okrug, Russia
gather% / fish % / hunt %
fat % / protein % / carb%
A rough estimate to help us understand how carnivorous and how ketogenic these people were before being exposed to western civilization
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About the Tribe
The Nenets (in Nenets - Neney «real man» or «true man») are an Indigenous people of the Russian Federation, who live in the North of European Russia and North-western Siberia. Nenets have retained much of their traditional nomadic way of life, moving with their reindeer through the seasons. This chapter will present a snapshot of the knowledge and culture of Yamal Nenets reindeer herders, who have maintained their family based traditional economy, language and culture, including their rich, though little documented, food culture. The Nenets people are known for their generosity and hospitality. Whenever a guest comes to a traditional camp, there will be always a warm welcome. In this way, herders going on a long journey would never bring a lot of products with them. Nenets herders regularly visit each other’s remote camps and stay for a long time. When guests arrive, the hosts always do ŋayabad.
In this case it would be the Nenet paradox. The Nenets, the indigenous reindeer-herding people of this part of Siberia, have a menu that sounds like just the opposite of what the doctor ordered: They eat reindeer meat, most of it raw and frozen. From September to May they eat very little else, apart from the odd piece of raw, preferably frozen, fish. One would think that this extreme protein- and fat-driven diet would lead to a lot of health problems – obesity, cardiovascular diseases – but the opposite is true.
“It is my experience that the further away you come from the city centers of the Arctic, the healthier people look,” says Lars Kullerud, president of the University of the Arctic, a network of more than 100 universities and colleges. He researches the diets of the region’s indigenous people.
Another hour or so away by reindeer sled, the connection between the land, the people and the diet is even more evident than in Schuch'ye. As the guest of Nicolai Laptander and his wife, Ustinia, I spend the night in a chum, a traditional tent made from reindeer skins not unlike a Native American tepee, where they live with their seven children. The children look extraordinarily healthy. And although the diet is a challenge, even for this omnivore, it is exceedingly clear that the Laptanders don't eat only the reindeer's meat; they eatjust about every part of the animal. To see an 8-year-old child reach for another piece of raw liver, then a helping of raw, frozen meat, then the marrow of a cooked bone, brings warmth and envy to any parent with a picky offspring. But it also tells a lot about the secret of the Nenet diet.
When we in the industrialized world discuss nutrition and health, the focus is often on balancing broad categories of food. A healthful diet, we are told, should consist of a good mix of grains, vegetables, fruits and fish and a moderate amount of red meat. But although that probably is the best rule where food of all types is plentiful, it is not really an option in the Arctic, especially not on the Siberian tundra.
Importance of Animal Products
The knowledge of raw eating: Nayabad - or how to determine the right reindeer for raw eating.
Ӈayabad (ngayabad) is fresh fish or reindeer meat, slaughtered in the traditional way and eaten only in raw (fresh or frozen) form. Ӈayabarma - is the traditional Nenets social meal that consists of freshly slaughtered reindeer meat and blood. For reindeer ŋayabad, herders choose a healthy and fat reindeer. Females without a calf (vaŋg ty) are considered especially good for slaughtering and eating raw. Ŋayabad has a lot of social and religious values. It is carried out on each of the important event of Nenets life, such as births, weddings, when slaughtering a reindeer for clothing, sacrifices on sacred places, funerals, etc. In the chum (the traditional tent), a share of ŋayabad - meat and drink - is also given to long-dead ancestors, whose images are represented by sacral dolls (sidryaŋg and ŋytarma). Near the fire, some food should also be left for the spirit of fire hostess (tu’ khada). Nenets herders chose a healthy reindeer for raw eating due to their deep knowledge about both the herd welfare and each reindeer’s health and condition. Herders determine the health of their reindeer by its appearance at that moment, and also memorize their behavior and well-being through out the previous years: the length of antlers in the summer in comparison to previous years; how quickly the horns fall and the hair sheds in the spring; how reindeer breathes during the summer heat (if a reindeer was panting without a shortness of breath it indicates the presence of some diseases). Herders also consider if necessary vaccinations (against rabies, gadflies, anthrax, etc.) were done. Slaughtering a Reindeer for Raw Eating On the Yamal tundra, reindeer are slaughtered from mid August to April. Slaughtering from spring to late summer is not recommended, as after a long winter the reindeer are exhausted and their meat is considered to be of poor quality. The method of slaughtering reindeer is an important factor in determining the meat quality. For raw eating, an ancient traditional method is used: strangulation. A reindeer is strangled by a lasso (tynzya’) which is tightened on both sides by two men, while the third one pulls a rope tied to the animal’s right (or left) foot. This method is considered by herders to cause less suffering to the animal and ensures the juiciness and good taste of the meat. Strangulation ensures that not a drop of blood is lost, and blood for the Nenets is very valuable. The second slaughtering method is thought to have been borrowed from other Indigenous people, probably from the Khanty (T.V. Sinitsyn, 1960: 69). It became widely practiced since the 1960s, with the mass slaughter and processing of reindeer in the Soviet state farms (Rus sovkhozy). According to eyewitnesses, at first the Nenets did not want to look at the killing of their reindeer in this unconventional way, namely by knocking them senseless with a blow to the head by an ax and by a knife into the heart and Nenets initially refused to eat the meat of a reindeer slaughtered in this way. Today, outside the official slaughterhouses the second method can be used in case of emergency, when a herder is alone in the tundra and help is not near at hand. For family use, clothing and food, including raw eating, Nenets herders will always use their traditional method of slaughtering. The ancient traditions in the process of removing reindeer skins and butchering carcasses are similar among the many Indigenous Peoples of Siberia. In Nenets culture, skinning as well as slaughtering the reindeer has always been a task for men. This is normally done by two people. First, an incision is made below the knee of a front leg, and then, holding the knife blade up, a cut from the knee to the belly and further from the belly to the neck is made. The next step is that the rear legs are cut in the same way and the knife goes almost up to the chest, and then to the tail. After this, the skin should be easily and quickly separated from the carcass, holding the skin in the left hand while pushing the fist of the right hand under the skin. After opening the abdomen with a knife, the kidneys (suik) are pulled out and given to children or guests as a delicacy. Then the stomach is taken out and its contents should be poured or squeezed out. The stomach contents (tiv) have healing properties: it helps to remove rheumatic pain and should be applied fresh and warm on stricken joints. Stomach contents can also be used in the processing the skins. The stomach is then filled with blood and/or meat in order to preserve it. In the summer time it should be rinsed with water. The guests and the family sit in the chum according to their recognized social status. The most honored man or guest would sit at the middle of the table. Women and children sit si’nyana around the table toward the back of the chum. Neighbors are also invited to the feast, and they are also given reindeer meat.
What to Eat & Not to Eat for ŋaybad?
Ӈayabad is always a kind of feast and is done to mark a special day. The whole family and guests gather around a slaughtered reindeer. Each person cuts off a piece of meat or other delicacies and dips it into the warm blood before putting it their mouth. The first things to be eaten after slaughter are the lymphatic nodes (syabkha). While still warm, they are often given to children, as they are easy to chew. Traditionally, for ŋayabad Nenets eat the ears, liver, kidney, larynx, adenoid glands, thymus, the meat of the cervical vertebrae (only from calves), lungs, pancreas, meat secretions from the back (makhey), fat from the back (in the autumn - winter period), bone marrow and neck meat. During ŋayabad the meat is eaten only from one side of the carcass (flesh from buttock, ribs, shoulder, etc.). The other side is left for boiling or preserving in other traditional ways. The head is a stand-alone dish that is usually served to children. In winter the reindeer head is a dish that is left to be prepared later – because it requires quite some time to butcher, which is not always convenient in cold weather. In the summer the head is often eaten immediately and for ŋayabad goes all the parts: the eyes (nyaŋuy ŋyamsa), brains, palate (paydy ŋyamsa), ears, the fat from the eyes, cheeks, the chin, and the brains are also eaten raw. Children are usually given raw kidneys, raw liver slices and ribs, because they are the tastiest morsels. Nenets regard reindeer meat that is still warm after slaughtering to be a delicacy. The tastiest parts of reindeer are the thymus (ŋaramz’), liver (myd), kidney (syuik), trachea (hungo), tongue (nyamyu), the lower lip (pibtya’), as well as the marrow of long bones (kheva). Immediately after slaughtering, the Nenets drink warm fresh blood, and it is considered as being very beneficial for human health. What is not eaten raw? The Nenets eat only reindeer meat and fish raw (but not all species of fish). For example, pike is never eaten raw, and although considered a delicacy in many other places burbot is not eaten at all by Yamal Nenets, except its liver, which is highly prized. In addition, they do not eat raw migratory game, nor local mammals like hare, moose, bear, etc. This is likely due to the fact that being so closely coupled to their reindeer, herders have a very good knowledge about the health of each animal in their herd (both past and present). Nenets do not eat certain parts of reindeer raw: the meat from the spinal bones of an adult reindeer, meat from the breastbone, legs, neck and ribs are never eaten raw, but are boiled in a soup. As are the heart, tongue, first and second stomachs. These parts are used to cook a traditional Nenets soup called «Ya». In addition, the heart of the reindeer is considered sacred, and it must not be either eaten raw nor cut across the muscles - it is considered to be a taboo.
THE BENEFITS OF RAW EATING IN THE NENETS DIET
Raw eating occupies a special place in the Nenets traditional diet, because raw reindeer meat and blood contains a lot of the vitamins and minerals needed to survive and be healthy in the harsh conditions of the North. Thanks to the raw eating of meat, fat, and blood the human body compensates for the lack of essential vitamins and nutrients in the Arctic. If a Nenets does not get to eat raw meat and drink blood, she or he will experience feelings of hunger or stress. Therefore, for the Yamal Nenets, consumption of raw meat is their ‘anti-stress diet’, as it is their only all-year round source on the tundra of many minerals and vitamins, in particular Vitamin C. Even in modern times, it is still difficult (and expensive), to deliver fresh fruits and vegetables to the nomadic herders of Yamal. If slaughtered in the traditional way reindeer meat has a special soft, pleasant taste. If frozen, reindeer meat should be unfrozen once and eaten or consumed while still frozen and sliced nicely. The consumption of fresh and still warm blood is very important for maintaining good health. About a healthy person, the Nenets have a special saying ‘Yan khamortada veyarida yargu’, that literally means: ‘there is no dripping blood’, i.e. «in the pink of health», describing someone who is the very picture of health, and this is obtained through the raw-eating of meat and blood of a healthy reindeer. Nenets and other peoples of the North have never suffered from scurvy (lack of Vit. C) or beriberi (lack of Vit. B). Reindeer blood is the best cure for scurvy. The raw marrow of reindeer leg bones is a true delicacy, which is not found in good restaurants, and will keep a person feeling full for many hours. What is High Quality Meat for Nenets? Nenets eat freshly slaughtered raw meat, and have a deep knowledge about how to judge if the meat is safe and of high quality, and how to adhere to certain conditions in order that it retain that quality. The best ŋayabad is from healthy well-fed reindeer (usually this is in the autumn and winter). Due to lengthy migration routes (up to 700 km toward the summer pastures) reindeer at that time are less well nourished. For example, Nenets do not usually slaughter ŋayabad in late spring and summer when reindeer have completed a long winter and a lengthy migration. The next important factor in selecting reindeer for ŋayabad is the absence of diseases that could be judged by the condition and appearance of the internal organs and meat, by blood clotting, by the presence of parasites that could be observed on the meat and organs. Nenets have a particular technique when eating raw: meat from the organs should be sliced in the hand before dipping into the blood and eaten.
TRADITIONAL WAYS TO PRESERVE MEAT
The traditional methods for preserving fresh meat vary depending on the season and the time of year. For example, in late summer, the meat is salted in wooden barrels or tanks and placed in pits that have been dug to serve as a refrigerator. Wild rosemary is used to cover the meat containers to deter insects. Another traditional way to preserve reindeer meat is smoking, which takes place inside the chum in the summer. Raw meat is hung on the crossbar in the chum, not directly above the fire. In summer, the fire is usually smoky as the wood (mostly willow, also some Arctic birch) is wet. This smoke dries the meat hard (in Nenets syamdravy) quickly and it can be saved for a long time. Another traditional method to preserve meat is by air and sunlight drying that is done outside the chum. One traditional way of preserving raw meat may be at risk due to climate change: During the spring thaw, salted raw meat could be placed in the snow on slopes that were in the shadows, where it could remain until the summer warmth. Due to the fact that in more recent years, the summer has been arriving several weeks earlier and heat waves have been extreme, this method of raw meat preservation has hardly been used in recent years. In late autumn reindeer meat is salted in barrels or containers, and left in sledges along migration routes at the spring campsites. The meat is preserved well and still tastes very good raw. Nenets use it in spring – 6 months later they return to these places during their migration to the summer pastures. Also in the autumn, when there is a busy season of slaughtering well fed reindeer in the traditional way and there is a lot of raw meat, it is folded into reindeer stomachs and put in the sledge. In winter, the meat is kept frozen on individual sleds. The meat can be preserved in this way until the warm weather comes in spring. These frozen stomachs can be sawn into pieces when needed and used for ŋaybad.
Reindeer meat that has been slaughtered, butchered, packed and frozen in a modern slaughterhouse, do not meet the Nenets requirements for raw eating. The qualities of taste cannot be compared with the traditional Nenets frozen ŋayabad. This limits opportunities for Nenets who are not practicing the nomadic way of life, for example children and youth at schools and universities, and who still long for raw meat and blood. This causes extra stress to those who are, for whatever reason, away from the reindeer and the land.
Hoffman, a world-renowned specialist in game meat and an avid carnivore, is critical of the anti-meat sentiments that have become more prominent in recent years.
"Meat, both red and fish, contains all the required amino acids in the correct ratios," he says. "After all, we eat muscle to build muscle. In addition, it contains all the minerals; it is particularly a good source of highly bioavailable iron. We now know that in Europe, a large number of teenage girls that are vegetarian become anemic when they reach puberty."
Except for liver, most meat does not contain much Vitamin C. Still, scurvy is almost nonexistent in traditional Arctic cultures. That is because reindeer and other game meats contain higher levels of Vitamin C than do other meats, because the natives eat the liver, and because the natives' diet is supplemented with cloudberries and cranberries. The fact that much of the meat and the fish are eaten raw is also important.
"Every time you process or cook something -- anything -- you are likely to be losing nutrients at every step," says Harriet V. Kuhnlein, professor of human nutrition at the Centre for Indigenous Peoples' Nutrition and Environment at McGill University in Montreal. "As long as this meat is still microbiologically safe, it is at its best raw or frozen fresh."
Reindeer meat is the most important part of the Nenets’ diet. It is eaten raw, frozen or boiled, together with the blood of a freshly slaughtered reindeer, which is rich in vitamins.
Every Nenets has a sacred reindeer, which must not be harnessed or slaughtered until it is no longer able to walk. Picture © Steve Morgan https://www.survivalinternational.org/galleries/nenet
The impact of traditional nutrition on reduction of the chronic nonobstructive bronchitis risk in the indigenous peoples living in tundra of the Arctic zone in Western Siberia, Russia
Sergey Andronov, Andrei Lobanov, Andrei Popov, Lilia Lobanova, Ruslan Kochkin, Elena Bogdanova, Irina ProtasovaEuropean Respiratory Journal 2018 52: PA796; DOI: 10.1183/13993003.congress-2018.PA796
Indigenous inhabitants of the Arctic zone the use of an open hearth, portable stoves for heating leads to a high load of pollutants, that combined with the cold what can cause the activation of peroxidation. It is possible to prevent activation with the help of traditional nutrition (raw fish, venison), with high antioxidant activity (vitamins A, ω-3).
Our study aimed to develop risk models to determine the minimum sufficient rates of venison and fish consumption and to prevent the development of chronic nonobstructive bronchitis in reindeer herders.
616 reindeer herders (26.8% of men) aged 30-59 (mean age – 42.2), that is 8.0% of the total adult population of the district, participated in a cross-sectional study. The analysis of the diet was conducted using questionnaires. Nonlinear logit regression was used to build risk models. Permissible minimum amount of venison and fish was calculated to reduce the risk. The diagnosis of chronic nonobstructive bronchitis was established according to WHO definition. Lung function was assessed by a dry spirometer (SpiroUSB ML 2525 CareFusion, UK).
To reduce the risk of developing chronic nonobstructive bronchitis, minimum sufficient daily portion of deer meat should be at least 190 grams (OR=1.5), cheek – 158 grams (OR=1.5), pikes – 40 grams (OR=4.2, 95% CI–1.3–10.2). Eating venison and pike 2 times a week, a cheek – every other day is considered to be enough.
To conclude, adequate use of traditional food reduces the risk of chronic nonobstructive bronchitis.
Importance of Plants
Transition to Industrialized Food Products
In Alaska and northern Canada, modernization has led to a change of diet. Pollutants have affected the staple foods such as seal, and traditional foods have been replaced by fast food and cheap carbohydrates, resulting in an increase in obesity and Type 2 diabetes.
"The problems occur when the traditional diet is lost or meets competition from Western food," Kullerud says. "Because the first thing to reach these areas is not salad and fruit; it is the junk food."
This part of Siberia is one of the centers of the new Russian oil adventure, and with prosperity and the influx of hordes of specialists from the south comes change. But, at least for now, change seems to be coming at a slower pace. For one, the traditional staple foods -- reindeer and fish -- are lower on the food chain and thus less affected by pollutants than the seal meat eaten by North American Inuits. Also, newcomers seem to be embracing some of the traditional foods.
In Salekhard, the capital of the Yamal-Nenets autonomous region, the town's most fashionable restaurant, Beer-Line, is serving $12 pints of imported beer to well-heeled administrators, businesspeople and oil executives. It is what you would expect in a trendy boomtown bar almost anywhere in the world. However, the food gives the place away. Peanuts and chips are not to be seen; instead, giggling girls and rough prospectors alike are eating stroganina, a kind of Siberian sashimi: long, crisp shavings of frozen fish.
And at the home of Sergey Kharutsji, one of the region's most prominent politicians, his wife, Galina, and daughter, Oxana, serve up a diet not very different from that served in the chum: frozen reindeer meat, stroganina, raw reindeer liver and various other named and unnamed cuts. Oxana says that is what the family eats every day for most meals.
At first I think it might be a political statement, an effort to convince me that they are not too cut off from their people even though they live in a mansion in the middle of town. But later, when I go to fetch some boiling water from the stove, I notice something that convinces me she is indeed telling the truth: One look at the kitchen fan makes it obvious that no one has ever fried food in this house.
Andreas Viestad, author of "Where Flavor Was Born," which was named best foreign cookery book in the 2008 Gourmand World Cookbook Awards, can be reached at firstname.lastname@example.org. His Gastronomer column appears monthly.
“Where Home Cooking Gets the Cold Shoulder”, The Washington Post (2008)
Obesity in Nenets - Siberian Times
By Olga Gertcyk20 February 2017
Decline in consumption of venison and fresh river fish along with cut in distances covered on nomadic pasture routes ushers in modern curse.
The volume of consumed carbohydrates increases significantly. They replace their traditional food with them.' Picture: Sergey Anisimov
Subtle changes in traditional lifestyle of native ethnic groups in the Yamalo-Nenets region have brought the first-ever cases of obesity. Until now, fatness has not existed in these population groups, but scientists say there has been a marked change.
Alexey Titovsky, regional director for science and innovation, said: 'It never happened before that the small local indigenous peoples of the north suffered from obesity. It is a nonsensical modern problem. Now even a predisposition to obesity is being noticed.'
Changes have seen the intake of venison and river fish cut by half, he said. 'Over the past few years the diet has changed considerably, and people living in the tundra started eating so-called chemically processed products.'
Researcher Dr Andrey Lobanov (his science way below) says nomadic herders nowadays often buy instant noodles in villages on their pasture routes and this has led to 'dramatic changes to the rations of the people living in the tundra'.
'This food is easy to transport, easy to make,' he said, while also saying the nomadic groups - from the Nenets and Khanty ethnic groups - have added sugar, pastry, pasta, and bread to their diets.
'The problem is that carbohydrates do not contain the necessary micro elements, which help survival in Arctic conditions,' he said. 'The seasonal diet has also changed - the periods when they do not eat traditional food and replace it with carbohydrates has become longer.'
He said: 'The indigenous can digest carbohydrates and sugar in particular. They can digest maybe even better than Europeans and this causes the problem. The volume of consumed carbohydrates increases significantly. They replace their traditional food with them.
'Besides, taste sensitivity to sucrose increases with time. The more a person eats sugar, the more he or she needs to feel the taste. So the consumption of sugar grows exponentially.'
The distance of pasture routes of nomadic herders with their reindeer have halved over the past 25 years, he said. The routes are also more circular now, around settlements and also facilities exploiting oil and gas, of which the Yamal peninsula has vast reserves.
But there has been a 'silent revolution which is almost unnoticed', and which is contributing to the arrival of obesity in the Arctic.
'In 2014, most of the families got their incomes from selling venison and fish,' he said. 'Now the main income comes from the sale of reindeer antlers. The currency rate has changed, and the demand has increased in the south-eastern countries. That is why the profitability of the antler business has increased several times.'
As a result, the 'logistics' or economic basis of nomadic herding has changed.
'You have more chance to sell antlers for good price if they are freshly cut,' he said. 'That is, the family needs to move closer to a settlement, or road, or trading post, to deliver the antlers to a drying or freezing facility as soon as possible,' he said.
Getting the best price for venison has also changed the routes of herders, minimising their age-old nomadic patterns.
'They also try to be closer to oil and gas deposits, because there they can sell the venison all year round,' he said. 'Shift workers will always buy fresh venison - and for a good price.
'The closer you are to a settlement, the cheaper are the products you buy, because gasoline is very expensive and the price of the products increases with the distance.
'It turns out that it is very profitable now for the indigenous peoples to stay closer to the settlements, and their family well-being rises sharply. They also want to use benefits of civilization - to go to the shops, have good mobile connection, solve some issues with officials quickly. These are pure economic reasons.'
They are also a change in how these people lived including during the Soviet era.
'At the same time tundra ecosystem cannot bear such a load. It changes. Problems of overgrazing have appeared. And their routes change dramatically.'
Here climate is a factor. 'The climate on Yamal changes very quickly, maybe faster than in other places,' he said. 'For example, this summer herders did not pass even half of their usual route. Instead, they returned to their winter pastures. New plants, grasses have appeared, and reindeer eat them instead of moss.'
This all has an impact on the diet of the the Arctic nomads, he said. 'The change in routes and climate leads to the fact that the diet also changes,' he said. 'Fish always was a sufficient - maybe the largest part of the indigenous diet.
'But as they would not carry big stocks of food, the point was to come to be in the right place at the right time. Earlier, for example in the late 19th and early 20th century, the pasture routes were huge.
'The indigenous people would travel from Tazovsky district to Khanty-Mansiysk to the annual fair, and even sometimes to Tobolsk. And the route worked like clockwork.'
He said that 'the lack of traditional venison and fish in the diet is bad not only for indigenous people.
'Every population is better eating traditional balanced food, than to replace it with carbohydrates and products from other regions. It can be more significant for Arctic, because the conditions are harsh and to adapt better to climate, traditional food is better.
'For example - to avoid the frostbite, it's good to eat venison. If you want to increase the resistance to cold stress, eat the fish fat, for example, of broad whitefish. If you want to prevent hypertension and respiratory disease, you need pike, or burbot.'
He said that the Nenets people - who number some 45,000 - are open to guidance about their diets. 'Locals are interested very much in a balanced diet, they see the problem and seek advice.'
Indigenous and tribal peoples' health (The Lancet–Lowitja Institute Global Collaboration): a population study
International studies of the health of Indigenous and tribal peoples provide important public health insights. Reliable data are required for the development of policy and health services. Previous studies document poorer outcomes for Indigenous peoples compared with benchmark populations, but have been restricted in their coverage of countries or the range of health indicators. Our objective is to describe the health and social status of Indigenous and tribal peoples relative to benchmark populations from a sample of countries.
Collaborators with expertise in Indigenous health data systems were identified for each country. Data were obtained for population, life expectancy at birth, infant mortality, low and high birthweight, maternal mortality, nutritional status, educational attainment, and economic status. Data sources consisted of governmental data, data from non-governmental organisations such as UNICEF, and other research. Absolute and relative differences were calculated.
Our data (23 countries, 28 populations) provide evidence of poorer health and social outcomes for Indigenous peoples than for non-Indigenous populations. However, this is not uniformly the case, and the size of the rate difference varies.
We document poorer outcomes for Indigenous populations for:
life expectancy at birth for 16 of 18 populations with a difference greater than 1 year in 15 populations;
infant mortality rate for 18 of 19 populations with a rate difference greater than one per 1000 livebirths in 16 populations;
maternal mortality in ten populations;
low birthweight with the rate difference greater than 2% in three populations;
high birthweight with the rate difference greater than 2% in one population;
child malnutrition for ten of 16 populations with a difference greater than 10% in five populations;
child obesity for eight of 12 populations with a difference greater than 5% in four populations;
adult obesity for seven of 13 populations with a difference greater than 10% in four populations;
educational attainment for 26 of 27 populations with a difference greater than 1% in 24 populations;
and economic status for 15 of 18 populations with a difference greater than 1% in 14 populations.
We systematically collated data across a broader sample of countries and indicators than done in previous studies. Taking into account the UN Sustainable Development Goals, we recommend that national governments develop targeted policy responses to Indigenous health, improving access to health services, and Indigenous data within national surveillance systems.
The Lowitja Institute.
Comparative characteristics of carotid atherosclerosis in patients with hypertension concurrent with chronic coronary heart disease among the indigenous and non-indigenous population of the Yamal-Nenets Autonomic District
To evaluate the degree of carotid artery (CA) atherosclerotic lesion and lipid metabolic disturbances in patients with hypertension and in those with hypertension concurrent with coronary heart disease (CHD) in the indigenous and non-indigenous population living in the Yamal-Nenets Autonomic District. Two hundred men and women aged 21 to 55 years (mean age 48.2 ± 0.7 years), who resided in the Far North, were examined. The patients were divided into 4 gender-and age-matched groups of 50 persons in each: 1) natives; 2) newcomers with hypertension only; 3) natives with CHD and hypertension; 4) non-natives with the above conditions. To study CA involvement, all the patients underwent duplex scanning of the brachiocephalic arteries at the extracranial level and blood lipid analysis in an outpatient setting (Salekhard). In all the patients, common CA intima-media thickness was significantly greater than the upper limit of the normal range defined in the Guidelines, this indicator proved to be highest in the groups of indigenous people (p<0.001). The latter with CHD and hypertension more commonly tended to have atherosclerotic lesion in the left CA (p=0.06) than the non-indigenous people whereas the number of stenosis in other CAs was similar. In the natives versus the newcomers with CHD and hypertension, the atherogenic blood lipid composition was due to the higher levels of total cholesterol and low-density lipoproteins. In the non- indigenous patients with CHD and hypertension, the atherogenicity of the blood lipid composition was characterized by the higher levels of triglycerides (p=0.04) and very low-density lipoproteins (p=0.02) with the lower concentrations of high-density lipoproteins as compared to those in the natives with CHD and hypertension.