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White Dr Chris R. Swain Dr David K. Stahl Dr Steven V. Walker Dr Brian V. Vickers Dr Christine B. Vickers-Klein Dr John D. Vickers and Dr. Michael J. Michael M. Wachter Dr Peter A. Wachs Dr Rachel E. Wachters Dr Karen B. Wig-Keeling Professor Michael J. Wigler Professor Judith F. Wagner Dr Katherine W.
Wagner and Dr. Karen E. Wagner Professor Margaret J. Wagner Dr Elizabeth W. Barbara C. Vogel Dr Helen C. Vogel and Dr. Dorothy B. Lutken Dr Nancy L. Lutkens Dr Tom C. Lutke Dr i thought about this L. Lutz Dr Julia O. Levee Dr Shai M. The club was founded in and was opened for registration in It was formed as a result of the merger of the two schools.
History The first club was founded soon after the merger of French and English schools in Community The club is a member-only club, and is very active in the community. It is the main club of the French community. It has a gymnasium, club room, and its own outdoor meeting space. The Club has since been the main club for students studying at the French Technical University. The club has a full gymnasium and has a gym for the staff and students. Urquhart, infants are nursed for very long periods of time amongst the Western Arctic Eskimos also.
Rabinowitch It is stated that rickets is practically unknown 1 case seen amongst Lapp children in spite of the short summer and poor dwellings. They are suckled for periods for about In contrast, the children of Finnish and Swedish parents, working at the mines in Lapland, under similar climatic but excellent housing conditions, show a high incidence of rickets. Schehk One observer also pointed to the traditional Inuit diet of raw meat with no cereals or cereal products: In Labrador, however, a distressing condition prevails.
There the natives have been for many years in somewhat close contact with the influence of civilization, and unfortunately have abandoned their primitive methods of existence. Other factors, however, are at work. Wood is abundant, so they cook their meat. The Moravian missions and the Hudson Bay Company, with the best of intentions, take their furs and sell them provisions—dried potatoes, flour, canned goods, cereals and cereal products—and their fare consists largely of these staples.
And Labrador, while not truly arctic, offers very little return for the labor of a gardener, so there is no available source of vegetable food. Consequently, scurvy, rickets and combinations of the two are universal. Thomas Not until later did reports of rickets come from Inuit farther north and west Haworth and Dilling ; Ward et al. By that time, almost a half-century later, there seems to have been little awareness of the earlier literature.
Even in summer, native infants traditionally are either kept indoors or protected from sun, wind and insects. Dietary sources of vitamin D may have been more available before the acculturation of native people, but now they are very limited.
Cultural custom, the unavailability of fresh milk and the high incidence of lactose intolerance among adult Indians seem to be the main factors responsible. Despite efforts to encourage pregnant native women to take vitamin supplements, compliance has been poor.
Two decades later, Ward et al. This conclusion, however, is based on the general vitamin D literature and not on any studies of northern Indigenous Peoples. Thus, since the s, the medical literature has argued that Inuit, particularly children and pregnant women, need vitamin D supplements.
Heavy clothing further blocks biosynthesis Haworth and Dilling Inuit cannot get enough vitamin D from their diet. Traditional country food is richer in vitamin D, but even that source cannot provide the recommended daily intake Kolahdooz et al. The situation is worsened by breastfeeding, which is a poor source of vitamin D Ward et al.
Yet there was a time in the recent past when Inuit rarely developed rickets, even though they were exposed to the same low-UVB sunlight, wore the same heavy clothing, were breastfed much longer and in a higher proportion than is the case today, and ate country food now judged to be an insufficient source of vitamin D.
This rarity of rickets is well documented in the medical literature of the early to mid-twentieth century, but that literature is not referenced in recent studies on vitamin D and the Inuit. Current researchers either are unaware of this earlier literature or feel that it does not meet modern standards of scientific evidence. Because earlier authors could not measure vitamin D in the food or in the blood, their mode of enquiry was often subjective e. Rickets, however, is not a subjective state and was reliably diagnosed even a century ago.
Its absence among Inuit until recent times weakens the case for vitamin D supplementation. In sum, we can conclude that rickets in Canada is today more common among Inuit than among non-Inuit, whereas the reverse used to be true. This conclusion should be treated with some caution because earlier observers were comparing the situation among Inuit with the very high incidence of rickets that prevailed throughout the Western world until the postwar era. The lower incidence among Inuit was attributed at that time to extended breastfeeding and a diet of fish and game.
Recent medical researchers have ignored these possible factors, noting that breast milk is low in vitamin D and that the vitamin D content of a traditional meat-based diet, though higher than that of store-bought food, cannot supply the recommended daily intake. These facts have apparently convinced policy makers that it is not enough to promote breastfeeding and country food: vitamin D supplementation is also needed.
How serious is this problem among Inuit today? Before proceeding with mass supplementation, we should ask whether this kind of intervention is warranted. Is the problem sufficiently serious? It seems so at first glance. The picture changes, however, when we ask how many Inuit suffer harmful effects, notably rickets in children and osteomalacia in adults. In Alaska, Native children are hospitalized for rickets at an annual rate of 0.
Both of these rates are very low by historical standards. Rickets is today classified as a rare disease in most Western populations, and the Inuit are no exception. To be fair, rickets is not the only harmful effect attributed to vitamin D deficiency or insufficiency, many others having in fact been cited in the literature see, e. Only one of them, a higher risk of respiratory infection, has been studied among Inuit in relation to vitamin D.
While all possible effects of vitamin D deficiency or insufficiency should be investigated, it would be surprising to find that some of them are common when the main one, rickets, is so rare. The problem may thus be definitional. These norms reflect the physiological needs of populations whose diet is not necessarily the same as that of Inuit in Nunavut. Breast milk may be low in vitamin D because less is needed to produce the same effect.
High meat consumption A British study found that meat decreases the risk of rickets and osteomalacia independently of its vitamin D content. This inverse association with meat eating grams ingested per day seems to be curvilinear, the risk of rickets not falling any further at meat intakes of 60 g daily.
Meat eating seems to reduce this risk more effectively in women than in children. No one has yet identified the meat component that produces this effect Dunnigan et al. Low cereal consumption The same British study found that fibre independently increases the risk of rickets and osteomalacia Dunnigan et al. The causal factor seems to be phytic acid, which is found in the hulls of nuts, seeds, and grains, and is most commonly ingested from store-bought bread. The body needs more vitamin D because less calcium is available in a usable form.
The association between this disease risk and cereal consumption has been shown in controlled animal and human studies. When puppies were fed an oatmeal diet, they developed rickets, the severity of which was in proportion to the phytic acid content of their diet Harrison and Mellanby Absorption of these elements was inversely proportional to the percentage of phytic acid in their flour diet McCance and Widdowson b. Similarly, Hagenau et al.
If we assume a mean generation time of 25 years, the Inuit and their ancestors have lived at high northern latitudes for to generations. During that time their bodies have adapted to the cold in various ways: shorter limbs in relation to the trunk to conserve body heat Yeats ; Foster and Collard ; shorter and stockier fingers for the same purpose Lazenby and Smashnuk ; Betti et al. Inuit bodies have also adapted to a diet high in polyunsaturated fatty acids Fumagalli et al.
Finally, the association between body fat and risk of heart disease is weaker in Inuit than in Euro-Canadians Young ; Smith et al. In addition to adapting to the cold and a high-meat diet, Inuit bodies have adapted to a low-UVB environment where vitamin D cannot easily be made in the skin. We have seen that Inuit have adapted to these circumstances through extended breastfeeding and a diet that is optimal for calcium, magnesium, phosphorus, and zinc absorption. Have they also adapted physiologically?
There is good evidence that they have, by using vitamin D and calcium more efficiently. According to a study of Nunavik children, Inuit need less vitamin D because their bodies need less calcium. With a traditional diet, Inuit children in northern Canada ingest only 20 mg of elemental calcium per day. Sellers et al. They seemed to be absorbing calcium more efficiently from their diet, in part because their vitamin D receptor bb genotype is associated with more efficient intestinal calcium absorption Sellers et al.
A study of Greenland adults has described two other genetic adaptations. First, Inuit have a lower set-point for calcium-regulated release of parathyroid hormone. The conversion rate may be even higher during prenatal and neonatal life, when bone growth is most critical.
To varying degrees, similar genetic adaptations may exist in Amerindian peoples, who originally lived at high latitudes, and in many cases still do. This may explain the apparent paradox of Amerindian women having lower levels of 25 OH D than Euro-American women while having higher bone mass until menopause Perry et al. Should there be mass supplementation?
More research is always needed, but current knowledge does not justify encouraging Inuit to take vitamin D supplements. First, we find little evidence of vitamin D deficiency if we look for the expected harmful effects, such as rickets, osteomalacia, and risk of respiratory infection. One can counter that Inuit have a rate of rickets almost twice that of non-Inuit, but in both cases the rate is very low. There may be other harmful effects, but none have been shown to date.
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