Objectives: To review the current literature to determine if there is a case for examining the presence of toxins in traditional foods and the environment as a possible risk factor for type 2 diabetes in Canadian Aboriginal populations.
Study design: Literature review. METHODS. The scientific literature on possible causes of type 2 diabetes in Aboriginal populations in Canada was reviewed. Potential exposure through food and water to environmental toxins such as methylmercury, arsenic, persistent organic pollutants (POPs), including bisphenol A and phthalates, as well as Aboriginal lifestyle and composition of the traditional diet is discussed. RESULTS. There is growing evidence to suggest that environmental toxins may be associated with noninsulin-dependent diabetes mellitus (type 2 diabetes), which many consider to be endemic worldwide. In Canada, diabetes has reached epidemic proportions, especially among Aboriginal populations. Based on both molecular and pathological findings, some toxins found in the environment interfere with the functioning of the pancreas' islets of Langerhans cells, and consequently they affect insulin production. In addition, there is new evidence suggesting that obesity may be linked to endocrine disruptors, thus increasing the likelihood that obesity in itself may not be a chief risk factor for diabetes.
Conclusions: Diabetes prevalence rates among First Nations, Inuit and Métis populations are 3-5 times higher than the general population. Accepted risk factors such as diet, lifestyle and genetics do not fully explain this phenomenon. However, as many environmental toxins bioaccumulate in the food chain and are found in wild game and fish traditionally harvested and consumed by Aboriginal peoples, these chemicals could present health risks not yet fully explored. As there is not enough evidence to rule out this possibility, further studies are suggested. If correct, such environmental risk factors, especially if they are encountered early in life, would have implications on Aboriginal public health.