In this chapter, we examine secular trends in diet, metabolism and body composition, including changes in the type of food consumed (‘country’ versus ‘market’ sources), the energy costs of ‘country’ versus urban activities, developing problems from the contamination of local food and water resources, secular trends in body composition, and specific indicators of metabolic health such as glucose tolerance and the blood lipid profile.

One major nutritional change associated with the ‘modernization’ of indigenous circumpolar populations has been a progressive shift from ‘country’ to ‘market’ foods. There has also been a decrease in the total food needs of the individual as daily energy expenditures have declined, and in at least a substantial minority of the population, a substantial intake of refined carbohydrates and/or alcohol has displaced more nutritious food items. Nevertheless, serious malnutrition remains much less common in the arctic than in many developing countries, in part because of financial support from central governments, and in part because many of the indigenous communities continue to supplement store purchases by protein-rich items of ‘country’ food. However, the continuing isolation of arctic settlements and the high costs of air-freight have precluded substantial purchases of fresh fruit and green vegetables by the average villager, so that deficiencies in the blood levels of certain vitamins are common. In some communities, a high intake of refined carbohydrate and lack of vegetable fibre has also had an adverse effect upon dental health.