Dietary preferences of children in the Nenets Autonomous Area considering ethnic affiliation

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BACKGROUND

The Nenets Autonomous Area (NAA) is part of the Arctic zone of the Russian Federation (AZRF)¹. Representatives of the indigenous small-numbered peoples of the North (Nenets, Komi-Zyrians, Komi-Izhemtsy), as well as representatives of the non-indigenous population, reside in the NAA. According to the 2010 All-Russian Population Census, Nenets make up 17.8% of the region’s population, and Komi account for 8.6% [1]. Among all entities of the AZRF, the NAA is considered a high-risk territory for primary morbidity across all classes of diseases (A00–T98 according to the International Classification of Diseases, 10th Revision) in all age groups, including children [2, 3].

In the 1970s–1980s, due to westernization and urbanization, the diet of the indigenous small-numbered peoples of the NAA underwent major changes [4, 5]. The importation of food products introduced new types of foods previously uncommon in the region. At the same time, children from nomadic communities were integrated into educational institutions, where a standardized dietary model was used that did not take traditional eating habits into account [6].

Violations of healthy eating principles, disregard for the specifics of the traditional diet of the peoples of the North, and a shift toward a European (carbohydrate-based) dietary pattern contribute to decreased intake of vitamins and minerals [7–10], and increase the risk of metabolic disorders and chronic non-communicable diseases, including overweight and obesity [11, 12]. The inclusion of ultra-processed foods containing high amounts of sugar and sodium in daily diets is particularly harmful for the health of the pediatric population [13, 14]. Genetic predispositions to obesity among the indigenous peoples of the North must also be considered, as they require special attention to the nutritional status of children [15].

Reducing the risk of chronic non-communicable diseases among children and adolescents living in the harsh Arctic conditions can be achieved by optimizing daily diets [16]. Dietary recommendations should not only contain information on the required nutrients but also include suggested meal plans and food products [17], and take into account the dietary preferences of children with regard to ethnic affiliation.

When designing diets for organized children’s groups, compliance with sanitary rules and regulations is essential². The development of optimal dietary plans for children is guided by the new norms of physiological requirements for energy and nutrients for various population groups of the Russian Federation [18], which must be considered alongside methodological recommendations for organizing the nutrition of preschool- and school-aged children in organized groups in the AZRF [19].

To increase the demand for the developed diets among children in the NAA, further research into the most preferred food products among children and adolescents is necessary.

This work presents the results of a survey aimed at assessing the dietary preferences of indigenous and non-indigenous children attending general educational institutions in the NAA.

Aim

The work aimed to identify the dietary preferences of the pediatric population of the Nenets Autonomous Area, taking into account ethnic affiliation.

METHODS

Study Design

It was a cross-sectional study of the frequency of food consumption and dietary preferences among children.

Eligibility Criteria

Inclusion criteria:

• Children aged 7–17 years;
• Children attending general educational institutions in the NAA.

For children aged 7–12 years, parents acted as respondents. Children aged 13 years and older completed the questionnaire on their own.

Main Study Outcome

Identification of dietary preferences in the pediatric population of the NAA, taking into account ethnic affiliation.

Subgroup Analysis

All children were divided into two groups according to ethnic affiliation:

• Group 1 included children from the indigenous population.
• Group 2 included children from the non-indigenous population.

Outcomes Registration

A modified semi-quantitative food frequency questionnaire [20], adapted to reflect the national dietary culture of the AZRF, was used for the survey. The questionnaire included items on the frequency of consumption of food products (6–7 times per week, 3–5 times per week, 1–2 times per week) and on preferences for certain foods according to their taste qualities. Dietary preferences based on taste were analyzed using a yes/no response to the question: “Do you prefer to include this food product in your diet more often than others in this group?”

Ethics Approval

The study was approved by the Ethics Committee of the Federal State Budgetary Educational Institution of Higher Education Northern State Medical University, Ministry of Health of Russia (protocol No. 08/11-18 dated November 28, 2018). Voluntary informed consent was obtained from all legal representatives of the surveyed children.

Statistical Analysis

Sample size calculation principles: the required sample size was calculated using EpiInfo™ 3.4.1, assuming an alpha error of 0.05, a statistical power of 80%, and an expected response frequency of 50%. The minimum required sample size was determined to be 358 participants.

Statistical Analysis. Qualitative variables were described using relative frequencies. Comparisons between indigenous and non-indigenous populations regarding the frequency of consumption of specific food products were performed using Pearson’s χ² test. In cases where significant differences were found, each category was further compared individually using Fisher’s angular transformation (φ_emp) to refine interpretation. A p-value of 0.05 was considered the threshold for statistical significance. Statistical analysis was performed using STATA® 18.0 software (StataCorp LLC, USA).

RESULTS

Participants

A total of 809 children participated in the survey. Of these, 209 (25.8%) were assigned to group 1, and 600 (74.2%) were assigned to group 2.

Primary Results

Statistically significant differences were identified in the frequency of consumption of fish, milk and dairy products, vegetables, fruit, cereals, legumes, grain-based products, and baked goods between children in group 1 and group 2 (see Table 1).

 

Table 1. Proportion of food product consumption among children from different ethnic groups

Food group	Group 1, n = 209			Group 2, n = 600			p (χ2 test)
	Frequency of food consumption per week (% of sample)
	6–7 times	3–5 times	1–2 times	6–7 times	3–5 times	1–2 times
Meat	34.9	49.8	15.3	36.3	46.3	17.3	0.654
Meat soups	45.5	32.5	22.0	37.8	37.3	24.8	0.152
Fish	6.7	31.62	61.71	3.2	17.72	79.21	<0.001
Eggs	10.5	40.7	48.8	6.2	44.3	49.5	0.104
Milk	23.0	50.2	26.8	31.3	42.0	26.7	0.047
Fermented dairy products	10.5	56.0	33.5	9.5	53.7	36.8	0.670
Cheese	11.52	50.7	37.8	22.22	47.0	30.8	0.003
Cereals	14.81	53.11	32.12	9.01	41.51	49.52	<0.001
Pasta	15.32	59.8	24.92	5.52	49.0	45.52	<0.001
Legumes	1.4	65.62	33.02	0.5	47.02	52.52	<0.001
White bread	44.0	33.0	23.02	36.3	29.2	34.52	0.008
Rye bread	35.9	28.7	35.4	34.5	32.5	33.0	0.589
Sweet pastries	38.3	34.9	26.8	40.3	34.0	25.7	0.870
Raw vegetables	24.4	49.8	25.8	27.5	39.2	33.3	0.024
Cooked vegetable side dishes	12.9	46.9	40.2	11.5	42.8	45.7	0.388
Pickled vegetables	2.4	59.81	37.82	1.8	44.01	54.22	<0.001
Onion, garlic, herbs	23.0	17.7	59.3	16.3	20.5	63.2	0.093
Fruit	39.21	47.82	12.9	53.81	32.82	13.3	<0.001
Berries	11.0	34.9	54.1	14.2	26.8	59.0	0.070
Dried fruit compote	7.7	39.2	53.1	9.5	29.2	61.3	0.026
Berry compotes, fruit drinks	29.21	38.3	32.52	20.81	30.2	49.02	<0.001
Juices	27.82	49.81	22.52	13.52	39.21	47.32	<0.001

Note: ¹, statistically significant differences according to Fisher’s exact test (p < 0.05); ², statistically significant differences according to Fisher’s exact test (p < 0.01).

 

The proportion of children in group 1 who consumed fish, legumes, and fruit 3–5 times per week was 1.4–1.8 times higher than in group 2. Likewise, the proportion of children in group 1 consuming cereals, pasta, berry compotes and fruit drinks, and juices 6–7 times per week was 1.4–2.8 times higher than in group 2 (see Table 1). The consumption of fruit and cheese 6–7 times per week was 1.1–1.9 times higher among children in group 2 (see Table 1).

To clarify the dietary preferences of the pediatric population of the NAA by ethnic affiliation, a comparative analysis of daily consumption (6–7 times per week) of food products was performed using Fisher’s angular transformation (see Table 2). It was found that fish was insufficiently represented in the daily diet of children, whereas foods with a high content of easily digestible (simple) carbohydrates predominated over those containing slowly digestible (complex) carbohydrates. The proportion of group 1 children consuming fish 6–7 times per week was 2.09 times higher than in group 2. In group 1, the proportion of children consuming meat daily was 5 times higher than those consuming fish daily (see Table 2). The proportion of children in group 2 who consumed fish daily was 11.3 times lower compared with those whose diet included meat on a daily basis (see Table 2).

 

Table 2. Comparative analysis of daily consumption (6–7 times per week) of food products by schoolchildren in the Nenets Autonomous Area

Products	Proportion of children, %	Products	Proportion of children, %	φemp	p
Group 1, n = 209
Meat	34.9	Fish	6.7	7.56	<0.01
Milk	23.0	Fermented dairy products	10.5	3.48	<0.01
White bread	44.0	Rye bread	35.9	1.69	<0.05
Fruit	39.2	Raw vegetables	24.4	3.27	<0.01
		Cooked vegetable side dishes	12.9	6.32	<0.01
		Berries	11.0	3.48	<0.01
Sweet pastries	38.3	Raw vegetables	24.4	3.09	<0.01
		Cooked vegetable side dishes	12.9	6.13	<0.01
		Fruit	39.2	0.18	>0.05
Group 2, n = 600
Meat	36.3	Fish	3.2	16.16	<0.01
Milk	31.3	Fermented dairy products	9.5	9.69	<0.01
White bread	36.3	Rye bread	34.5	0.64	>0.05
Fruit	53.8	Raw vegetables	27.5	9.41	<0.01
		Cooked vegetable side dishes	11.5	16.54	<0.01
		Berries	14.2	15.14	<0.01
Sweet pastries	40.3	Raw vegetables	27.5	3.09	<0.01
		Cooked vegetable side dishes	11.5	11.85	<0.01
		Fruit	24.4	4.69	<0.01

 

Group 1 children were less likely than group 2 to include milk, fruit, and berries in their daily diet, and more likely to consume white bread. Daily consumption of white bread was reported by 44.0% of group 1 children, which was 1.2 times higher than the proportion of children consuming rye bread daily (see Table 2).

In both groups, the proportion of children whose daily diet included fruit was 1.6–1.9 times higher than the proportion consuming raw vegetables (see Table 2), 3.04–4.68 times higher than those consuming cooked vegetable side dishes, and 3.56–3.79 times higher than those consuming berries (see Table 2).

The proportion of schoolchildren in the NAA consuming sweet pastries daily was 1.6–3.6 times higher than those consuming vegetables or berries (see Table 2). In group 2, the proportion of children whose daily diets included more sweet pastries than fruit was 1.65 times higher (see Table 2).

Further analysis of taste preferences among schoolchildren in the NAA showed that the proportion of children in group 1 who included reindeer meat, cloudberry, bilberry, lingonberry, and beetroot in their diets was 1.2–1.6 times higher compared with children in group 2 (see Table 3). At the same time, children in group 2 included poultry (chicken), beef, pork, and cranberry in their diets 1.2–1.6 times more often than children in group 1 (see Table 3). No differences in preferences for different types of fish or fruit were identified between the groups.

 

Table 3. Dietary preferences of children in the Nenets Autonomous Area according to ethnic affiliation

Products	Group 1, n = 209		Group 2, n = 600		p (χ2 test)
	Yes, %	No, %	Yes, %	No, %
Meat
Beef		83.3	27.7	72.3	0.002
Pork		83.7	26.8	73.2	0.002
Poultry — chicken		43.5	68.8	31.2	0.001
Reindeer meat		17.2	61.8	38.2	<0.001
Fish
Cod		85.2	19.3	80.7	0.146
Perch		89.0	8.3	91.7	0.246
Herring		79.9	15.7	84.3	0.140
Whitefish		59.3	41.0	59.0	0.933
Omul		81.3	18.7	81.3	0.998
Vegetable side dishes
Potato		7.7	91.0	9.0	0.552
Cabbage		65.1	37.3	62.7	0.534
Zucchini		90.0	8.3	91.7	0.451
Beetroot		72.7	18.0	82.0	0.004
Fruit
Apples, pears		17.2	84.7	15.3	0.519
Citrus fruits		26.3	67.2	32.8	0.080
Berries
Cloudberry		25.4	50.8	49.2	<0.001
Lingonberry		41.6	49.5	50.5	0.027
Bilberry		39.2	38.3	61.7	<0.001
Cranberry		71.8	41.5	58.5	0.001

 

DISCUSSION

The present study showed that the frequency of food consumption among children in the NAA was suboptimal. Fewer than half of the respondents consumed certain food groups 6–7 times per week. According to regulatory documents, all food groups must be present in schoolchildren’s daily diet in the required amounts. A lower food consumption frequency compared with recommended values contradicts the principles of balanced nutrition².

Deviations from healthy eating principles among children in the AZRF have also been studied by other authors: Korchina et al. [21], Nikityuk et al. [22], and Lebedeva et al. [8].

In our study, we noted a markedly lower consumption of fish compared with meat (fivefold lower) among the pediatric population of the NAA. Insufficient frequency of meat and fish consumption—compared with the levels needed to maintain adaptive capacity in people living in the North—was also highlighted by Murashko et al. [23], who conducted research as part of the Monitoring of Traditional Nature Use in the NAA project.

A substantial decline in the consumption of fish and seafood by indigenous residents of the Arctic Zone worldwide during the 1960s–1980s has had a negative impact on vitamin D status of the population [24]. A study on determinants of serum 25-hydroxyvitamin D [25(OH)D] concentration among indigenous peoples in northern Ontario (Canada) revealed a positive association with a traditional dietary pattern characterized by the inclusion of fish, moose meat, wild fowl (duck, goose), and wild berries, and a negative association with a Western dietary pattern. People who consumed northern fish (whitefish, pike, sturgeon, etc.) more than once per month had higher serum 25(OH)D concentrations compared with those who consumed it less frequently [25].

The need to include northern fish in the diet is also linked to ensuring adequate intake of high-quality protein, omega-3 polyunsaturated fatty acids, macro- and microelements (including iodine and selenium), as well as B vitamins and vitamins A and E, for residents of the Arctic Zone. Traditional diets of the AZRF population, which take into account the specific features of the northern type of metabolism and, compared with the diets of residents of other regions, contain a greater proportion of animal products—particularly fish—contribute to maintaining the adaptive capacity of the inhabitants of the North [11, 23].

The results obtained also indicate a reduced frequency of dairy product consumption among children in the NAA, these products being an optimal dietary source of bioavailable calcium. A previously conducted large-scale study of the actual nutrition of children and adolescents identified a calcium deficiency problem in the pediatric population of the Russian Federation, associated with insufficient intake of dairy products [26].

A comparative analysis of the frequency of consumption of plant-based foods showed that, in the diets of both indigenous and non-indigenous children, foods high in readily digestible carbohydrates were more common than those rich in dietary fiber. In particular, sweet pastries were consumed more frequently than raw vegetables or vegetable side dishes. Children from the non-indigenous population included sweet pastries in their daily diet more often than fruit.

The polar dietary pattern differs from the European pattern by its lower carbohydrate content and is essential for survival under the extreme conditions of the North. A higher intake of readily digestible carbohydrates, compared with the level recommended for this climatic zone, may adversely affect the health of both indigenous and non-indigenous populations [27]. Furthermore, it has been established that the transition of indigenous peoples to civilized diets promotes the development of maladaptive conditions and is accompanied by increased oxidative stress, impaired immune function, deterioration of blood rheology, and increased risk of dyslipidemia, hypertension, obesity, and type 2 diabetes mellitus [11, 28].

An analysis of food preferences among NAA children and adolescents based on product taste characteristics showed that preferences for certain types of meat, vegetable side dishes, and northern wild berries varied by ethnic affiliation.

Indigenous children more often consumed reindeer meat, whereas non-indigenous children preferred beef, pork, and poultry (chicken).

This study did not identify differences in taste preferences for different types of fish between children from the indigenous group and the non-indigenous group. Children most often preferred whitefish for its taste qualities.

CONCLUSION

Analysis of the frequency of food consumption among children in the NAA indicates non-compliance with the principles of rational nutrition established by SanPiN 2.3/2.4.3590-20.

A comparative assessment of children’s choices across different food groups, based on dietary preferences, showed that diets of the NAA pediatric population significantly more often contained meat, milk, fruit, and sweet pastries compared with fish, fermented dairy products, raw vegetables, vegetable side dishes, and berries.

An analysis of food consumption by ethnic affiliation revealed that children from the indigenous group more frequently included fish, cereals, pasta, legumes, sauerkraut, berry compotes and fruit drinks, and juices in their diets. At the same time, children from the non-indigenous group more often consumed cheese and fruit.

Taking taste preferences into account during the comparative analysis of individual product consumption drew attention to the fact that indigenous children in the NAA were more likely to include reindeer meat, beetroot, cloudberry, bilberry, and lingonberry in their diets, whereas non-indigenous children preferred beef, pork, poultry (chicken), and cranberry.

The data obtained on dietary preferences by ethnic affiliation can be used when developing menus in general educational institutions to increase the engagement of both children and their parents in school nutrition.

The identified statistically significant preferences in consumption of certain foods among children in the NAA could serve as a basis for developing supplements—aligned with the dietary traditions of the indigenous peoples of the North—to collections of recipes and culinary products intended for schoolchildren in educational institutions

The development of functional food products using local traditional raw materials is also a promising direction for preventing maladaptive states and reducing the risk of diet-related diseases in children living in the harsh climatic conditions of the AZRF.

Further research is required into hygiene education for the younger generation and their parents to improve knowledge about healthy nutrition for residents of northern regions.

ADDITIONAL INFORMATION

Author contributions: O.A. Shepeleva: conceptualization, methodology, data curation, formal analysis, writing—original draft; T.N. Unguryanu: formal analysis, writing—original draft; G.N. Degteva: conceptualization, methodology, writing—review & editing; N.N. Simonova: formal analysis; I.I. Novikova: writing—review & editing. All the authors approved the version of the manuscript to be published and agreed to be accountable for all aspects of the work, ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Ethics approval: The study was approved by the local ethics committee of the Northern State Medical University (Protocol No. 08/11-18 dated November 28, 2018). All patients’ legal representatives provided written informed consent prior to inclusion in the study.

Funding sources: No funding.

Disclosure of interests: The authors have no relationships, activities, or interests for the last three years related to for-profit or not-for-profit third parties whose interests may be affected by the content of the article.

Statement of originality: No previously published material (text, images, or data) was used in this work.

Data availability statement: All data generated during this study are available in this article.

Generative AI: No generative artificial intelligence technologies were used to prepare this article.

Provenance and peer review: This paper was submitted unsolicited and reviewed following the standard procedure. The peer review process involved two external reviewers, a member of the editorial board, and the in-house scientific editor.

 

¹ Decree of the President of the Russian Federation No. 296 of May 2, 2014, On the Land Territories of the Arctic Zone of the Russian Federation. Available at: https://www.consultant.ru/document/cons_doc_LAW_162553/ Accessed on: April 19, 2021.

² Resolution of the Chief State Sanitary Doctor of the Russian Federation No. 32 of October 27, 2020, On the Approval of Sanitary Rules and Regulations SanPiN 2.3/2.4.3590-20 “Sanitary and Epidemiological Requirements for the Organization of Public Catering for the Population.” Available at: https://docs.cntd.ru/document/566276706 Accessed on: April 19, 2021.

About the authors

Olga A. Shepeleva

Northern State Medical University

Author for correspondence.
Email: shepelevaoangmu@mail.ru
ORCID iD: 0000-0002-7973-9320
SPIN-code: 8947-5552

MD, Cand. Sci. (Medicine), Associate Professor

Russian Federation, Arkhangelsk

Tatiana N. Unguryanu

Northern State Medical University

Email: unguryanu_tn@mail.ru
ORCID iD: 0000-0001-8936-7324
SPIN-code: 7358-1674

MD, Dr. Sci. (Medicine), Associate Professor

Russian Federation, Arkhangelsk

Galina N. Degteva

Northern State Medical University

Email: gala7d@mail.ru
ORCID iD: 0000-0002-3269-2588
SPIN-code: 3606-3363

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Arkhangelsk

Natalia N. Simonova

Lomonosov Moscow State University

Email: n23117@mail.ru
ORCID iD: 0000-0001-5658-6811
SPIN-code: 8362-1808

Dr. Sci. (Psychology), Professor

Russian Federation, Moscow

Irina I. Novikova

Novosibirsk Research Institute of Hygiene

Email: novikova_ii@niig.su
ORCID iD: 0000-0003-1105-471X
SPIN-code: 3773-2898

MD, Dr. Sci. (Medicine), Professor

Russian Federation, 630108, Novosibirsk

References

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