The best of two worlds: how the Greenland Board of Nutrition has handled conflicting evidence about diet and health

The traditional diet in Greenland consists to a large extent of meat and organs of seal and other marine mammals, which is polluted by POPs and mercury. These substances are present in the blood of Greenlanders in concentrations well above international guidelines, and as these contaminants are suspected of having negative impacts on health, some action should be taken. On the other hand, traditional food is also an important source of health promoting micronutrients that are not provided by imported food in sufficient quantities, for example vitamin D, long chain n-3 fatty acids, and selenium, not to mention the traditional diet's function as a social glue that is perceived as important for Inuit identity in Greenland. The proportion of the total diet that comes from marine mammals is on a constant decrease, and especially children and young adults consume rather little seal and whale. The traditional food items are consequently being replaced by imported food, and among the imported food items several rather unhealthy items are popular, that is carbonated soft drinks with sugar, sweets, chips and farmed (red) meat with a high content of saturated fat. Together with a decrease in physical activity, this dietary transition has resulted in a severe epidemic of overweight and diabetes. In giving advice to the public, the Greenland Board of Nutrition was therefore faced with the challenge to retain the benefits of the traditional diet while minimizing the contaminant exposure, and at the same time to counteract the effects of poor quality imported food. The Board tried to balance the known and suspected positive and negative aspects of the total diet in relation not only to physical health but to general wellbeing, and decided on 10 simple recommendations. As the consumption of traditional food becomes less prominent and as the consumption of food rich in empty calories increases, the guidelines are continuously revised and updated.