The association between razor clam consumption and memory in the CoASTAL cohort

© 2016This study represents a preliminary effort to examine the potential impacts of chronic, low level domoic acid (DA) exposure on memory in the CoASTAL cohort over the first four years of data collection (Wave 1). Five hundred and thirteen adult men and women representing three Native American Tribes were studied annually with standard measures of cognition and razor clam consumption (a known vector of DA exposure) over a four-year period. In addition, a pilot metric of DA concentration exposure was used which took into consideration average DA concentration levels in source beaches, as well as the amount consumed. Based upon generalized estimating equations (GEE) analysis, controlling for age, sex, race, year, education level, tribe, and employment status, findings indicated that high razor clam consumers (15 or more per month) had isolated decrements on some measures of memory (p = 0.02–0.03), with other cognitive functions unaffected. The relatively lower memory scores were still within normal limits, and were thus not clinically significant. The pilot DA exposure metric had no association with any other aspect of cognition or behavior. There is a possible association between long-term, low-level exposure to DA through heavy razor clam consumption and memory functioning

Dietary patterns are associated with dietary recommendations but have limited relationship to BMI in the Communities Advancing the Studies of Tribal Nations Across the Lifespan (CoASTAL) cohort

Objective Traditional food systems in indigenous groups have historically had health-promoting benefits. The objectives of the present study were to determine if a traditional dietary pattern of Pacific Northwest Tribal Nations (PNwT) could be derived using reduced rank regression and if the pattern would be associated with lower BMI and current Dietary Reference Intakes. Design The baseline data from the Communities Advancing the Studies of Tribal Nations Across the Lifespan (CoASTAL) cohort were used to derive dietary patterns for the total sample and those with plausibly reported energy intakes. Setting Pacific Northwest Coast of Washington State, USA. Subjects Adult PNwT members of the CoASTAL cohort with laboratory-measured weight and height and up to 4 d of dietary records (n 418). Results A traditional dietary pattern did not evolve from the analysis. Moderate consumption of a sweet drinks dietary pattern was associated with lower BMI while higher consumption of a vegetarian-based dietary pattern was associated with higher BMI. The highest consumers of the vegetarian-based dietary pattern were almost six times more likely to meet the recommendations for dietary fibre. Conclusions Distinct dietary patterns were found. Further exploration is needed to confirm whether the lack of finding a traditional pattern is due to methodology or the loss of a traditional dietary pattern among this population. Longitudinal assessment of the CoASTAL cohort's dietary patterns needs to continue

Communities advancing the studies of Tribal nations across their lifespan: Design, methods, and baseline of the CoASTAL cohort

© 2016The CoASTAL cohort represents the first community cohort assembled to study a HAB-related illness. It is comprised of three Native American tribes in the Pacific NW for the purpose of studying the health impacts of chronic, low level domoic acid (DA) exposure through razor clam consumption. This cohort is at risk of DA toxicity by virtue of their geographic location (access to beaches with a history of elevated DA levels in razor clams) and the cultural and traditional significance of razor clams in their diet. In this prospective, longitudinal study, Wave 1 of the cohort was comprised of 678 members across the human lifespan, with both sexes represented within child, adult, and geriatric age groups. All participants were followed annually with standard measures of medical and social history; neuropsychological functions, psychological status, and dietary exposure. DA concentrations were measured at both public and reservation beaches where razor clams are acquired. Multiple metrics were piloted to further determine exposure. Baseline data indicated that all cognitive and psychological functions were within normal limits. In addition, there was considerable variability in razor clam exposure. Therefore, the CoASTAL cohort offers a unique opportunity to investigate the potential health effects of chronic, low level exposure to DA over time

Dietary assessment of domoic acid exposure: What can be learned from traditional methods and new applications for a technology assisted device

Three Tribal Nations in the Pacific Northwest United States comprise the members of the CoASTAL cohort. These populations may be at risk for neurobehavioral impairment, i.e., amnesic shellfish poisoning, from shellfish consumption resulting in repeated, low-level domoic acid (DA) exposure. Previous work with this cohort confirmed a high proportion of clam consumers with varying levels of potential exposure over time. Since clams are an episodically consumed food, traditional dietary records do not fully capture exposure. Frequency questionnaires can capture accumulated doses over time and this data can be used to examine dose–response relationships with periodic studies of memory and learning. However, frequency questionnaires cannot be used to assess consumption and memory response in real time. To address this shortcoming, a modified technology assisted dietary assessment (TADA) iPod application was developed to capture images of the clam meal, sourcing data, and associated memory functioning within 24 h and seven days after consumption. This methodology was piloted with razor clam meals consumed by members from the CoASTAL cohort. Preliminary findings suggest that the TADA iPod application is potentially useful in collecting real-time data with respect to razor clam consumption, as well as one day and seven day memory outcome data. This technology holds promise for addressing the challenges of other HAB related dietary exposure outcome studies

Estimated Nutrient Intakes from Food Generally Do Not Meet Dietary Reference Intakes among Adult Members of Pacific Northwest Tribal Nations1–3

Diet is influential in the etiology of chronic diseases in many populations including Native Americans. The objective of this report is to present the first comprehensive dietary survey, to our knowledge, of a representative sample of nonpregnant adults from Pacific Northwest tribal nations participating in the Communities Advancing the Studies of Tribal Nations Across the Lifespan (CoASTAL) cohort. Only participants who completed 1–4 d of dietary records and had weights and heights measured in the laboratory were eligible for this analysis (n = 418). Mean nutrient intakes were stratified by gender for the total sample, those with plausibly reported energy intakes (rEI), and those with implausibly rEI. Estimates of nutrient intakes were compared with Dietary Reference Intakes (DRI). Nutrient estimates from NHANES 2001–2002 were used as a reference. Among both men and women, total fat contributed 34–37% of energy intake and saturated fat contributed 11–12% of energy intake. Daily cholesterol intakes ranged from 262 to 442 mg. A majority of men and women were not meeting recommendations for vitamins A, C, and E, magnesium, and sodium. For a majority of the nutrients examined, plausibility resulted in higher mean estimates. The CoASTAL cohort nutrient profile is similar to NHANES 2001–2002, with a majority of DRI recommendations not being met. Adequate dietary intake information may be more important for this population, because Native Americans experience a disproportionate burden for diseases