Are the circumpolar Inuit becoming obese?

This paper reviews the ethnographic, historical, and recent epidemiological evidence of obesity among the Inuit/Eskimo in the circumpolar region. The Inuit are clearly at higher risk for obesity than other populations globally, if "universal" measures based on body mass index (BMI) and waist circumference and criteria such as those of WHO are used. Inuit women in particular have very high mean waist circumference levels in international comparisons. Given the limited trend data, BMI-defined obesity is more common today than even as recently as three decades ago. Inuit are not immune from the health hazards associated with obesity. However, the "dose-response" curves for the impact of obesity on metabolic indicators such as plasma lipids and blood pressure are lower than in other populations. Long-term, follow-up studies are needed to determine the metabolic consequences and disease risks of different categories of obesity. At least in one respect, the higher relative sitting height among Inuit, obesity measures based on BMI may not be appropriate for the Inuit. Ultimately, it is important to go beyond simple anthropometry to more accurate determination of body composition studies, and also localization of body fat using imaging techniques such as ultrasound and computed tomography. Internationally, there is increasing recognition of the need for ethnospecific obesity criteria. Notwithstanding the need for better quality epidemiological data, there is already an urgent need for action in the design and evaluation of community-based health interventions, if the emerging epidemic of obesity and other chronic diseases are to be averted.