Factors Contributing to Obesity Among Indigenous Peoples of Canada: A Narrative Review
Danial Aminaei, Minhal Ahmed, Asal Ozlati, Kristin Kyomi Clemens, Arsh Jain, Sonja Reichert, Stewart Harris, Jaclyn Ernst, Louise MoistPurpose of Review
Obesity is a major and growing public health concern in Canada and an important contributor to chronic kidney disease (CKD). Indigenous Peoples in Canada experience a disproportionately high burden of obesity and CKD, driven by complex social, cultural, environmental, and biological factors. This review synthesizes the literature on factors contributing to obesity among Indigenous Peoples in Canada and discusses implications for kidney health.
Methods
A narrative review was conducted using predefined search terms related to obesity, Indigenous Peoples, Canada, and CKD. Following screening in Covidence, 44 studies were selected from 131 eligible articles based on relevance and contribution to emerging themes.
Key Findings
Obesity among Indigenous Peoples in Canada is influenced by an interconnected network of determinants, including dietary transition, food insecurity, socioeconomic inequities, reduced physical activity, environmental change, cultural disruption, historical trauma, systemic racism, and limited access to culturally safe healthcare. Biological and genetic factors may also contribute. These determinants increase CKD risk directly through obesity-related kidney injury and indirectly through diabetes and hypertension. Barriers to obesity treatment, including limited access to bariatric surgery, pharmacotherapy, and culturally appropriate care, may further contribute to disparities in kidney health and transplantation access.
Limitations
The literature is limited by reliance on cross-sectional and self-reported data, a lack of longitudinal studies, underrepresentation of urban Indigenous populations, and limited evaluation of culturally relevant measures of health and obesity.
Implications
Addressing obesity among Indigenous Peoples requires culturally grounded, community-led, and system-level interventions that improve food security, healthcare access, and culturally safe obesity management. Such approaches may contribute to reducing CKD burden and advancing kidney health equity.