Healthy Roots : Building capacity through shared stories rooted in Haudenosaunee knowledge to promote Indigenous foodways and well-being

Urban and reserve-based First Nation families in southern Ontario frequently experience food insecurity as well as more limited access to traditional, more nutrient dense foods from the local environment. Healthy Roots was initiated in the community of Six Nations to promote traditional food consumption. A small number of participants eating only locally available foods reported better-controlled blood glucose, positive weight change and increased traditional food knowledge. New relationships and partnerships were also developed. Our Sustenance, a community organization that was responsible for the local farmers market, community gardens, good food box program, and other community programs, joined the Healthy Roots Committee to continue advancing the knowledge and activation of the community-based initiatives such as the development of a Haudenosaunee Food Guide. Healthy Roots may serve as a model and inspiration to other Indigenous communities looking to reconnect to their local environments and Indigenous lifeways to promote Indigenous foodways and well-being.


Introduction
This field report documents the implementation and outcomes of two Haudenosaunee community-based programs in Southern Ontario, Healthy Roots and Our Sustenance.Part of the outcome was the development of the Haudenosaunee Food Guide and building personal and community capacity around traditional food procurement.
It is well known that traditional foods harvested locally contribute towards the holistic well-being of Indigenous peoples and that a shift towards marketed foods has had negative consequences for health and well-being (Elgeland et al., 2011;Schuster et al., 2011).Quality may be compromised as store-bought foods can contain more saturated fats and refined carbohydrates, while traditional foods are more biologically diverse and more nutrient dense (Gagné et al. 2012).This transition away from nutrient-rich locally harvested foods has resulted in significant changes and challenges negatively influencing the health and well-being of individuals and communities.There have been similarly adverse effects on Indigenous food knowledge systems (Lambden et al., 2007).A more comprehensive understanding of the factors or determinants related to impacts on food security is necessary to address and combat these complex trends across local Territories.In doing so, food security should not be narrowly defined as having enough to eat or enough household funds to purchase processed foods that may be more accessible (Willows et al., 2009).Rather, its meaning, certainly in an Indigenous context, encompasses the ability to acquire foods in socially or culturally acceptable ways that may encompass access to traditional knowledge as well as knowledge of the local environment (FAO, 1996;Schuster et al., 2011;Willows et al., 2009).
The majority of research on traditional food access and local food systems has taken place in northern and more remote locations (Lambden et al., 2006;Receveur et al., 1997).It is well known that urban and reserve-based First Nation families in southern Canada frequently experience food insecurity as well as more limited access to traditional foods or being out on the land (FNIGC, 2012;Richmond et al., forthcoming.).Access to knowledge, including Indigenous knowledge, contact with Elders, and increased cultural capacity around traditional foods are important determinants of food security, nutritional health, and well-being (Neufeld et al., 2017).The concept of food sovereignty encompasses acquiring foods in culturally acceptable ways, such as through traditional practices (FAO, 1996;Schuster et al., 2011;Willows et al., 2009).An Indigenous food sovereignty framework explicitly connects the health properties of food with the health of the environment and identifies a history of social injustice as having radically reduced Indigenous food sovereignty in nations such as Canada (Morrison, 2011).It addresses aspirations for collective well-being, along with acknowledging land rights and cultural integrity.Indigenous food sovereignty also considers gender equity, adequate nutrition, addressing structural racism and a restructuring of socio-political processes (Cidro et al., 2015).
In 2012, Six Nations families participating in the First Nations Food Nutrition and Environment Study (FNFNES) similarly reported multiple barriers to increased use of traditional foods, such as knowledge access (Chan et al., 2014).More than 73 percent of participants expressed they would like to include more traditional and locally accessed foods in their families' diets.The Southwest Ontario Aboriginal Health Access Centre (SOAHAC) Food Choice Study that included urban and reserve-based families in southwestern Ontario found that 35 percent of reserve-based and 55 percent of urban-based respondents describe themselves as food insecure (Richmond et al. forthcoming).Survey respondents from both groups expressed strong interest in consuming more traditional foods, with 76 percent of urban-based respondents and 52 percent of reserve based respondents indicating that they would prefer to consume these foods more frequently.
Six Nations of the Grand River Territory is the largest First Nations reserve in Canada, located in south western Ontario and home to approximately 13,000 members living on reserve (Six Nations, 2013).Many community initiatives have ensued over the years, with efforts to promote wellness and improve the health and well-being of our community.More recently increased acknowledgement and need for community collaboration centred on traditional Haudenosaunee culture and food ways have been expressed (Chan et al., 2014).Haudenosaunee refers to "people of the longhouse", commonly referred to as "Iroquois" or "Six Nations", originally made up of Mohawk, Cayuga, Oneida, Seneca and Onondaga Nations, and eventually Tuscarora Nations.Through the continued realization of the value and impact of the knowledge of the Ancestors, the community is shifting to apply existing knowledge to cultivate a healthy Haudenosaunee community.

Background
The following sections are written from the point of view of the first two authors who were involved throughout this community initiative.
Beginning in mid-December 2014, Six Nations Health Services was approached by Two Row Times, one of the local news publications.They were looking to partner together and create something for the community to engage in.One idea was to build on the upcoming flurry of New Year's resolutions, with an initiative focused on foods promoting healthier lifestyles.Little did anyone involved realize that this initial conversation between Two Row Times and Six Nations Health Services would have such an impact on the community.Creating the momentum that moved us forward to where we find ourselves today, in a place where the concept of this community initiative is becoming more imbedded in the work being done in the community with an increased interest, availability and acceptance of Haudenosaunee foods.The conversations about how Healthy Roots should begin was actually started around the kitchen tables of families in the community.It was these family conversations that prompted the focus on Indigenous foods first and made the on-going exchanges between Two Row Times and Six Nations Health Services so exciting.
We brainstormed about a community challenge that focused on our traditional foods and knowledge and considered the potential for a community challenge that would allow us to acknowledge, honour, and bring forward the knowledge of our Ancestors.Our people knew how to live a healthy lifestyle, through their relationships with the land, community, and ourselves.Our inherent knowledge as Indigenous Peoples can tell us what we need to know to become healthy again.
The term Healthy Roots was used to describe this new challenge for the community of Six Nations.Entsisewata'kari:teke (Mohawk) and Esa:do:gwe: (Cayuga) each mean "you will become healthy again".This phrase inspired a 90-day community challenge, it was part of the Healthy Roots logo, this branding appeared on all promotion items and press.The goal of the community challenge was to integrate the knowledge of our Ancestors through increasing access to traditional foods, activities and promoting interconnectedness.The Healthy Roots Challenge was set to begin on January 1, 2015.As a collective group, Health Services and Two Row Times staff selected four community members who were willing to participate in the Challenge.The selection process was not structured and the four selected were those that had existing relationships with Health Services, and had expressed interest in wanting to make positive changes to their health.
The participants were committing to preparing and consuming only foods that were available on Turtle Island (North America) pre-settler contact.They were to eliminate wheat flours, white sugar, dairy products, salt and lard (also known as the "five white gifts") and aim to sustain on foods that originated in North America.The Challenge also involved a commitment to participating in at least 30 minutes of physical activity each day.The overall purpose of the Healthy Roots Challenge was to see if by engaging in these lifestyle changes for 90 days, eating only foods original to our Indigenous peoples, and moving our bodies more, we would see any positive impact.

The start of the Healthy Roots Challenge
Once they agreed to take part in the Challenge, the selected participants were required to sign a formal letter of commitment that included their permission to share their experience with the intervention publically either through social media sites, such as the Healthy Roots Facebook Page, Instagram, or Twitter and in the Two Row Times weekly paper.Each participant received a booklet at the start of the challenge to record their daily food intake, activities, and document weekly activity and dietary goals.An honorarium of $100 also went towards food costs and each received a Fitbit (pedometer) to track daily activity.Throughout the challenge relationships were established with the community dietitian at Six Nations Health Services for on-going support according to their individual needs and to establish measures for weight, waist, hip, and chest, and body fat percentage.This relationship also prompted dialogue with the participants' family doctor if any additional monitoring was required, such as medication management or blood values.
Participants were also required to engage in Healthy Roots specific community events which were planned where the entire community was invited to learn more about Healthy Roots.
Local chefs led cooking demonstrations using traditional foods and traditional activities such as snowshoeing took place with interested community members of all ages.At the end of the Challenge a finale dinner took place to celebrate the participants and hear stories about their journey.
The potential impact varied greatly depending on each of the four community participants.They were all adults, ranging in age from 21-50, with two males and two females.Each of them expressed different hopes and goals they wanted to achieve as being a part of the Challenge including: having better blood sugar control; taking less medications for diabetes and cholesterol; losing weight; sleeping better; being more productive at work; limiting digestive distress after meals; learning more about our traditional foods; gaining strength; preventing diabetes from worsening or decreasing diabetes complication risks; and feeling better.Initially the majority of the goals each of the participants shared focused primarily on physical health, but as they moved through the Challenge, their experience deepened extending beyond to emotional and spiritual well-being.

Gaining momentum
The public engagement through the sharing of individual experiences, challenges, and successes each day via social media initiated a surge of interest and momentum around the Healthy Roots Challenge.The participants felt an additional sense of responsibility, or accountability not only to themselves, but to their communities, knowing their community; friends, family, coworkers were all watching, supporting and learning.As the Challenge continued, participants started to share a different point of view, something that had started as a predominately physical challenge focused on lifestyle changes had started to dig deeper.For example, participants were becoming more aware of the link to their food, what they put into their body and how it strengthened their emotional and spiritual well-being; they were becoming more rooted in their Indigenous culture.
Participants started sharing about their improved relationships with themselves and those around them, including their foods.As they were investing much more time and energy into sourcing, preparing, and enjoying their foods, they each spoke of how they viewed food differently, as a life sustainer.They shared stories of how they felt an increased connection to their culture and Ancestors as they engaged in traditional activities and foodways, thereby strengthening their identities as Indigenous Peoples.One of the Healthy Roots participants expressed these connections in a quote published in Two Row Times: It's also giving me a sense of how our ancestors used to eat.How would they have eaten and been more physically active?It really got me thinking.One time my meat was on a ration and I was still hungry and I thought to myself, 'Is this maybe what it would have felt like when back in the day there was only so much food to go around until they could go out and get more?(Garlow, 2015) The collaboration of different community partners influenced the community engagement.By partnering with Two Row Times, who were generously supported by Dreamcatcher Charitable Foundation, the outreach and scope of the initiative was much broader.Through support from Dreamcatcher Foundation we were able to provide promotional items at community events and provide monetary honorariums to the participants.Healthy Roots T-shirts, toques, stickers, other promotional items, and door prizes were given away to raise awareness among community members.We were able to positivity influence community members to participate in events, again extending our outreach.Using the newspaper to convey stories from the participants' perspectives allowed the community to hear about the success and impact of the project from their point of view, rather than from a health care provider.For example, the newspaper was able to convey the experience of Julee Green, who had been a participant in the Healthy Roots Challenge.She had stopped eating the "five white gifts" of sugar, salt, lard, dairy, and wheat.She had incorporated 30 minutes of daily activity, and in doing so she felt she was changing her life.As she expressed herself: I'm feeling great!Before I began I was feeling horrible.I had aches and pains in my back and feet.My digestion wasn't working right.But I noticed a difference just after two days into the diet.That sold me!That is when I realized, 'Okay.This is what I'm supposed to be doing.(Garlow, 2015) The community finale of the Healthy Roots Challenge was held on Thursday March 26, 2015.Each of the participants shared stories of their journey over the past three months.A delicious Healthy Roots inspired meal was served to a full house of over 100 people at Six Nations Community Hall, as community members gathered to hear about the experiences of the four community participants.In attendance were peoples' family members, coworkers, neighbours, cousins, and friends.All had been closely following participants' progress each week in the Two Row Times newspaper, on social media, and out in the community at the bank, grocery store or local restaurant.The physical changes participants observed-such as weight loss, controlled blood glucose, and gained strength-had a profound impact when combined with the personal, intimate accounts of how many felt their lives had changed forever through this process.Participants shared that their initial hopes and goals at the onset of the study were surpassed.Community members remarked at how such change could have occurred in such a short period of time by just acknowledging and activating the knowledge of our Ancestors.The success we experienced with this initiative made us realize that the end of this project established the groundwork for the beginning of future projects.New partnerships were developed and integrated into the Healthy Roots Committee, including Our Sustenance, a community organization that was responsible for the local farmers market, community gardens, good food box program and other community programs, and Kakhwa'on:we "Real People Eat Real Food", another community organization.Discussions occurred on how to maintain the momentum gained from Healthy Roots challenge and to continue advancing the knowledge and activation of the community.

Our Sustenance
The Our Sustenance program has focused on sustainability, food access, and education since it began in 2011 and the Healthy Roots partnership was a synergy that could not be ignored.The plans were simple: to find ways to help anyone who was interested to learn how to bring healthy food choices to their front yard.We had classes on composting food waste, vermicomposting (worms), and how to plant and grow a garden.Our Sustenance has an ongoing program that allows people to access the greenhouse where fresh greens and seasonal vegetables are available for just a few dollars.
From the perspective of the Our Sustenance program, the goal of joining the committee was to provide support to the initiative and the community in order to sustain the momentum gained from the Healthy Roots initiative.The expansion to include the first Homegrown Goodness series that would be centred on the strengths of Our Sustenance: growing food.This series included various activities and information aimed at engaging the community, such as gardens or home grown whole foods in their lifestyle.The Homegrown Goodness series was tailored for the first time to introduce the idea of gardening and sourcing local foods.Our Sustenance brought the Healthy Roots challenge into the front yards of community members who wanted to take up the challenge of including whole, fresh healthy foods, and as the title suggests, home-grown food.
By opening up a series of gardening how-to workshops and events, the Healthy Roots program was now showing people how to "plant the seeds of wellness" and integrating that into the communities' awareness.This was a first endeavour for Our Sustenance and our first as a partner in Healthy Roots.As a community, our historical culture is one that was agricultural, but over generations and with many of the issues that have occurred over time, growing our own food has become less and less common.The gardening skills workshops were a way to offer both cultural and practical skills and information to allow anyone to participate.
The first series included the planting of the community garden, where a community youth came and sang her seed song, as others were busy planting the garden.The Our Sustenance Community Garden is a public garden.You can access space for a private garden, but the larger section is planted and grown and the motto is, "if it's ripe and you'll eat it, please take what you can use".The Our Sustenance program has eight raised beds, twelve feet square each and they are planted by the program and cared for by staff and volunteers, with a community member doing the tilling.They are grown expressly for the community.We have had no issues with vandalism, and we promote our own brand of "theft" since we have no limitations on who can take food from the gardens.The private plots that are maintained by family members have not had any loss of food and only ever suffered from other supportive gestures, such as watering.The program promotes the ability and willingness to share and the community has responded in kind.
The partnership has brought Our Sustenance to the forefront in the community, but also created a positive step for Healthy Roots.The Homegrown Goodness Series of Healthy Roots gave the entire community the opportunity to be part of Healthy Roots in an accessible way, relating to whole healthy foods, not strictly Indigenous food only.You no longer needed to be one of the challengers to be able to proudly say you were taking on the Healthy Roots flag.In this case actually it was less a flag and more swag.That year you could not go anywhere in the community without seeing someone in a Healthy Roots swag item.Toques from winter, t-shirts from the summer, and aprons from the Healthy Harvest series held in the fall showed that community participation was increasing and had a growing following.
In the fall, Healthy Roots and Our Sustenance held a Healthy Harvest initiative, which offered a series of canning and food preservation classes.What started as a class for 10-15 registrants ended up being closer to 25 community members showing up each week, with and apron in hand and an eager face.The classes began with Kitty, the Greenhouse Grower (and educator) at Our Sustenance, teaching the basics of canning techniques and the science behind it.
Kitty would eventually become a participant in the second Healthy Roots community challenge as a member of the board represented in the community.This was the second time a ninety day challenge of specifically Indigenous food only was created.This time, rather than the original 4 community members, there were 9, including a family of 3 as a single unit.Kakhwa'on:we "Real food for real people" Another integral contributor of the Healthy Roots Committee is Chandra Maracle, representing Kakhwa'on:we.Chandra, with the support of Rick Hill, developed The Haudenosaunee Food Guide.This was a document that intended to increase and inspire awareness of foods known to be within the Haudenosaunee territory prior to European arrival.Haudenosaunee agricultural knowledge and skill were well developed in the region, with an extensive amount of foods being cultivated from the garden.All other available food sources would have been wild and therefore collected/gathered or hunted during the appropriate season (see Figure 3).The Haudenosaunee Food guide was developed with the intention to support the second Healthy Roots Community Challenge, scheduled to begin on January 1, 2016.The purpose was to honour the foods of the Territory and truly model the diets of our Ancestors.Within the first Healthy Roots Community Challenge in 2015, the goal was to focus on foods available on Turtle Island pre-settler contact.Through discussions amongst the committee and community members, the focus shifted in the second challenge towards engaging participants who would commit to a Haudenosaunee specific diet.The first challenge pertained to local food, or foods Indigenous to North America, whereas the second challenge used a list of foods very specific to the region the Haudenosaunee would have lived in, namely Southern Ontario and east toward the Finger Lakes region of New York and up to Quebec and the St Lawrence seaway.The resource developed by Chandra and Rick is a work in progress and will continue to grow and develop with the community.

Building community capacity
The second Healthy Roots Community Challenge was slated to begin January 1, 2016.The recruitment for this Challenge began in fall 2015.A community call was issued inviting interested potential participants to submit an application stating "why they wanted to be a part of the second Healthy Roots Challenge?"The Healthy Roots Committee selected nine of the twelve applicants to participate in the three month challenge and commit to following the Haudenosaunee Food Guide.The Committee selected participants based on the content of their application and reason for wanting to be a part of the Challenge with the goal of creating a group with diversity in age, gender, and knowledge.The nine participants were made up of: a family of three (mother, father, and teenaged daughter); an educator; an artist/historian; a police foundations student; a food access worker; a mother/caregiver; and a health professional.The participants were a motivated group that was inspired to commit to the challenge for various reasons, such as those quoted in the Two Row Times: I've always wondered if switching to an all traditional diet would heal us on several levels and the challenge is an opportunity to find out if it will.(TRT Staff, 2015) I observed the participants last year and felt a great sense of renewal and inspiration as part of what I wanted to see change in our community when I moved home almost 6 years ago was our relationship with food.Not only how we eat but how we grow and harvest.I chose to be a part of this project based on learning more in depth and with support about our traditional foods and the different ways to prepare them.I'm hoping it will optimize my disease management.(TRT Staff, 2015) As the Director of Health Services, I have been observing the program over the past year and have seen the positive impact that the program has had on the community both for individuals and as a whole.It has been my philosophy as a leader that it is important to walk the talk, and so I see this challenge as my opportunity to demonstrate my personal and professional commitment to health and wellness.(TRT Staff, 2015) I want to participate in this because I want to see if I can actually live by the cultural standards that I teach about.(TRT Staff, 2015) Just as was observed during the first Healthy Roots Community Challenge, the second Challenge offered a variety of opportunities for the nine participants and community members to engage in workshops, community, and educational events (Figures 4-5).One of the participants spoke about fostering connections between herself, her food, community and family: The thing I would like people to take from Healthy Roots is the connectedness that we have to each other, to the world around usthe animals, the plants, the thought process that we have.We're all connected.And if changing our lifestyle by eating something a little different brings that to the forefront and helps us to remember that, it might be a little easier to make the world better.That's all it's going to take.(Hill, 2016)

Growing forward
The ongoing goal of the Healthy Roots partnership, and in particular the presence of Our Sustenance, is the hope to see the growth of a community.The growth of relationships on many levels; individuals to their food, to each other and to the larger community as a whole.The solidification of the Healthy Roots committee has been integral to the progress of this program.The community moving forward will be able to look to Healthy Roots for guidance, ideas and, initiatives to bring together food, culture, community, and health.The partnership between the committee members means that we work in a synergistic relationship feeding off each others ideas and creativity, just as a garden works together to grow.The roots from the soil, leaves, and flowers bring forth the fruits we will all share as we tend our garden.We look forward to the Healthy Roots program offering support to the community to grow food, friendships, and promote health as Indigenous people.
New research opportunities have also emerged from the Healthy Roots Community Challenges.A partnership between Six Nations Health Services and McMaster University has formed to assess the efficacy of the Healthy Roots intervention on cardio-metabolic factors.The main objectives of this pilot study are to investigate the impact of the three-month Healthy Roots This Healthy Roots intervention ran from March 20, 2017 until June 20, 2017.The goal was to recruit 20 participants who met the inclusion/exclusion criteria and could commit to following the Haudenosaunee food guide for a three month period and other intervention parameters.This pilot study presented an exciting opportunity to explore the bio-physical impacts of the Healthy Roots intervention.From the previous two years' challenges we have heard various testimonials of positive changes.This pilot study will help to build on those testimonials and potentially provide biological evidence to support the previously reported changes from the Healthy Roots Community challenges.To build on these initiatives, and add to previous research conducted in southwestern Ontario on traditional food systems, a four-year grant has been funded by the Canadian Institutes of Health Research (CIHR) to support a participatory research project building on these community successes.The study aims to increase the local availability of traditional foods and address access in addition to knowledge barriers identified in southwestern Ontario by documenting and integrating inter-generational knowledge resources.Photovoice methodology will be used to investigate knowledge and sources of traditional foods with Elders and Youth.Results generated it is anticipated will inform Healthy Roots and other community-based programs like Our Sustenance to better meet the needs of the larger community.
It is anticipated that the study's community-based framework, photographs, and stories may also be transferable to other Indigenous communities living in urban centres and other rural locations.There is also the potential for the project to develop into a larger research program or community-based health initiative focused on healthy eating and sustainable food systems.Results from the proposed research will also inform the creation of community-informed and delivered nutrition services and resources that will promote a greater diversity of food choices by bridging sources and locations of traditional food knowledge.The opportunity to blend a Western medical understanding of Indigenous health with traditional food and knowledge will create a level of accessibility to Healthy Roots with a much wider audience, including potentially health care providers.
These opportunities are just the beginning, in regards to outreach and shared voices.Healthy Roots is an initiative that began on the Six Nations of the Grand River Territory and draws on traditional Haudenosaunee knowledge around food and health.The hope is that Healthy Roots will serve as a model and inspiration to other Indigenous communities looking to reconnect to their local environment and Indigenous lifeways in the promotion of well-being.

Concluding perspectives
In unison with Healthy Roots, Our Sustenance, and other partners, movements towards community engagement and research aimed at increasing control over the sustainability of local food systems and environments has shifted towards Indigenous food sovereignty (Grey & Patel, 2015).The emerging literature on the Indigenous food movement identifies community involvement and family-centred education about food and re-establishing a relationship with the land as essential to restore traditional food systems as has evolved through collaborative community processes in the community of Six Nations.
Elsewhere, progress has been made in the resurrection of traditional food systems.In northern Minnesota, for example, the community of White Earth Anishnaabeg are focused on achieving the localized harvesting of traditional foods.Manoomin (wild rice) is still harvested traditionally by many community members (Silva & Nelson, 2005) and acres of flint corn are grown.Fish, deer, and buffalo are similarly locally sourced.Food-related projects such as gardening and maple-sugaring also have an impact on the physical health and cultural connectedness of community members including a lunch programme for elementary school kids, and the provision of traditional foods to community Elders (LaDuke 2005).Another project in Saskatchewan highlights the importance of Elders and community members in Indigenous foods exploration and revitalization by passing on knowledge through workshops on Indigenous food and medicine protocols, identification, harvesting, processing and preparation of Indigenous foods and medicines, along with partnership and networking activities (Gendron et al., 2016).
While Healthy Roots is centered in the community of Six Nations, the community initiative and intervention are arguably relevant to Indigenous communities elsewhere.Other communities are asking to be involved in more activities around traditional foods (Chan et al., 2014;Gendron et al. 2016, Richmond et al., forthcoming).The activities promoted as part of Healthy Roots could be applied by other communities within their own unique Indigenous food environments and systems.Traditional food systems are complex and holistic.They are valued from a physical health perspective and the activities involved in their acquisition and distribution allow for the practice of cultural values, such as sharing and cooperation (Earle, 2011).There is urgency in sharing practices and increasing knowledge capacity around traditional foods through increased social support and knowledge regeneration.Elevating traditional foods and food systems as pathways towards self-determination also reinforces both dietary and biocultural diversity (Johns & Sthapit, 2004).The dimensions that constitute Indigenous foodways collectively contribute towards the holistic health of individuals, Nations and Territories.

Figure 1 :
Figure 1: Two Row Times Coverage (Permission to use this image (Dec.31, 2014) was granted by the Two Row Times)

Figure 2 :
Figure 2: Before and After Healthy Roots Challenge (Photo credit: Julee Green)

Figure 3 :
Figure 3: Haudenosaunee Food Guide 1 lifestyle intervention on: (1) body weight; (2) subcutaneous and ectopic fat (including visceral and liver adipose tissue); (3) serum lipids and glucose; (4) gut microbiome and serum metabolome; and (5) gene expression and epigenetic changes among First Nations people of the Six Nations of the Grand River Territory.