A study was undertaken of plants used for treatment of diabetic symptoms by traditional healers of the Eeyou Istchee Cree (Canada), Lukomir Highlanders (Bosnia & Herzegovina), and Q’eqchi’ Maya (Belize). All antidiabetic plants were ranked by syndromic importance value (SIV) based on 15 symptoms, all of which were recognized by the Cree and Maya and 8 by the Highlanders. The Cree used only 18 species, the Highlanders 41, and the Maya 150, numbers which reflect the diversity of flora in their region. Vaccinium (Ericaceae) was one of the few genera in all three regions and the only consensus genus between the Cree and Highlander study sites. The Q’eqchi’ Maya ethnobotany did not present any cross-cultural consensus genera with Cree or Highlander medicinal plants, perhaps due to major biogeographic differences. In ethnopharmacological studies, Vaccinium species and Q’eqchi’ antidiabetic plants were tested in an assay relevant to diabetes, the advanced glycation endproduct (AGE) inhibition assay. Boreal and tropical Vaccinium species were potent inhibitors of AGEs and demonstrated concentration dependent inhibition, with a half maximal inhibitory concentration (IC50) range of 5.93–100 µg/mL. Phenolic content ranged from 80.3 to 201 µg/mL in boreal samples and from 1470 to 2170 µg/mL in tropical samples. Tropical species have a greater phenolic content and AGE inhibition. Seven Q’eqchi’ antidiabetic plant species were tested and all plant extracts showed AGE-inhibition. The IC50s ranged from 40.8 to 733 µg/mL, and the most active was Tynanthus guatemalensis Donn.. Tynanthus guatemalensis IC50 was about fives times greater (less active) than the mean ± SE IC50 reported for six tropical Vaccinium species of Vaccinium (8.77 ± 0.79 μg/mL). The highest consensus and most active Maya antidiabetic plant, Tynanthus guatemalensis Donn. Sm. was discovered to be an important plant recorded in archeological artifacts from the Late Classic Maya period (~750 CE). Ancient Maya used a cross shaped sign (k’an glyph) as a decorative element on Late Classic polychrome vessels and murals. The sign was believed to be the xylem template for a plant used as a flavouring in cacao drinks. However, the plant was incorrectly identified in the literature as Pimenta dioica (L.) Merr. (common name: Allspice) based on a common name and aromatic plant quality – not from a botanical voucher specimen. Pimenta dioica wood does not have a cross shape visible in the xylem but a unique character visible after a cross section of T. guatemalensis, is the xylem's cross shape organization. Wood of T. guatemalensis' also has an "allspice" aroma. Tynanthus guatemalensis is most likely the true botanical template behind the ancient Maya k’an glyph and this finding would show the continuity of use of this medicinal plant from ancient to modern times. Vaccinium was selected for an in depth phytochemical analysis using modern metabolomic methods. Nuclear magnetic resonance (1H NMR) was used to evaluate leaf extract spectra to provide information on (1) the taxonomic identity and (2) quantities of bioactive metabolites across multiple sites. Spectra clearly differentiated leaf samples of V. angustifolium, V. boreale, V. corymbosum, V. macrocarpon, V. myrtilloides, V. myrtillus, V. ovalifolium, and V. uliginosum according to generic, subgeneric, specific, phenotypic circumscriptions. Quantification of chlorogenic acid and hyperoside were replicated with a method that is highly reproducible across multiple sites with different NMR equipment. This methodology provides an important new approach to taxonomy and quality control for plants and natural health products.

A study was undertaken of plants used for treatment of diabetic symptoms by traditional healers of the Eeyou Istchee Cree (Canada), Lukomir Highlanders (Bosnia & Herzegovina), and Q’eqchi’ Maya (Belize). All antidiabetic plants were ranked by syndromic importance value (SIV) based on 15 symptoms, all of which were recognized by the Cree and Maya and 8 by the Highlanders. The Cree used only 18 species, the Highlanders 41, and the Maya 150, numbers which reflect the diversity of flora in their region. Vaccinium (Ericaceae) was one of the few genera in all three regions and the only consensus genus between the Cree and Highlander study sites. The Q’eqchi’ Maya ethnobotany did not present any cross-cultural consensus genera with Cree or Highlander medicinal plants, perhaps due to major biogeographic differences. In ethnopharmacological studies, Vaccinium species and Q’eqchi’ antidiabetic plants were tested in an assay relevant to diabetes, the advanced glycation endproduct (AGE) inhibition assay. Boreal and tropical Vaccinium species were potent inhibitors of AGEs and demonstrated concentration dependent inhibition, with a half maximal inhibitory concentration (IC50) range of 5.93–100 µg/mL. Phenolic content ranged from 80.3 to 201 µg/mL in boreal samples and from 1470 to 2170 µg/mL in tropical samples. Tropical species have a greater phenolic content and AGE inhibition. Seven Q’eqchi’ antidiabetic plant species were tested and all plant extracts showed AGE-inhibition. The IC50s ranged from 40.8 to 733 µg/mL, and the most active was Tynanthus guatemalensis Donn.. Tynanthus guatemalensis IC50 was about fives times greater (less active) than the mean ± SE IC50 reported for six tropical Vaccinium species of Vaccinium (8.77 ± 0.79 μg/mL). The highest consensus and most active Maya antidiabetic plant, Tynanthus guatemalensis Donn. Sm. was discovered to be an important plant recorded in archeological artifacts from the Late Classic Maya period (~750 CE). Ancient Maya used a cross shaped sign (k’an glyph) as a decorative element on Late Classic polychrome vessels and murals. The sign was believed to be the xylem template for a plant used as a flavouring in cacao drinks. However, the plant was incorrectly identified in the literature as Pimenta dioica (L.) Merr. (common name: Allspice) based on a common name and aromatic plant quality – not from a botanical voucher specimen. Pimenta dioica wood does not have a cross shape visible in the xylem but a unique character visible after a cross section of T. guatemalensis, is the xylem's cross shape organization. Wood of T. guatemalensis' also has an "allspice" aroma. Tynanthus guatemalensis is most likely the true botanical template behind the ancient Maya k’an glyph and this finding would show the continuity of use of this medicinal plant from ancient to modern times. Vaccinium was selected for an in depth phytochemical analysis using modern metabolomic methods. Nuclear magnetic resonance (1H NMR) was used to evaluate leaf extract spectra to provide information on (1) the taxonomic identity and (2) quantities of bioactive metabolites across multiple sites. Spectra clearly differentiated leaf samples of V. angustifolium, V. boreale, V. corymbosum, V. macrocarpon, V. myrtilloides, V. myrtillus, V. ovalifolium, and V. uliginosum according to generic, subgeneric, specific, phenotypic circumscriptions. Quantification of chlorogenic acid and hyperoside were replicated with a method that is highly reproducible across multiple sites with different NMR equipment. This methodology provides an important new approach to taxonomy and quality control for plants and natural health products.

Objectif: La santé des Indiens inscrits est inférieure à celle des autres Canadiens et dévoile des écarts importants entre les différents groupes qui la composent. La nation crie de l’Iiyiyiu Aschii, signataire de la Convention de la Baie-James et du Nord québécois (CBJNQ), bénéficie à cet égard d’un état de santé supérieur à celui des autres Indiens inscrits. L’objectif de ce mémoire est d’examiner l’impact de la CBJNQ sur les déterminants sociaux et l’état de santé de ses signataires cris depuis son entrée en vigueur en 1977. Méthodologie : Des analyses comparatives entre les Cris de l’Iiyiyiu Aschii, les Indiens inscrits et les Canadiens ont permis de suivre l’évolution à travers le temps des différences socioéconomiques, d’habitudes de vie et d’état de santé de ces groupes. Résultats : Les Cris ont enregistré, comparativement aux autres groupes d’Indiens inscrits vivant sur une réserve, une plus grande amélioration de leurs déterminants socioéconomiques, une progression relativement limitée de leurs comportements à risque et une préservation à un niveau plus élevé de leurs pratiques traditionnelles. Les Cris ont également vu progresser plus rapidement leur espérance de vie à la naissance que les Canadiens, et leur mortalité infantile a connu une chute encore plus importante que celle enregistrée chez les Indiens inscrits sur réserve. Conclusion : La CBJNQ a vraisemblablement eu un impact significatif sur la santé des Cris de l’Iiyiyiu Aschii. Cette amélioration sanitaire s’explique notamment par la Convention qui a su mettre en place des structures politiques qui ont favorisé l’amélioration des déterminants sociaux et le développement de l’autonomie gouvernementale des Cris. / Objective : The health of Status Indians is below that of other Canadians, showing important gaps among the different Status groups. The Cree Nation of Eeyou Istchee, signatory to the James Bay and Northern Quebec Agreement (JBNQA), shows a higher health level than that of other Indian Nations. The objective of this thesis is to examine the impact of the JBNQA, signed in 1977, on the health of the Cree. Method : A comparative health analysis was conduted among the Cree of Eeyou Istchee, other Indian Nations’ levels, and that of non-Native Canadians, in order to examine the evolution of social determinants of health statuses of these groups. Results : The Cree achieved the highest improvement in their socioeconomic determinants, limited progress in reducing their risky behaviors, and better retention of their traditional ways of life, than other Native Nations. The Cree increased their life-expectancy at birth to a higher status than the Canadian status, and their child mortality rates decreased compared to those of other Status Indians. Conclusion : The JBNQA seems to have had a significant impact on the health of the Cree Nation of Eeyou Istchee. The improvements might be explained by the political structures created by the Agreement. These structures supported both the improvement of the social determinants and the development of the Cree self-governement.

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