This article delineates specific issues relating to health literacy for Indigenous Australians. Drawing on the extensive experience of the authors' work with Yolnu people (of north-east Arnhem Land) and using one model for health literacy described in the international literature, various components of health literacy are explored, including fundamental literacy, scientific literacy, community literacy and cultural literacy. By matching these components to the characteristics of Yolnu people, the authors argue that language and worldview form an integral part of health education methodology when working with Indigenous people whose first language is not English and who do not have a biomedical worldview in their history. Only through acknowledging and actively engaging with these characteristics of Indigenous people can all aspects of health literacy be addressed and health empowerment be attained.

A diet using portion-controlled meal replacements yielded significantly greater initial weight loss and less regain after 1 year of maintenance than a standard, self-selected, food-based diet. As PCDs may help obese patients with type 2 diabetes adhere to a weight control program, diabetes educators may consider recommending them as part of a comprehensive approach to weight control.

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Background: Breast cancer (BC) survivors treated with anthracycline-based chemotherapy (AC) have increased risk of functional limitation and cardiac dysfunction. We conducted a 12-month randomized controlled trial in 104 early-stage BC patients scheduled for AC to determine if 12-months of exercise training (ExT) could attenuate functional disability (primary endpoint), improve cardiorespiratory fitness (VO 2 peak) and prevent cardiac dysfunction. Methods: Women aged 40-75 years with stage I-III BC scheduled for AC were randomized to 3-4 days/wk of aerobic and resistance ExT for 12-months (n = 52) or usual care ([ UC ], n = 52). Functional measures were performed at baseline, 4-weeks following AC (4-months) and at 12-months comprising: 1) cardiopulmonary exercise testing to quantify VO 2 peak and functional disability (VO 2 peak ≤18.0mL/kg/min), 2) cardiac reserve (response from rest to peak exercise) quantified using exercise cardiac magnetic resonance measures to determine changes in left- and right-ventricular ejection fraction [ LVEF, RVEF ], cardiac output [ CO ], and stroke volume [ SV ]), 3) standard-of-care echocardiography-derived resting LVEF and global longitudinal strain [ GLS ], and 4) biochemistry (troponin and B-type natriuretic peptide [ BNP ]). Results: Among 104 participants randomized, greater study attrition was observed among UC participants (P=0.031) with 93 women assessed at 4-months (ExT: n=49, UC: n=44) and 87 at 12-months (ExT: n=49, UC: n=38). ExT attenuated functional disability at 4-months (OR: 0.32 [95% CI 0.11, 0.94], P=0.03), but not at 12-months (OR: 0.27, [95% CI 0.06, 1.12], P=0.07). In a per-protocol analysis, functional disability was entirely prevented at 12-months among participants adherent to ExT (ExT: 0% vs. UC: 20%, P=0.005). As compared with UC at 12-months, ExT was associated with a net +3.5 mL/kg/min improvement in VO 2 peak that coincided with greater CO, SV, LVEF and RVEF reserve (P<0.001 for all). There was no effect of ExT on resting measures of LV function. Post-chemotherapy troponin increased less in ExT than UC (8-fold vs. 16-fold increase, P=0.002). There were no changes in BNP in either group. Conclusions: In women with early-stage BC undergoing AC, 12-months of ExT did not attenuate functional disability but provided large and clinically meaningful benefits on VO2peak and cardiac reserve. Clinical Trial Registration: URL: https://www.anzctr.org.au/ Unique Identifier: ACTRN12617001408370