Improvements in circulating cholesterol, antioxidants, and homocysteine after dietary intervention in an Australian Aboriginal community

Abstract

This community-directed dietary intervention program reduced the prevalence of coronary heart disease risk factors related to diet.

Kava use, dyslipidaemia and biomarkers of dietary quality in Aboriginal people in Arnhem Land in the Northern Territory (NT), Australia

“…Although kava users had a significantly lower body fat, low levels of biomarkers of dietary quality that were similar to those already reported for other Aboriginal Australian populations (Lee et al, 1995;Rowley et al, 2001), were not further compromised in kava users. Loss of body fat in kava users has been described as similar to that in anorexia nervosa (Mathews et al, 1988, p 545).…”

“…Per cent body fat was measured using a Tanita Body Fat (TBF 521) instrument. Plasma samples (nonfasting) were analysed for lipids (Clough et al, 2003), carotenoids and micronutrients (Rowley et al, 2001).…”

“…While clinical observation suggests that sudden deaths have occurred in Arnhem Land among heavy kava users, no clear evidence for increased risk of ischaemic heart disease was found in a recent case-control study (unpublished data) or of atherogenesis in a crosssectional study (Clough et al, 2003). Poor nutrition, which contributes to high rates of coronary heart disease (CHD) in Aboriginal Australians (Thomson, 1991;Rowley et al, 2001), may add to this concern.…”

Differential association of C-reactive protein with adiposity in men and women in an Aboriginal community in northeast Arnhem Land of Australia

“…24 Poor nutritional status in remote Aboriginal communities is well established. [25][26][27] In this context, we have reported inverse associations of CRP and activity of the HDL-C associated anti-oxidant enzyme paraoxonase-1 with plasma diet-derived antioxidants in a Western Australian Aboriginal population. 12,28 In addition to its recognised role in reverse cholesterol transport, HDL-C has antioxidant, antithrombotic and anti-inflammatory actions.…”

Nutrition interventions for the prevention of type 2 diabetes

“…Indigenous American Indian population in British Columbia (49) 105 high-risk individuals Design: quasi experimental, community-based 2 year programme targeted at the Indian population of rural Okanagan region in Canada Intervention: single intervention community matched to two comparison communities; intervention community, workers conducted interviews of individuals with or at risk for DM for 7 months (pre-intervention phase); programme used a participatory approach and included strategies to improve the environment and to change behaviour; cohorts tracked over a 16-month intervention phase; cross-sectional population surveys of DM risk factors were conducted at baseline and post intervention Results: the project yielded few changes in quantifiable outcomes, which was thought to be a result of the short planning and intervention phases and the level of penetration was too limited Pilot study in Pima Indians (3) n 95, obese, normoglycaemic, age 25-54 years Design: RCT, 12 months Aim: to determine the relative effectiveness of two interventions in altering risk factors for DM Intervention: two lifestyle Pima interventions: action (intervention group), structured activity and nutrition; pride(control group), activities emphasising Pima history, received basic printed information on healthy eating and exercise habits Results: after 12 months increased physical fitness in both groups; BP, BMI, 2 h glucose and insulin all increased significantly in action members compared with pride members Conclusion: sustaining adherence in behavioural interventions over a long term was challenging; Pima Indians may find a less-direct less-structured approach and more participative intervention more acceptable than a direct and highly-structured approach Church-based Programme (50) n 78, South Auckland, New Zealand Design: open-prospective non-RCT Aim: to evaluate the impact of a comprehensive DM-related lifestyle programme on DM knowledge, exercise habits, dietary habits and body size among a Samoan church congregation Intervention: two church congregations (one intervention and one control church), intervention congregation coordinated by a DM nurse specialist and one of two Samoan women, one as a DM fieldworker and the other as an aerobics instructor; four DM-awareness sessions held as part of a church service with the DM educator as the main presenter; also formed exercise groups that included sitting exercises, low-impact aerobics, walking and sports; sessions held weekly for the first year and twice weekly thereafter Results: reduction in waist circumference and consumption of fatty foods reduced in the intervention church; increased DM knowledge and an increase in the proportion exercising regularly Conclusion: DM risk-reduction programmes based on lifestyle change, DM awareness and empowerment of high-risk communities can significantly reduce risk factors for future type 2 DM Looma Healthy Lifestyle (51) n 199, over 4 years in Western Australia, adults aged ‡ 15 years Design: Cross-sectional risk-factor surveys Aim: To evaluate the effectiveness of a community-directed intervention programme to reduce CHD risk through dietary modification Intervention: intervention process included store management policy changes, health promotion, and nutrition education aimed at high-risk individuals; programme focused initially on a group of individuals at high risk of DM and CHD, consisted of education sessions by a DM nurse educator Results: significant reduction in the prevalence of hypercholesterolemia; significant increases in plasma concentrations of a-tocopherol, lutein and zeaxanthin, cryptoxanthin and b-carotene across the population Conclusion: the community-directed intervention programme reduced the prevalence of CHD risk factors related to diet...…”