Survival tucker: improved diet and health indicators in an Aboriginal community

Abstract

The poor nutritional status of Aboriginal Australians is a serious and complex public health concern. We describe an unusually successful health and nutrition project initiated by the people of Minjilang, which was developed, implemented and evaluated with the community. Apparent community dietary intake, assessed by the ‘store‐turnover’ method, and biochemical, anthropometric and haematological indicators of health and nutritional status were measured before intervention and at three‐monthly intervals during the intervention year. Following intervention, there was a significant decrease in dietary intake of sugar and saturated fat, an increase in micronutrient density, corresponding improvements in biochemical indices (for example, a 12 per cent decrease in mean serum cholesterol, increases in serum and red cell folate, serum vitamin B6 and plasma ascorbic acid), decrease in mean systolic and diastolic blood pressures, a normalisation of body mass index, and a normalisation of haematologic indices. The success of this project demonstrates that Aboriginal communities can bring about improvements in their generally poor nutritional status, and that the store‐turnover method provides a valid, inexpensive and noninvasive method for evaluating the resultant changes in community diet. Although the project was undoubtedly effective in the short term, further work is in progress to assess individual strategies with respect to sustainability, cost‐effectiveness and generalisability.

Health and wellbeing outcomes of programs for Indigenous Australians that include strategies to enable the expression of cultural identities: a systematic review

“…Of these Eley et al (2010) detected improved outcomes for Study 1 but not Study 2 or for two subsequent iterations of the program. For eight interventions described in the study, observed improvements were statistically significant (O'Dea 1984; Lee et al 1994;Rowley et al 2001;d'Espaignet et al 2003;Nagel et al 2009;Eley et al 2010;Dimer et al 2013;Sun and Buys 2013). Two studies where statistical analyses were not conducted show positive directions of effects in health and wellbeing outcomes (Nel and Pashen 2003;Preuss and Brown 2006) (Table 1).…”

“…One RCT (Nagel et al 2009), one cluster RCT (Kiran and Knights 2010) and two studies with non-randomised controls (Lee et al 1994;d'Espaignet et al 2003) were included. Other papers report case series or serial cross-sectional data.…”

“…Hunting and gathering food offers both exercise and improved nutrition, both of which are likely to have contributed to the improved cholesterol and other metabolic measures noted in three studies (O'Dea 1984;Lee et al 1994;Rowley et al 2001). All were all set in remote communities with few food outlets.…”

“…They include visiting Country and cultural sites (O'Dea 1984;Preuss and Brown 2006), education in traditional cultural practices (Preuss and Brown 2006), hunting, fishing and eating bush foods (O'Dea 1984; Rowley et al 2001), traditional games (Kiran and Knights 2010) yarning (an Indigenous mode of talking) and sharing cultural stories (Lee et al 1994;Dimer et al 2013), mapping and activating cultural relationships of care (d'Espaignet et al 2003;Nel and Pashen 2003;Nagel et al 2009), reinforcing Elder authority (Preuss and Brown 2006) and painting, dancing, playing instruments and singing as a community (Dimer et al 2013;Sun and Buys 2013). Programs were implemented in a range of locations.…”

“…Also, targeting diet and the effects of processed Western diets for Aboriginal people, Lee et al (1994) described a remote community-initiated program in the Northern Territory (NT) that was directed by Elders B . The program entailed encouraging exercise, building on traditional understandings of health to promote improved nutrition and improving the availability of nutritious food in the store.…”