Are there health benefits from improving basic nutrition in a remote Aboriginal community? Longitudinal study of variation in body mass index in middle-aged UK females Effectiveness of a community‐directed ‘healthy lifestyle’ program in a remote Australian Aboriginal community Effect of a price discount and consumer education strategy on food and beverage purchases in remote Indigenous Australia: a stepped-wedge randomised controlled trial.
BACKGROUND Otitis media , chronic suppurative otitis media , and skin infections are common in many Aboriginal communities . METHOD Primary school students in a remote Aboriginal community were examined by  blood testing . Audiometry  was compared before and 6 months after children were provided with fresh fruit each school day , as were rates of skin infections , and the prescription of  antibiotics  for otitis media and skin infections . RESULTS All 12 students who completed both points of hearing testing had slight or greater hearing loss at baseline . Five had improved hearing at 6 months and seven ( 58 % ) had no change . Mean antibiotic prescriptions decreased from seven to 1 per month . All 15 tested had low serum vitamin C concentrations and 11 had abnormal iron studies , suggesting their poor health might be caused by poor nutrition . DISCUSSION Although many other factors may have contributed to the improvements , the results suggest nutrition as a possible factor for poor health outcomes in remote Aboriginal communities , which could be easily overcome . A r and omised trial should be conducted The importance of changing patterns of obesity in society and its implication s for public health are well recognized . However , the adult life course of body mass index ( BMI ) changes in individuals over time is largely unknown and has mostly been extrapolated from cross-sectional studies . The present study examines individual specific variation of BMI during a 15-year follow-up period in a community-based sample of UK females . We attempted to establish whether there is a common , generalized pattern which captures variation in BMI over time . The participants of this study belong to a prospect i ve population cohort of British women studied intensively since 1989 : the Chingford Study . The sample originally consisted of 1,003 women aged 45–68 years , who were assessed annually for BMI during follow-up period .  Polynomial regression models were used to assess longitudinal BMI variation . We observed a great stability in individual BMI variation during the follow-up period , reflected by high correlations between the baseline BMI and follow-up BMI 10 and 15 years later ( r = 0.876 , N = 810 , and r = 0.824 , N = 638 , respectively ) . We also found that three different major age-related patterns in BMI could be clearly identified : no change in 30.6 % in 58 % it increased and in 11.4 % it decreased with age . Thus , our data suggest that individual age-related changes in BMI are very different . Therefore , simply combining all individuals into groups by any other criteria ( age , sex , etc . ) and overlooking the distinctive patterns of BMI change may lead to biased inferences in epidemiologic and etiologic research of the future Objective : To assess the sustainability and effectiveness of a community‐directed program for primary and secondary prevention of obesity , diabetes and cardiovascular disease in an Aboriginal community in north‐west Western Australia BACKGROUND Evidence is mounting that price discounts can be effective in improving diet . This study examined the effectiveness of a 20 % price discount on food and drink purchases with and without consumer education in remote Indigenous Australia . METHODS A 20 % discount on fruit , vegetables , water , and artificially sweetened soft drinks was applied for 24 weeks in 20 communities in remote Indigenous Australia where the community store was managed by the Arnhem L and Progress Aboriginal Corporation ( ALPA ) or Outback Stores ( OBS ) in a stepped-wedge r and omised trial . Communities were r and omly allocated to a fixed framework of five sets of four stratified by store association ; ten stores ( two in each set ) were r and omly assigned to receive consumer education . A store from each of the ALPA and OBS store groups ( contained in separate opaque envelopes ) was selected , and stores in turn continued to be consecutively allocated to the fixed store set framework , starting with the first store slot in the first store set , until all stores had been allocated . The effect of the discount on the weight of fruit and vegetables purchased ( the primary endpoint ) was assessed using weekly store sales data and mixed models per protocol . We did sensitivity analyses by repeating the analyses with the outliers included and repeating the analyses for the primary outcome measure removing each store one at a time . This trial was registered with Australian New Zeal and Clinical Trials Registry , number ACTRN12613000694718 . FINDINGS Weekly store sales data on all food and drink products sold in 20 stores were collected from July 1 , 2012 , to Dec 28 , 2014 . Price discount alone was associated with a 12·7 % ( 95 % CI 4·1 - 22·1 ) increase in purchases in grams of fruit and vegetables combined ( primary outcome ) , and a 19·8 % ( 6·2 - 35·1 ) increase post discount ( after vs before ) ; an effect of 12 g and 18 g per capita per day . Sensitivity analyses did not modify the results for the primary outcome measure . INTERPRETATION A 20 % discount can only increase fruit and vegetable purchases to help protect against obesity and diet related disease to a certain extent . Large discounts might have a greater impact than small discounts . Creative merch and ising approaches to consumer education could also be considered alongside fiscal interventions to achieve marked improvements in diet . FUNDING Australian National Health and Medical Research Council
OBJECTIVE To review the literature on nutrition interventions and identify which work to improve diet-related and health outcomes in Australian Aboriginal and Torres Strait Isl and er people .