Increase in prevalence of obesity and diabetes and decrease in plasma cholesterol in a central Australian Aboriginal community

Objective: To document change in prevalence of obesity, diabetes and other cardiovascular diease (CVD) risk factors, and trends in dietary macronutrie nt intake, over an eight-year period in a rural Aboriginal community in cen tral Australia. Design: Sequential cross-sectional community surveys in 1987, 1991 and 1995 . Subjects: All adults (15 years and over) in the community were invited to p articipate. In 1987, 1991 and 1995, 335 (87% of eligible adults), 331 (76%) and 304 (68%), respectively, were surveyed. Main outcome measures: Body mass index and waist:hip ratio; blood glucose l evel and glucose tolerance; fasting total and high density lipoprotein (HDL ) cholesterol and triglyceride levels; and apparent dietary intake (estimat ed by the store turnover method). Intervention: A community-based nutrition awareness and healthy lifestyle p rogram, 1988-1990. Results: At the eight-year follow-up, the odds ratios (95% Cls) for CVD ris k factors relative to baseline were obesity, 1.84 (1.28-2.66); diabetes, 1. 83 (1.113.03); hypercholesterolaemia, 0.29 (0.20-0.42); and dyslipidaemia ( high triglyceride plus low HDL cholesterol level), 4.54 (2.84-7.29). In you nger women (15-24 years), there was a trebling in obesity prevalence and a four- to fivefold increase in diabetes prevalence. Store turnover data sugg ested a relative reduction in the consumption of refined carbohydrates and saturated fats. Conclusion: Interventions targeting nutritional factors alone are unlikely to greatly alter trends towards increasing prevalences of obesity and diabe tes. In communities where healthy food choices are limited, the role of reg ular physical activity in improving metabolic fitness may also need to be e mphasised.