Reduced prevalence of impaired glucose tolerance and no change in prevalence ol diabetes despite increasing BMI among aboriginal people from a group of remote homeland communities

OBJECTIVE - To examine trends in glucose tolerance and coronary risk among Aboriginal people from a group of homeland communities in central Australia during a 7-year follow-up period. RESEARCH DESIGN AND METHODS - Community-based screenings of adult volunteer s were performed in 1988 (n = 437; 93% response rate) and in 1995 (n = 424; 85% response rate). A health promotion intervention program commenced afte r the 1988 survey that focused on the benefits of exercise and appropriate diet. RESULTS - Mean (95% CI) BMI increased significantly from 22.8 kg/m(2) (22.3 -23.2) to 24.2 kg/m(2) (23.8-24.7) during the follow-up period (P < 0.001). This increase was similar for men and women and across all age-groups. The increase in BMI was greater among subjects residing adjacent to a store co mpared with those residing in communities located far from a store (P < 0.0 01). Decreases were evident in the prevalence of impaired glucose tolerance (IGT) (from 22.5 to 10.1% among women, P < 0.001; from 12.2 to 6.5% among men, P = 0.074) and hypercholesterolemia (from 36.7 to 25.8% among women, P < 0.01; from 52.4 to 44.0% among men, P = 0.147), but no change was eviden t in the prevalence of diabetes. Smoking remained rare among women (<4%) an d decreased among men (from 52.9 to 40.8%, P < 0.05). CONCLUSIONS - The trends in glucose intolerance were clearly better than ha ve been observed in other Aboriginal communities. The institution of an int ervention program corresponded with reductions in the prevalence of IGT, hy percholesterolemia, and smoking. The prevalence of diabetes remained unalte red despite a significant increase in mean BMI, possibly because of the pro motion of increased physical activity levels.