Improvements in Circulating Cholesterol, Antioxidants, and Homocysteine after Dietary Intervention in an Australian Aboriginal Community

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Year: 2001
Author(s): Rowley, KG., Su, Q., Cincotta M., Skinner, M., Skinner, K., Pindan, B, White, GA and O’Dea, K.
Book/Journal: American Journal of Clinical Nutrition
Volume and Page Info: Vol. 74, No. 4, pp.442–448
Type: Journal
Topics:
Evidenced Based Programs and Research
Publisher: American Journal of Clinical Nutrition
Abstract
Background: Poor nutrition contributes to high rates of coronary heart disease among Australian Aboriginal populations. Since late 1993, the Aboriginal community described here has operated a healthy lifestyle program aimed at reducing the risk of chronic disease. Objective: We evaluated the effectiveness of a community directed intervention program to reduce coronary heart disease risk through dietary modification. Design: Intervention processes included store management policy changes, health promotion activities, and nutrition education aimed at high-risk individuals. Dietary advice was focused on decreasing saturated fat and sugar intake and increasing fruit and vegetable intake. Evaluation of the program included conducting sequential, cross-sectional risk factor surveys at 2-y intervals; measuring fasting cholesterol, lipid-soluble antioxidants, and homocysteine concentrations; and assessing smoking status. Nutrient intakes were estimated from analysis of food turnover in the single community store. Results: There was a significant reduction in the prevalence of hypercholesterolemia (age-adjusted prevalences were 31%, 21%, and 15% at baseline, 2 y, and 4 y, respectively; P < 0.001). There were significant increases in plasma concentrations of α-tocopherol, lutein and zeaxanthin, cryptoxanthin, and ß-carotene across the population. Retinol and lycopene concentrations did not change significantly. Mean plasma homocysteine concentrations decreased by 3 μmol/L. There was no significant change in smoking prevalence between the 2 follow-up surveys. There was an increase in the density of fresh fruit and vegetables and carotenoids in the food supply at the community store. Conclusion: This community-directed dietary intervention program reduced the prevalence of coronary heart disease risk factors related to diet.