Abstract
Nutrition interventions can support Aboriginal and Torres Strait Islander peoples to reduce their risk of cardiovascular disease (CVD). This review examines nutritional interventions aiming to improve CVD outcomes and appraises peer-reviewed interventions using an Aboriginal and Torres Strait Islander Quality Appraisal Tool. Five electronic databases and grey literature were searched, applying no time limit. Two reviewers completed the screening, data extraction and quality assessment independently. The study quality was assessed using the South Australian Health and Medical Research Institute and the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT). Twenty-one nutrition programs were included in this review. Twelve reported on anthropometric measurements, ten on biochemical and/or hematological measurements and sixteen on other outcome domains. Most programs reported improvements in measurable CVD risk factors, including reduced body mass index (BMI), waist circumference (WC), weight, blood pressure and improved lipid profiles. Most programs performed well at community engagement and capacity strengthening, but many lacked the inclusion of Indigenous research paradigms, governance and strengths-based approaches. This review highlights the need for contemporary nutrition programs aimed at improving cardiovascular health outcomes to include additional key cultural components.
Highlights
IntroductionAboriginal and Torres Strait Islander Australians are strongly connected to “country”
History tells us that practices, policies and legislations directed towards Aboriginal and Torres Strait Islander peoples during Australia’s early colonial years resulted in their forceful removal from lands and a disconnection from “country” that contributed to sudden changes in their dietary and lifestyle behaviours [1]
The low energy density of traditional diets along with the energy expended in food procurement processes provided a natural constraint on energy intake, and research suggests that precolonisation Aboriginal and Torres Strait Islander peoples were physically fit and lean [3]
Summary
Aboriginal and Torres Strait Islander Australians are strongly connected to “country”. History tells us that practices, policies and legislations directed towards Aboriginal and Torres Strait Islander peoples during Australia’s early colonial years resulted in their forceful removal from lands and a disconnection from “country” that contributed to sudden changes in their dietary and lifestyle behaviours [1]. The nutrient composition of Aboriginal and Torres Strait Islander peoples’ diet was high in protein, fibre, polyunsaturated fats and complex unrefined carbohydrates [2]. The low energy density of traditional diets along with the energy expended in food procurement processes provided a natural constraint on energy intake, and research suggests that precolonisation Aboriginal and Torres Strait Islander peoples were physically fit and lean [3]
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